NRNP 6635: PSYCHOPATHOLOGY AND
DIAGNOSTIC REASONING
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A 28-year-old male presents with auditory hallucinations and delusions of persecution
lasting for 7 months. He has also demonstrated a significant decline in social and occupational
functioning. Which neurotransmitter pathway is primarily associated with the positive
symptoms described?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesolimbic pathway
Answer: D
Conceptual Explanation: The mesolimbic pathway is associated with the positive
symptoms of schizophrenia, such as hallucinations and delusions, due to overactivity of
dopamine.
,2. Which of the following is a mandatory diagnostic criterion for Bipolar II Disorder according
to the DSM-5-TR?
A. At least one manic episode
B. Hospitalization during the hypomanic episode
C. Psychotic features during the hypomanic phase
D. At least one hypomanic episode and one major depressive episode
Answer: D
Conceptual Explanation: Bipolar II requires at least one hypomanic episode and at least
one major depressive episode. If there is ever a manic episode, the diagnosis changes to
Bipolar I.
3. A patient taking Clozapine presents with a fever, sore throat, and mouth sores. What is the
most critical immediate laboratory test to order?
A. Liver function tests
B. Serum Clozapine level
C. Fast blood glucose
D. Complete Blood Count (CBC) with differential
Answer: D
Conceptual Explanation: Clozapine carries a risk of agranulocytosis. A CBC with
differential is required to monitor the Absolute Neutrophil Count (ANC).
, 4. In the neurobiology of Post-Traumatic Stress Disorder (PTSD), which brain structure is
typically found to be hyper-responsive to stimuli?
A. Hippocampus
B. Prefrontal Cortex
C. Amygdala
D. Cerebellum
Answer: C
Conceptual Explanation: In PTSD, the amygdala is hyper-responsive, leading to increased
fear and startle responses, while the prefrontal cortex fails to inhibit this response.
5. A 19-year-old college student describes a persistent fear of being scrutinized or negatively
evaluated by others in social situations. This has led to avoiding classes. What is the most
likely diagnosis?
A. Social Anxiety Disorder
B. Agoraphobia
C. Avoidant Personality Disorder
D. Generalized Anxiety Disorder
Answer: A
Conceptual Explanation: Social Anxiety Disorder is characterized by intense fear of social
situations where the individual may be scrutinized by others.
DIAGNOSTIC REASONING
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A 28-year-old male presents with auditory hallucinations and delusions of persecution
lasting for 7 months. He has also demonstrated a significant decline in social and occupational
functioning. Which neurotransmitter pathway is primarily associated with the positive
symptoms described?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesolimbic pathway
Answer: D
Conceptual Explanation: The mesolimbic pathway is associated with the positive
symptoms of schizophrenia, such as hallucinations and delusions, due to overactivity of
dopamine.
,2. Which of the following is a mandatory diagnostic criterion for Bipolar II Disorder according
to the DSM-5-TR?
A. At least one manic episode
B. Hospitalization during the hypomanic episode
C. Psychotic features during the hypomanic phase
D. At least one hypomanic episode and one major depressive episode
Answer: D
Conceptual Explanation: Bipolar II requires at least one hypomanic episode and at least
one major depressive episode. If there is ever a manic episode, the diagnosis changes to
Bipolar I.
3. A patient taking Clozapine presents with a fever, sore throat, and mouth sores. What is the
most critical immediate laboratory test to order?
A. Liver function tests
B. Serum Clozapine level
C. Fast blood glucose
D. Complete Blood Count (CBC) with differential
Answer: D
Conceptual Explanation: Clozapine carries a risk of agranulocytosis. A CBC with
differential is required to monitor the Absolute Neutrophil Count (ANC).
, 4. In the neurobiology of Post-Traumatic Stress Disorder (PTSD), which brain structure is
typically found to be hyper-responsive to stimuli?
A. Hippocampus
B. Prefrontal Cortex
C. Amygdala
D. Cerebellum
Answer: C
Conceptual Explanation: In PTSD, the amygdala is hyper-responsive, leading to increased
fear and startle responses, while the prefrontal cortex fails to inhibit this response.
5. A 19-year-old college student describes a persistent fear of being scrutinized or negatively
evaluated by others in social situations. This has led to avoiding classes. What is the most
likely diagnosis?
A. Social Anxiety Disorder
B. Agoraphobia
C. Avoidant Personality Disorder
D. Generalized Anxiety Disorder
Answer: A
Conceptual Explanation: Social Anxiety Disorder is characterized by intense fear of social
situations where the individual may be scrutinized by others.
