NR 605 MIDTERM EXAM: DIAGNOSIS
AND MANAGEMENT IN PSYCHIATRIC-
MENTAL HEALTH QUESTIONS AND
ANSWERS
1. A 24-year-old patient presents with symptoms of mania that have lasted for 5 days. The
symptoms are not severe enough to cause marked impairment in social or occupational
functioning and do not require hospitalization. Which diagnosis is most appropriate?
A. Bipolar I Disorder
B. Cyclothymic Disorder
C. Bipolar II Disorder
D. Major Depressive Disorder with Mixed Features
Answer: C
Conceptual Explanation: Bipolar II is characterized by at least one hypomanic episode
(lasting at least 4 days) and at least one major depressive episode. Bipolar I requires a full
manic episode (lasting at least 7 days or requiring hospitalization).
,2. Which neurobiological pathway is primarily associated with the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesolimbic pathway
Answer: D
Conceptual Explanation: Overactivity in the mesolimbic dopamine pathway is thought to
mediate positive symptoms of schizophrenia, whereas dysfunction in the mesocortical
pathway is associated with negative symptoms.
3. A patient taking Clozapine must have their Absolute Neutrophil Count (ANC) monitored
regularly. At what ANC level should the provider consider interrupting treatment due to the
risk of agranulocytosis?
A. ANC < 2000/mm3
B. ANC < 1500/mm3
C. ANC < 1000/mm3
D. ANC < 500/mm3
Answer: B
, Conceptual Explanation: In general practice, treatment is typically interrupted or
monitored very closely if the ANC drops below 1500/mm3 (mild neutropenia), though
protocols vary by country (e.g., FDA REMS program specifically monitors the 1500 and
1000 thresholds).
4. Which of the following antidepressants is contraindicated in patients with a history of
seizure disorders or eating disorders?
A. Fluoxetine
B. Sertraline
C. Bupropion
D. Venlafaxine
Answer: C
Conceptual Explanation: Bupropion lowers the seizure threshold and is specifically
contraindicated in patients with seizure disorders and those with current or past diagnoses
of anorexia or bulimia due to increased seizure risk.
5. When assessing for Major Depressive Disorder (MDD) using DSM-5-TR criteria, symptoms
must be present for at least how many consecutive weeks?
A. 2 weeks
B. 1 week
C. 4 weeks
AND MANAGEMENT IN PSYCHIATRIC-
MENTAL HEALTH QUESTIONS AND
ANSWERS
1. A 24-year-old patient presents with symptoms of mania that have lasted for 5 days. The
symptoms are not severe enough to cause marked impairment in social or occupational
functioning and do not require hospitalization. Which diagnosis is most appropriate?
A. Bipolar I Disorder
B. Cyclothymic Disorder
C. Bipolar II Disorder
D. Major Depressive Disorder with Mixed Features
Answer: C
Conceptual Explanation: Bipolar II is characterized by at least one hypomanic episode
(lasting at least 4 days) and at least one major depressive episode. Bipolar I requires a full
manic episode (lasting at least 7 days or requiring hospitalization).
,2. Which neurobiological pathway is primarily associated with the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesolimbic pathway
Answer: D
Conceptual Explanation: Overactivity in the mesolimbic dopamine pathway is thought to
mediate positive symptoms of schizophrenia, whereas dysfunction in the mesocortical
pathway is associated with negative symptoms.
3. A patient taking Clozapine must have their Absolute Neutrophil Count (ANC) monitored
regularly. At what ANC level should the provider consider interrupting treatment due to the
risk of agranulocytosis?
A. ANC < 2000/mm3
B. ANC < 1500/mm3
C. ANC < 1000/mm3
D. ANC < 500/mm3
Answer: B
, Conceptual Explanation: In general practice, treatment is typically interrupted or
monitored very closely if the ANC drops below 1500/mm3 (mild neutropenia), though
protocols vary by country (e.g., FDA REMS program specifically monitors the 1500 and
1000 thresholds).
4. Which of the following antidepressants is contraindicated in patients with a history of
seizure disorders or eating disorders?
A. Fluoxetine
B. Sertraline
C. Bupropion
D. Venlafaxine
Answer: C
Conceptual Explanation: Bupropion lowers the seizure threshold and is specifically
contraindicated in patients with seizure disorders and those with current or past diagnoses
of anorexia or bulimia due to increased seizure risk.
5. When assessing for Major Depressive Disorder (MDD) using DSM-5-TR criteria, symptoms
must be present for at least how many consecutive weeks?
A. 2 weeks
B. 1 week
C. 4 weeks
