NR 605 DIAGNOSIS AND MANAGEMENT
IN PSYCHIATRIC CARE FINAL EXAM
1. Which dopamine pathway is primarily associated with the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Nigrostriatal pathway
B. Mesocortical pathway
C. Tuberoinfundibular pathway
D. Mesolimbic pathway
Answer: D
Conceptual Explanation: Overactivity in the mesolimbic pathway is linked to positive
symptoms, while underactivity in the mesocortical pathway is linked to negative
symptoms.
2. A patient taking Clozapine must have regular blood monitoring for which potentially life-
threatening side effect?
A. Hepatic failure
B. Agranulocytosis
C. Renal toxicity
,D. Thrombocytopenia
Answer: B
Conceptual Explanation: Clozapine carries a risk of agranulocytosis (severe low WBC),
requiring mandatory Absolute Neutrophil Count (ANC) monitoring.
3. In the DSM-5, how long must symptoms persist for a diagnosis of Generalized Anxiety
Disorder (GAD)?
A. At least 1 month
B. At least 3 months
C. At least 12 months
D. At least 6 months
Answer: D
Conceptual Explanation: GAD criteria require excessive anxiety and worry occurring
more days than not for at least 6 months.
4. Which neurotransmitter is primarily targeted by Benzodiazepines to produce their
anxiolytic effect?
A. Serotonin
B. Norepinephrine
C. Glutamate
D. GABA
, Answer: D
Conceptual Explanation: Benzodiazepines act as positive allosteric modulators at the
GABA-A receptor, enhancing the inhibitory effect of GABA.
5. A 45-year-old male presents with tremors, diaphoresis, and tachycardia 48 hours after his
last alcoholic drink. What is the priority diagnosis?
A. Wernicke-Korsakoff Syndrome
B. Opioid Withdrawal
C. Alcohol Withdrawal Delirium (DTs)
D. Alcoholic Hallucinosis
Answer: C
Conceptual Explanation: Delirium Tremens (DTs) usually occurs within 48-72 hours of
cessation and is a medical emergency characterized by autonomic instability.
6. What is the primary mechanism of action of SSRIs?
A. Inhibition of Monoamine Oxidase
B. Antagonism of Post-synaptic 5-HT2 receptors
C. Blockage of Serotonin Reuptake Transporters
D. Stimulation of Serotonin production
Answer: C
IN PSYCHIATRIC CARE FINAL EXAM
1. Which dopamine pathway is primarily associated with the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Nigrostriatal pathway
B. Mesocortical pathway
C. Tuberoinfundibular pathway
D. Mesolimbic pathway
Answer: D
Conceptual Explanation: Overactivity in the mesolimbic pathway is linked to positive
symptoms, while underactivity in the mesocortical pathway is linked to negative
symptoms.
2. A patient taking Clozapine must have regular blood monitoring for which potentially life-
threatening side effect?
A. Hepatic failure
B. Agranulocytosis
C. Renal toxicity
,D. Thrombocytopenia
Answer: B
Conceptual Explanation: Clozapine carries a risk of agranulocytosis (severe low WBC),
requiring mandatory Absolute Neutrophil Count (ANC) monitoring.
3. In the DSM-5, how long must symptoms persist for a diagnosis of Generalized Anxiety
Disorder (GAD)?
A. At least 1 month
B. At least 3 months
C. At least 12 months
D. At least 6 months
Answer: D
Conceptual Explanation: GAD criteria require excessive anxiety and worry occurring
more days than not for at least 6 months.
4. Which neurotransmitter is primarily targeted by Benzodiazepines to produce their
anxiolytic effect?
A. Serotonin
B. Norepinephrine
C. Glutamate
D. GABA
, Answer: D
Conceptual Explanation: Benzodiazepines act as positive allosteric modulators at the
GABA-A receptor, enhancing the inhibitory effect of GABA.
5. A 45-year-old male presents with tremors, diaphoresis, and tachycardia 48 hours after his
last alcoholic drink. What is the priority diagnosis?
A. Wernicke-Korsakoff Syndrome
B. Opioid Withdrawal
C. Alcohol Withdrawal Delirium (DTs)
D. Alcoholic Hallucinosis
Answer: C
Conceptual Explanation: Delirium Tremens (DTs) usually occurs within 48-72 hours of
cessation and is a medical emergency characterized by autonomic instability.
6. What is the primary mechanism of action of SSRIs?
A. Inhibition of Monoamine Oxidase
B. Antagonism of Post-synaptic 5-HT2 receptors
C. Blockage of Serotonin Reuptake Transporters
D. Stimulation of Serotonin production
Answer: C
