NR 605 FINAL EXAM (DIAGNOSIS
MANAGEMENT IN PSYCHIATRIC)
ACTUAL EXAM 2026/2027
1. A 24-year-old patient presents with a history of recurrent panic attacks. They have started
avoiding crowded places for fear of not being able to escape if an attack occurs. Which is the
most appropriate primary diagnosis?
A. Panic Disorder without Agoraphobia
B. Social Anxiety Disorder
C. Agoraphobia
D. Generalized Anxiety Disorder
Answer: C
Conceptual Explanation: Agoraphobia is defined by intense fear or anxiety triggered by
the real or anticipated exposure to a wide range of situations, particularly those where
escape might be difficult or help unavailable.
,2. Which neurotransmitter pathway is primarily implicated in the development of the positive
symptoms of Schizophrenia?
A. Mesocortical pathway
B. Tuberoinfundibular pathway
C. Nigrostriatal pathway
D. Mesolimbic pathway
Answer: D
Conceptual Explanation: The mesolimbic pathway is associated with reward and
pleasure, and hyperactivity in this pathway is thought to mediate the positive symptoms of
schizophrenia, such as hallucinations and delusions.
3. A patient is prescribed Clozapine for treatment-resistant schizophrenia. Which laboratory
monitoring parameter is mandatory according to the FDA Risk Evaluation and Mitigation
Strategy (REMS)?
A. Serum Creatinine
B. Liver Function Tests
C. Fastin Glucose levels
D. Absolute Neutrophil Count (ANC)
Answer: D
, Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis;
therefore, strict monitoring of the Absolute Neutrophil Count (ANC) is required to identify
potential life-threatening neutropenia.
4. In differentiating Bipolar I from Bipolar II disorder, which of the following is the defining
clinical feature?
A. The presence of at least one major depressive episode
B. The presence of at least one manic episode
C. The severity of the depressive episodes
D. The duration of hypomanic symptoms
Answer: B
Conceptual Explanation: Bipolar I Disorder requires at least one manic episode. Bipolar II
requires at least one hypomanic episode and one major depressive episode, but never a
manic episode.
5. A 45-year-old patient on Lithium for 5 years presents with polydipsia, polyuria, and a
serum lithium level of 0.9 mEq/L. What is the most likely renal complication?
A. Nephrogenic Diabetes Insipidus
B. Acute Glomerulonephritis
C. Renal Artery Stenosis
D. IgA Nephropathy
MANAGEMENT IN PSYCHIATRIC)
ACTUAL EXAM 2026/2027
1. A 24-year-old patient presents with a history of recurrent panic attacks. They have started
avoiding crowded places for fear of not being able to escape if an attack occurs. Which is the
most appropriate primary diagnosis?
A. Panic Disorder without Agoraphobia
B. Social Anxiety Disorder
C. Agoraphobia
D. Generalized Anxiety Disorder
Answer: C
Conceptual Explanation: Agoraphobia is defined by intense fear or anxiety triggered by
the real or anticipated exposure to a wide range of situations, particularly those where
escape might be difficult or help unavailable.
,2. Which neurotransmitter pathway is primarily implicated in the development of the positive
symptoms of Schizophrenia?
A. Mesocortical pathway
B. Tuberoinfundibular pathway
C. Nigrostriatal pathway
D. Mesolimbic pathway
Answer: D
Conceptual Explanation: The mesolimbic pathway is associated with reward and
pleasure, and hyperactivity in this pathway is thought to mediate the positive symptoms of
schizophrenia, such as hallucinations and delusions.
3. A patient is prescribed Clozapine for treatment-resistant schizophrenia. Which laboratory
monitoring parameter is mandatory according to the FDA Risk Evaluation and Mitigation
Strategy (REMS)?
A. Serum Creatinine
B. Liver Function Tests
C. Fastin Glucose levels
D. Absolute Neutrophil Count (ANC)
Answer: D
, Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis;
therefore, strict monitoring of the Absolute Neutrophil Count (ANC) is required to identify
potential life-threatening neutropenia.
4. In differentiating Bipolar I from Bipolar II disorder, which of the following is the defining
clinical feature?
A. The presence of at least one major depressive episode
B. The presence of at least one manic episode
C. The severity of the depressive episodes
D. The duration of hypomanic symptoms
Answer: B
Conceptual Explanation: Bipolar I Disorder requires at least one manic episode. Bipolar II
requires at least one hypomanic episode and one major depressive episode, but never a
manic episode.
5. A 45-year-old patient on Lithium for 5 years presents with polydipsia, polyuria, and a
serum lithium level of 0.9 mEq/L. What is the most likely renal complication?
A. Nephrogenic Diabetes Insipidus
B. Acute Glomerulonephritis
C. Renal Artery Stenosis
D. IgA Nephropathy
