NR 605 MIDTERM EXAM: ADVANCED
DIAGNOSIS AND MANAGEMENT IN
PSYCHIATRIC-MENTAL HEALTH
NURSING QUESTIONS AND ANSWERS
1. A 28-year-old patient presents with a history of at least one major depressive episode and
at least one hypomanic episode. However, they have never experienced a full manic episode.
Which diagnosis is most appropriate?
A. Bipolar I Disorder
B. Bipolar II Disorder
C. Cyclothymic Disorder
D. Major Depressive Disorder with Psychotic Features
Answer: B
Conceptual Explanation: Bipolar II Disorder is characterized by the occurrence of one or
more Major Depressive Episodes and at least one Hypomanic Episode, without a history of
a full Manic Episode.
,2. According to the DSM-5, what is the minimum duration of symptoms required to diagnose
Schizophrenia?
A. 6 months
B. 3 months
C. 1 month
D. 1 year
Answer: A
Conceptual Explanation: DSM-5 requires continuous signs of the disturbance persisting
for at least 6 months, including at least 1 month of active-phase symptoms.
3. A patient is prescribed Clozapine for treatment-resistant schizophrenia. Which laboratory
value is the most critical to monitor due to the risk of agranulocytosis?
A. Serum Potassium
B. Thyroid Stimulating Hormone (TSH)
C. Liver Function Tests (LFTs)
D. Absolute Neutrophil Count (ANC)
Answer: D
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis;
therefore, monitoring the Absolute Neutrophil Count (ANC) is mandatory.
, 4. Which of the following symptoms is considered a ‘negative symptom’ of Schizophrenia?
A. Auditory Hallucinations
B. Alogia
C. Disorganized speech
D. Delusions of grandeur
Answer: B
Conceptual Explanation: Negative symptoms include Alogia (poverty of speech), Affective
flattening, Anhedonia, and Avolition. Hallucinations and delusions are positive symptoms.
5. A patient taking Lithium Carbonate presents with coarse tremors, ataxia, and confusion.
What is the most likely cause?
A. Serotonin Syndrome
B. Neuroleptic Malignant Syndrome
C. Lithium Toxicity
D. Akathisia
Answer: C
Conceptual Explanation: Coarse tremors, ataxia, confusion, and blurred vision are classic
signs of Lithium toxicity (usually levels > 1.5 mEq/L).
DIAGNOSIS AND MANAGEMENT IN
PSYCHIATRIC-MENTAL HEALTH
NURSING QUESTIONS AND ANSWERS
1. A 28-year-old patient presents with a history of at least one major depressive episode and
at least one hypomanic episode. However, they have never experienced a full manic episode.
Which diagnosis is most appropriate?
A. Bipolar I Disorder
B. Bipolar II Disorder
C. Cyclothymic Disorder
D. Major Depressive Disorder with Psychotic Features
Answer: B
Conceptual Explanation: Bipolar II Disorder is characterized by the occurrence of one or
more Major Depressive Episodes and at least one Hypomanic Episode, without a history of
a full Manic Episode.
,2. According to the DSM-5, what is the minimum duration of symptoms required to diagnose
Schizophrenia?
A. 6 months
B. 3 months
C. 1 month
D. 1 year
Answer: A
Conceptual Explanation: DSM-5 requires continuous signs of the disturbance persisting
for at least 6 months, including at least 1 month of active-phase symptoms.
3. A patient is prescribed Clozapine for treatment-resistant schizophrenia. Which laboratory
value is the most critical to monitor due to the risk of agranulocytosis?
A. Serum Potassium
B. Thyroid Stimulating Hormone (TSH)
C. Liver Function Tests (LFTs)
D. Absolute Neutrophil Count (ANC)
Answer: D
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis;
therefore, monitoring the Absolute Neutrophil Count (ANC) is mandatory.
, 4. Which of the following symptoms is considered a ‘negative symptom’ of Schizophrenia?
A. Auditory Hallucinations
B. Alogia
C. Disorganized speech
D. Delusions of grandeur
Answer: B
Conceptual Explanation: Negative symptoms include Alogia (poverty of speech), Affective
flattening, Anhedonia, and Avolition. Hallucinations and delusions are positive symptoms.
5. A patient taking Lithium Carbonate presents with coarse tremors, ataxia, and confusion.
What is the most likely cause?
A. Serotonin Syndrome
B. Neuroleptic Malignant Syndrome
C. Lithium Toxicity
D. Akathisia
Answer: C
Conceptual Explanation: Coarse tremors, ataxia, confusion, and blurred vision are classic
signs of Lithium toxicity (usually levels > 1.5 mEq/L).
