NR 605: ADVANCED PSYCHIATRIC
DIAGNOSIS AND MANAGEMENT -
EXAM PREP QUESTIONS AND
CORRECT ANSWERS A+ GRADE
1. In the neurobiology of schizophrenia, which dopamine pathway is primarily associated
with the presence of positive symptoms such as hallucinations and delusions?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Mesolimbic pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: The Mesolimbic pathway is associated with reward and
pleasure, and its overactivity is linked to the positive symptoms of schizophrenia.
2. A patient taking Clozapine presents with a sore throat and fever. Which absolute
neutrophil count (ANC) value necessitates immediate discontinuation of the medication?
A. ANC < 500/mm³
B. ANC < 1000/mm³
C. ANC < 1500/mm³
,D. ANC < 2000/mm³
Answer: A
Conceptual Explanation: Per REMS guidelines, Clozapine must be stopped if the ANC falls
below 500/mm³ (Severe Neutropenia) to prevent life-threatening infection.
3. Which of the following is a classic dietary restriction for patients prescribed Phenelzine
(Nardil) to avoid a hypertensive crisis?
A. Aged cheeses and fermented meats
B. Leafy green vegetables high in Vitamin K
C. Grapefruit and citrus juices
D. High-protein lean meats
Answer: A
Conceptual Explanation: Phenelzine is an MAOI. Tyramine, found in aged or fermented
foods, can lead to massive norepinephrine release, causing a hypertensive crisis.
4. When initiating Lamotrigine for Bipolar II disorder, what is the most critical life-threatening
adverse effect the PMHNP must monitor for?
A. Aplastic Anemia
B. Pancreatitis
C. Nephrogenic diabetes insipidus
D. Stevens-Johnson Syndrome (SJS)
, Answer: D
Conceptual Explanation: Lamotrigine carries a black box warning for serious rashes,
including SJS and Toxic Epidermal Necrolysis, requiring slow titration.
5. According to DSM-5 criteria, what is the minimum duration of symptoms required for a
diagnosis of Post-Traumatic Stress Disorder (PTSD)?
A. 1 month
B. 3 months
C. 6 months
D. 2 weeks
Answer: A
Conceptual Explanation: Symptoms must last for more than one month for a PTSD
diagnosis; symptoms lasting less than one month are categorized as Acute Stress Disorder.
6. Which personality disorder is characterized by a pervasive pattern of preoccupation with
orderliness, perfectionism, and mental and interpersonal control?
A. Avoidant Personality Disorder
B. Narcissistic Personality Disorder
C. Obsessive-Compulsive Personality Disorder
D. Schizotypal Personality Disorder
Answer: C
DIAGNOSIS AND MANAGEMENT -
EXAM PREP QUESTIONS AND
CORRECT ANSWERS A+ GRADE
1. In the neurobiology of schizophrenia, which dopamine pathway is primarily associated
with the presence of positive symptoms such as hallucinations and delusions?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Mesolimbic pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: The Mesolimbic pathway is associated with reward and
pleasure, and its overactivity is linked to the positive symptoms of schizophrenia.
2. A patient taking Clozapine presents with a sore throat and fever. Which absolute
neutrophil count (ANC) value necessitates immediate discontinuation of the medication?
A. ANC < 500/mm³
B. ANC < 1000/mm³
C. ANC < 1500/mm³
,D. ANC < 2000/mm³
Answer: A
Conceptual Explanation: Per REMS guidelines, Clozapine must be stopped if the ANC falls
below 500/mm³ (Severe Neutropenia) to prevent life-threatening infection.
3. Which of the following is a classic dietary restriction for patients prescribed Phenelzine
(Nardil) to avoid a hypertensive crisis?
A. Aged cheeses and fermented meats
B. Leafy green vegetables high in Vitamin K
C. Grapefruit and citrus juices
D. High-protein lean meats
Answer: A
Conceptual Explanation: Phenelzine is an MAOI. Tyramine, found in aged or fermented
foods, can lead to massive norepinephrine release, causing a hypertensive crisis.
4. When initiating Lamotrigine for Bipolar II disorder, what is the most critical life-threatening
adverse effect the PMHNP must monitor for?
A. Aplastic Anemia
B. Pancreatitis
C. Nephrogenic diabetes insipidus
D. Stevens-Johnson Syndrome (SJS)
, Answer: D
Conceptual Explanation: Lamotrigine carries a black box warning for serious rashes,
including SJS and Toxic Epidermal Necrolysis, requiring slow titration.
5. According to DSM-5 criteria, what is the minimum duration of symptoms required for a
diagnosis of Post-Traumatic Stress Disorder (PTSD)?
A. 1 month
B. 3 months
C. 6 months
D. 2 weeks
Answer: A
Conceptual Explanation: Symptoms must last for more than one month for a PTSD
diagnosis; symptoms lasting less than one month are categorized as Acute Stress Disorder.
6. Which personality disorder is characterized by a pervasive pattern of preoccupation with
orderliness, perfectionism, and mental and interpersonal control?
A. Avoidant Personality Disorder
B. Narcissistic Personality Disorder
C. Obsessive-Compulsive Personality Disorder
D. Schizotypal Personality Disorder
Answer: C
