NU 671 Final Exam Questions and Answers
Purdue University Global | Updated| Pass Guaranteed
1. A patient with borderline personality disorder and chronic self-
harm is referred for evidence-based psychotherapy. Which modality
has the strongest evidence and was specifically developed for this
population?
A. Client-centered therapy
B. Dialectical behavior therapy (DBT)
C. Systematic desensitization
D. Classical psychoanalysis
Answer: B. Dialectical behavior therapy (DBT)
Rationale: DBT (Linehan) combines individual therapy, skills training
(mindfulness, distress tolerance, emotion regulation, interpersonal
effectiveness), phone coaching, and consultation team. It reduces self-
harm and suicidal behavior in BPD.
2. A patient is stable on lithium for bipolar I disorder. Which serum
level is the usual target for maintenance therapy?
A. 1.5–2.0 mEq/L
B. 0.2–0.4 mEq/L
C. 2.0–2.5 mEq/L
D. 0.6–1.0 mEq/L
Answer: D. 0.6–1.0 mEq/L
Rationale: Maintenance range is about 0.6–1.0 mEq/L (acute mania 0.8–
1.2). Levels above 1.5 risk toxicity; draw 12 hours after the last dose.
NU 671 Exam | Page 1
,3. A patient on sertraline is given linezolid and develops agitation,
diaphoresis, hyperreflexia, inducible clonus, and temperature of
39.2°C. What is the most likely diagnosis?
A. Neuroleptic malignant syndrome
B. Anticholinergic toxicity
C. Malignant hyperthermia
D. Serotonin syndrome
Answer: D. Serotonin syndrome
Rationale: Serotonin syndrome has rapid onset (hours) with
neuromuscular hyperactivity (clonus, hyperreflexia), autonomic instability,
and altered mental status. Linezolid is a weak MAOI. Treat by stopping
agents, supportive care, benzodiazepines, and cyproheptadine.
4. Which finding best distinguishes neuroleptic malignant syndrome
(NMS) from serotonin syndrome?
A. Diaphoresis
B. Lead-pipe rigidity with bradyreflexia and gradual onset over days
C. Fever
D. Tachycardia
Answer: B. Lead-pipe rigidity with bradyreflexia and gradual onset
over days
Rationale: NMS occurs with dopamine antagonists, develops over days,
and shows lead-pipe rigidity, hyporeflexia, and elevated CK. Serotonin
syndrome is rapid with clonus and hyperreflexia.
5. Which laboratory monitoring is required for patients taking
clozapine?
A. Serum ammonia
B. Absolute neutrophil count (ANC)
C. Serum lithium level
D. Thyroid antibodies
Answer: B. Absolute neutrophil count (ANC)
Rationale: Clozapine can cause severe neutropenia/agranulocytosis. ANC
is monitored per the REMS-era protocols (weekly initially, then less often).
Also monitor for myocarditis, seizures, metabolic effects, and constipation.
NU 671 Exam | Page 2
,6. How many symptoms, and for how long, are required to diagnose a
major depressive episode per DSM-5-TR?
A. 3 symptoms for 1 week
B. 4 symptoms for 1 month
C. 2 symptoms for 2 years
D. 5 or more symptoms for at least 2 weeks, including depressed mood or
anhedonia
Answer: D. 5 or more symptoms for at least 2 weeks, including
depressed mood or anhedonia
Rationale: MDE requires five or more of nine symptoms in the same 2-
week period, at least one being depressed mood or loss of
interest/pleasure, with clinically significant distress or impairment.
7. What is the minimum duration of symptoms for persistent
depressive disorder (dysthymia) in an adult?
A. 2 weeks
B. 2 years
C. 1 year
D. 6 months
Answer: B. 2 years
Rationale: Adults need depressed mood most of the day, more days than
not, for at least 2 years (1 year in children/adolescents), with 2 or more
associated symptoms.
8. A manic episode in bipolar I disorder must last at least how long
(unless hospitalization is required)?
A. 1 month
B. 4 days
C. 1 week
D. 2 weeks
Answer: C. 1 week
Rationale: Mania requires elevated/expansive/irritable mood plus
increased energy for at least 1 week, or any duration if hospitalization is
necessary. Hypomania requires 4 days and no marked impairment or
psychosis.
NU 671 Exam | Page 3
, 9. A patient has excessive, uncontrollable worry about multiple life
domains for 8 months with restlessness, fatigue, and muscle tension.
Which is first-line pharmacotherapy?
A. Alprazolam
B. Haloperidol
C. Lithium
D. SSRI or SNRI (e.g., escitalopram, venlafaxine)
Answer: D. SSRI or SNRI (e.g., escitalopram, venlafaxine)
Rationale: GAD requires 6 months of excessive worry. SSRIs/SNRIs are
first-line; buspirone is an option; benzodiazepines are short-term only
because of dependence risk. CBT is also first-line.
10. Which combination is first-line for panic disorder?
A. Antipsychotic plus mood stabilizer
B. SSRI plus cognitive behavioral therapy with interoceptive exposure
C. Psychoanalysis alone
D. Benzodiazepine alone long term
Answer: B. SSRI plus cognitive behavioral therapy with interoceptive
exposure
Rationale: SSRIs/SNRIs and CBT are first-line. Benzodiazepines provide
quick relief but risk dependence and are not preferred as long-term
monotherapy.
11. Which psychotherapies have the strongest evidence for PTSD?
A. Debriefing immediately after trauma
B. Psychodynamic therapy only
C. Supportive counseling only
D. Trauma-focused therapies: prolonged exposure, cognitive processing
therapy, EMDR
Answer: D. Trauma-focused therapies: prolonged exposure, cognitive
processing therapy, EMDR
Rationale: VA/DoD and APA guidelines recommend trauma-focused
psychotherapy first-line. Sertraline, paroxetine, and venlafaxine are
recommended medications. Single-session psychological debriefing is not
recommended.
NU 671 Exam | Page 4
Purdue University Global | Updated| Pass Guaranteed
1. A patient with borderline personality disorder and chronic self-
harm is referred for evidence-based psychotherapy. Which modality
has the strongest evidence and was specifically developed for this
population?
A. Client-centered therapy
B. Dialectical behavior therapy (DBT)
C. Systematic desensitization
D. Classical psychoanalysis
Answer: B. Dialectical behavior therapy (DBT)
Rationale: DBT (Linehan) combines individual therapy, skills training
(mindfulness, distress tolerance, emotion regulation, interpersonal
effectiveness), phone coaching, and consultation team. It reduces self-
harm and suicidal behavior in BPD.
2. A patient is stable on lithium for bipolar I disorder. Which serum
level is the usual target for maintenance therapy?
A. 1.5–2.0 mEq/L
B. 0.2–0.4 mEq/L
C. 2.0–2.5 mEq/L
D. 0.6–1.0 mEq/L
Answer: D. 0.6–1.0 mEq/L
Rationale: Maintenance range is about 0.6–1.0 mEq/L (acute mania 0.8–
1.2). Levels above 1.5 risk toxicity; draw 12 hours after the last dose.
NU 671 Exam | Page 1
,3. A patient on sertraline is given linezolid and develops agitation,
diaphoresis, hyperreflexia, inducible clonus, and temperature of
39.2°C. What is the most likely diagnosis?
A. Neuroleptic malignant syndrome
B. Anticholinergic toxicity
C. Malignant hyperthermia
D. Serotonin syndrome
Answer: D. Serotonin syndrome
Rationale: Serotonin syndrome has rapid onset (hours) with
neuromuscular hyperactivity (clonus, hyperreflexia), autonomic instability,
and altered mental status. Linezolid is a weak MAOI. Treat by stopping
agents, supportive care, benzodiazepines, and cyproheptadine.
4. Which finding best distinguishes neuroleptic malignant syndrome
(NMS) from serotonin syndrome?
A. Diaphoresis
B. Lead-pipe rigidity with bradyreflexia and gradual onset over days
C. Fever
D. Tachycardia
Answer: B. Lead-pipe rigidity with bradyreflexia and gradual onset
over days
Rationale: NMS occurs with dopamine antagonists, develops over days,
and shows lead-pipe rigidity, hyporeflexia, and elevated CK. Serotonin
syndrome is rapid with clonus and hyperreflexia.
5. Which laboratory monitoring is required for patients taking
clozapine?
A. Serum ammonia
B. Absolute neutrophil count (ANC)
C. Serum lithium level
D. Thyroid antibodies
Answer: B. Absolute neutrophil count (ANC)
Rationale: Clozapine can cause severe neutropenia/agranulocytosis. ANC
is monitored per the REMS-era protocols (weekly initially, then less often).
Also monitor for myocarditis, seizures, metabolic effects, and constipation.
NU 671 Exam | Page 2
,6. How many symptoms, and for how long, are required to diagnose a
major depressive episode per DSM-5-TR?
A. 3 symptoms for 1 week
B. 4 symptoms for 1 month
C. 2 symptoms for 2 years
D. 5 or more symptoms for at least 2 weeks, including depressed mood or
anhedonia
Answer: D. 5 or more symptoms for at least 2 weeks, including
depressed mood or anhedonia
Rationale: MDE requires five or more of nine symptoms in the same 2-
week period, at least one being depressed mood or loss of
interest/pleasure, with clinically significant distress or impairment.
7. What is the minimum duration of symptoms for persistent
depressive disorder (dysthymia) in an adult?
A. 2 weeks
B. 2 years
C. 1 year
D. 6 months
Answer: B. 2 years
Rationale: Adults need depressed mood most of the day, more days than
not, for at least 2 years (1 year in children/adolescents), with 2 or more
associated symptoms.
8. A manic episode in bipolar I disorder must last at least how long
(unless hospitalization is required)?
A. 1 month
B. 4 days
C. 1 week
D. 2 weeks
Answer: C. 1 week
Rationale: Mania requires elevated/expansive/irritable mood plus
increased energy for at least 1 week, or any duration if hospitalization is
necessary. Hypomania requires 4 days and no marked impairment or
psychosis.
NU 671 Exam | Page 3
, 9. A patient has excessive, uncontrollable worry about multiple life
domains for 8 months with restlessness, fatigue, and muscle tension.
Which is first-line pharmacotherapy?
A. Alprazolam
B. Haloperidol
C. Lithium
D. SSRI or SNRI (e.g., escitalopram, venlafaxine)
Answer: D. SSRI or SNRI (e.g., escitalopram, venlafaxine)
Rationale: GAD requires 6 months of excessive worry. SSRIs/SNRIs are
first-line; buspirone is an option; benzodiazepines are short-term only
because of dependence risk. CBT is also first-line.
10. Which combination is first-line for panic disorder?
A. Antipsychotic plus mood stabilizer
B. SSRI plus cognitive behavioral therapy with interoceptive exposure
C. Psychoanalysis alone
D. Benzodiazepine alone long term
Answer: B. SSRI plus cognitive behavioral therapy with interoceptive
exposure
Rationale: SSRIs/SNRIs and CBT are first-line. Benzodiazepines provide
quick relief but risk dependence and are not preferred as long-term
monotherapy.
11. Which psychotherapies have the strongest evidence for PTSD?
A. Debriefing immediately after trauma
B. Psychodynamic therapy only
C. Supportive counseling only
D. Trauma-focused therapies: prolonged exposure, cognitive processing
therapy, EMDR
Answer: D. Trauma-focused therapies: prolonged exposure, cognitive
processing therapy, EMDR
Rationale: VA/DoD and APA guidelines recommend trauma-focused
psychotherapy first-line. Sertraline, paroxetine, and venlafaxine are
recommended medications. Single-session psychological debriefing is not
recommended.
NU 671 Exam | Page 4
