NRNP 6635 COMPREHENSIVE
PSYCHOPATHOLOGY AND
DIAGNOSTIC REASONING - WEEK 8
QUESTIONS AND ANSWERS 100%
VERIFIED BY EXPERTS. 2026/2027
1. A 75-year-old male presents with sudden onset of fluctuating consciousness, visual
hallucinations, and impaired attention. His daughter states he was fine two days ago. Which
of the following is the most likely diagnosis?
A. Alzheimer’s Disease
B. Lewy Body Dementia
C. Delirium
D. Major Depressive Disorder with Psychotic Features
Answer: C
Conceptual Explanation: Delirium is characterized by an acute onset, fluctuating course,
and disturbances in attention and consciousness, whereas dementia is typically
progressive and chronic.
2. Which dopaminergic pathway is primarily associated with the development of
Extrapyramidal Symptoms (EPS) when blocked by first-generation antipsychotics?
A. Nigrostriatal pathway
,B. Mesocortical pathway
C. Mesolimbic pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: The Nigrostriatal pathway controls motor function. Antagonism
of D2 receptors in this pathway leads to EPS like dystonia, akathisia, and Parkinsonism.
3. A patient taking Clozapine presents with a sore throat, fever, and an Absolute Neutrophil
Count (ANC) of 450/mm³. What is the immediate priority action?
A. Reduce the dose and retest in 48 hours
B. Discontinue Clozapine immediately
C. Add an antibiotic and continue the current dose
D. Switch to a second-generation antipsychotic like Olanzapine
Answer: B
Conceptual Explanation: An ANC below 500/mm³ indicates severe neutropenia
(agranulocytosis). Clozapine must be discontinued immediately to prevent fatal infection.
4. Which of the following cognitive assessments is specifically designed to detect mild
cognitive impairment (MCI) and is more sensitive than the MMSE for early stages of
dementia?
A. PHQ-9
, B. MoCA (Montreal Cognitive Assessment)
C. GDS (Geriatric Depression Scale)
D. CAGE Questionnaire
Answer: B
Conceptual Explanation: The MoCA is highly sensitive for MCI and early Alzheimer’s,
covering executive functions that the MMSE often misses.
5. In differentiating Schizoaffective Disorder from Bipolar Disorder with Psychotic Features,
which criterion is essential?
A. The severity of the manic episode.
B. The presence of hallucinations for at least 2 weeks in the absence of a major mood
episode.
C. The presence of auditory hallucinations versus visual hallucinations.
D. The duration of the mood symptoms being longer than the psychosis.
Answer: B
Conceptual Explanation: For Schizoaffective Disorder, delusions or hallucinations must
be present for at least 2 weeks without a major mood episode (depressive or manic).
6. A patient with Alzheimer’s is prescribed Memantine. What is the mechanism of action of
this medication?
A. Cholinesterase inhibitor
PSYCHOPATHOLOGY AND
DIAGNOSTIC REASONING - WEEK 8
QUESTIONS AND ANSWERS 100%
VERIFIED BY EXPERTS. 2026/2027
1. A 75-year-old male presents with sudden onset of fluctuating consciousness, visual
hallucinations, and impaired attention. His daughter states he was fine two days ago. Which
of the following is the most likely diagnosis?
A. Alzheimer’s Disease
B. Lewy Body Dementia
C. Delirium
D. Major Depressive Disorder with Psychotic Features
Answer: C
Conceptual Explanation: Delirium is characterized by an acute onset, fluctuating course,
and disturbances in attention and consciousness, whereas dementia is typically
progressive and chronic.
2. Which dopaminergic pathway is primarily associated with the development of
Extrapyramidal Symptoms (EPS) when blocked by first-generation antipsychotics?
A. Nigrostriatal pathway
,B. Mesocortical pathway
C. Mesolimbic pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: The Nigrostriatal pathway controls motor function. Antagonism
of D2 receptors in this pathway leads to EPS like dystonia, akathisia, and Parkinsonism.
3. A patient taking Clozapine presents with a sore throat, fever, and an Absolute Neutrophil
Count (ANC) of 450/mm³. What is the immediate priority action?
A. Reduce the dose and retest in 48 hours
B. Discontinue Clozapine immediately
C. Add an antibiotic and continue the current dose
D. Switch to a second-generation antipsychotic like Olanzapine
Answer: B
Conceptual Explanation: An ANC below 500/mm³ indicates severe neutropenia
(agranulocytosis). Clozapine must be discontinued immediately to prevent fatal infection.
4. Which of the following cognitive assessments is specifically designed to detect mild
cognitive impairment (MCI) and is more sensitive than the MMSE for early stages of
dementia?
A. PHQ-9
, B. MoCA (Montreal Cognitive Assessment)
C. GDS (Geriatric Depression Scale)
D. CAGE Questionnaire
Answer: B
Conceptual Explanation: The MoCA is highly sensitive for MCI and early Alzheimer’s,
covering executive functions that the MMSE often misses.
5. In differentiating Schizoaffective Disorder from Bipolar Disorder with Psychotic Features,
which criterion is essential?
A. The severity of the manic episode.
B. The presence of hallucinations for at least 2 weeks in the absence of a major mood
episode.
C. The presence of auditory hallucinations versus visual hallucinations.
D. The duration of the mood symptoms being longer than the psychosis.
Answer: B
Conceptual Explanation: For Schizoaffective Disorder, delusions or hallucinations must
be present for at least 2 weeks without a major mood episode (depressive or manic).
6. A patient with Alzheimer’s is prescribed Memantine. What is the mechanism of action of
this medication?
A. Cholinesterase inhibitor
