WGU C213 Accounting for Decision Makers OA Exam 2026/2027 |
80 Verified Questions & Answers | Western Governors University
Prep | 5 Core Domains | Instant Download .
INTRODUCTION
NRNP 6635: Psychopathology and Diagnostic Reasoning is a core course in the Walden
University MSN Psychiatric-Mental Health Nurse Practitioner (PMHNP) program . This
comprehensive final examination covers 4 core domains of advanced psychiatric practice,
preparing PMHNP candidates for clinical diagnostic reasoning and DSM-5-TR application.
The course emphasizes the development of advanced diagnostic reasoning skills essential for
psychiatric-mental health nurse practitioners. Students learn to apply the DSM-5-TR
diagnostic criteria systematically while considering cultural, developmental, and biological
factors that influence mental health presentations .
SECTION 1: MOOD DISORDERS & DIFFERENTIAL DIAGNOSIS
Question 1:
A patient presents with a 2-week history of depressed mood, anhedonia, insomnia, fatigue,
and feelings of worthlessness. Which of the following is required for a diagnosis of major
depressive disorder?
A) At least 3 symptoms present for 1 week
B) At least 5 symptoms present for 2 weeks, including depressed mood or anhedonia
C) At least 7 symptoms present for 1 month
D) At least 2 symptoms present for 6 months
Correct Answer: B) At least 5 symptoms present for 2 weeks, including depressed mood or
anhedonia
Rationale: According to DSM-5-TR criteria, a major depressive episode requires five or more
symptoms present during the same 2-week period, representing a change from previous
functioning. At least one symptom must be either (1) depressed mood or (2) loss of interest
or pleasure .
Question 2:
A 45-year-old patient reports decreased need for sleep, grandiosity, rapid speech, and
,excessive involvement in risky activities for the past 5 days. The patient has a history of major
depressive episodes. What is the most likely diagnosis?
A) Major depressive disorder with mixed features
B) Bipolar I disorder
C) Bipolar II disorder
D) Cyclothymic disorder
Correct Answer: B) Bipolar I disorder
Rationale: The presence of a manic episode (decreased need for sleep, grandiosity, rapid
speech, risky behavior lasting at least 1 week or requiring hospitalization) confirms Bipolar I
disorder. A major depressive episode is not required for Bipolar I diagnosis, though most
patients experience one .
Question 3:
Which specifier is applied when a patient experiences four or more mood episodes within a
12-month period?
A) Seasonal pattern
B) Rapid cycling
C) Mixed features
D) With psychotic features
Correct Answer: B) Rapid cycling
Rationale: Rapid cycling is defined as four or more mood episodes (mania, hypomania, or
major depression) during a 12-month period. This specifier can be applied to Bipolar I or
Bipolar II disorder .
Question 4:
A patient with recurrent depressive episodes reports that symptoms consistently begin in
November and remit in March each year. Which specifier is most appropriate?
A) With peripartum onset
B) With seasonal pattern
C) With atypical features
D) With melancholic features
Correct Answer: B) With seasonal pattern
,Rationale: Seasonal pattern refers to a regular temporal relationship between the onset of
mood episodes and a particular time of year for at least 2 years. Depressive episodes typically
occur in winter, while hypomanic/manic episodes may occur in spring/summer .
Question 5:
A patient presents with depressed mood, loss of interest, significant weight gain,
hypersomnia, and leaden paralysis. Which specifier best describes this presentation?
A) With melancholic features
B) With atypical features
C) With catatonia
D) With anxious distress
Correct Answer: B) With atypical features
Rationale: Atypical features include mood reactivity (mood brightens in response to positive
events), significant weight gain or increased appetite, hypersomnia, leaden paralysis (heavy
feeling in limbs), and a longstanding pattern of interpersonal rejection sensitivity .
Question 6:
What is the minimum duration of symptoms required for a diagnosis of persistent depressive
disorder (dysthymia)?
A) 2 weeks
B) 1 month
C) 1 year
D) 2 years
Correct Answer: D) 2 years
Rationale: Persistent depressive disorder requires a depressed mood for most of the day, for
more days than not, for at least 2 years in adults (1 year in children/adolescents). The
symptoms are less severe than major depression but chronic .
Question 7:
A 28-year-old woman presents with severe depression, insomnia, and suicidal ideation during
the third trimester of pregnancy. Which specifier applies?
A) With postpartum onset
B) With peripartum onset
, C) With seasonal pattern
D) With psychotic features
Correct Answer: B) With peripartum onset
Rationale: Peripartum onset applies when mood episode symptoms occur during pregnancy
or within 4 weeks postpartum. This specifier replaced the previous "postpartum onset" to
include depressive episodes beginning during pregnancy .
Question 8:
Which of the following is NOT a criterion for major depressive disorder?
A) Depressed mood
B) Anhedonia
C) Grandiosity
D) Insomnia
Correct Answer: C) Grandiosity
Rationale: Grandiosity is a symptom of mania/hypomania, not major depression. Major
depressive episode criteria include depressed mood, anhedonia, weight changes, sleep
disturbances, psychomotor changes, fatigue, worthlessness/guilt, concentration difficulties,
and suicidal ideation .
Question 9:
A patient with bipolar disorder presents with elevated mood, increased energy, and
decreased need for sleep lasting 4 days, without significant impairment. This is most
consistent with:
A) Manic episode
B) Hypomanic episode
C) Mixed episode
D) Major depressive episode
Correct Answer: B) Hypomanic episode
Rationale: A hypomanic episode is a distinct period of abnormally elevated, expansive, or
irritable mood lasting at least 4 consecutive days. It is not severe enough to cause marked
impairment in social or occupational functioning or require hospitalization .
80 Verified Questions & Answers | Western Governors University
Prep | 5 Core Domains | Instant Download .
INTRODUCTION
NRNP 6635: Psychopathology and Diagnostic Reasoning is a core course in the Walden
University MSN Psychiatric-Mental Health Nurse Practitioner (PMHNP) program . This
comprehensive final examination covers 4 core domains of advanced psychiatric practice,
preparing PMHNP candidates for clinical diagnostic reasoning and DSM-5-TR application.
The course emphasizes the development of advanced diagnostic reasoning skills essential for
psychiatric-mental health nurse practitioners. Students learn to apply the DSM-5-TR
diagnostic criteria systematically while considering cultural, developmental, and biological
factors that influence mental health presentations .
SECTION 1: MOOD DISORDERS & DIFFERENTIAL DIAGNOSIS
Question 1:
A patient presents with a 2-week history of depressed mood, anhedonia, insomnia, fatigue,
and feelings of worthlessness. Which of the following is required for a diagnosis of major
depressive disorder?
A) At least 3 symptoms present for 1 week
B) At least 5 symptoms present for 2 weeks, including depressed mood or anhedonia
C) At least 7 symptoms present for 1 month
D) At least 2 symptoms present for 6 months
Correct Answer: B) At least 5 symptoms present for 2 weeks, including depressed mood or
anhedonia
Rationale: According to DSM-5-TR criteria, a major depressive episode requires five or more
symptoms present during the same 2-week period, representing a change from previous
functioning. At least one symptom must be either (1) depressed mood or (2) loss of interest
or pleasure .
Question 2:
A 45-year-old patient reports decreased need for sleep, grandiosity, rapid speech, and
,excessive involvement in risky activities for the past 5 days. The patient has a history of major
depressive episodes. What is the most likely diagnosis?
A) Major depressive disorder with mixed features
B) Bipolar I disorder
C) Bipolar II disorder
D) Cyclothymic disorder
Correct Answer: B) Bipolar I disorder
Rationale: The presence of a manic episode (decreased need for sleep, grandiosity, rapid
speech, risky behavior lasting at least 1 week or requiring hospitalization) confirms Bipolar I
disorder. A major depressive episode is not required for Bipolar I diagnosis, though most
patients experience one .
Question 3:
Which specifier is applied when a patient experiences four or more mood episodes within a
12-month period?
A) Seasonal pattern
B) Rapid cycling
C) Mixed features
D) With psychotic features
Correct Answer: B) Rapid cycling
Rationale: Rapid cycling is defined as four or more mood episodes (mania, hypomania, or
major depression) during a 12-month period. This specifier can be applied to Bipolar I or
Bipolar II disorder .
Question 4:
A patient with recurrent depressive episodes reports that symptoms consistently begin in
November and remit in March each year. Which specifier is most appropriate?
A) With peripartum onset
B) With seasonal pattern
C) With atypical features
D) With melancholic features
Correct Answer: B) With seasonal pattern
,Rationale: Seasonal pattern refers to a regular temporal relationship between the onset of
mood episodes and a particular time of year for at least 2 years. Depressive episodes typically
occur in winter, while hypomanic/manic episodes may occur in spring/summer .
Question 5:
A patient presents with depressed mood, loss of interest, significant weight gain,
hypersomnia, and leaden paralysis. Which specifier best describes this presentation?
A) With melancholic features
B) With atypical features
C) With catatonia
D) With anxious distress
Correct Answer: B) With atypical features
Rationale: Atypical features include mood reactivity (mood brightens in response to positive
events), significant weight gain or increased appetite, hypersomnia, leaden paralysis (heavy
feeling in limbs), and a longstanding pattern of interpersonal rejection sensitivity .
Question 6:
What is the minimum duration of symptoms required for a diagnosis of persistent depressive
disorder (dysthymia)?
A) 2 weeks
B) 1 month
C) 1 year
D) 2 years
Correct Answer: D) 2 years
Rationale: Persistent depressive disorder requires a depressed mood for most of the day, for
more days than not, for at least 2 years in adults (1 year in children/adolescents). The
symptoms are less severe than major depression but chronic .
Question 7:
A 28-year-old woman presents with severe depression, insomnia, and suicidal ideation during
the third trimester of pregnancy. Which specifier applies?
A) With postpartum onset
B) With peripartum onset
, C) With seasonal pattern
D) With psychotic features
Correct Answer: B) With peripartum onset
Rationale: Peripartum onset applies when mood episode symptoms occur during pregnancy
or within 4 weeks postpartum. This specifier replaced the previous "postpartum onset" to
include depressive episodes beginning during pregnancy .
Question 8:
Which of the following is NOT a criterion for major depressive disorder?
A) Depressed mood
B) Anhedonia
C) Grandiosity
D) Insomnia
Correct Answer: C) Grandiosity
Rationale: Grandiosity is a symptom of mania/hypomania, not major depression. Major
depressive episode criteria include depressed mood, anhedonia, weight changes, sleep
disturbances, psychomotor changes, fatigue, worthlessness/guilt, concentration difficulties,
and suicidal ideation .
Question 9:
A patient with bipolar disorder presents with elevated mood, increased energy, and
decreased need for sleep lasting 4 days, without significant impairment. This is most
consistent with:
A) Manic episode
B) Hypomanic episode
C) Mixed episode
D) Major depressive episode
Correct Answer: B) Hypomanic episode
Rationale: A hypomanic episode is a distinct period of abnormally elevated, expansive, or
irritable mood lasting at least 4 consecutive days. It is not severe enough to cause marked
impairment in social or occupational functioning or require hospitalization .
