This is Part 1 of the Psychiatry Fundamentals 6th
Edition Comprehensive Test Bank by Sadock,
Sadock, and Ruiz.
TABLE OF CONTENTS - PART 1 of 5
Chapter 1: Psychiatric Interview and Diagnosis (Questions 1-25)
Chapter 2: Neurodevelopmental Disorders (Questions 26-50)
Chapter 3: Schizophrenia Spectrum and Other Psychotic Disorders (Questions 51-75)
Chapter 4: Bipolar and Related Disorders (Questions 76-100)
CHAPTER 1: PSYCHIATRIC INTERVIEW AND DIAGNOSIS
Q1. A 34-year-old woman presents to a psychiatrist for evaluation of persistent sadness. During the
interview, she describes her mood as "down" for the past eight months. Which of the following is the
most important initial step in the psychiatric evaluation?
A. Obtaining a detailed history of present illness
B. Ordering a comprehensive metabolic panel
C. Prescribing an antidepressant medication
D. Referring the patient for cognitive behavioral therapy
Correct Answer: A
Rationale: The most important initial step in any psychiatric evaluation is obtaining a thorough
history of the present illness, which establishes the timeline, severity, and context of the patient's
symptoms. Ordering laboratory tests, prescribing medication, or making a therapy referral before
completing the history would be premature and could lead to diagnostic error. A detailed history also
guides the choice of appropriate ancillary tests and treatment interventions.
Q2. A 28-year-old man is brought to the emergency department by his family after expressing
thoughts of harming himself. Which of the following questions is most appropriate to assess his
safety?
A. "Do you hear voices telling you to hurt yourself?"
,B. "Do you have a plan to end your life?"
C. "Have you ever been arrested?"
D. "Do you drink alcohol daily?"
Correct Answer: D
Rationale: Assessing safety in a patient with suicidal ideation requires direct inquiry about
suicidal intent, plan, and access to means. Asking about a specific plan to end his life is the most
direct and critical question for determining imminent risk. Inquiring about auditory hallucinations,
arrest history, or daily alcohol use, while potentially relevant, does not directly assess the acute risk
of self-harm. The priority is always immediate safety assessment.
Q3. A 45-year-old woman presents with complaints of poor sleep, low energy, and difficulty
concentrating. She reports these symptoms began after her husband's death six months ago. Which
of the following is the most likely diagnosis?
A. Major depressive disorder
B. Persistent depressive disorder
C. Adjustment disorder with depressed mood
D. Normal bereavement
Correct Answer: B
Rationale: Adjustment disorder with depressed mood is characterized by emotional or
behavioral symptoms in response to an identifiable stressor, such as the death of a spouse, occurring
within three months of the stressor. The symptoms are clinically significant but do not meet the full
criteria for major depressive disorder. Normal bereavement may resemble this presentation but is a
normal process rather than a diagnosable disorder. Persistent depressive disorder requires a chronic
course of at least two years.
Q4. A 52-year-old man is being evaluated for suspected dementia. He has difficulty remembering
recent events but can recall distant memories well. Which of the following cognitive domains is most
likely impaired?
A. Executive function
B. Short-term memory
C. Language
D. Visuospatial ability
Correct Answer: C
Rationale: In early Alzheimer disease, short-term memory is typically the first and most
prominently affected cognitive domain, while long-term memory remains relatively preserved until
,later stages. Executive function, language, and visuospatial abilities may become impaired as the
disease progresses, but the initial and most characteristic deficit is in short-term memory. This
pattern helps distinguish Alzheimer disease from other dementias, such as frontotemporal dementia,
which often presents with executive or language deficits first.
Q5. A 23-year-old woman reports a two-year history of intense fear of social situations, fearing she
will be judged or embarrassed. She avoids parties, meetings, and eating in public. Which of the
following is the most likely diagnosis?
A. Generalized anxiety disorder
B. Panic disorder
C. Social anxiety disorder
D. Agoraphobia
Correct Answer: B
Rationale: Social anxiety disorder is characterized by a marked and persistent fear of one or
more social or performance situations in which the person is exposed to unfamiliar people or to
possible scrutiny by others. The individual fears that they will act in a way that will be humiliating or
embarrassing. Generalized anxiety disorder involves excessive worry about multiple domains, not
just social situations. Panic disorder involves recurrent unexpected panic attacks, and agoraphobia
involves fear of situations where escape might be difficult.
Q6. A 60-year-old man presents with a three-week history of persistent sadness, loss of appetite, and
insomnia following his retirement. Which of the following is the most appropriate initial screening
tool?
A. Mini-Mental State Examination
B. Patient Health Questionnaire-9
C. CAGE questionnaire
D. Generalized Anxiety Disorder-7
Correct Answer: A
Rationale: The Patient Health Questionnaire-9 is a validated and widely used screening tool for
depression that assesses the nine diagnostic criteria for major depressive disorder. The Mini-Mental
State Examination screens for cognitive impairment, the CAGE questionnaire screens for alcohol use
disorder, and the Generalized Anxiety Disorder-7 screens for anxiety. Given the patient's presentation
of sadness, appetite loss, and insomnia, depression screening is the most appropriate initial step.
Q7. A 31-year-old woman is evaluated for a first episode of psychosis. She reports hearing voices
commenting on her behavior and believes her neighbors are plotting against her. Which of the
following is the most important next step?
, A. Start an antipsychotic medication
B. Obtain a urine toxicology screen
C. Refer for cognitive behavioral therapy
D. Admit to an inpatient psychiatric unit
Correct Answer: C
Rationale: Before diagnosing a primary psychotic disorder, it is essential to rule out substance-
induced psychosis, which is a common and treatable cause of first-episode psychosis. A urine
toxicology screen is the most important next step to identify potential substance use, such as
cannabis, stimulants, or hallucinogens, that could explain the symptoms. Starting antipsychotic
medication, referring for therapy, or admitting the patient may be appropriate later but should follow
a thorough medical and substance use evaluation.
Q8. A 40-year-old man presents with a six-month history of excessive worry about multiple areas of
his life, including his job, finances, and his children's health. He reports muscle tension and difficulty
sleeping. Which of the following is the most likely diagnosis?
A. Social anxiety disorder
B. Panic disorder
C. Generalized anxiety disorder
D. Obsessive-compulsive disorder
Correct Answer: D
Rationale: Generalized anxiety disorder is characterized by excessive anxiety and worry about
a number of events or activities, occurring more days than not for at least six months. The worry is
difficult to control and is associated with symptoms such as muscle tension, sleep disturbance, and
difficulty concentrating. Social anxiety disorder is limited to social situations, panic disorder involves
recurrent panic attacks, and obsessive-compulsive disorder involves obsessions and compulsions
rather than free-floating worry.
Q9. A 27-year-old woman is brought to the clinic by her partner, who reports she has been talking
rapidly, sleeping only two hours per night, and spending large sums of money. She denies any
problems. Which of the following is the most likely diagnosis?
A. Major depressive disorder
B. Bipolar I disorder
C. Schizophrenia
D. Generalized anxiety disorder
Correct Answer: A
Edition Comprehensive Test Bank by Sadock,
Sadock, and Ruiz.
TABLE OF CONTENTS - PART 1 of 5
Chapter 1: Psychiatric Interview and Diagnosis (Questions 1-25)
Chapter 2: Neurodevelopmental Disorders (Questions 26-50)
Chapter 3: Schizophrenia Spectrum and Other Psychotic Disorders (Questions 51-75)
Chapter 4: Bipolar and Related Disorders (Questions 76-100)
CHAPTER 1: PSYCHIATRIC INTERVIEW AND DIAGNOSIS
Q1. A 34-year-old woman presents to a psychiatrist for evaluation of persistent sadness. During the
interview, she describes her mood as "down" for the past eight months. Which of the following is the
most important initial step in the psychiatric evaluation?
A. Obtaining a detailed history of present illness
B. Ordering a comprehensive metabolic panel
C. Prescribing an antidepressant medication
D. Referring the patient for cognitive behavioral therapy
Correct Answer: A
Rationale: The most important initial step in any psychiatric evaluation is obtaining a thorough
history of the present illness, which establishes the timeline, severity, and context of the patient's
symptoms. Ordering laboratory tests, prescribing medication, or making a therapy referral before
completing the history would be premature and could lead to diagnostic error. A detailed history also
guides the choice of appropriate ancillary tests and treatment interventions.
Q2. A 28-year-old man is brought to the emergency department by his family after expressing
thoughts of harming himself. Which of the following questions is most appropriate to assess his
safety?
A. "Do you hear voices telling you to hurt yourself?"
,B. "Do you have a plan to end your life?"
C. "Have you ever been arrested?"
D. "Do you drink alcohol daily?"
Correct Answer: D
Rationale: Assessing safety in a patient with suicidal ideation requires direct inquiry about
suicidal intent, plan, and access to means. Asking about a specific plan to end his life is the most
direct and critical question for determining imminent risk. Inquiring about auditory hallucinations,
arrest history, or daily alcohol use, while potentially relevant, does not directly assess the acute risk
of self-harm. The priority is always immediate safety assessment.
Q3. A 45-year-old woman presents with complaints of poor sleep, low energy, and difficulty
concentrating. She reports these symptoms began after her husband's death six months ago. Which
of the following is the most likely diagnosis?
A. Major depressive disorder
B. Persistent depressive disorder
C. Adjustment disorder with depressed mood
D. Normal bereavement
Correct Answer: B
Rationale: Adjustment disorder with depressed mood is characterized by emotional or
behavioral symptoms in response to an identifiable stressor, such as the death of a spouse, occurring
within three months of the stressor. The symptoms are clinically significant but do not meet the full
criteria for major depressive disorder. Normal bereavement may resemble this presentation but is a
normal process rather than a diagnosable disorder. Persistent depressive disorder requires a chronic
course of at least two years.
Q4. A 52-year-old man is being evaluated for suspected dementia. He has difficulty remembering
recent events but can recall distant memories well. Which of the following cognitive domains is most
likely impaired?
A. Executive function
B. Short-term memory
C. Language
D. Visuospatial ability
Correct Answer: C
Rationale: In early Alzheimer disease, short-term memory is typically the first and most
prominently affected cognitive domain, while long-term memory remains relatively preserved until
,later stages. Executive function, language, and visuospatial abilities may become impaired as the
disease progresses, but the initial and most characteristic deficit is in short-term memory. This
pattern helps distinguish Alzheimer disease from other dementias, such as frontotemporal dementia,
which often presents with executive or language deficits first.
Q5. A 23-year-old woman reports a two-year history of intense fear of social situations, fearing she
will be judged or embarrassed. She avoids parties, meetings, and eating in public. Which of the
following is the most likely diagnosis?
A. Generalized anxiety disorder
B. Panic disorder
C. Social anxiety disorder
D. Agoraphobia
Correct Answer: B
Rationale: Social anxiety disorder is characterized by a marked and persistent fear of one or
more social or performance situations in which the person is exposed to unfamiliar people or to
possible scrutiny by others. The individual fears that they will act in a way that will be humiliating or
embarrassing. Generalized anxiety disorder involves excessive worry about multiple domains, not
just social situations. Panic disorder involves recurrent unexpected panic attacks, and agoraphobia
involves fear of situations where escape might be difficult.
Q6. A 60-year-old man presents with a three-week history of persistent sadness, loss of appetite, and
insomnia following his retirement. Which of the following is the most appropriate initial screening
tool?
A. Mini-Mental State Examination
B. Patient Health Questionnaire-9
C. CAGE questionnaire
D. Generalized Anxiety Disorder-7
Correct Answer: A
Rationale: The Patient Health Questionnaire-9 is a validated and widely used screening tool for
depression that assesses the nine diagnostic criteria for major depressive disorder. The Mini-Mental
State Examination screens for cognitive impairment, the CAGE questionnaire screens for alcohol use
disorder, and the Generalized Anxiety Disorder-7 screens for anxiety. Given the patient's presentation
of sadness, appetite loss, and insomnia, depression screening is the most appropriate initial step.
Q7. A 31-year-old woman is evaluated for a first episode of psychosis. She reports hearing voices
commenting on her behavior and believes her neighbors are plotting against her. Which of the
following is the most important next step?
, A. Start an antipsychotic medication
B. Obtain a urine toxicology screen
C. Refer for cognitive behavioral therapy
D. Admit to an inpatient psychiatric unit
Correct Answer: C
Rationale: Before diagnosing a primary psychotic disorder, it is essential to rule out substance-
induced psychosis, which is a common and treatable cause of first-episode psychosis. A urine
toxicology screen is the most important next step to identify potential substance use, such as
cannabis, stimulants, or hallucinogens, that could explain the symptoms. Starting antipsychotic
medication, referring for therapy, or admitting the patient may be appropriate later but should follow
a thorough medical and substance use evaluation.
Q8. A 40-year-old man presents with a six-month history of excessive worry about multiple areas of
his life, including his job, finances, and his children's health. He reports muscle tension and difficulty
sleeping. Which of the following is the most likely diagnosis?
A. Social anxiety disorder
B. Panic disorder
C. Generalized anxiety disorder
D. Obsessive-compulsive disorder
Correct Answer: D
Rationale: Generalized anxiety disorder is characterized by excessive anxiety and worry about
a number of events or activities, occurring more days than not for at least six months. The worry is
difficult to control and is associated with symptoms such as muscle tension, sleep disturbance, and
difficulty concentrating. Social anxiety disorder is limited to social situations, panic disorder involves
recurrent panic attacks, and obsessive-compulsive disorder involves obsessions and compulsions
rather than free-floating worry.
Q9. A 27-year-old woman is brought to the clinic by her partner, who reports she has been talking
rapidly, sleeping only two hours per night, and spending large sums of money. She denies any
problems. Which of the following is the most likely diagnosis?
A. Major depressive disorder
B. Bipolar I disorder
C. Schizophrenia
D. Generalized anxiety disorder
Correct Answer: A
