NURS 5357 Exam 4 / Final Review — Comprehensive Questions and Answers with Rationales |
2026/2027 Update | 100% Correct.
Questions 1–17 | Neurobiology, executive function, catecholamines, diagnostic criteria, and
clinical reasoning
Question 1
A 21-year-old patient with ADHD reports difficulty organizing assignments, maintaining
attention, prioritizing responsibilities, and completing tasks requiring sustained mental effort.
Which brain region is particularly important for these executive functions?
A. Primary visual cortex B. Cerebellar vermis C. Prefrontal cortex D. Primary auditory cortex
Correct Answer: C. Prefrontal cortex
Rationale: The prefrontal cortex supports executive functions, including planning, working
memory, attention regulation, behavioral inhibition, and goal-directed decision-making.
Altered functioning of frontostriatal and other distributed neural circuits has been implicated in
ADHD. However, ADHD is a neurodevelopmental disorder involving multiple interacting
networks rather than an isolated prefrontal cortex abnormality.
Question 2
Which neurotransmitter systems are especially relevant to the regulation of attention, executive
functioning, and behavioral control in ADHD?
A. Dopamine and norepinephrine B. Glycine and histamine exclusively C. Acetylcholine and
oxytocin exclusively D. Melatonin and cortisol exclusively
Correct Answer: A. Dopamine and norepinephrine
Rationale: Dopamine and norepinephrine are catecholamine neurotransmitters involved in
attention, motivation, arousal, and executive functioning.
Both influence prefrontal and related neural circuits. Catecholaminergic signaling is also relevant
to the neurobiological actions of several ADHD medications.
ADHD should not be understood simply as a universal deficiency of either neurotransmitter.
Question 3
,A patient struggles to suppress an automatic response during a cognitive task that requires
waiting for a specific signal before acting.
Which cognitive process is most directly being assessed?
A. Autobiographical memory B. Visual accommodation C. Olfactory discrimination D.
Response inhibition
Correct Answer: D. Response inhibition
Rationale: Response inhibition refers to the ability to suppress or delay an automatic,
inappropriate, or no-longer-relevant response.
It is an important component of executive control and is associated with networks involving the
prefrontal cortex, anterior cingulate cortex, and basal ganglia.
Difficulties with inhibitory control can contribute to impulsive behavior in some individuals with
ADHD, although not every person with ADHD demonstrates the same neuropsychological
profile.
Question 4
A 25-year-old patient requests evaluation for possible ADHD. The patient describes difficulties
with concentration and organization that became noticeable during demanding university
coursework.
Which additional history is essential for determining whether ADHD diagnostic criteria may be
met?
A. Whether the patient had a headache in the previous month B. Whether several ADHD
symptoms were present before age 12 C. Whether the patient prefers studying in the morning D.
Whether the patient has ever changed academic majors
Correct Answer: B. Whether several ADHD symptoms were present before age 12
Rationale: DSM-5/DSM-5-TR ADHD criteria require evidence that several inattentive or
hyperactive-impulsive symptoms occurred before age 12.
ADHD may be first recognized during adolescence or adulthood, particularly when academic
and occupational demands increase. Recognition in adulthood does not mean the condition must
have started in adulthood.
Developmental history, school experiences, and collateral information may help establish earlier
symptoms.
, Question 5
For a patient aged 17 years or older, what is the minimum number of qualifying symptoms
required in at least one ADHD symptom domain, assuming the remaining diagnostic criteria are
met?
A. Three symptoms B. Four symptoms C. Five symptoms D. Eight symptoms
Correct Answer: C. Five symptoms
Rationale: For individuals aged 17 years and older, the DSM-5 diagnostic threshold is at least
five qualifying symptoms in the inattention domain and/or at least five in the hyperactivity-
impulsivity domain.
For children up to age 16, the threshold is six qualifying symptoms in the relevant domain.
The symptom count alone is insufficient. Clinicians must evaluate duration, developmental
appropriateness, onset, functional consequences, and other diagnostic requirements.
CDC
Question 6
How long must qualifying symptoms of inattention or hyperactivity-impulsivity generally persist
to meet the ADHD duration criterion?
A. At least six months B. At least two weeks C. At least one month D. At least twelve
consecutive months
Correct Answer: A. At least six months
Rationale: ADHD requires persistent symptoms for at least six months that are inconsistent with
developmental expectations and negatively affect functioning.
This requirement helps distinguish enduring neurodevelopmental symptoms from temporary
difficulties associated with stress, fatigue, illness, or changes in circumstances.
Question 7
A child demonstrates clinically significant inattentive symptoms at home and school. Both
parents and teachers describe similar difficulties, and academic performance has been affected.
Which ADHD diagnostic principle does this case illustrate?
2026/2027 Update | 100% Correct.
Questions 1–17 | Neurobiology, executive function, catecholamines, diagnostic criteria, and
clinical reasoning
Question 1
A 21-year-old patient with ADHD reports difficulty organizing assignments, maintaining
attention, prioritizing responsibilities, and completing tasks requiring sustained mental effort.
Which brain region is particularly important for these executive functions?
A. Primary visual cortex B. Cerebellar vermis C. Prefrontal cortex D. Primary auditory cortex
Correct Answer: C. Prefrontal cortex
Rationale: The prefrontal cortex supports executive functions, including planning, working
memory, attention regulation, behavioral inhibition, and goal-directed decision-making.
Altered functioning of frontostriatal and other distributed neural circuits has been implicated in
ADHD. However, ADHD is a neurodevelopmental disorder involving multiple interacting
networks rather than an isolated prefrontal cortex abnormality.
Question 2
Which neurotransmitter systems are especially relevant to the regulation of attention, executive
functioning, and behavioral control in ADHD?
A. Dopamine and norepinephrine B. Glycine and histamine exclusively C. Acetylcholine and
oxytocin exclusively D. Melatonin and cortisol exclusively
Correct Answer: A. Dopamine and norepinephrine
Rationale: Dopamine and norepinephrine are catecholamine neurotransmitters involved in
attention, motivation, arousal, and executive functioning.
Both influence prefrontal and related neural circuits. Catecholaminergic signaling is also relevant
to the neurobiological actions of several ADHD medications.
ADHD should not be understood simply as a universal deficiency of either neurotransmitter.
Question 3
,A patient struggles to suppress an automatic response during a cognitive task that requires
waiting for a specific signal before acting.
Which cognitive process is most directly being assessed?
A. Autobiographical memory B. Visual accommodation C. Olfactory discrimination D.
Response inhibition
Correct Answer: D. Response inhibition
Rationale: Response inhibition refers to the ability to suppress or delay an automatic,
inappropriate, or no-longer-relevant response.
It is an important component of executive control and is associated with networks involving the
prefrontal cortex, anterior cingulate cortex, and basal ganglia.
Difficulties with inhibitory control can contribute to impulsive behavior in some individuals with
ADHD, although not every person with ADHD demonstrates the same neuropsychological
profile.
Question 4
A 25-year-old patient requests evaluation for possible ADHD. The patient describes difficulties
with concentration and organization that became noticeable during demanding university
coursework.
Which additional history is essential for determining whether ADHD diagnostic criteria may be
met?
A. Whether the patient had a headache in the previous month B. Whether several ADHD
symptoms were present before age 12 C. Whether the patient prefers studying in the morning D.
Whether the patient has ever changed academic majors
Correct Answer: B. Whether several ADHD symptoms were present before age 12
Rationale: DSM-5/DSM-5-TR ADHD criteria require evidence that several inattentive or
hyperactive-impulsive symptoms occurred before age 12.
ADHD may be first recognized during adolescence or adulthood, particularly when academic
and occupational demands increase. Recognition in adulthood does not mean the condition must
have started in adulthood.
Developmental history, school experiences, and collateral information may help establish earlier
symptoms.
, Question 5
For a patient aged 17 years or older, what is the minimum number of qualifying symptoms
required in at least one ADHD symptom domain, assuming the remaining diagnostic criteria are
met?
A. Three symptoms B. Four symptoms C. Five symptoms D. Eight symptoms
Correct Answer: C. Five symptoms
Rationale: For individuals aged 17 years and older, the DSM-5 diagnostic threshold is at least
five qualifying symptoms in the inattention domain and/or at least five in the hyperactivity-
impulsivity domain.
For children up to age 16, the threshold is six qualifying symptoms in the relevant domain.
The symptom count alone is insufficient. Clinicians must evaluate duration, developmental
appropriateness, onset, functional consequences, and other diagnostic requirements.
CDC
Question 6
How long must qualifying symptoms of inattention or hyperactivity-impulsivity generally persist
to meet the ADHD duration criterion?
A. At least six months B. At least two weeks C. At least one month D. At least twelve
consecutive months
Correct Answer: A. At least six months
Rationale: ADHD requires persistent symptoms for at least six months that are inconsistent with
developmental expectations and negatively affect functioning.
This requirement helps distinguish enduring neurodevelopmental symptoms from temporary
difficulties associated with stress, fatigue, illness, or changes in circumstances.
Question 7
A child demonstrates clinically significant inattentive symptoms at home and school. Both
parents and teachers describe similar difficulties, and academic performance has been affected.
Which ADHD diagnostic principle does this case illustrate?
