NRNP6635 / NRNP 6635 Final Exam 2025/2026 – Grade A
Verified Copy
Psychopathology and Diagnostic Reasoning | Walden University
Multiple-Choice Questions
Question 1: Which assessment tool is most appropriate for screening depression in a 35-year-old
patient presenting with low mood?
A. Mini-Mental State Examination (MMSE)
B. Patient Health Questionnaire-9 (PHQ-9)
C. Young Mania Rating Scale (YMRS)
D. Montreal Cognitive Assessment (MoCA)
Correct Answer: B. Patient Health Questionnaire-9 (PHQ-9)
Rationale: The PHQ-9 is a validated, evidence-based tool specifically designed to
screen for depression severity, assessing symptoms like low mood and anhedonia.
MMSE and MoCA evaluate cognition, and YMRS screens for mania, not depression.
Question 2: A 28-year-old patient reports auditory hallucinations commanding self-harm. What
is the priority intervention?
A. Initiate cognitive behavioral therapy (CBT)
B. Assess suicide risk
C. Prescribe an antidepressant
D. Recommend mindfulness exercises
Correct Answer: B. Assess suicide risk
Rationale: Command hallucinations increase suicide risk in psychotic disorders.
Immediate risk assessment is critical to ensure patient safety, per evidence-based
psychiatric protocols. CBT, antidepressants, or mindfulness are secondary inter-
ventions.
Question 3: Which medication is first-line for a 40-year-old patient diagnosed with generalized
anxiety disorder (GAD)?
A. Alprazolam
B. Sertraline
C. Haloperidol
D. Lithium
Correct Answer: B. Sertraline
Rationale: SSRIs like sertraline are first-line for GAD due to efficacy and safety,
supported by APA guidelines. Alprazolam risks dependence, haloperidol is for
psychosis, and lithium is for bipolar disorder.
1
,Question 4: A 50-year-old patient with bipolar I disorder presents with acute mania. Which
medication is most appropriate?
A. Fluoxetine
B. Olanzapine
C. Buspirone
D. Clonazepam
Correct Answer: B. Olanzapine
Rationale: Olanzapine, an atypical antipsychotic, is effective for acute mania in
bipolar I disorder, per evidence-based guidelines. Fluoxetine may trigger mania,
buspirone is for anxiety, and clonazepam is adjunctive for anxiety, not mania.
Question 5: What is a hallmark symptom of post-traumatic stress disorder (PTSD) in a 32-
year-old veteran?
A. Euphoria
B. Intrusive memories
C. Compulsive handwashing
D. Grandiose delusions
Correct Answer: B. Intrusive memories
Rationale: Intrusive memories, such as flashbacks or nightmares, are a core DSM-5
criterion for PTSD, reflecting trauma re-experiencing. Euphoria, handwashing, and
delusions are unrelated to PTSD.
Question 6: A 45-year-old patient reports insomnia and weight loss for 3 months. Which diag-
nosis should be considered first?
A. Schizophrenia
B. Major depressive disorder (MDD)
C. Generalized anxiety disorder (GAD)
D. Obsessive-compulsive disorder (OCD)
Correct Answer: B. Major depressive disorder (MDD)
Rationale: Insomnia and weight loss are hallmark MDD symptoms per DSM-5,
especially with a 3-month duration. Schizophrenia involves psychosis, GAD focuses
on worry, and OCD involves obsessions/compulsions.
Question 7: Which laboratory test is required before initiating lithium for a 38-year-old patient
with bipolar disorder?
A. Complete blood count (CBC)
B. Thyroid function tests
C. Fasting blood glucose
D. Lipid panel
2
, Correct Answer: B. Thyroid function tests
Rationale: Lithium can cause hypothyroidism, necessitating baseline thyroid func-
tion tests, per evidence-based guidelines. CBC, glucose, and lipids are relevant for
other psychotropics but not primary for lithium.
Question 8: A 29-year-old patient with schizophrenia reports muscle stiffness after starting
risperidone. What is the likely cause?
A. Serotonin syndrome
B. Extrapyramidal symptoms (EPS)
C. Neuroleptic malignant syndrome (NMS)
D. Tardive dyskinesia (TD)
Correct Answer: B. Extrapyramidal symptoms (EPS)
Rationale: Muscle stiffness is a common EPS side effect of antipsychotics like
risperidone, due to dopamine blockade. Serotonin syndrome involves autonomic
instability, NMS includes fever, and TD involves involuntary movements.
Question 9: Which intervention is most effective for a 34-year-old patient with panic disorder?
A. Exposure therapy
B. Antipsychotic medication
C. Electroconvulsive therapy (ECT)
D. Mood stabilizers
Correct Answer: A. Exposure therapy
Rationale: Exposure therapy, a component of CBT, is first-line for panic disorder,
reducing avoidance behaviors, per APA guidelines. Antipsychotics, ECT, and mood
stabilizers are not indicated.
Question 10: A 55-year-old patient presents with flat affect and social withdrawal. Which diag-
nosis is most likely?
A. Bipolar disorder
B. Schizophrenia
C. Social anxiety disorder
D. Borderline personality disorder
Correct Answer: B. Schizophrenia
Rationale: Flat affect and social withdrawal are negative symptoms of schizophre-
nia, per DSM-5. Bipolar disorder involves mood episodes, social anxiety involves
fear of scrutiny, and borderline personality involves emotional instability.
Question 11: What is the first step in assessing a 42-year-old patient reporting suicidal ideation?
A. Prescribe an SSRI
B. Conduct a risk assessment
C. Refer to a therapist
3
Verified Copy
Psychopathology and Diagnostic Reasoning | Walden University
Multiple-Choice Questions
Question 1: Which assessment tool is most appropriate for screening depression in a 35-year-old
patient presenting with low mood?
A. Mini-Mental State Examination (MMSE)
B. Patient Health Questionnaire-9 (PHQ-9)
C. Young Mania Rating Scale (YMRS)
D. Montreal Cognitive Assessment (MoCA)
Correct Answer: B. Patient Health Questionnaire-9 (PHQ-9)
Rationale: The PHQ-9 is a validated, evidence-based tool specifically designed to
screen for depression severity, assessing symptoms like low mood and anhedonia.
MMSE and MoCA evaluate cognition, and YMRS screens for mania, not depression.
Question 2: A 28-year-old patient reports auditory hallucinations commanding self-harm. What
is the priority intervention?
A. Initiate cognitive behavioral therapy (CBT)
B. Assess suicide risk
C. Prescribe an antidepressant
D. Recommend mindfulness exercises
Correct Answer: B. Assess suicide risk
Rationale: Command hallucinations increase suicide risk in psychotic disorders.
Immediate risk assessment is critical to ensure patient safety, per evidence-based
psychiatric protocols. CBT, antidepressants, or mindfulness are secondary inter-
ventions.
Question 3: Which medication is first-line for a 40-year-old patient diagnosed with generalized
anxiety disorder (GAD)?
A. Alprazolam
B. Sertraline
C. Haloperidol
D. Lithium
Correct Answer: B. Sertraline
Rationale: SSRIs like sertraline are first-line for GAD due to efficacy and safety,
supported by APA guidelines. Alprazolam risks dependence, haloperidol is for
psychosis, and lithium is for bipolar disorder.
1
,Question 4: A 50-year-old patient with bipolar I disorder presents with acute mania. Which
medication is most appropriate?
A. Fluoxetine
B. Olanzapine
C. Buspirone
D. Clonazepam
Correct Answer: B. Olanzapine
Rationale: Olanzapine, an atypical antipsychotic, is effective for acute mania in
bipolar I disorder, per evidence-based guidelines. Fluoxetine may trigger mania,
buspirone is for anxiety, and clonazepam is adjunctive for anxiety, not mania.
Question 5: What is a hallmark symptom of post-traumatic stress disorder (PTSD) in a 32-
year-old veteran?
A. Euphoria
B. Intrusive memories
C. Compulsive handwashing
D. Grandiose delusions
Correct Answer: B. Intrusive memories
Rationale: Intrusive memories, such as flashbacks or nightmares, are a core DSM-5
criterion for PTSD, reflecting trauma re-experiencing. Euphoria, handwashing, and
delusions are unrelated to PTSD.
Question 6: A 45-year-old patient reports insomnia and weight loss for 3 months. Which diag-
nosis should be considered first?
A. Schizophrenia
B. Major depressive disorder (MDD)
C. Generalized anxiety disorder (GAD)
D. Obsessive-compulsive disorder (OCD)
Correct Answer: B. Major depressive disorder (MDD)
Rationale: Insomnia and weight loss are hallmark MDD symptoms per DSM-5,
especially with a 3-month duration. Schizophrenia involves psychosis, GAD focuses
on worry, and OCD involves obsessions/compulsions.
Question 7: Which laboratory test is required before initiating lithium for a 38-year-old patient
with bipolar disorder?
A. Complete blood count (CBC)
B. Thyroid function tests
C. Fasting blood glucose
D. Lipid panel
2
, Correct Answer: B. Thyroid function tests
Rationale: Lithium can cause hypothyroidism, necessitating baseline thyroid func-
tion tests, per evidence-based guidelines. CBC, glucose, and lipids are relevant for
other psychotropics but not primary for lithium.
Question 8: A 29-year-old patient with schizophrenia reports muscle stiffness after starting
risperidone. What is the likely cause?
A. Serotonin syndrome
B. Extrapyramidal symptoms (EPS)
C. Neuroleptic malignant syndrome (NMS)
D. Tardive dyskinesia (TD)
Correct Answer: B. Extrapyramidal symptoms (EPS)
Rationale: Muscle stiffness is a common EPS side effect of antipsychotics like
risperidone, due to dopamine blockade. Serotonin syndrome involves autonomic
instability, NMS includes fever, and TD involves involuntary movements.
Question 9: Which intervention is most effective for a 34-year-old patient with panic disorder?
A. Exposure therapy
B. Antipsychotic medication
C. Electroconvulsive therapy (ECT)
D. Mood stabilizers
Correct Answer: A. Exposure therapy
Rationale: Exposure therapy, a component of CBT, is first-line for panic disorder,
reducing avoidance behaviors, per APA guidelines. Antipsychotics, ECT, and mood
stabilizers are not indicated.
Question 10: A 55-year-old patient presents with flat affect and social withdrawal. Which diag-
nosis is most likely?
A. Bipolar disorder
B. Schizophrenia
C. Social anxiety disorder
D. Borderline personality disorder
Correct Answer: B. Schizophrenia
Rationale: Flat affect and social withdrawal are negative symptoms of schizophre-
nia, per DSM-5. Bipolar disorder involves mood episodes, social anxiety involves
fear of scrutiny, and borderline personality involves emotional instability.
Question 11: What is the first step in assessing a 42-year-old patient reporting suicidal ideation?
A. Prescribe an SSRI
B. Conduct a risk assessment
C. Refer to a therapist
3
