disorder?
a. Avoidance of social interactions
b. Fear of abandonment
c. Ongoing need for admiration✔️
d. Dramatic emotional expression
People with narcissistic personality disorder have an inflated sense of self-importance
and seek excessive admiration.
Tip: “Narcissists need applause.”
2. A 25-year-old client presents with mood swings: feeling "down" last
month and now having insomnia, high energy, and irritability. What’s the
most consistent diagnosis?
a. Major depressive disorder
b. Bipolar I disorder
c. Cyclothymia✔️
d. Borderline personality disorder
Cyclothymia involves periods of hypomanic and depressive symptoms without
meeting full criteria for either.
Tip: Think “cycling moods,” like a low-intensity rollercoaster.
3. Initial medication choice for a 75-year-old newly diagnosed with major
depressive disorder?
a. Amitriptyline 25 mg
b. Escitalopram 10 mg daily✔️
c. Fluoxetine 40 mg
d. Bupropion XL 300 mg
Escitalopram is safer for the elderly with fewer anticholinergic effects.
Tip: "E for elderly = Escitalopram."
,4. CIWA-AR score of 12: What’s the most appropriate NP action?
a. No treatment needed
b. Prescribe STAT dose of oral lorazepam and reassess hourly✔️
c. Start haloperidol
d. Provide fluids and observe
Score ≥10 requires benzodiazepine administration to prevent complications like
seizures.
Tip: CIWA >10? Think "Lorazepam = Life saver."
5. A recently divorced client fears living alone, relies on others, and is
already dating again. What’s the likely diagnosis?
a. Histrionic personality disorder
b. Dependent personality disorder✔️
c. Borderline personality disorder
d. Narcissistic personality disorder
Dependent PD is marked by fear of abandonment and an inability to make decisions
without reassurance.
Tip: “Dependent = decision difficulty.”
6. Which are characteristics of borderline personality disorder?
a. Grandiosity and need for admiration
b. Detachment from social relationships
c. Tumultuous interpersonal relationships and short-lived psychotic
episodes✔️
d. Rigid perfectionism
Borderline PD includes unstable relationships, mood instability, and impulsivity.
Tip: BPD = "Borderline Push and Draw" — hot and cold behavior.
7. What does “What did you have for dinner last night?” assess in cognitive
testing?
a. Immediate memory
b. Recent memory✔️
, c. Remote memory
d. Abstract thinking
Asking about yesterday assesses recent memory, a component of short-term recall.
Tip: Yesterday = recent. Long ago = remote.
8. A client used marijuana 3 days ago and is worried about passing a urine
test. Most appropriate NP response?
a. You’ll test negative for sure
b. THC is only detectable in blood
c. Marijuana can be detected in the urine for up to 7 days✔️
d. You’ll need a blood test instead
Occasional users may test positive for up to 7 days, heavy users longer.
Tip: THC = “Takes a Hella while to Clear.”
9. Which symptoms are linked to the DSM specifier “anxious distress” in
MDD?
a. Delusions and hallucinations
b. Feeling restless, excessive worry✔️
c. Flight of ideas
d. Rapid cycling
Anxious distress includes tension, worry, and restlessness added to depressive
symptoms.
Tip: Add anxiety = anxious distress.
10. Best therapy add-ons for mild major depressive disorder?
a. Electroconvulsive therapy
b. Antipsychotic augmentation
c. CBT and exercise three times per week✔️
d. Hospitalization
CBT and regular aerobic exercise have proven benefits in mild MDD.
Tip: "Mind + Move = Mood Boost!"
11. A client with a history of heavy alcohol use presents with ataxia, memory
loss, and nystagmus. What is the most likely diagnosis?