1
Diagnosis & Management in Psychiatric-
Mental Health Across the Lifespan I
Practicum (NR605) – Chamberlain
University – Final Exam (Weeks 5–8) with
Verified Questions and Answers (2024/2025)
Psychiatric Disorders and DSM-5 Diagnosis
1. A 28-year-old patient reports persistent sadness, loss of interest, and fatigue for 3 months,
with no history of mania. Which DSM-5 diagnosis is most likely?
A. Bipolar I disorder
B. Major depressive disorder
C. Cyclothymic disorder
D. Persistent depressive disorder
Rationale : Per DSM-5, major depressive disorder (MDD) requires at least 5
depressive symptoms (e.g., sadness, anhedonia, fatigue) for ≥2 weeks, with significant
impairment. The absence of mania rules out bipolar I, and the duration is too short for
persistent depressive disorder (≥2 years). Cyclothymic disorder involves milder, chronic
mood fluctuations.
2. A patient exhibits excessive worry about multiple events for 6 months, with restlessness
and difficulty concentrating. What is the most likely diagnosis?
A. Panic disorder
B. Generalized anxiety disorder
C. Social anxiety disorder
D. Obsessive-compulsive disorder
Rationale : Generalized anxiety disorder (GAD) per DSM-5 is characterized by
excessive, uncontrollable worry for ≥6 months, with symptoms like restlessness and
impaired concentration. Panic disorder involves recurrent panic attacks, social anxiety
disorder focuses on social situations, and OCD involves obsessions and compulsions.
3. Clinical Scenario: A 15-year-old reports recurrent, intrusive thoughts about
contamination and compulsive hand-washing. What is the DSM-5 diagnosis?
A. Post-traumatic stress disorder
B. Obsessive-compulsive disorder
C. Generalized anxiety disorder
D. Specific phobia
, 2
Rationale : OCD per DSM-5 involves intrusive thoughts (obsessions) and
repetitive behaviors (compulsions) to reduce distress, as seen with contamination fears
and hand-washing. PTSD involves trauma-related symptoms, GAD involves generalized
worry, and specific phobia involves fear of specific objects/situations.
4. Which symptom is required for a DSM-5 diagnosis of schizophrenia?
A. Mania
B. Delusions
C. Anxiety
D. Amnesia
Rationale : DSM-5 requires at least two symptoms for schizophrenia, one of which
must be delusions, hallucinations, or disorganized speech, persisting for ≥1 month with
significant dysfunction. Mania is specific to bipolar disorder, anxiety is non-specific, and
amnesia is unrelated.
5. (SATA) Which symptoms are diagnostic for post-traumatic stress disorder (PTSD) per
DSM-5? (Select all that apply)
A. Intrusive memories
B. Avoidance of trauma-related stimuli
C. Euphoria
D. Hypervigilance
E. Compulsions
Rationale : DSM-5 criteria for PTSD include intrusive memories, avoidance,
negative mood changes, and arousal symptoms (e.g., hypervigilance) following a
traumatic event. Euphoria is not a PTSD symptom, and compulsions are specific to OCD.
Therapeutic Interventions
6. A patient with MDD is resistant to pharmacotherapy. What is the first-line
psychotherapy?
A. Dialectical behavior therapy
B. Cognitive behavioral therapy
C. Eye movement desensitization and reprocessing
D. Psychodynamic therapy
Rationale : Cognitive behavioral therapy (CBT) is the first-line psychotherapy for
MDD, focusing on modifying negative thought patterns and behaviors. DBT is for
borderline personality disorder, EMDR for trauma, and psychodynamic therapy explores
unconscious conflicts but is less evidence-based for MDD.
, 3
7. A nurse is using motivational interviewing with a patient with substance use disorder.
What is a key technique?
A. Confronting denial
B. Reflective listening
C. Giving direct advice
D. Assigning homework
Rationale : Motivational interviewing uses reflective listening to explore
ambivalence and promote change, avoiding confrontation. Direct advice and homework
are not core techniques.
8. Clinical Scenario: A patient with borderline personality disorder has intense emotional
outbursts. Which therapy is most effective?
A. Supportive therapy
B. Dialectical behavior therapy
C. Interpersonal therapy
D. Family therapy
Rationale : Dialectical behavior therapy (DBT) is the gold standard for borderline
personality disorder, addressing emotional dysregulation through skills like mindfulness
and distress tolerance. Other therapies are less specific for BPD.
9. What is the primary goal of group therapy for patients with social anxiety disorder?
A. Develop medication adherence
B. Improve social skills
C. Resolve unconscious conflicts
D. Enhance physical health
Rationale : Group therapy for social anxiety disorder provides a safe environment
to practice social interactions, improving skills and reducing fear. It is not primarily for
medication, unconscious conflicts, or physical health.
10. A nurse uses therapeutic communication with a suicidal patient. Which response is most
appropriate?
A. “You have so much to live for.”
B. “Can you tell me more about how you’re feeling?”
C. “You shouldn’t feel this way.”
D. “Let’s talk about something else.”
Rationale : Open-ended questions like “Can you tell me more?” encourage the
patient to express feelings, facilitating assessment and rapport. Dismissive or directive
responses (A, C, D) are non-therapeutic and may shut down communication.
Diagnosis & Management in Psychiatric-
Mental Health Across the Lifespan I
Practicum (NR605) – Chamberlain
University – Final Exam (Weeks 5–8) with
Verified Questions and Answers (2024/2025)
Psychiatric Disorders and DSM-5 Diagnosis
1. A 28-year-old patient reports persistent sadness, loss of interest, and fatigue for 3 months,
with no history of mania. Which DSM-5 diagnosis is most likely?
A. Bipolar I disorder
B. Major depressive disorder
C. Cyclothymic disorder
D. Persistent depressive disorder
Rationale : Per DSM-5, major depressive disorder (MDD) requires at least 5
depressive symptoms (e.g., sadness, anhedonia, fatigue) for ≥2 weeks, with significant
impairment. The absence of mania rules out bipolar I, and the duration is too short for
persistent depressive disorder (≥2 years). Cyclothymic disorder involves milder, chronic
mood fluctuations.
2. A patient exhibits excessive worry about multiple events for 6 months, with restlessness
and difficulty concentrating. What is the most likely diagnosis?
A. Panic disorder
B. Generalized anxiety disorder
C. Social anxiety disorder
D. Obsessive-compulsive disorder
Rationale : Generalized anxiety disorder (GAD) per DSM-5 is characterized by
excessive, uncontrollable worry for ≥6 months, with symptoms like restlessness and
impaired concentration. Panic disorder involves recurrent panic attacks, social anxiety
disorder focuses on social situations, and OCD involves obsessions and compulsions.
3. Clinical Scenario: A 15-year-old reports recurrent, intrusive thoughts about
contamination and compulsive hand-washing. What is the DSM-5 diagnosis?
A. Post-traumatic stress disorder
B. Obsessive-compulsive disorder
C. Generalized anxiety disorder
D. Specific phobia
, 2
Rationale : OCD per DSM-5 involves intrusive thoughts (obsessions) and
repetitive behaviors (compulsions) to reduce distress, as seen with contamination fears
and hand-washing. PTSD involves trauma-related symptoms, GAD involves generalized
worry, and specific phobia involves fear of specific objects/situations.
4. Which symptom is required for a DSM-5 diagnosis of schizophrenia?
A. Mania
B. Delusions
C. Anxiety
D. Amnesia
Rationale : DSM-5 requires at least two symptoms for schizophrenia, one of which
must be delusions, hallucinations, or disorganized speech, persisting for ≥1 month with
significant dysfunction. Mania is specific to bipolar disorder, anxiety is non-specific, and
amnesia is unrelated.
5. (SATA) Which symptoms are diagnostic for post-traumatic stress disorder (PTSD) per
DSM-5? (Select all that apply)
A. Intrusive memories
B. Avoidance of trauma-related stimuli
C. Euphoria
D. Hypervigilance
E. Compulsions
Rationale : DSM-5 criteria for PTSD include intrusive memories, avoidance,
negative mood changes, and arousal symptoms (e.g., hypervigilance) following a
traumatic event. Euphoria is not a PTSD symptom, and compulsions are specific to OCD.
Therapeutic Interventions
6. A patient with MDD is resistant to pharmacotherapy. What is the first-line
psychotherapy?
A. Dialectical behavior therapy
B. Cognitive behavioral therapy
C. Eye movement desensitization and reprocessing
D. Psychodynamic therapy
Rationale : Cognitive behavioral therapy (CBT) is the first-line psychotherapy for
MDD, focusing on modifying negative thought patterns and behaviors. DBT is for
borderline personality disorder, EMDR for trauma, and psychodynamic therapy explores
unconscious conflicts but is less evidence-based for MDD.
, 3
7. A nurse is using motivational interviewing with a patient with substance use disorder.
What is a key technique?
A. Confronting denial
B. Reflective listening
C. Giving direct advice
D. Assigning homework
Rationale : Motivational interviewing uses reflective listening to explore
ambivalence and promote change, avoiding confrontation. Direct advice and homework
are not core techniques.
8. Clinical Scenario: A patient with borderline personality disorder has intense emotional
outbursts. Which therapy is most effective?
A. Supportive therapy
B. Dialectical behavior therapy
C. Interpersonal therapy
D. Family therapy
Rationale : Dialectical behavior therapy (DBT) is the gold standard for borderline
personality disorder, addressing emotional dysregulation through skills like mindfulness
and distress tolerance. Other therapies are less specific for BPD.
9. What is the primary goal of group therapy for patients with social anxiety disorder?
A. Develop medication adherence
B. Improve social skills
C. Resolve unconscious conflicts
D. Enhance physical health
Rationale : Group therapy for social anxiety disorder provides a safe environment
to practice social interactions, improving skills and reducing fear. It is not primarily for
medication, unconscious conflicts, or physical health.
10. A nurse uses therapeutic communication with a suicidal patient. Which response is most
appropriate?
A. “You have so much to live for.”
B. “Can you tell me more about how you’re feeling?”
C. “You shouldn’t feel this way.”
D. “Let’s talk about something else.”
Rationale : Open-ended questions like “Can you tell me more?” encourage the
patient to express feelings, facilitating assessment and rapport. Dismissive or directive
responses (A, C, D) are non-therapeutic and may shut down communication.
