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Exam (elaborations)

NRNP 6635 – Psychopathology and Diagnostic Reasoning (Walden University, 2025/2026) | Final Exam | Grade A Verified Copy

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This document provides the verified Final Exam material for NRNP 6635 (Psychopathology and Diagnostic Reasoning) at Walden University, updated for the 2025/2026 academic year. It includes authentic exam questions with 100% correct answers and clear rationales covering psychopathological concepts, diagnostic reasoning, and DSM-5 criteria across the lifespan. Topics include mood disorders, anxiety disorders, psychotic and personality disorders, and neurodevelopmental conditions. Designed for PMHNP students, this resource aligns with Walden’s NRNP 6635 curriculum and supports strong clinical reasoning and diagnostic proficiency in psychiatric practice.

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Uploaded on
October 16, 2025
Number of pages
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Written in
2025/2026
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NRNP6635 / NRNP 6635 Final Exam
2025/2026 – Grade A Verified Copy
Psychopathology and Diagnostic Reasoning |
Walden University

Section 1: Foundations & Diagnostic Reasoning (30
Questions)
1. What mental function is most affected in mild cognitive impairment?
Recent memory
Rationale: Mild cognitive impairment primarily impairs short-term memory; long-term memory
and executive function are less affected.



2. What is the most frequent genetic cause of intellectual disability in children?
Down syndrome
Rationale: Down syndrome (trisomy 21) is the leading genetic cause, affecting ~1 in 700 births;
cognitive and adaptive deficits are hallmarks.



3. Which neurotransmitter is most associated with ADHD?
Dopamine
Rationale: Dopamine dysregulation in prefrontal circuits contributes to inattention and
hyperactivity; stimulants enhance dopamine levels.



4. What is the drug of choice for psychosis in delirious patients?
Haloperidol
Rationale: Low-dose haloperidol (IM/IV) is effective for delirium-related psychosis due to
minimal anticholinergic effects; treat underlying cause (e.g., infection).



5. What characteristic is more prominent in childhood-onset schizophrenia than adult-
onset?
Social withdrawal

,Rationale: Childhood schizophrenia shows greater premorbid social deficits; adults often have
better baseline functioning.



6. Which personality disorder is characterized by continual crises and unpredictable
behavior?
Borderline
Rationale: Borderline PD involves emotional instability, impulsivity, and chaotic relationships;
often presents with self-harm or suicidality.



7. What factor best correlates with attempted and completed suicide?
Mental illness
Rationale: Over 90% of suicides are linked to psychiatric disorders (e.g., depression, bipolar);
assess with C-SSRS for risk.



8. Which brain region shows the greatest anatomical abnormalities in schizophrenia?
Basal ganglia
Rationale: Basal ganglia abnormalities are linked to motor symptoms and dopamine
dysregulation in schizophrenia.



9. What is the onset time for symptoms of neuroleptic malignant syndrome?
24-72 hours
Rationale: NMS, a reaction to antipsychotics, presents with rigidity, fever, and altered mental
status; treat with dantrolene/bromocriptine.



10. What rating scale is used for medication-induced movement disorders?
AIMS
Rationale: Abnormal Involuntary Movement Scale monitors tardive dyskinesia in patients on
antipsychotics; assess annually.



11. What substance decreases antipsychotic blood concentrations but may improve
cognitive impairments in schizophrenia?
Nicotine
Rationale: Nicotine induces CYP1A2, reducing antipsychotic levels (e.g., clozapine); may
enhance cognition via nicotinic receptors.

, 12. Which drug is most likely to inhibit female orgasm?
SSRIs
Rationale: SSRIs (e.g., fluoxetine) cause sexual dysfunction in 40-70% of patients via serotonin
modulation; bupropion is an alternative.



13. What is the onset time for tolerance to hallucinogens like LSD?
4-7 days
Rationale: LSD tolerance develops rapidly due to 5-HT2A receptor downregulation; resets after
3-4 days abstinence.



14. What is the most reliable method to diagnose schizophrenia?
Clinical interview
Rationale: Longitudinal history (symptoms ≥6 months) is key; no single test is definitive—rule
out medical/substance causes.



15. Which class of drugs is most effective for pain disorder?
Tricyclic antidepressants
Rationale: TCAs (e.g., amitriptyline) modulate pain via norepinephrine/serotonin; avoid opioids
due to dependence risk.



16. Which drug is effective for social anxiety in children?
Fluvoxamine
Rationale: Fluvoxamine (SSRI) is FDA-approved for pediatric social anxiety; start low, titrate
slowly, combine with CBT.



17. Select two imaging methods used to study anxiety disorders.
fMRI, PET
Rationale: fMRI detects amygdala hyperactivity; PET assesses GABA/serotonin activity in
anxiety.



18. What is the most effective treatment for adolescent depression?
CBT + Fluoxetine

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