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NRNP 6635 WEEK 11 FINAL EXAM 2026/2027 |
Psychopathology & Diagnostic Reasoning | Verified
Correct Answers & Rationales | 100% Guarantee Pass | A+
Graded
Section 1: Personality Disorders (Questions 1-15)
Question 1
A 45-year-old man presents for evaluation after his third divorce. He reports that all
his ex-wives were "out to get him" and were secretly plotting to take his money. He
reads hidden demeaning meanings into benign remarks, persistently bears grudges,
and is reluctant to confide in others because he fears the information will be used
against him. He has no history of psychosis. Which diagnosis best fits this
presentation?
A. Schizotypal personality disorder; ideas of reference and social anxiety are present
B. Paranoid personality disorder; pervasive distrust and suspiciousness without
psychotic features
C. Delusional disorder, persecutory type; fixed delusions about spousal conspiracy
D. Borderline personality disorder; unstable relationships and fear of abandonment
Rationale: Paranoid personality disorder is characterized by a pervasive pattern of
distrust and suspiciousness, interpreting others' motives as malevolent, reading
hidden meanings into benign remarks, and bearing grudges, without the frank
psychosis of delusional disorder or the cognitive/perceptual distortions of
schizotypal PD. Delusional disorder requires fixed delusions; BPD involves emotional
dysregulation and abandonment fears rather than pervasive suspiciousness.
Correct Answer: B
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Question 2
A 32-year-old software engineer lives alone, has no close friends, and expresses no
desire for intimate relationships. He describes himself as a "loner" and chooses
solitary hobbies such as computer programming and hiking alone. He appears
emotionally cold and detached during the interview, showing minimal facial
expression. He denies any psychotic symptoms or social anxiety. Which diagnosis is
most appropriate?
A. Schizoid personality disorder; voluntary detachment from social relationships with
restricted affect
B. Avoidant personality disorder; social inhibition due to fear of negative evaluation
C. Schizotypal personality disorder; eccentric behavior and cognitive distortions
D. Autism spectrum disorder; restricted interests and social communication deficits
since childhood
Rationale: Schizoid personality disorder is defined by a pervasive pattern of
detachment from social relationships and a restricted range of emotional expression,
with voluntary social isolation and solitary activities, unlike avoidant PD where there
is desire for relationships inhibited by fear of rejection. Schizotypal PD includes odd
beliefs and perceptual distortions; autism requires developmental onset and
repetitive behaviors.
Correct Answer: A
Question 3
A 28-year-old woman presents with longstanding social anxiety, odd speech
patterns, and magical thinking. She believes she can "sense" when people are talking
about her (ideas of reference), dresses in eccentric clothing, and has difficulty
forming close relationships due to "not fitting in." She reports occasional perceptual
illusions but no frank hallucinations. Which cluster does this personality disorder
belong to, and what is the diagnosis?
A. Cluster B; borderline personality disorder with psychotic features
B. Cluster A; schizotypal personality disorder with cognitive and perceptual
distortions
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C. Cluster C; avoidant personality disorder with magical thinking as a defense
D. Cluster A; paranoid personality disorder with social anxiety
Rationale: Schizotypal personality disorder belongs to Cluster A (odd/eccentric) and
is characterized by acute discomfort in close relationships, cognitive or perceptual
distortions (ideas of reference, magical thinking), eccentric behavior, and odd speech,
distinguishing it from paranoid PD (suspiciousness without oddness) and avoidant
PD (Cluster C, fear of rejection without odd beliefs).
Correct Answer: B
Question 4
A 24-year-old man is evaluated after his third arrest for assault. History reveals he
began stealing and fighting at age 10, was expelled from multiple schools, and
showed no remorse after beating a peer. He is deceitful, impulsive, and has
repeatedly violated the rights of others. He lacks empathy and rationalizes his
behavior. Which criterion is essential for diagnosing antisocial personality disorder?
A. A history of conduct disorder with onset before age 15 years
B. Presence of grandiosity and need for admiration
C. Excessive emotionality and attention-seeking behavior
D. Social inhibition and feelings of inadequacy
Rationale: Antisocial personality disorder requires evidence of conduct disorder with
onset before age 15 years, plus a pervasive pattern of disregard for and violation of
the rights of others since age 15, including failure to conform to social norms,
deceitfulness, impulsivity, irritability/aggressiveness, reckless disregard for safety,
consistent irresponsibility, and lack of remorse. Grandiosity suggests narcissistic PD;
excessive emotionality suggests histrionic PD; social inhibition suggests avoidant PD.
Correct Answer: A
Question 5
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A 26-year-old woman is referred after her fifth emergency department visit for self-
inflicted lacerations. She describes intense, unstable relationships alternating
between idealization and devaluation, chronic feelings of emptiness, frantic efforts to
avoid real or imagined abandonment, recurrent suicidal gestures, and marked
reactivity of mood lasting hours. She reports transient dissociative episodes under
stress. How many DSM-5-TR criteria are met, and what is the diagnosis?
A. 5 of 9 criteria; meets threshold for borderline personality disorder
B. 4 of 9 criteria; subthreshold borderline traits
C. 6 of 9 criteria; meets threshold for histrionic personality disorder
D. 7 of 9 criteria; meets threshold for bipolar II disorder
Rationale: This patient meets at least 6 criteria for borderline personality disorder:
frantic efforts to avoid abandonment, unstable interpersonal relationships, identity
disturbance (implied by chronic emptiness), impulsivity (self-harm), suicidal behavior,
affective instability, and dissociation under stress. Five of nine criteria are required for
diagnosis. Histrionic PD lacks self-harm and abandonment fears; bipolar II requires
hypomanic episodes of ≥4 days.
Correct Answer: A
Question 6
A 35-year-old actress presents with a pattern of excessive emotionality and
attention-seeking. She is uncomfortable when not the center of attention, uses
physical appearance to draw attention, has rapidly shifting and shallow emotions,
and is suggestible. She has been sexually provocative in inappropriate situations.
Which personality disorder is most consistent with this presentation?
A. Narcissistic personality disorder; grandiosity and need for admiration
B. Borderline personality disorder; unstable relationships and self-harm
C. Histrionic personality disorder; excessive emotionality and attention-seeking
D. Dependent personality disorder; excessive need to be taken care of
Rationale: Histrionic personality disorder is characterized by a pervasive pattern of
excessive emotionality and attention-seeking, including discomfort when not the
center of attention, inappropriate sexual provocativeness, rapidly shifting emotions,
NRNP 6635 WEEK 11 FINAL EXAM 2026/2027 |
Psychopathology & Diagnostic Reasoning | Verified
Correct Answers & Rationales | 100% Guarantee Pass | A+
Graded
Section 1: Personality Disorders (Questions 1-15)
Question 1
A 45-year-old man presents for evaluation after his third divorce. He reports that all
his ex-wives were "out to get him" and were secretly plotting to take his money. He
reads hidden demeaning meanings into benign remarks, persistently bears grudges,
and is reluctant to confide in others because he fears the information will be used
against him. He has no history of psychosis. Which diagnosis best fits this
presentation?
A. Schizotypal personality disorder; ideas of reference and social anxiety are present
B. Paranoid personality disorder; pervasive distrust and suspiciousness without
psychotic features
C. Delusional disorder, persecutory type; fixed delusions about spousal conspiracy
D. Borderline personality disorder; unstable relationships and fear of abandonment
Rationale: Paranoid personality disorder is characterized by a pervasive pattern of
distrust and suspiciousness, interpreting others' motives as malevolent, reading
hidden meanings into benign remarks, and bearing grudges, without the frank
psychosis of delusional disorder or the cognitive/perceptual distortions of
schizotypal PD. Delusional disorder requires fixed delusions; BPD involves emotional
dysregulation and abandonment fears rather than pervasive suspiciousness.
Correct Answer: B
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Question 2
A 32-year-old software engineer lives alone, has no close friends, and expresses no
desire for intimate relationships. He describes himself as a "loner" and chooses
solitary hobbies such as computer programming and hiking alone. He appears
emotionally cold and detached during the interview, showing minimal facial
expression. He denies any psychotic symptoms or social anxiety. Which diagnosis is
most appropriate?
A. Schizoid personality disorder; voluntary detachment from social relationships with
restricted affect
B. Avoidant personality disorder; social inhibition due to fear of negative evaluation
C. Schizotypal personality disorder; eccentric behavior and cognitive distortions
D. Autism spectrum disorder; restricted interests and social communication deficits
since childhood
Rationale: Schizoid personality disorder is defined by a pervasive pattern of
detachment from social relationships and a restricted range of emotional expression,
with voluntary social isolation and solitary activities, unlike avoidant PD where there
is desire for relationships inhibited by fear of rejection. Schizotypal PD includes odd
beliefs and perceptual distortions; autism requires developmental onset and
repetitive behaviors.
Correct Answer: A
Question 3
A 28-year-old woman presents with longstanding social anxiety, odd speech
patterns, and magical thinking. She believes she can "sense" when people are talking
about her (ideas of reference), dresses in eccentric clothing, and has difficulty
forming close relationships due to "not fitting in." She reports occasional perceptual
illusions but no frank hallucinations. Which cluster does this personality disorder
belong to, and what is the diagnosis?
A. Cluster B; borderline personality disorder with psychotic features
B. Cluster A; schizotypal personality disorder with cognitive and perceptual
distortions
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C. Cluster C; avoidant personality disorder with magical thinking as a defense
D. Cluster A; paranoid personality disorder with social anxiety
Rationale: Schizotypal personality disorder belongs to Cluster A (odd/eccentric) and
is characterized by acute discomfort in close relationships, cognitive or perceptual
distortions (ideas of reference, magical thinking), eccentric behavior, and odd speech,
distinguishing it from paranoid PD (suspiciousness without oddness) and avoidant
PD (Cluster C, fear of rejection without odd beliefs).
Correct Answer: B
Question 4
A 24-year-old man is evaluated after his third arrest for assault. History reveals he
began stealing and fighting at age 10, was expelled from multiple schools, and
showed no remorse after beating a peer. He is deceitful, impulsive, and has
repeatedly violated the rights of others. He lacks empathy and rationalizes his
behavior. Which criterion is essential for diagnosing antisocial personality disorder?
A. A history of conduct disorder with onset before age 15 years
B. Presence of grandiosity and need for admiration
C. Excessive emotionality and attention-seeking behavior
D. Social inhibition and feelings of inadequacy
Rationale: Antisocial personality disorder requires evidence of conduct disorder with
onset before age 15 years, plus a pervasive pattern of disregard for and violation of
the rights of others since age 15, including failure to conform to social norms,
deceitfulness, impulsivity, irritability/aggressiveness, reckless disregard for safety,
consistent irresponsibility, and lack of remorse. Grandiosity suggests narcissistic PD;
excessive emotionality suggests histrionic PD; social inhibition suggests avoidant PD.
Correct Answer: A
Question 5
, 4
A 26-year-old woman is referred after her fifth emergency department visit for self-
inflicted lacerations. She describes intense, unstable relationships alternating
between idealization and devaluation, chronic feelings of emptiness, frantic efforts to
avoid real or imagined abandonment, recurrent suicidal gestures, and marked
reactivity of mood lasting hours. She reports transient dissociative episodes under
stress. How many DSM-5-TR criteria are met, and what is the diagnosis?
A. 5 of 9 criteria; meets threshold for borderline personality disorder
B. 4 of 9 criteria; subthreshold borderline traits
C. 6 of 9 criteria; meets threshold for histrionic personality disorder
D. 7 of 9 criteria; meets threshold for bipolar II disorder
Rationale: This patient meets at least 6 criteria for borderline personality disorder:
frantic efforts to avoid abandonment, unstable interpersonal relationships, identity
disturbance (implied by chronic emptiness), impulsivity (self-harm), suicidal behavior,
affective instability, and dissociation under stress. Five of nine criteria are required for
diagnosis. Histrionic PD lacks self-harm and abandonment fears; bipolar II requires
hypomanic episodes of ≥4 days.
Correct Answer: A
Question 6
A 35-year-old actress presents with a pattern of excessive emotionality and
attention-seeking. She is uncomfortable when not the center of attention, uses
physical appearance to draw attention, has rapidly shifting and shallow emotions,
and is suggestible. She has been sexually provocative in inappropriate situations.
Which personality disorder is most consistent with this presentation?
A. Narcissistic personality disorder; grandiosity and need for admiration
B. Borderline personality disorder; unstable relationships and self-harm
C. Histrionic personality disorder; excessive emotionality and attention-seeking
D. Dependent personality disorder; excessive need to be taken care of
Rationale: Histrionic personality disorder is characterized by a pervasive pattern of
excessive emotionality and attention-seeking, including discomfort when not the
center of attention, inappropriate sexual provocativeness, rapidly shifting emotions,
