NR607 Pre-diagnostic exam
NR607 Pre-diagnostic exam Practice Exam
2026 Edition 100 Advanced Questions with
Answers and Detailed Rationales
PART 1 (Questions 1–25)
Question 1
A 28-year-old woman presents with a two-month history of persistent sadness, insomnia, loss of
appetite, guilt, and decreased concentration. She denies mania or substance use.
Which diagnosis is most appropriate?
A. Persistent Depressive Disorder
B. Major Depressive Disorder
C. Bipolar II Disorder
D. Adjustment Disorder
Answer: B
Rationale
Major depressive disorder requires five or more symptoms lasting at least two weeks,
including either depressed mood or anhedonia.
The patient demonstrates:
Depressed mood
Insomnia
Poor appetite
Guilt
Poor concentration
These satisfy DSM-5-TR criteria.
Why others are incorrect:
Persistent depressive disorder requires symptoms for 2 years
, NR607 Pre-diagnostic exam
Bipolar II requires hypomania
Adjustment disorder requires an identifiable stressor.
Question 2
A patient taking lithium develops tremors, confusion, vomiting, and ataxia.
What is the priority intervention?
A. Increase lithium dose
B. Hold lithium immediately
C. Give benztropine
D. Continue medication
Answer: B
Rationale
These findings indicate lithium toxicity.
Priority:
Stop lithium
Obtain lithium level
Evaluate renal function
Hydration
Severe toxicity may require dialysis.
Question 3
Which neurotransmitter deficiency is most associated with depression?
A. Dopamine
B. Serotonin
C. Acetylcholine
, NR607 Pre-diagnostic exam
D. Histamine
Answer: B
Rationale
Although depression is multifactorial, decreased serotonergic activity remains a major
neurochemical finding.
Question 4
A patient has auditory hallucinations for 8 months, flat affect, and social withdrawal.
Most likely diagnosis?
A. Brief Psychotic Disorder
B. Schizophreniform Disorder
C. Schizophrenia
D. Delusional Disorder
Answer: C
Rationale
Symptoms lasting greater than six months meet criteria for schizophrenia.
Question 5
Which medication requires monitoring for agranulocytosis?
A. Fluoxetine
B. Clozapine
C. Quetiapine
D. Lamotrigine
, NR607 Pre-diagnostic exam
Answer: B
Rationale
Clozapine carries a risk of severe neutropenia. Routine ANC monitoring is mandatory.
Question 6
A patient reports panic attacks occurring unexpectedly with persistent fear of future attacks.
Diagnosis?
A. Generalized Anxiety Disorder
B. Panic Disorder
C. Social Anxiety Disorder
D. Illness Anxiety Disorder
Answer: B
Rationale
Unexpected recurrent panic attacks plus persistent concern define panic disorder.
Question 7 (SATA)
Which are negative symptoms of schizophrenia?
Select all that apply.
A. Flat affect
B. Hallucinations
C. Avolition
D. Alogia
E. Delusions
NR607 Pre-diagnostic exam Practice Exam
2026 Edition 100 Advanced Questions with
Answers and Detailed Rationales
PART 1 (Questions 1–25)
Question 1
A 28-year-old woman presents with a two-month history of persistent sadness, insomnia, loss of
appetite, guilt, and decreased concentration. She denies mania or substance use.
Which diagnosis is most appropriate?
A. Persistent Depressive Disorder
B. Major Depressive Disorder
C. Bipolar II Disorder
D. Adjustment Disorder
Answer: B
Rationale
Major depressive disorder requires five or more symptoms lasting at least two weeks,
including either depressed mood or anhedonia.
The patient demonstrates:
Depressed mood
Insomnia
Poor appetite
Guilt
Poor concentration
These satisfy DSM-5-TR criteria.
Why others are incorrect:
Persistent depressive disorder requires symptoms for 2 years
, NR607 Pre-diagnostic exam
Bipolar II requires hypomania
Adjustment disorder requires an identifiable stressor.
Question 2
A patient taking lithium develops tremors, confusion, vomiting, and ataxia.
What is the priority intervention?
A. Increase lithium dose
B. Hold lithium immediately
C. Give benztropine
D. Continue medication
Answer: B
Rationale
These findings indicate lithium toxicity.
Priority:
Stop lithium
Obtain lithium level
Evaluate renal function
Hydration
Severe toxicity may require dialysis.
Question 3
Which neurotransmitter deficiency is most associated with depression?
A. Dopamine
B. Serotonin
C. Acetylcholine
, NR607 Pre-diagnostic exam
D. Histamine
Answer: B
Rationale
Although depression is multifactorial, decreased serotonergic activity remains a major
neurochemical finding.
Question 4
A patient has auditory hallucinations for 8 months, flat affect, and social withdrawal.
Most likely diagnosis?
A. Brief Psychotic Disorder
B. Schizophreniform Disorder
C. Schizophrenia
D. Delusional Disorder
Answer: C
Rationale
Symptoms lasting greater than six months meet criteria for schizophrenia.
Question 5
Which medication requires monitoring for agranulocytosis?
A. Fluoxetine
B. Clozapine
C. Quetiapine
D. Lamotrigine
, NR607 Pre-diagnostic exam
Answer: B
Rationale
Clozapine carries a risk of severe neutropenia. Routine ANC monitoring is mandatory.
Question 6
A patient reports panic attacks occurring unexpectedly with persistent fear of future attacks.
Diagnosis?
A. Generalized Anxiety Disorder
B. Panic Disorder
C. Social Anxiety Disorder
D. Illness Anxiety Disorder
Answer: B
Rationale
Unexpected recurrent panic attacks plus persistent concern define panic disorder.
Question 7 (SATA)
Which are negative symptoms of schizophrenia?
Select all that apply.
A. Flat affect
B. Hallucinations
C. Avolition
D. Alogia
E. Delusions
