NRNP 6635 COMPREHENSIVE FINAL
EXAM STUDY GUIDE 2026 QUESTIONS
AND ANSWERS
1. A 28-year-old patient presents with a 2-week history of persistently elevated mood,
decreased need for sleep (3 hours a night), and pressured speech. He has spent $5,000 on a
new business venture and is currently experiencing auditory hallucinations. What is the most
likely diagnosis?
A. Bipolar I Disorder
B. Bipolar II Disorder
C. Cyclothymic Disorder
D. Schizoaffective Disorder
Answer: A
Conceptual Explanation: Bipolar I Disorder is characterized by at least one manic episode.
The presence of psychosis (hallucinations) and significant functional impairment (spending
sprees) during a mood episode confirms Mania, which is the hallmark of Bipolar I.
,2. Which neurotransmitter is primarily implicated in the ‘reward pathway’ of the brain,
contributing to substance use disorders?
A. Serotonin
B. Dopamine
C. Norepinephrine
D. GABA
Answer: B
Conceptual Explanation: Dopamine release in the nucleus accumbens is the primary
mechanism associated with the reinforcing properties of drugs and the brain’s reward
system.
3. A patient taking Clozapine must have regular blood draws to monitor for which life-
threatening side effect?
A. Thrombocytopenia
B. Hepatotoxicity
C. Nephrotoxicity
D. Agranulocytosis
Answer: D
, Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis, a
severe drop in the Absolute Neutrophil Count (ANC), requiring strict monitoring via the
REMS program.
4. To diagnose Major Depressive Disorder, symptoms must be present for at least how long?
A. 1 week
B. 6 months
C. 1 month
D. 2 weeks
Answer: D
Conceptual Explanation: According to the DSM-5, a patient must experience five or more
symptoms of depression for at least a 2-week period, representing a change from previous
functioning.
5. Which personality disorder is characterized by a pervasive pattern of instability in
interpersonal relationships, self-image, and affects, along with marked impulsivity?
A. Antisocial Personality Disorder
B. Narcissistic Personality Disorder
C. Borderline Personality Disorder
D. Histrionic Personality Disorder
Answer: C
EXAM STUDY GUIDE 2026 QUESTIONS
AND ANSWERS
1. A 28-year-old patient presents with a 2-week history of persistently elevated mood,
decreased need for sleep (3 hours a night), and pressured speech. He has spent $5,000 on a
new business venture and is currently experiencing auditory hallucinations. What is the most
likely diagnosis?
A. Bipolar I Disorder
B. Bipolar II Disorder
C. Cyclothymic Disorder
D. Schizoaffective Disorder
Answer: A
Conceptual Explanation: Bipolar I Disorder is characterized by at least one manic episode.
The presence of psychosis (hallucinations) and significant functional impairment (spending
sprees) during a mood episode confirms Mania, which is the hallmark of Bipolar I.
,2. Which neurotransmitter is primarily implicated in the ‘reward pathway’ of the brain,
contributing to substance use disorders?
A. Serotonin
B. Dopamine
C. Norepinephrine
D. GABA
Answer: B
Conceptual Explanation: Dopamine release in the nucleus accumbens is the primary
mechanism associated with the reinforcing properties of drugs and the brain’s reward
system.
3. A patient taking Clozapine must have regular blood draws to monitor for which life-
threatening side effect?
A. Thrombocytopenia
B. Hepatotoxicity
C. Nephrotoxicity
D. Agranulocytosis
Answer: D
, Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis, a
severe drop in the Absolute Neutrophil Count (ANC), requiring strict monitoring via the
REMS program.
4. To diagnose Major Depressive Disorder, symptoms must be present for at least how long?
A. 1 week
B. 6 months
C. 1 month
D. 2 weeks
Answer: D
Conceptual Explanation: According to the DSM-5, a patient must experience five or more
symptoms of depression for at least a 2-week period, representing a change from previous
functioning.
5. Which personality disorder is characterized by a pervasive pattern of instability in
interpersonal relationships, self-image, and affects, along with marked impulsivity?
A. Antisocial Personality Disorder
B. Narcissistic Personality Disorder
C. Borderline Personality Disorder
D. Histrionic Personality Disorder
Answer: C
