NR607 PRE-DIAGNOSTIC EXAM QUESTIONS
WITH CORRECT ANSWERS & RATIONALES
||COMPLETE A+ GUIDE
Question 1
A phenomenon in which a markedly increased dose of a substance is required to
achieve the desired effect or a markedly reduced effect is experienced when the usual
(original) dose is consumed is better known as what?
-Withdrawal
-Tolerance
-Addiction
-Dependence
Correct Answer
Tolerance
Tolerance is a phenomenon in which after repeated administration, a given dose of
a substance produces a decreased effect or larger doses are required to achieve the
same effect as the original dose.
Page 1 of 152
,Question 2
A 60-year-old male recently underwent repair of a right fractured hip. He developed a
post-operative delirium. He has been awake for 52 hours and ripped off his surgical
dressing. Treatment for delirium in this scenario may include what?
-Hydroxyzine
-Tramadol
-Hanging a clock and calendar in view of the patient
-Clonazepam
Correct Answer
Hanging a clock and calendar in view of the patient
One would want to avoid benzodiazepines in the elderly and especially
benzodiazepines with long half lives when treating delirium. Tramadol use has been
associated with delirium. H1 Antagonisets contribute to anticholinergice burden,
which is considered a risk factor for delirium.
Question 3
Gloria is a 68-year-old female with a chronic history of severe anxiety disorder
presents with mild shortness of breath, fine crackles in the right lower lobe with
auscultation and a nonproductive cough. She recently "ran out of pills". Which
medication omission most likely lead to her current presenting symptoms?
-Metoprolol
-Lorazepam
-Furosemide
-Metformin
Correct Answer
Furosemide
Furosemide or Lasix is a diuretic utilized in the management of heart failure.
Although anxiety can produce shortness of breath, one would not expect fine
crackles on exam unless additional comorbidity exists.
Page 2 of 152
,Question 4
A 30-year-old man with three past psychiatric hospitalizations for schizoaffective
disorder presents for follow-up care with the PMHNP. Before discharge, the patient
received court ordered Zyprexa Relprevv 300 mg IM X 1. The patient tells the PMHNP
that he is aware that smoking can "make him need more medication." Which stage of
change is the patient in?
-Contemplation
-Maintenance
-Precontemplation
-Action
-Preparation
Correct Answer
Contemplation
Question 5
PTSD is thought to cause which part of the brain to shrink?
-Hippocampus
-Have no effect
-Amygdala
-Pons
Correct Answer
Hippocampus
A smaller hippocampus is associated with PTSD vulnerability. Trauma shrinks the
hippocampus.
Question 6
Which of the following is an indication for monitoring of serum drug levels?
-Smoking cessation
-New diagnosis of hyperlipidemia
-Resolution of symptoms
-New diagnosis of diabetes
Correct Answer
Smoking cessation
Page 3 of 152
, Question 7
A 62-year-old billionaire was recently arrested on charges of pedophilia and child
pornography. He was denied bail at his hearing and is waiting in jail pending his trial.
The next morning the patient was found passed out on the ground and transferred to
the emergency department. He was evaluated, and the work up was negative. Upon
discharge, he tells the emergency department attending he is suicidal and wants to
hang himself. The patient is referred to psychiatry for evaluation of suicidal ideation.
Which of the following conditions must be considered in the differential diagnosis?
-Hypochondriasis
-Agoraphobia
-Delusional disorder
-Malingering
Correct Answer
Malingering
Question 8
Which of the following is a therapeutic technique to facilitate a health behavior
change in a 28-year-old male with substance use disorder who is in denial regarding
the severity of his habit?
-Strategic therapy
-Psychopharmacology with naltrexone 50 mg daily
-Motivational interviewing
-Solution-focused therapy
Correct Answer
Motivational interviewing
Page 4 of 152
WITH CORRECT ANSWERS & RATIONALES
||COMPLETE A+ GUIDE
Question 1
A phenomenon in which a markedly increased dose of a substance is required to
achieve the desired effect or a markedly reduced effect is experienced when the usual
(original) dose is consumed is better known as what?
-Withdrawal
-Tolerance
-Addiction
-Dependence
Correct Answer
Tolerance
Tolerance is a phenomenon in which after repeated administration, a given dose of
a substance produces a decreased effect or larger doses are required to achieve the
same effect as the original dose.
Page 1 of 152
,Question 2
A 60-year-old male recently underwent repair of a right fractured hip. He developed a
post-operative delirium. He has been awake for 52 hours and ripped off his surgical
dressing. Treatment for delirium in this scenario may include what?
-Hydroxyzine
-Tramadol
-Hanging a clock and calendar in view of the patient
-Clonazepam
Correct Answer
Hanging a clock and calendar in view of the patient
One would want to avoid benzodiazepines in the elderly and especially
benzodiazepines with long half lives when treating delirium. Tramadol use has been
associated with delirium. H1 Antagonisets contribute to anticholinergice burden,
which is considered a risk factor for delirium.
Question 3
Gloria is a 68-year-old female with a chronic history of severe anxiety disorder
presents with mild shortness of breath, fine crackles in the right lower lobe with
auscultation and a nonproductive cough. She recently "ran out of pills". Which
medication omission most likely lead to her current presenting symptoms?
-Metoprolol
-Lorazepam
-Furosemide
-Metformin
Correct Answer
Furosemide
Furosemide or Lasix is a diuretic utilized in the management of heart failure.
Although anxiety can produce shortness of breath, one would not expect fine
crackles on exam unless additional comorbidity exists.
Page 2 of 152
,Question 4
A 30-year-old man with three past psychiatric hospitalizations for schizoaffective
disorder presents for follow-up care with the PMHNP. Before discharge, the patient
received court ordered Zyprexa Relprevv 300 mg IM X 1. The patient tells the PMHNP
that he is aware that smoking can "make him need more medication." Which stage of
change is the patient in?
-Contemplation
-Maintenance
-Precontemplation
-Action
-Preparation
Correct Answer
Contemplation
Question 5
PTSD is thought to cause which part of the brain to shrink?
-Hippocampus
-Have no effect
-Amygdala
-Pons
Correct Answer
Hippocampus
A smaller hippocampus is associated with PTSD vulnerability. Trauma shrinks the
hippocampus.
Question 6
Which of the following is an indication for monitoring of serum drug levels?
-Smoking cessation
-New diagnosis of hyperlipidemia
-Resolution of symptoms
-New diagnosis of diabetes
Correct Answer
Smoking cessation
Page 3 of 152
, Question 7
A 62-year-old billionaire was recently arrested on charges of pedophilia and child
pornography. He was denied bail at his hearing and is waiting in jail pending his trial.
The next morning the patient was found passed out on the ground and transferred to
the emergency department. He was evaluated, and the work up was negative. Upon
discharge, he tells the emergency department attending he is suicidal and wants to
hang himself. The patient is referred to psychiatry for evaluation of suicidal ideation.
Which of the following conditions must be considered in the differential diagnosis?
-Hypochondriasis
-Agoraphobia
-Delusional disorder
-Malingering
Correct Answer
Malingering
Question 8
Which of the following is a therapeutic technique to facilitate a health behavior
change in a 28-year-old male with substance use disorder who is in denial regarding
the severity of his habit?
-Strategic therapy
-Psychopharmacology with naltrexone 50 mg daily
-Motivational interviewing
-Solution-focused therapy
Correct Answer
Motivational interviewing
Page 4 of 152
