NRNP 6635 Week 6 Midterm Exam Questions and Revised
Correct Answers & Rationales () 100% Guarantee
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Multiple-Choice Questions
Question 1: Which neurotransmitter is primarily implicated in the reward system of substance
use disorders? A. Serotonin
B. Dopamine
C. GABA
D. Glutamate
Correct Answer: B. Dopamine
Rationale: Dopamine in the mesolimbic pathway, particularly the nucleus accum-
bens, is central to the reward and reinforcement mechanisms driving substance use
disorders. Serotonin modulates mood, GABA inhibits neural activity, and gluta-
mate is excitatory, but none are primary in reward.
Question 2: A patient presents with delusions for 3 months without hallucinations. What is the
most likely diagnosis? A. Schizophrenia
B. Delusional disorder
C. Brief psychotic disorder
D. Schizophreniform disorder
Correct Answer: B. Delusional disorder
Rationale: Delusional disorder involves non-bizarre delusions for at least 1 month
without prominent hallucinations or significant impairment outside the delusion.
Schizophrenia requires additional symptoms (e.g., hallucinations), brief psychotic
disorder lasts <1 month, and schizophreniform disorder lasts 1–6 months.
Question 3: Which of the following is a core symptom of major depressive disorder per DSM-5?
A. Grandiosity
B. Anhedonia
C. Disorganized speech
D. Visual hallucinations
Correct Answer: B. Anhedonia
Rationale: Anhedonia (loss of interest or pleasure) is a core symptom of major
depressive disorder, along with depressed mood. Grandiosity is associated with
mania, disorganized speech with schizophrenia, and visual hallucinations are rare
in depression unless psychotic features are present.
Question 4: A patient with panic disorder experiences fear of future attacks. This is best de-
scribed as: A. Agoraphobia
B. Anticipatory anxiety
C. Generalized anxiety
D. Social phobia
Correct Answer: B. Anticipatory anxiety
Rationale: Anticipatory anxiety in panic disorder involves fear of recurrent panic
attacks, leading to avoidance behaviors. Agoraphobia is fear of situations, general-
ized anxiety is chronic worry, and social phobia involves fear of social scrutiny.
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, Question 5: Which medication is contraindicated in a patient with a history of seizures? A.
Sertraline
B. Bupropion
C. Lorazepam
D. Lithium
Correct Answer: B. Bupropion
Rationale: Bupropion lowers the seizure threshold, making it contraindicated in pa-
tients with seizure disorders. Sertraline, lorazepam, and lithium do not significantly
increase seizure risk, though monitoring is needed for lithium toxicity.
Question 6: A patient exhibits repetitive hand-washing to reduce contamination fears. This is
characteristic of: A. Generalized anxiety disorder
B. Obsessive-compulsive disorder
C. Post-traumatic stress disorder
D. Specific phobia
Correct Answer: B. Obsessive-compulsive disorder
Rationale: Repetitive hand-washing to alleviate contamination fears is a compul-
sion, a hallmark of OCD driven by obsessions. GAD involves chronic worry, PTSD
involves trauma-related symptoms, and specific phobias involve fear of specific ob-
jects or situations.
Question 7: Which of the following is a first-line treatment for generalized anxiety disorder? A.
Haloperidol
B. Escitalopram
C. Risperidone
D. Carbamazepine
Correct Answer: B. Escitalopram
Rationale: SSRIs like escitalopram are first-line for GAD due to their efficacy and
safety profile. Haloperidol and risperidone are antipsychotics for psychosis, and
carbamazepine is for bipolar disorder or seizures.
Question 8: A patient with schizophrenia reports command auditory hallucinations. What is
the most appropriate initial intervention? A. Increase social activities
B. Initiate antipsychotic therapy
C. Prescribe an SSRI
D. Recommend psychotherapy only
Correct Answer: B. Initiate antipsychotic therapy
Rationale: Command auditory hallucinations in schizophrenia require antipsychotic
therapy (e.g., risperidone) to target dopamine dysregulation. SSRIs are for depres-
sion/anxiety, psychotherapy is adjunctive, and social activities do not address acute
psychosis.
Question 9: Which of the following is a symptom of opioid withdrawal? A. Miosis
B. Bradycardia
C. Lacrimation
D. Sedation
Correct Answer: C. Lacrimation
Rationale: Opioid withdrawal includes lacrimation, mydriasis, diarrhea, and auto-
nomic hyperactivity. Miosis, bradycardia, and sedation are associated with opioid
intoxication, not withdrawal.
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Correct Answers & Rationales () 100% Guarantee
Pass
Multiple-Choice Questions
Question 1: Which neurotransmitter is primarily implicated in the reward system of substance
use disorders? A. Serotonin
B. Dopamine
C. GABA
D. Glutamate
Correct Answer: B. Dopamine
Rationale: Dopamine in the mesolimbic pathway, particularly the nucleus accum-
bens, is central to the reward and reinforcement mechanisms driving substance use
disorders. Serotonin modulates mood, GABA inhibits neural activity, and gluta-
mate is excitatory, but none are primary in reward.
Question 2: A patient presents with delusions for 3 months without hallucinations. What is the
most likely diagnosis? A. Schizophrenia
B. Delusional disorder
C. Brief psychotic disorder
D. Schizophreniform disorder
Correct Answer: B. Delusional disorder
Rationale: Delusional disorder involves non-bizarre delusions for at least 1 month
without prominent hallucinations or significant impairment outside the delusion.
Schizophrenia requires additional symptoms (e.g., hallucinations), brief psychotic
disorder lasts <1 month, and schizophreniform disorder lasts 1–6 months.
Question 3: Which of the following is a core symptom of major depressive disorder per DSM-5?
A. Grandiosity
B. Anhedonia
C. Disorganized speech
D. Visual hallucinations
Correct Answer: B. Anhedonia
Rationale: Anhedonia (loss of interest or pleasure) is a core symptom of major
depressive disorder, along with depressed mood. Grandiosity is associated with
mania, disorganized speech with schizophrenia, and visual hallucinations are rare
in depression unless psychotic features are present.
Question 4: A patient with panic disorder experiences fear of future attacks. This is best de-
scribed as: A. Agoraphobia
B. Anticipatory anxiety
C. Generalized anxiety
D. Social phobia
Correct Answer: B. Anticipatory anxiety
Rationale: Anticipatory anxiety in panic disorder involves fear of recurrent panic
attacks, leading to avoidance behaviors. Agoraphobia is fear of situations, general-
ized anxiety is chronic worry, and social phobia involves fear of social scrutiny.
1
, Question 5: Which medication is contraindicated in a patient with a history of seizures? A.
Sertraline
B. Bupropion
C. Lorazepam
D. Lithium
Correct Answer: B. Bupropion
Rationale: Bupropion lowers the seizure threshold, making it contraindicated in pa-
tients with seizure disorders. Sertraline, lorazepam, and lithium do not significantly
increase seizure risk, though monitoring is needed for lithium toxicity.
Question 6: A patient exhibits repetitive hand-washing to reduce contamination fears. This is
characteristic of: A. Generalized anxiety disorder
B. Obsessive-compulsive disorder
C. Post-traumatic stress disorder
D. Specific phobia
Correct Answer: B. Obsessive-compulsive disorder
Rationale: Repetitive hand-washing to alleviate contamination fears is a compul-
sion, a hallmark of OCD driven by obsessions. GAD involves chronic worry, PTSD
involves trauma-related symptoms, and specific phobias involve fear of specific ob-
jects or situations.
Question 7: Which of the following is a first-line treatment for generalized anxiety disorder? A.
Haloperidol
B. Escitalopram
C. Risperidone
D. Carbamazepine
Correct Answer: B. Escitalopram
Rationale: SSRIs like escitalopram are first-line for GAD due to their efficacy and
safety profile. Haloperidol and risperidone are antipsychotics for psychosis, and
carbamazepine is for bipolar disorder or seizures.
Question 8: A patient with schizophrenia reports command auditory hallucinations. What is
the most appropriate initial intervention? A. Increase social activities
B. Initiate antipsychotic therapy
C. Prescribe an SSRI
D. Recommend psychotherapy only
Correct Answer: B. Initiate antipsychotic therapy
Rationale: Command auditory hallucinations in schizophrenia require antipsychotic
therapy (e.g., risperidone) to target dopamine dysregulation. SSRIs are for depres-
sion/anxiety, psychotherapy is adjunctive, and social activities do not address acute
psychosis.
Question 9: Which of the following is a symptom of opioid withdrawal? A. Miosis
B. Bradycardia
C. Lacrimation
D. Sedation
Correct Answer: C. Lacrimation
Rationale: Opioid withdrawal includes lacrimation, mydriasis, diarrhea, and auto-
nomic hyperactivity. Miosis, bradycardia, and sedation are associated with opioid
intoxication, not withdrawal.
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