1
NRNP 6635 Final Exam 2025/2026 – Clinical Scenario-
Based Questions with Verified Answers & Expert
Explanations | Walden University | A+ Grade
Psychiatric Diagnosis
1. A 28-year-old female presents with a 2-month history of persistent sadness, loss of
interest in hobbies, and difficulty sleeping. She denies suicidal ideation but reports low
energy and poor concentration. What is the most likely diagnosis?
a. Bipolar II disorder
b. Major depressive disorder
c. Generalized anxiety disorder
d. Adjustment disorder
Explanation: The patient’s symptoms of persistent sadness, anhedonia, insomnia, low
energy, and poor concentration for 2 months meet DSM-5 criteria for major depressive
disorder (MDD). Bipolar II requires hypomanic episodes, not present here. GAD involves
excessive worry, and adjustment disorder requires a clear stressor with symptoms not
meeting MDD criteria.
2. A 19-year-old male college student reports racing thoughts, decreased need for sleep, and
excessive spending for 1 week, followed by a period of depression. What is the most
appropriate diagnosis?
a. Major depressive disorder
b. Bipolar I disorder
c. Cyclothymic disorder
d. Schizophrenia
Explanation: The patient’s manic episode (racing thoughts, decreased sleep need,
excessive spending) lasting at least 1 week, followed by depression, meets DSM-5
criteria for bipolar I disorder. Cyclothymia involves milder symptoms over 2 years, and
schizophrenia requires psychotic symptoms, not described here.
3. A 35-year-old male presents with excessive worry about work, difficulty controlling the
worry, and physical symptoms like muscle tension and restlessness for 6 months. What is
the most likely diagnosis?
a. Panic disorder
b. Generalized anxiety disorder
c. Obsessive-compulsive disorder
d. Social anxiety disorder
Explanation: Excessive, uncontrollable worry with physical symptoms like muscle
tension for 6 months aligns with DSM-5 criteria for generalized anxiety disorder (GAD).
Panic disorder involves recurrent panic attacks, OCD requires obsessions/compulsions,
and social anxiety disorder is specific to social situations.
4. A 40-year-old female reports recurrent, intrusive thoughts about harming her child and
performs rituals to prevent harm. She recognizes these thoughts as irrational. What is the
most likely diagnosis?
, 2
a. Postpartum depression
b. Obsessive-compulsive disorder
c. Postpartum psychosis
d. Generalized anxiety disorder
Explanation: Intrusive thoughts (obsessions) and rituals (compulsions) recognized as
irrational are hallmark symptoms of obsessive-compulsive disorder (OCD). Postpartum
depression lacks rituals, postpartum psychosis involves loss of reality testing, and GAD
involves generalized worry without specific obsessions.
5. A 22-year-old male presents with auditory hallucinations, disorganized speech, and social
withdrawal for 8 months. What is the most likely diagnosis?
a. Bipolar I disorder
b. Schizophrenia
c. Schizoaffective disorder
d. Major depressive disorder with psychotic features
Explanation: Auditory hallucinations, disorganized speech, and social withdrawal for
over 6 months meet DSM-5 criteria for schizophrenia. Schizoaffective disorder requires
mood episodes, and MDD with psychotic features requires a predominant depressive
episode, neither of which are described.
6. A 30-year-old female reports intense fear of public speaking, avoiding presentations at
work, and physical symptoms like sweating and trembling during such events. What is
the most likely diagnosis?
a. Generalized anxiety disorder
b. Social anxiety disorder
c. Panic disorder
d. Agoraphobia
Explanation: Fear and avoidance of specific social situations like public speaking, with
physical symptoms, align with DSM-5 criteria for social anxiety disorder. GAD involves
generalized worry, panic disorder involves unexpected attacks, and agoraphobia involves
fear of open spaces or situations where escape is difficult.
7. A 45-year-old male veteran presents with nightmares, hypervigilance, and avoidance of
crowded places since returning from deployment 3 months ago. What is the most likely
diagnosis?
a. Acute stress disorder
b. Posttraumatic stress disorder
c. Adjustment disorder
d. Generalized anxiety disorder
Explanation: Nightmares, hypervigilance, and avoidance lasting over 1 month after a
traumatic event meet DSM-5 criteria for posttraumatic stress disorder (PTSD). Acute
stress disorder lasts less than 1 month, adjustment disorder lacks trauma-specific
symptoms, and GAD involves generalized worry.
8. A 17-year-old female reports binge eating followed by self-induced vomiting twice
weekly for 3 months, with intense fear of weight gain. What is the most likely diagnosis?
a. Anorexia nervosa
b. Bulimia nervosa
c. Binge-eating disorder
d. Avoidant/restrictive food intake disorder
NRNP 6635 Final Exam 2025/2026 – Clinical Scenario-
Based Questions with Verified Answers & Expert
Explanations | Walden University | A+ Grade
Psychiatric Diagnosis
1. A 28-year-old female presents with a 2-month history of persistent sadness, loss of
interest in hobbies, and difficulty sleeping. She denies suicidal ideation but reports low
energy and poor concentration. What is the most likely diagnosis?
a. Bipolar II disorder
b. Major depressive disorder
c. Generalized anxiety disorder
d. Adjustment disorder
Explanation: The patient’s symptoms of persistent sadness, anhedonia, insomnia, low
energy, and poor concentration for 2 months meet DSM-5 criteria for major depressive
disorder (MDD). Bipolar II requires hypomanic episodes, not present here. GAD involves
excessive worry, and adjustment disorder requires a clear stressor with symptoms not
meeting MDD criteria.
2. A 19-year-old male college student reports racing thoughts, decreased need for sleep, and
excessive spending for 1 week, followed by a period of depression. What is the most
appropriate diagnosis?
a. Major depressive disorder
b. Bipolar I disorder
c. Cyclothymic disorder
d. Schizophrenia
Explanation: The patient’s manic episode (racing thoughts, decreased sleep need,
excessive spending) lasting at least 1 week, followed by depression, meets DSM-5
criteria for bipolar I disorder. Cyclothymia involves milder symptoms over 2 years, and
schizophrenia requires psychotic symptoms, not described here.
3. A 35-year-old male presents with excessive worry about work, difficulty controlling the
worry, and physical symptoms like muscle tension and restlessness for 6 months. What is
the most likely diagnosis?
a. Panic disorder
b. Generalized anxiety disorder
c. Obsessive-compulsive disorder
d. Social anxiety disorder
Explanation: Excessive, uncontrollable worry with physical symptoms like muscle
tension for 6 months aligns with DSM-5 criteria for generalized anxiety disorder (GAD).
Panic disorder involves recurrent panic attacks, OCD requires obsessions/compulsions,
and social anxiety disorder is specific to social situations.
4. A 40-year-old female reports recurrent, intrusive thoughts about harming her child and
performs rituals to prevent harm. She recognizes these thoughts as irrational. What is the
most likely diagnosis?
, 2
a. Postpartum depression
b. Obsessive-compulsive disorder
c. Postpartum psychosis
d. Generalized anxiety disorder
Explanation: Intrusive thoughts (obsessions) and rituals (compulsions) recognized as
irrational are hallmark symptoms of obsessive-compulsive disorder (OCD). Postpartum
depression lacks rituals, postpartum psychosis involves loss of reality testing, and GAD
involves generalized worry without specific obsessions.
5. A 22-year-old male presents with auditory hallucinations, disorganized speech, and social
withdrawal for 8 months. What is the most likely diagnosis?
a. Bipolar I disorder
b. Schizophrenia
c. Schizoaffective disorder
d. Major depressive disorder with psychotic features
Explanation: Auditory hallucinations, disorganized speech, and social withdrawal for
over 6 months meet DSM-5 criteria for schizophrenia. Schizoaffective disorder requires
mood episodes, and MDD with psychotic features requires a predominant depressive
episode, neither of which are described.
6. A 30-year-old female reports intense fear of public speaking, avoiding presentations at
work, and physical symptoms like sweating and trembling during such events. What is
the most likely diagnosis?
a. Generalized anxiety disorder
b. Social anxiety disorder
c. Panic disorder
d. Agoraphobia
Explanation: Fear and avoidance of specific social situations like public speaking, with
physical symptoms, align with DSM-5 criteria for social anxiety disorder. GAD involves
generalized worry, panic disorder involves unexpected attacks, and agoraphobia involves
fear of open spaces or situations where escape is difficult.
7. A 45-year-old male veteran presents with nightmares, hypervigilance, and avoidance of
crowded places since returning from deployment 3 months ago. What is the most likely
diagnosis?
a. Acute stress disorder
b. Posttraumatic stress disorder
c. Adjustment disorder
d. Generalized anxiety disorder
Explanation: Nightmares, hypervigilance, and avoidance lasting over 1 month after a
traumatic event meet DSM-5 criteria for posttraumatic stress disorder (PTSD). Acute
stress disorder lasts less than 1 month, adjustment disorder lacks trauma-specific
symptoms, and GAD involves generalized worry.
8. A 17-year-old female reports binge eating followed by self-induced vomiting twice
weekly for 3 months, with intense fear of weight gain. What is the most likely diagnosis?
a. Anorexia nervosa
b. Bulimia nervosa
c. Binge-eating disorder
d. Avoidant/restrictive food intake disorder
