NR 547 Final exam Questions with Verified Answers (Correct
Update)
Question 1: A 68-year-old male pre- C) sents to your clinic with his daughter, who expresses
concern about his recent lack of interest in hobbies, decreased energy, and complaints of feeling
"down." He denies any history of manic or hypomanic episodes. Which of the following
depression screening tools would be most appropriate for initial assessment in this patient?
A) HAM-D B) Mood Disorder Questionnaire (MDQ)
C) Geriatric Depression Scale (GDS)
D) PHQ-9
A. HAM-D (Hamilton Depression Rating Scale): While the HAM-D is a valid and widely used
depression scale, it is a clinician-rated tool. This means a trained clinician administers it and
rates the patient's symptoms. While it could be used, the question asks for the "most appropriate
for initial assessment," and for an older adult, a self-report specific to their age group is often
preferred for initial screening, especially when family is presenting the concern.
B. Mood Disorder Questionnaire (MDQ): The MDQ is specifically designed as a screening tool
for bipolar disorder. The patient denies any history of manic or hypomanic episodes, and while
it's good to keep bipolar disorder in mind, the primary concern here is depression in an older
adult. It would not be the most appropriate initial screening tool for depression.
C. Geriatric Depression Scale (GDS): This is the most appropri
Answer: Geriatric Depression Scale (GDS)
A) HAM-D (Hamilton Depression Rating Scale): While the HAM-D is a valid and widely used
depression scale, it is a clinician-rated tool. This means a trained clinician administers it and rates the
patient's symptoms. While it could be used, the question asks for the "most appropriate for initial
assessment," and for an older adult, a self-report specific to their age group is often preferred for initial
screening, especially when family is presenting the concern.
B) Mood Disorder Questionnaire (MDQ): The MDQ is specifically designed as a screening tool for
bipolar disorder. The patient denies any history of manic or hypomanic episodes, and while it's good to
keep bipolar disorder in mind, the primary concern here is depression in an older adult. It would not be
the most appropriate initial screening tool for depression.
C) Geriatric Depression Scale (GDS): This is the most appropri
Page 1
,Question 2: A 35-year-old female is diagnosed with Major Depressive Disorder (MDD) with
atypical teristic features. Which of the following symptoms is characteristic of MDD with
atypical features?
A) Profound despondency and anhedonia
B) Significant weight loss and early morning awakening
C) Mood reactivity and hypersomnia
D) Psychomotor retardation and excessive guilt
C. Mood reactivity and hypersomnia
A. Profound despondency and anhedonia: These symptoms are characof Major Depressive
Disorder with melancholic features. Melancholia typically involves a profound loss of pleasure in
all or almost all activities and severe despondency, often with non-reactive mood.
B. Significant weight loss and early morning awakening: These are also classic symptoms
associated with Major Depressive Disorder with melancholic features. People with melancholic
depression often experience severe insomnia (early morning awakening) and significant
appetite/weight loss.
C. Mood reactivity and hypersomnia: This is correct for MDD with atypical features. Mood
reactivity means the person's mood can brighten in response to positive events, even if
temporarily. This is in contrast to melancholic depression, where the mood is often non-reactive
to positive stimuli. Hypersomnia (sleeping too much) is a
Answer: C) Mood reactivity and hypersomnia
A) Profound despondency and anhedonia: These symptoms are characof Major Depressive Disorder
with melancholic features. Melancholia typically involves a profound loss of pleasure in all or almost all
activities and severe despondency, often with non-reactive mood.
B) Significant weight loss and early morning awakening: These are also classic symptoms associated
with Major Depressive Disorder with melancholic features. People with melancholic depression often
experience severe insomnia (early morning awakening) and significant appetite/weight loss.
C) Mood reactivity and hypersomnia: This is correct for MDD with atypical features. Mood reactivity
means the person's mood can brighten in response to positive events, even if temporarily. This is in
contrast to melancholic depression, where the mood is often non-reactive to positive stimuli.
Hypersomnia (sleeping too much) is a
Page 2
, Question 3: A patient presents with a history of recurrent mood swings that do not meet the full
criteria for either a hypomanic or major depresrules sive episode, but have persisted for more
than episode two years. These mood fluctuations cause significant distress. Which diagnosis is
most consistent with this presentation?
A) Bipolar I Disorder
B) Bipolar II Disorder
C) Cyclothymic Disorder
D) Persistent Depressive Disorder
C. Cyclothymic Disorder
A. Bipolar I Disorder: This diagnosis requires at least one full manic episode. The question states
the patient's mood swings "do not meet the full criteria for either a hypomanic or major
depressive episode," which out a full manic episode.
B. Bipolar II Disorder: This diagnosis requires at least one hypomanic and at least one major
depressive episode. Again, the question specifies that the mood swings "do not meet the full
criteria" for either of these, thus ruling out Bipolar II.
C. Cyclothymic Disorder: This is the correct answer. Cyclothymia is characterized by a chronic,
fluctuating mood disturbance involving numerous periods of hypomanic symptoms (that do not
meet full criteria for a hypomanic episode) and numerous periods of depressive symptoms (that
do not meet full criteria for a major depressive episode), lasting for at least 2 years (1 year in
children/adolescents).
Answer: C) Cyclothymic Disorder
A) Bipolar I Disorder: This diagnosis requires at least one full manic episode. The question states the
patient's mood swings "do not meet the full criteria for either a hypomanic or major depressive episode,"
which out a full manic episode.
B) Bipolar II Disorder: This diagnosis requires at least one hypomanic and at least one major depressive
episode. Again, the question specifies that the mood swings "do not meet the full criteria" for either of
these, thus ruling out Bipolar II.
C) Cyclothymic Disorder: This is the correct answer. Cyclothymia is characterized by a chronic,
fluctuating mood disturbance involving numerous periods of hypomanic symptoms (that do not meet
full criteria for a hypomanic episode) and numerous periods of depressive symptoms (that do not meet
full criteria for a major depressive episode), lasting for at least 2 years (1 year in children/adolescents).
Page 3
Update)
Question 1: A 68-year-old male pre- C) sents to your clinic with his daughter, who expresses
concern about his recent lack of interest in hobbies, decreased energy, and complaints of feeling
"down." He denies any history of manic or hypomanic episodes. Which of the following
depression screening tools would be most appropriate for initial assessment in this patient?
A) HAM-D B) Mood Disorder Questionnaire (MDQ)
C) Geriatric Depression Scale (GDS)
D) PHQ-9
A. HAM-D (Hamilton Depression Rating Scale): While the HAM-D is a valid and widely used
depression scale, it is a clinician-rated tool. This means a trained clinician administers it and
rates the patient's symptoms. While it could be used, the question asks for the "most appropriate
for initial assessment," and for an older adult, a self-report specific to their age group is often
preferred for initial screening, especially when family is presenting the concern.
B. Mood Disorder Questionnaire (MDQ): The MDQ is specifically designed as a screening tool
for bipolar disorder. The patient denies any history of manic or hypomanic episodes, and while
it's good to keep bipolar disorder in mind, the primary concern here is depression in an older
adult. It would not be the most appropriate initial screening tool for depression.
C. Geriatric Depression Scale (GDS): This is the most appropri
Answer: Geriatric Depression Scale (GDS)
A) HAM-D (Hamilton Depression Rating Scale): While the HAM-D is a valid and widely used
depression scale, it is a clinician-rated tool. This means a trained clinician administers it and rates the
patient's symptoms. While it could be used, the question asks for the "most appropriate for initial
assessment," and for an older adult, a self-report specific to their age group is often preferred for initial
screening, especially when family is presenting the concern.
B) Mood Disorder Questionnaire (MDQ): The MDQ is specifically designed as a screening tool for
bipolar disorder. The patient denies any history of manic or hypomanic episodes, and while it's good to
keep bipolar disorder in mind, the primary concern here is depression in an older adult. It would not be
the most appropriate initial screening tool for depression.
C) Geriatric Depression Scale (GDS): This is the most appropri
Page 1
,Question 2: A 35-year-old female is diagnosed with Major Depressive Disorder (MDD) with
atypical teristic features. Which of the following symptoms is characteristic of MDD with
atypical features?
A) Profound despondency and anhedonia
B) Significant weight loss and early morning awakening
C) Mood reactivity and hypersomnia
D) Psychomotor retardation and excessive guilt
C. Mood reactivity and hypersomnia
A. Profound despondency and anhedonia: These symptoms are characof Major Depressive
Disorder with melancholic features. Melancholia typically involves a profound loss of pleasure in
all or almost all activities and severe despondency, often with non-reactive mood.
B. Significant weight loss and early morning awakening: These are also classic symptoms
associated with Major Depressive Disorder with melancholic features. People with melancholic
depression often experience severe insomnia (early morning awakening) and significant
appetite/weight loss.
C. Mood reactivity and hypersomnia: This is correct for MDD with atypical features. Mood
reactivity means the person's mood can brighten in response to positive events, even if
temporarily. This is in contrast to melancholic depression, where the mood is often non-reactive
to positive stimuli. Hypersomnia (sleeping too much) is a
Answer: C) Mood reactivity and hypersomnia
A) Profound despondency and anhedonia: These symptoms are characof Major Depressive Disorder
with melancholic features. Melancholia typically involves a profound loss of pleasure in all or almost all
activities and severe despondency, often with non-reactive mood.
B) Significant weight loss and early morning awakening: These are also classic symptoms associated
with Major Depressive Disorder with melancholic features. People with melancholic depression often
experience severe insomnia (early morning awakening) and significant appetite/weight loss.
C) Mood reactivity and hypersomnia: This is correct for MDD with atypical features. Mood reactivity
means the person's mood can brighten in response to positive events, even if temporarily. This is in
contrast to melancholic depression, where the mood is often non-reactive to positive stimuli.
Hypersomnia (sleeping too much) is a
Page 2
, Question 3: A patient presents with a history of recurrent mood swings that do not meet the full
criteria for either a hypomanic or major depresrules sive episode, but have persisted for more
than episode two years. These mood fluctuations cause significant distress. Which diagnosis is
most consistent with this presentation?
A) Bipolar I Disorder
B) Bipolar II Disorder
C) Cyclothymic Disorder
D) Persistent Depressive Disorder
C. Cyclothymic Disorder
A. Bipolar I Disorder: This diagnosis requires at least one full manic episode. The question states
the patient's mood swings "do not meet the full criteria for either a hypomanic or major
depressive episode," which out a full manic episode.
B. Bipolar II Disorder: This diagnosis requires at least one hypomanic and at least one major
depressive episode. Again, the question specifies that the mood swings "do not meet the full
criteria" for either of these, thus ruling out Bipolar II.
C. Cyclothymic Disorder: This is the correct answer. Cyclothymia is characterized by a chronic,
fluctuating mood disturbance involving numerous periods of hypomanic symptoms (that do not
meet full criteria for a hypomanic episode) and numerous periods of depressive symptoms (that
do not meet full criteria for a major depressive episode), lasting for at least 2 years (1 year in
children/adolescents).
Answer: C) Cyclothymic Disorder
A) Bipolar I Disorder: This diagnosis requires at least one full manic episode. The question states the
patient's mood swings "do not meet the full criteria for either a hypomanic or major depressive episode,"
which out a full manic episode.
B) Bipolar II Disorder: This diagnosis requires at least one hypomanic and at least one major depressive
episode. Again, the question specifies that the mood swings "do not meet the full criteria" for either of
these, thus ruling out Bipolar II.
C) Cyclothymic Disorder: This is the correct answer. Cyclothymia is characterized by a chronic,
fluctuating mood disturbance involving numerous periods of hypomanic symptoms (that do not meet
full criteria for a hypomanic episode) and numerous periods of depressive symptoms (that do not meet
full criteria for a major depressive episode), lasting for at least 2 years (1 year in children/adolescents).
Page 3
