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NR 547 Final Exam
Questions with Verified Answers
Section 1: Psychiatric Assessment and Diagnosis (Questions 1-25)
1. What is the primary goal of a psychiatric assessment? A) To prescribe medication B) To gather comprehensive information for accurate diagnosis and treatment planning C) To determine insurance coverage D) To establish therapeutic rapport Answer: B - The primary goal is to gather comprehensive information for accurate diagnosis and treatment planning. 2. Which of the following is NOT part of the mental status examination? A) Appearance and behavior B) Speech and language C) Laboratory results D) Thought processes Answer: C - Laboratory results are not part of the mental status examination. 3. The DSM- 5 - TR uses which approach to psychiatric diagnosis? A) Dimensional
B) Categorical C) Psychodynamic D) Behavioral Answer: B - The DSM- 5 - TR uses a categorical approach to psychiatric diagnosis.
4. What does the term "affect" refer to in psychiatric assessment? A) The patient's mood over time B) The observable emotional expression C) The patient's insight D) The patient's judgment Answer: B - Affect refers to the observable emotional expression. 5. Which assessment tool is commonly used to evaluate suicide risk? A) PHQ- 9 B) GAD- 7 C) Columbia Suicide Severity Rating Scale D) MMSE Answer: C - The Columbia Suicide Severity Rating Scale is commonly used to evaluate suicide risk. 6. What is the difference between mood and affect? A) There is no difference B) Mood is objective, affect is subjective C) Mood is the patient's internal emotional state, affect is the observable expression D) Mood is short-term, affect is long-term
Patient's cultural background and how it influences symptom expression D) Patient's employment status Answer: C - Cultural background and how it influences symptom expression is most important.
12. What does "pressured speech" indicate? A) Difficulty speaking B) Rapid, excessive talking that's difficult to interrupt C) Whispered speech D) Stuttering Answer: B - Pressured speech indicates rapid, excessive talking that's difficult to interrupt. 13. Which of the following is a positive symptom of schizophrenia? A) Avolition B) Hallucinations C) Flat affect D) Social withdrawal Answer: B - Hallucinations are a positive symptom of schizophrenia. 14. What is the minimum duration for symptoms to diagnose Major Depressive Disorder? A) 1 week B) 2 weeks C) 1 month D) 6 months Answer: B - The minimum duration is 2 weeks. 15. Which assessment focuses on cognitive function? A) Beck Depression Inventory B) Mini-Mental State Examination C) Hamilton Rating Scale for Depression D) Yale-Brown Obsessive Compulsive Scale Answer: B - The Mini-Mental State Examination focuses on cognitive function. 16. What is the primary difference between delusions and hallucinations? A) Delusions are false beliefs, hallucinations are false perceptions B) Delusions are auditory, hallucinations are visual C) There is no difference D) Delusions are treatable, hallucinations are not
Answer: A - Delusions are false beliefs, hallucinations are false perceptions.
17. Which of the following suggests impaired judgment? A) Patient makes appropriate decisions B) Patient cannot make decisions about treatment or safety C) Patient asks questions about treatment D) Patient follows recommendations Answer: B - Impaired judgment is suggested when a patient cannot make decisions about treatment or safety. 18. What does "tangentiality" describe? A) Staying on topic B) Veering off topic and not returning to the original point C) Speaking loudly D) Repeating the same words Answer: B - Tangentiality describes veering off topic and not returning to the original point. 19. The term "anhedonia" refers to: A) Excessive pleasure-seeking B) Loss of interest or pleasure in activities C) Difficulty sleeping D) Increased appetite Answer: B - Anhedonia refers to loss of interest or pleasure in activities. 20. Which is most important when assessing suicide risk? A) Age of the patient B) Specific plan, means, and intent C) Previous therapy history D) Educational background Answer: B - Specific plan, means, and intent are most important when assessing suicide risk. 21. What does "concrete thinking" indicate? A) Abstract reasoning abilities B) Difficulty with abstract concepts, literal interpretation C) Creative problem-solving D) Philosophical thinking Answer: B - Concrete thinking indicates difficulty with abstract concepts and literal interpretation.
27. What is the mechanism of action of benzodiazepines? A) Serotonin reuptake inhibition B) Dopamine receptor blockade C) GABA receptor enhancement D) Norepinephrine reuptake inhibition Answer: C - Benzodiazepines enhance GABA receptor function. 28. Which medication requires regular blood level monitoring? A) Sertraline B) Lithium C) Lorazepam D) Quetiapine Answer: B - Lithium requires regular blood level monitoring. 29. What is the primary concern with abrupt discontinuation of SSRIs? A) Rebound depression B) Discontinuation syndrome C) Seizures D) Hypertensive crisis Answer: B - The primary concern is discontinuation syndrome. 30. Which antipsychotic is associated with the highest risk of metabolic side effects? A) Haloperidol B) Risperidone C) Olanzapine D) Aripiprazole Answer: C - Olanzapine is associated with the highest risk of metabolic side effects. 31. What is the therapeutic range for lithium? A) 0.1-0.4 mEq/L B) 0.6-1.2 mEq/L C) 1.5- 2.0 mEq/L D) 2.0-3.0 mEq/L Answer: B - The therapeutic range for lithium is 0.6-1.2 mEq/L. 32. Which medication is first-line treatment for panic disorder? A) Haloperidol B) Lithium C) Sertraline D) Valproic acid Answer: C - Sertraline (an SSRI) is first-line treatment for panic disorder.
33. What is the mechanism of action of bupropion? A) Serotonin reuptake inhibition B) Dopamine and norepinephrine reuptake inhibition C) GABA enhancement D) Histamine receptor blockade Answer: B - Bupropion inhibits dopamine and norepinephrine reuptake. 34. Which side effect is most common with anticholinergic medications? A) Diarrhea B) Dry mouth C) Hypertension D) Tremor Answer: B - Dry mouth is the most common anticholinergic side effect. 35. What is the primary indication for mood stabilizers? A) Major depressive disorder B) Bipolar disorder C) Anxiety disorders D) Psychotic disorders Answer: B - The primary indication for mood stabilizers is bipolar disorder. 36. Which medication can cause tardive dyskinesia? A) Fluoxetine B) Lorazepam C) Haloperidol D) Lithium Answer: C - Haloperidol can cause tardive dyskinesia. 37. What is the black box warning for antidepressants? A) Liver toxicity B) Increased suicide risk in young adults C) Cardiac arrhythmias D) Kidney damage Answer: B - The black box warning is for increased suicide risk in young adults. 38. Which medication is contraindicated with MAOIs? A) Lithium B) Tyramine-rich foods C) Benzodiazepines D) Antipsychotics Answer: B - Tyramine-rich foods are contraindicated with MAOIs.
45. What is the half-life of lorazepam? A) 2-4 hours B) 12-15 hours C) 24-48 hours D) 3- 5 days Answer: B - The half-life of lorazepam is 12-15 hours. 46. Which medication is used for alcohol withdrawal? A) Haloperidol B) Lithium C) Chlordiazepoxide D) Fluoxetine Answer: C - Chlordiazepoxide is used for alcohol withdrawal. 47. What is the primary concern with combining SSRIs and tramadol? A) Hypertensive crisis B) Serotonin syndrome C) Kidney damage D) Liver toxicity Answer: B - The primary concern is serotonin syndrome. 48. Which medication is first-line for generalized anxiety disorder? A) Alprazolam B) Buspirone C) Escitalopram D) Propranolol Answer: C - Escitalopram (an SSRI) is first-line for generalized anxiety disorder. 49. What is the mechanism of action of aripiprazole? A) Dopamine receptor antagonist B) Dopamine partial agonist C) Serotonin reuptake inhibitor D) GABA enhancer Answer: B - Aripiprazole is a dopamine partial agonist. 50. Which laboratory test is required before starting carbamazepine? A) Thyroid function B) Complete blood count C) Liver function D) All of the above Answer: D - All of the above tests are required before starting carbamazepine.
Section 3: Mood Disorders (Questions 51-75)
51. What is the minimum number of symptoms required for Major Depressive Episode? A) 3 B) 5 C) 7 D) 9 Answer: B - A minimum of 5 symptoms is required for Major Depressive Episode. 52. Which of the following is NOT a symptom of major depression? A) Anhedonia B) Fatigue C) Euphoria D) Sleep disturbances Answer: C - Euphoria is not a symptom of major depression. 53. What is the key difference between Bipolar I and Bipolar II disorder? A) Age of onset B) Presence of manic vs. hypomanic episodes C) Duration of symptoms D) Response to treatment Answer: B - The key difference is the presence of manic vs. hypomanic episodes. 54. How long must a manic episode last to meet diagnostic criteria? A) 3 days B) 1 week (or hospitalization) C) 2 weeks D) 1 month Answer: B - A manic episode must last 1 week or require hospitalization. 55. What is the minimum duration for hypomanic episodes? A) 2 days B) 4 days C) 1 week D) 2 weeks Answer: B - The minimum duration for hypomanic episodes is 4 days. 56. Which is the most common comorbid condition with major depression? A) Schizophrenia B) Anxiety disorders C) Substance use disorders D) Eating disorders
62. Which of the following is a vegetative symptom of depression? A) Guilt B) Sleep disturbances C) Suicidal ideation D) Concentration problems Answer: B - Sleep disturbances are a vegetative symptom of depression. 63. What is mixed state in bipolar disorder? A) Alternating mood episodes B) Simultaneous manic and depressive symptoms C) Mild symptoms D) Absence of symptoms Answer: B - Mixed state involves simultaneous manic and depressive symptoms. 64. Which is the most effective treatment for severe depression with psychotic features? A) Psychotherapy alone B) Antidepressants alone C) ECT D) Antipsychotics alone Answer: C - ECT is the most effective treatment for severe depression with psychotic features. 65. What is rapid cycling in bipolar disorder? A) Quick mood changes within a day B) Four or more mood episodes per year C) Manic episodes lasting less than a week D) Immediate response to medication Answer: B - Rapid cycling is four or more mood episodes per year. 66. Which neurotransmitter theory is most associated with depression? A) Dopamine excess B) Serotonin deficiency C) GABA excess D) Acetylcholine deficiency Answer: B - Serotonin deficiency is most associated with depression. 67. What is postpartum depression? A) Depression during pregnancy B) Depression after childbirth C) Depression in new fathers D) Depression in children Answer: B - Postpartum depression is depression after childbirth.
68. Which assessment tool is commonly used to screen for depression? A) GAD-7 B) PHQ-9 C) MMSE D) AIMS Answer: B - PHQ-9 is commonly used to screen for depression. 69. What is the prognosis for bipolar disorder? A) Complete recovery is common B) Chronic condition requiring lifelong management C) Self-limiting condition D) Progressive deterioration Answer: B - Bipolar disorder is a chronic condition requiring lifelong management. 70. Which is a protective factor against depression? A) Social isolation B) Substance use C) Strong social support D) Chronic illness Answer: C - Strong social support is a protective factor against depression. 71. What is atypical depression? A) Depression with psychotic features B) Depression with mood reactivity and specific symptoms C) Depression in elderly patients D) Depression with rapid cycling Answer: B - Atypical depression is depression with mood reactivity and specific symptoms. 72. Which is the most common trigger for first manic episode? A) Medication B) Stress C) Sleep deprivation D) Substance use Answer: B - Stress is the most common trigger for first manic episode. 73. What is the difference between grief and depression? A) Duration B) Grief is normal response to loss, depression is persistent mood disorder C) Severity D) Treatment response Answer: B - Grief is normal response to loss, depression is persistent mood disorder.
Answer: C - Euphoria is not a symptom of panic attack.
80. What is agoraphobia? A) Fear of heights B) Fear of enclosed spaces C) Fear of situations where escape might be difficult D) Fear of social situations Answer: C - Agoraphobia is fear of situations where escape might be difficult. 81. Which neurotransmitter is primarily associated with anxiety? A) Dopamine B) Serotonin C) GABA D) Acetylcholine Answer: C - GABA is primarily associated with anxiety. 82. What is the first-line treatment for most anxiety disorders? A) Benzodiazepines B) SSRIs C) Tricyclic antidepressants D) Antipsychotics Answer: B - SSRIs are first-line treatment for most anxiety disorders. 83. Which therapy is most effective for phobias? A) Psychodynamic therapy B) Cognitive- behavioral therapy C) Interpersonal therapy D) Group therapy Answer: B - Cognitive-behavioral therapy is most effective for phobias. 84. What is social anxiety disorder? A) Fear of all social situations B) Fear of public speaking only C) Fear of scrutiny in social/performance situations D) Fear of crowds Answer: C - Social anxiety disorder is fear of scrutiny in social/performance situations. 85. Which is a physical symptom of anxiety? A) Bradycardia B) Muscle tension C) Hypotension D) Decreased respiratory rate Answer: B - Muscle tension is a physical symptom of anxiety.
86. What is the lifetime prevalence of anxiety disorders? A) 10% B) 20% C) 30% D) 40% Answer: C - The lifetime prevalence of anxiety disorders is approximately 30%. 87. Which gender is more likely to experience anxiety disorders? A) Males B) Females C) Equal prevalence D) Varies by disorder Answer: B - Females are more likely to experience anxiety disorders. 88. What is anticipatory anxiety? A) Anxiety about past events B) Anxiety about potential future panic attacks C) Anxiety about medication side effects D) Anxiety about therapy Answer: B - Anticipatory anxiety is anxiety about potential future panic attacks. 89. Which is a cognitive symptom of anxiety? A) Nausea B) Sweating C) Catastrophic thinking D) Trembling Answer: C - Catastrophic thinking is a cognitive symptom of anxiety. 90. What is the most common specific phobia? A) Heights B) Animals C) Flying D) Blood/injection Answer: B - Animal phobias are the most common specific phobias. 91. Which medical condition can mimic anxiety symptoms? A) Diabetes B) Hyperthyroidism C) Anemia D) Osteoarthritis Answer: B - Hyperthyroidism can mimic anxiety symptoms.
97. Which is an appropriate goal for anxiety treatment? A) Complete elimination of anxiety B) Management and reduction of anxiety to functional levels C) Immediate symptom relief D) Avoidance of all anxiety-provoking situations Answer: B - The goal is management and reduction of anxiety to functional levels. 98. What is the relationship between anxiety and depression? A) They never occur together B) They are frequently comorbid C) They are opposite conditions D) They have no relationship Answer: B - Anxiety and depression are frequently comorbid. 99. Which is a behavioral symptom of anxiety? A) Rapid heartbeat B) Sweating C) Avoidance D) Muscle tension Answer: C - Avoidance is a behavioral symptom of anxiety. 100. What is the prognosis for anxiety disorders with treatment? A) Poor prognosis B) Moderate improvement C) Good prognosis with proper treatment D) Spontaneous recovery Answer: C - Anxiety disorders have a good prognosis with proper treatment.
Section 5: Additional Practice Questions (Questions 101-120)
101. What is the primary difference between delirium and dementia? A) Age of onset B) Delirium is acute and reversible, dementia is chronic and progressive C) Delirium affects memory, dementia affects attention D) No difference Answer: B - Delirium is acute and reversible, dementia is chronic and progressive.
102. Which is the most common cause of delirium in hospitalized patients? A) Psychiatric disorders B) Medication effects C) Infection D) Dehydration Answer: B - Medication effects are the most common cause of delirium in hospitalized patients. 103. What is the primary neurotransmitter involved in ADHD? A) Serotonin B) Dopamine C) GABA D) Acetylcholine Answer: B - Dopamine is the primary neurotransmitter involved in ADHD. 104. Which is a core symptom of ADHD? A) Hallucinations B) Mood swings C) Inattention D) Compulsions Answer: C - Inattention is a core symptom of ADHD. 105. What is the gold standard for ADHD diagnosis? A) Brain imaging B) Blood tests C) Comprehensive clinical assessment D) Psychological testing Answer: C - Comprehensive clinical assessment is the gold standard for ADHD diagnosis. 106. Which medication is first-line for ADHD? A) Antidepressants B) Stimulants C) Antipsychotics D) Mood stabilizers Answer: B - Stimulants are first-line for ADHD. 107. What is the prevalence of ADHD in children? A) 2-3% B) 5-10% C) 15-20% D) 25- 30% Answer: B - The prevalence of ADHD in children is 5-10%.
