NR-547 MIDTERM EXAM QUESTIONS
& ACTUAL CORRECT ANSWERS
Name the 6 of a differential diagnosis - CORRECT ANSWER 1.) RULE OUT
Malingering or Factitious disorder
2.)Ruling out substance etiology
3.) ruling out a medical etiology
4.) Determining the specific primary disorder
5.) Differentiating adjustment disorder from the residual "other specified" and
"unspecified" conditions
6.) Establishing the boundary with no mental disorder
Remember with step 5, the PMHNP can use "other specified" in the diagnosis when
they want to indicate the specific reason for a diagnosis.
They use "unspecified" if:
the information doesn’t conform to DSM5
there is insufficient info to make a specific diagnosis
there is more info the be revealed with time OR they want to help the patient avoid
stigmas - CORRECT ANSWER
The PMHNP wants to rule out anemia as a cause for a patients fatigue and lack of
motivation. What lab should she order? - CORRECT ANSWER a CBC with iron studies
hg-12-18
hematocrit: 38-48%
What is normal creat/BUN level? - CORRECT ANSWER BUN: 7-18
creat: 0.6-1.2
A patient presents with brain fog, lack of focus, insomnia & mood swing, lack of mental
alertness. What lab should the PMHNP order? - CORRECT ANSWER THYROID
FUNCTION TEST
TSH: 0.4-4.5
T3: 100-200
T4: 5-11
The patient has a b12 level of 126 picograms/mL. what symptoms may the patient
experience? - CORRECT ANSWER normal B12: 190-950 picograms/mL
but borderline is 200-300 & will need additional testing.
depression, mania, psychotic symptoms, cognitive impairment
, Name the normal vitamin D levels: - CORRECT ANSWER 20-50 ng/ML
Tell me about the HAM-A - CORRECT ANSWER This is the Hamilton Anxiety Scale,
creates to assess somatic/cognitive anxiety symptoms. MAINLY TO ASSESS
ANXIETY. It does not help to assess the worry aspect usually found with GAD.
less than 17- mild
18-23- mod
25-30 mod-severe
_____ shows there is an INCREASE activation of the amygdala which is an increase in
the fear response. There is a decreased activation of the pre-frontal cortex which results
in lessened reasoning. - CORRECT ANSWER Generalized Anxiety Disorder
Explain GAD - CORRECT ANSWER This is characterized when a person WORRY
about ORDINARY, everyday situations. These patients have a hard time getting over
the what ifs and hyperfixate. Due to this they are unable to get more of their pressing
tasks done
What is the DSM criteria for GAD? - CORRECT ANSWER WORRY about everyday
tasks, sleep disturbance, restlessness, fatigue and immanent fear, muscle tension or
difficulty concentrating has to be persistent for six months or GREATER
Name the first line treatment for GAD. - CORRECT ANSWER SSRIs
What are some s/e of SSRIS? - CORRECT ANSWER hyponatremia, weight loss,
weight gain, anxiety in the initial stages.
What is another adjunct treatment or PRN medication used as a treatment for GAD? -
CORRECT ANSWER Buspirone- This is an anxiolytic with decreased adverse effects &
drug interactions. It can take about 2-4 weeks to work and it is pretty weak however
effective when used as an adjunct.
What is the GAD-7 screening tool? - CORRECT ANSWER This is a rapid screening for
the presence of clinically significant anxiety disorders such as: GAD, Panic disorders,
PTSD, & social phobias.
5-9- mild
10-14- moderate
over 15- severe & active treatment is warranted
Name the DSM for panic disorder - CORRECT ANSWER Panic disorder is a MARKED
PERSISTENT reoccurimg panic attacks associated with worry or concern of a negative
outcome. These attacks are usually UNPROVOKED & can happen in familiar places
like home or school. The panic attacks can peak from 10-20 minutes but some can last
for hours.
& ACTUAL CORRECT ANSWERS
Name the 6 of a differential diagnosis - CORRECT ANSWER 1.) RULE OUT
Malingering or Factitious disorder
2.)Ruling out substance etiology
3.) ruling out a medical etiology
4.) Determining the specific primary disorder
5.) Differentiating adjustment disorder from the residual "other specified" and
"unspecified" conditions
6.) Establishing the boundary with no mental disorder
Remember with step 5, the PMHNP can use "other specified" in the diagnosis when
they want to indicate the specific reason for a diagnosis.
They use "unspecified" if:
the information doesn’t conform to DSM5
there is insufficient info to make a specific diagnosis
there is more info the be revealed with time OR they want to help the patient avoid
stigmas - CORRECT ANSWER
The PMHNP wants to rule out anemia as a cause for a patients fatigue and lack of
motivation. What lab should she order? - CORRECT ANSWER a CBC with iron studies
hg-12-18
hematocrit: 38-48%
What is normal creat/BUN level? - CORRECT ANSWER BUN: 7-18
creat: 0.6-1.2
A patient presents with brain fog, lack of focus, insomnia & mood swing, lack of mental
alertness. What lab should the PMHNP order? - CORRECT ANSWER THYROID
FUNCTION TEST
TSH: 0.4-4.5
T3: 100-200
T4: 5-11
The patient has a b12 level of 126 picograms/mL. what symptoms may the patient
experience? - CORRECT ANSWER normal B12: 190-950 picograms/mL
but borderline is 200-300 & will need additional testing.
depression, mania, psychotic symptoms, cognitive impairment
, Name the normal vitamin D levels: - CORRECT ANSWER 20-50 ng/ML
Tell me about the HAM-A - CORRECT ANSWER This is the Hamilton Anxiety Scale,
creates to assess somatic/cognitive anxiety symptoms. MAINLY TO ASSESS
ANXIETY. It does not help to assess the worry aspect usually found with GAD.
less than 17- mild
18-23- mod
25-30 mod-severe
_____ shows there is an INCREASE activation of the amygdala which is an increase in
the fear response. There is a decreased activation of the pre-frontal cortex which results
in lessened reasoning. - CORRECT ANSWER Generalized Anxiety Disorder
Explain GAD - CORRECT ANSWER This is characterized when a person WORRY
about ORDINARY, everyday situations. These patients have a hard time getting over
the what ifs and hyperfixate. Due to this they are unable to get more of their pressing
tasks done
What is the DSM criteria for GAD? - CORRECT ANSWER WORRY about everyday
tasks, sleep disturbance, restlessness, fatigue and immanent fear, muscle tension or
difficulty concentrating has to be persistent for six months or GREATER
Name the first line treatment for GAD. - CORRECT ANSWER SSRIs
What are some s/e of SSRIS? - CORRECT ANSWER hyponatremia, weight loss,
weight gain, anxiety in the initial stages.
What is another adjunct treatment or PRN medication used as a treatment for GAD? -
CORRECT ANSWER Buspirone- This is an anxiolytic with decreased adverse effects &
drug interactions. It can take about 2-4 weeks to work and it is pretty weak however
effective when used as an adjunct.
What is the GAD-7 screening tool? - CORRECT ANSWER This is a rapid screening for
the presence of clinically significant anxiety disorders such as: GAD, Panic disorders,
PTSD, & social phobias.
5-9- mild
10-14- moderate
over 15- severe & active treatment is warranted
Name the DSM for panic disorder - CORRECT ANSWER Panic disorder is a MARKED
PERSISTENT reoccurimg panic attacks associated with worry or concern of a negative
outcome. These attacks are usually UNPROVOKED & can happen in familiar places
like home or school. The panic attacks can peak from 10-20 minutes but some can last
for hours.
