NR 547/NR 547 MIDTERM EXAM DIFFERENTIAL DIAGNOSIS
IN PSYCHIATRIC-MENTAL HEALTH ACROSS THE LIFESPAN
NEWEST EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES LATEST UPDATES
2026-2027(VERIFIED ANSWERS) ALREADY GRADED A+
Question 1
A 32-year-old woman presents with depressed mood, anhedonia, hypersomnia, and increased appetite
for 3 weeks. Symptoms began 2 weeks postpartum. Which differential diagnosis is most likely?
A. Major depressive disorder, single episode
B. Bipolar II disorder, current episode depressed
C. **Adjustment disorder with depressed mood
D. Major depressive disorder with peripartum onset
Rationale: Peripartum onset is specified when mood symptoms begin during pregnancy or within 4
weeks postpartum. The timeframe and symptoms fit this diagnosis best.
Question 2
A 45-year-old man reports recurrent episodes of sudden fear, palpitations, sweating, and feeling of
choking lasting 10 minutes. No triggers identified. Medical workup is normal. What is the most likely
differential diagnosis?
A. Specific phobia
B. Generalized anxiety disorder
C. **Panic disorder
D. Social anxiety disorder
Rationale: Panic disorder requires recurrent unexpected panic attacks followed by at least one month
of concern about additional attacks or maladaptive behavior change.
Question 3
A 22-year-old college student avoids speaking in class, fears embarrassment, and has had these
symptoms since adolescence. She speaks normally with family. Most likely diagnosis?
,A. Agoraphobia
B. **Social anxiety disorder (social phobia)
C. Panic disorder
D. Avoidant personality disorder
Rationale: Social anxiety disorder involves marked fear of social situations where scrutiny may occur,
with avoidance or distress. Symptoms since adolescence are typical.
Question 4
A 60-year-old woman with no psychiatric history develops new-onset auditory hallucinations, paranoid
delusions, and confusion over 2 days. She is febrile and has a urinary tract infection. Best differential?
A. Schizophrenia
B. **Delirium
C. Major neurocognitive disorder
D. Brief psychotic disorder
Rationale: Delirium is acute, fluctuates, and is caused by a medical condition (UTI). Onset over days
with fever points away from primary psychiatric disorders.
Question 5
A 28-year-old man has had 1 week of grandiose delusions, decreased need for sleep, pressured speech,
and risky spending. No previous episodes. No substance use. Most likely diagnosis?
A. Cyclothymic disorder
B. **Bipolar I disorder, current episode manic
C. Schizoaffective disorder
D. Substance-induced manic episode
Rationale: Manic episode lasting at least 1 week with functional impairment meets criteria for bipolar
I disorder. First episode possible at this age.
Question 6
A 19-year-old woman reports feeling “sad and empty” for 2 years, with low self-esteem, poor appetite,
and insomnia. No manic or hypomanic episodes. What is the best diagnosis?
A. Major depressive disorder, recurrent
B. **Persistent depressive disorder (dysthymia)
C. Adjustment disorder with depressed mood
D. Bipolar II disorder
, Rationale: Persistent depressive disorder requires depressed mood most of the day, more days than not,
for at least 2 years (1 year for youth).
Question 7
A 35-year-old man has recurrent intrusive thoughts about contamination and repetitive handwashing
that take 3 hours daily. He recognizes these are excessive. Most likely diagnosis?
A. Generalized anxiety disorder
B. Illness anxiety disorder
C. **Obsessive-compulsive disorder
D. Body dysmorphic disorder
Rationale: OCD involves obsessions (intrusive thoughts) and compulsions (handwashing) that are
time-consuming and ego-dystonic.
Question 8
A 50-year-old woman reports multiple somatic complaints (pain, fatigue, nausea) for 5 years.
Extensive workup normal. She is distressed but not intentionally producing symptoms. Best
differential?
A. Factitious disorder
B. Malingering
C. **Somatic symptom disorder
D. Conversion disorder
Rationale: Somatic symptom disorder involves distressing somatic symptoms with disproportionate
thoughts and behaviors, without intentional deception.
Question 9
A 24-year-old man has a 6-month history of believing coworkers are poisoning his food, but no
hallucinations or disorganized speech. He functions poorly. Most likely?
A. Schizotypal personality disorder
B. **Delusional disorder, persecutory type
C. Schizophrenia
D. Brief psychotic disorder
*Rationale: Delusional disorder involves non-bizarre delusions for ≥1 month without other psychotic
symptoms or significant impairment in functioning.*
IN PSYCHIATRIC-MENTAL HEALTH ACROSS THE LIFESPAN
NEWEST EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES LATEST UPDATES
2026-2027(VERIFIED ANSWERS) ALREADY GRADED A+
Question 1
A 32-year-old woman presents with depressed mood, anhedonia, hypersomnia, and increased appetite
for 3 weeks. Symptoms began 2 weeks postpartum. Which differential diagnosis is most likely?
A. Major depressive disorder, single episode
B. Bipolar II disorder, current episode depressed
C. **Adjustment disorder with depressed mood
D. Major depressive disorder with peripartum onset
Rationale: Peripartum onset is specified when mood symptoms begin during pregnancy or within 4
weeks postpartum. The timeframe and symptoms fit this diagnosis best.
Question 2
A 45-year-old man reports recurrent episodes of sudden fear, palpitations, sweating, and feeling of
choking lasting 10 minutes. No triggers identified. Medical workup is normal. What is the most likely
differential diagnosis?
A. Specific phobia
B. Generalized anxiety disorder
C. **Panic disorder
D. Social anxiety disorder
Rationale: Panic disorder requires recurrent unexpected panic attacks followed by at least one month
of concern about additional attacks or maladaptive behavior change.
Question 3
A 22-year-old college student avoids speaking in class, fears embarrassment, and has had these
symptoms since adolescence. She speaks normally with family. Most likely diagnosis?
,A. Agoraphobia
B. **Social anxiety disorder (social phobia)
C. Panic disorder
D. Avoidant personality disorder
Rationale: Social anxiety disorder involves marked fear of social situations where scrutiny may occur,
with avoidance or distress. Symptoms since adolescence are typical.
Question 4
A 60-year-old woman with no psychiatric history develops new-onset auditory hallucinations, paranoid
delusions, and confusion over 2 days. She is febrile and has a urinary tract infection. Best differential?
A. Schizophrenia
B. **Delirium
C. Major neurocognitive disorder
D. Brief psychotic disorder
Rationale: Delirium is acute, fluctuates, and is caused by a medical condition (UTI). Onset over days
with fever points away from primary psychiatric disorders.
Question 5
A 28-year-old man has had 1 week of grandiose delusions, decreased need for sleep, pressured speech,
and risky spending. No previous episodes. No substance use. Most likely diagnosis?
A. Cyclothymic disorder
B. **Bipolar I disorder, current episode manic
C. Schizoaffective disorder
D. Substance-induced manic episode
Rationale: Manic episode lasting at least 1 week with functional impairment meets criteria for bipolar
I disorder. First episode possible at this age.
Question 6
A 19-year-old woman reports feeling “sad and empty” for 2 years, with low self-esteem, poor appetite,
and insomnia. No manic or hypomanic episodes. What is the best diagnosis?
A. Major depressive disorder, recurrent
B. **Persistent depressive disorder (dysthymia)
C. Adjustment disorder with depressed mood
D. Bipolar II disorder
, Rationale: Persistent depressive disorder requires depressed mood most of the day, more days than not,
for at least 2 years (1 year for youth).
Question 7
A 35-year-old man has recurrent intrusive thoughts about contamination and repetitive handwashing
that take 3 hours daily. He recognizes these are excessive. Most likely diagnosis?
A. Generalized anxiety disorder
B. Illness anxiety disorder
C. **Obsessive-compulsive disorder
D. Body dysmorphic disorder
Rationale: OCD involves obsessions (intrusive thoughts) and compulsions (handwashing) that are
time-consuming and ego-dystonic.
Question 8
A 50-year-old woman reports multiple somatic complaints (pain, fatigue, nausea) for 5 years.
Extensive workup normal. She is distressed but not intentionally producing symptoms. Best
differential?
A. Factitious disorder
B. Malingering
C. **Somatic symptom disorder
D. Conversion disorder
Rationale: Somatic symptom disorder involves distressing somatic symptoms with disproportionate
thoughts and behaviors, without intentional deception.
Question 9
A 24-year-old man has a 6-month history of believing coworkers are poisoning his food, but no
hallucinations or disorganized speech. He functions poorly. Most likely?
A. Schizotypal personality disorder
B. **Delusional disorder, persecutory type
C. Schizophrenia
D. Brief psychotic disorder
*Rationale: Delusional disorder involves non-bizarre delusions for ≥1 month without other psychotic
symptoms or significant impairment in functioning.*
