NR 547 / NR547 Differential Diagnosis
Psychiatric-Mental Health Lifespan Midterm Exam
Review Actual 2025/2026 with Detailed Rationales |
100% Verified | Pass Guaranteed – A+ Graded
SECTION 1: Foundations of Psychiatric Differential Diagnosis (10
Questions)
Q1: A 28-year-old patient presents with depressed mood, anhedonia, and fatigue.
They report a 2-week history of hypomanic symptoms that resolved spontaneously.
What is the most likely diagnosis?
A. Major depressive disorder
B. Bipolar II disorder
C. Persistent depressive disorder
D. Cyclothymic disorder
Correct Answer: B
Rationale: Correct because bipolar II requires at least one hypomanic episode and
major depressive episodes.
Q2: A patient reports hearing voices commenting on their actions. There are no other
psychotic symptoms, and the patient is not distressed. What is the most appropriate
next step?
A. Diagnose schizophrenia
B. Conduct a thorough psychiatric evaluation
C. Prescribe antipsychotic medication
D. Hospitalize immediately
Correct Answer: B
Rationale: Correct because isolated auditory hallucinations may be within normal
variation or require further evaluation.
,Q3: A patient with schizophrenia has been stable on antipsychotics but now presents
with worsening psychosis and new-onset tremors. What is the most likely cause?
A. Medication side effects
B. Substance use
C. Non-adherence
D. All of the above
Correct Answer: D
Rationale: Correct because all are potential causes requiring differential assessment.
Q4: A patient with MDD is started on an antidepressant and now reports elevated
mood, increased energy, and decreased need for sleep. What is the most likely
diagnosis?
A. Medication-induced hypomania
B. Bipolar disorder
C. Normal response
D. Mania
Correct Answer: A
Rationale: Correct because antidepressant-induced elevated mood suggests bipolar
diathesis or medication effect.
Q5: A patient with depressive symptoms, but TSH is elevated. What is the most likely
diagnosis?
A. MDD
B. Bipolar depression
C. Hypothyroidism-induced depression
D. Substance-induced depression
Correct Answer: C
Rationale: Correct because hypothyroidism commonly presents as depression; TSH
must be checked.
Q6: A patient with weight loss, hyperactivity, and palpitations. TSH is low. What is the
most likely diagnosis?
A. Hyperthyroidism
B. MDD
C. Bipolar disorder
D. Anxiety disorder
Correct Answer: A
, Rationale: Correct because hyperthyroidism causes weight loss, hyperactivity, and
palpitations.
Q7: A patient with MDD and anxiety is started on an SSRI and now reports agitation
and restlessness. What is the most likely cause?
A. SSRI-induced agitation
B. Worsening depression
C. Bipolar switch
D. Serotonin syndrome
Correct Answer: A
Rationale: Correct because SSRI activation can cause early agitation; dose
adjustment may be needed.
Q8: A patient with substance use disorder has been using alcohol heavily. What is
the most important assessment?
A. Liver function
B. Withdrawal symptoms
C. Nutritional status
D. All of the above
Correct Answer: D
Rationale: Correct because comprehensive assessment including LFTs, withdrawal,
and nutrition is needed.
Q9: A patient with schizophrenia is prescribed clozapine. What lab monitoring is
required for agranulocytosis?
A. WBC and absolute neutrophil count
B. CBC with differential
C. Both A and B
D. LFTs
Correct Answer: C
Rationale: Correct because clozapine requires WBC and ANC monitoring for
agranulocytosis.
Q10: A patient with schizophrenia on clozapine has a WBC of 2,900. What is the
action?
A. Continue current dose
Psychiatric-Mental Health Lifespan Midterm Exam
Review Actual 2025/2026 with Detailed Rationales |
100% Verified | Pass Guaranteed – A+ Graded
SECTION 1: Foundations of Psychiatric Differential Diagnosis (10
Questions)
Q1: A 28-year-old patient presents with depressed mood, anhedonia, and fatigue.
They report a 2-week history of hypomanic symptoms that resolved spontaneously.
What is the most likely diagnosis?
A. Major depressive disorder
B. Bipolar II disorder
C. Persistent depressive disorder
D. Cyclothymic disorder
Correct Answer: B
Rationale: Correct because bipolar II requires at least one hypomanic episode and
major depressive episodes.
Q2: A patient reports hearing voices commenting on their actions. There are no other
psychotic symptoms, and the patient is not distressed. What is the most appropriate
next step?
A. Diagnose schizophrenia
B. Conduct a thorough psychiatric evaluation
C. Prescribe antipsychotic medication
D. Hospitalize immediately
Correct Answer: B
Rationale: Correct because isolated auditory hallucinations may be within normal
variation or require further evaluation.
,Q3: A patient with schizophrenia has been stable on antipsychotics but now presents
with worsening psychosis and new-onset tremors. What is the most likely cause?
A. Medication side effects
B. Substance use
C. Non-adherence
D. All of the above
Correct Answer: D
Rationale: Correct because all are potential causes requiring differential assessment.
Q4: A patient with MDD is started on an antidepressant and now reports elevated
mood, increased energy, and decreased need for sleep. What is the most likely
diagnosis?
A. Medication-induced hypomania
B. Bipolar disorder
C. Normal response
D. Mania
Correct Answer: A
Rationale: Correct because antidepressant-induced elevated mood suggests bipolar
diathesis or medication effect.
Q5: A patient with depressive symptoms, but TSH is elevated. What is the most likely
diagnosis?
A. MDD
B. Bipolar depression
C. Hypothyroidism-induced depression
D. Substance-induced depression
Correct Answer: C
Rationale: Correct because hypothyroidism commonly presents as depression; TSH
must be checked.
Q6: A patient with weight loss, hyperactivity, and palpitations. TSH is low. What is the
most likely diagnosis?
A. Hyperthyroidism
B. MDD
C. Bipolar disorder
D. Anxiety disorder
Correct Answer: A
, Rationale: Correct because hyperthyroidism causes weight loss, hyperactivity, and
palpitations.
Q7: A patient with MDD and anxiety is started on an SSRI and now reports agitation
and restlessness. What is the most likely cause?
A. SSRI-induced agitation
B. Worsening depression
C. Bipolar switch
D. Serotonin syndrome
Correct Answer: A
Rationale: Correct because SSRI activation can cause early agitation; dose
adjustment may be needed.
Q8: A patient with substance use disorder has been using alcohol heavily. What is
the most important assessment?
A. Liver function
B. Withdrawal symptoms
C. Nutritional status
D. All of the above
Correct Answer: D
Rationale: Correct because comprehensive assessment including LFTs, withdrawal,
and nutrition is needed.
Q9: A patient with schizophrenia is prescribed clozapine. What lab monitoring is
required for agranulocytosis?
A. WBC and absolute neutrophil count
B. CBC with differential
C. Both A and B
D. LFTs
Correct Answer: C
Rationale: Correct because clozapine requires WBC and ANC monitoring for
agranulocytosis.
Q10: A patient with schizophrenia on clozapine has a WBC of 2,900. What is the
action?
A. Continue current dose
