NR547 Week 9 Exam V1 | NR547
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 9 Exam) | Chamberlain University
1. A 32-year-old patient presents with a history of at least one week of expansive mood,
grandiosity, and decreased need for sleep which led to an arrest for reckless driving. He has
never experienced a major depressive episode. According to DSM-5-TR, what is the most
likely diagnosis?
A. Bipolar II Disorder
B. Cyclothymic Disorder
C. Bipolar I Disorder
D. Major Depressive Disorder
Answer: C
Rationale: Bipolar I disorder requires the presence of at least one manic episode that lasts
at least one week or requires hospitalization. Unlike Bipolar II, a major depressive episode
is not a requirement for a Bipolar I diagnosis. The patient’s symptoms of grandiosity and
reckless behavior meet the criteria for mania.
,2. Which of the following clinical features most accurately distinguishes Delirium from Major
Neurocognitive Disorder?
A. Memory impairment
B. Acute onset and fluctuating course
C. Difficulty with complex tasks
D. Aphasia and apraxia
Answer: B
Rationale: Delirium is characterized by an acute onset, typically over hours to days, and a
fluctuating course throughout the day. Major Neurocognitive Disorder, such as Alzheimer’s,
usually involves a slow, progressive decline in cognitive function. Identifying the temporal
pattern of symptom onset is critical for differential diagnosis in geriatric populations.
3. A 9-year-old child exhibits persistent irritability and frequent episodes of extreme
behavioral dyscontrol occurring at least three times a week for the past year. What is the
appropriate DSM-5-TR diagnosis?
A. Oppositional Defiant Disorder
B. Disruptive Mood Dysregulation Disorder (DMDD)
C. Bipolar I Disorder
D. Attention-Deficit/Hyperactivity Disorder
Answer: B
,Rationale: Disruptive Mood Dysregulation Disorder was introduced to address the over-
diagnosis of bipolar disorder in children. It requires severe recurrent temper outbursts and
a persistently irritable or angry mood between outbursts. Symptoms must be present for at
least 12 months and manifest before age 10.
4. When evaluating a patient for Schizoaffective Disorder, what is the primary requirement
regarding the relationship between mood symptoms and psychotic symptoms?
A. There must be no history of mood episodes.
B. Mood symptoms must be present for the entire duration of the illness.
C. Psychotic symptoms only occur during a major depressive or manic episode.
D. Delusions or hallucinations must be present for 2 weeks in the absence of a major mood
episode.
Answer: D
Rationale: The DSM-5-TR specifies that for a diagnosis of Schizoaffective Disorder,
delusions or hallucinations must occur for at least 2 weeks without a major mood episode.
This distinguishes it from mood disorders with psychotic features, where psychosis occurs
only during the mood episode. Additionally, mood symptoms must be present for the
majority of the total duration of the active and residual illness phases.
5. Which symptom is part of the ‘negative symptoms’ cluster in Schizophrenia?
A. Hallucinations
B. Flat affect
, C. Disorganized speech
D. Delusions
Answer: B
Rationale: Negative symptoms refer to a decrease or loss of normal functions, such as flat
affect, alogia, or avolition. Hallucinations and delusions are considered positive symptoms
because they represent an excess or distortion of normal function. Distinguishing between
positive and negative symptoms is essential for selecting appropriate pharmacological
interventions.
6. A patient reports excessive worry about several events or activities for the past 7 months.
She finds it difficult to control the worry and reports restlessness and muscle tension. What
diagnosis is most likely?
A. Panic Disorder
B. Social Anxiety Disorder
C. Adjustment Disorder with Anxiety
D. Generalized Anxiety Disorder (GAD)
Answer: D
Rationale: Generalized Anxiety Disorder requires excessive anxiety and worry occurring
more days than not for at least 6 months. The worry must be associated with at least three
physical or cognitive symptoms such as restlessness, fatigue, or muscle tension. This
patient meets both the duration and symptomatic criteria for GAD.
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 9 Exam) | Chamberlain University
1. A 32-year-old patient presents with a history of at least one week of expansive mood,
grandiosity, and decreased need for sleep which led to an arrest for reckless driving. He has
never experienced a major depressive episode. According to DSM-5-TR, what is the most
likely diagnosis?
A. Bipolar II Disorder
B. Cyclothymic Disorder
C. Bipolar I Disorder
D. Major Depressive Disorder
Answer: C
Rationale: Bipolar I disorder requires the presence of at least one manic episode that lasts
at least one week or requires hospitalization. Unlike Bipolar II, a major depressive episode
is not a requirement for a Bipolar I diagnosis. The patient’s symptoms of grandiosity and
reckless behavior meet the criteria for mania.
,2. Which of the following clinical features most accurately distinguishes Delirium from Major
Neurocognitive Disorder?
A. Memory impairment
B. Acute onset and fluctuating course
C. Difficulty with complex tasks
D. Aphasia and apraxia
Answer: B
Rationale: Delirium is characterized by an acute onset, typically over hours to days, and a
fluctuating course throughout the day. Major Neurocognitive Disorder, such as Alzheimer’s,
usually involves a slow, progressive decline in cognitive function. Identifying the temporal
pattern of symptom onset is critical for differential diagnosis in geriatric populations.
3. A 9-year-old child exhibits persistent irritability and frequent episodes of extreme
behavioral dyscontrol occurring at least three times a week for the past year. What is the
appropriate DSM-5-TR diagnosis?
A. Oppositional Defiant Disorder
B. Disruptive Mood Dysregulation Disorder (DMDD)
C. Bipolar I Disorder
D. Attention-Deficit/Hyperactivity Disorder
Answer: B
,Rationale: Disruptive Mood Dysregulation Disorder was introduced to address the over-
diagnosis of bipolar disorder in children. It requires severe recurrent temper outbursts and
a persistently irritable or angry mood between outbursts. Symptoms must be present for at
least 12 months and manifest before age 10.
4. When evaluating a patient for Schizoaffective Disorder, what is the primary requirement
regarding the relationship between mood symptoms and psychotic symptoms?
A. There must be no history of mood episodes.
B. Mood symptoms must be present for the entire duration of the illness.
C. Psychotic symptoms only occur during a major depressive or manic episode.
D. Delusions or hallucinations must be present for 2 weeks in the absence of a major mood
episode.
Answer: D
Rationale: The DSM-5-TR specifies that for a diagnosis of Schizoaffective Disorder,
delusions or hallucinations must occur for at least 2 weeks without a major mood episode.
This distinguishes it from mood disorders with psychotic features, where psychosis occurs
only during the mood episode. Additionally, mood symptoms must be present for the
majority of the total duration of the active and residual illness phases.
5. Which symptom is part of the ‘negative symptoms’ cluster in Schizophrenia?
A. Hallucinations
B. Flat affect
, C. Disorganized speech
D. Delusions
Answer: B
Rationale: Negative symptoms refer to a decrease or loss of normal functions, such as flat
affect, alogia, or avolition. Hallucinations and delusions are considered positive symptoms
because they represent an excess or distortion of normal function. Distinguishing between
positive and negative symptoms is essential for selecting appropriate pharmacological
interventions.
6. A patient reports excessive worry about several events or activities for the past 7 months.
She finds it difficult to control the worry and reports restlessness and muscle tension. What
diagnosis is most likely?
A. Panic Disorder
B. Social Anxiety Disorder
C. Adjustment Disorder with Anxiety
D. Generalized Anxiety Disorder (GAD)
Answer: D
Rationale: Generalized Anxiety Disorder requires excessive anxiety and worry occurring
more days than not for at least 6 months. The worry must be associated with at least three
physical or cognitive symptoms such as restlessness, fatigue, or muscle tension. This
patient meets both the duration and symptomatic criteria for GAD.
