NR547 Week 6 Exam V1 | NR547
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 6 Exam) | Chamberlain University
1. A 28-year-old female presents with a history of recurrent depressive episodes. She
describes a distinct period last year where she felt ‘on top of the world,’ required only 3 hours
of sleep for 5 days, and was much more talkative than usual, though she continued to work
effectively. What is the most likely diagnosis?
A. Bipolar II Disorder
B. Bipolar I Disorder
C. Cyclothymic Disorder
D. Major Depressive Disorder
Answer: A
Rationale: Bipolar II Disorder is characterized by at least one major depressive episode
and at least one hypomanic episode. Hypomania lasts at least 4 consecutive days and does
not cause marked impairment in social or occupational functioning. Bipolar I requires a full
manic episode lasting at least 7 days or requiring hospitalization.
,2. A 45-year-old patient being treated for Schizophrenia with Clozapine presents for a routine
follow-up. Which laboratory monitoring is strictly required by the FDA for this medication?
A. Liver Function Tests (LFTs)
B. Serum Creatinine
C. Thyroid Stimulating Hormone (TSH)
D. Absolute Neutrophil Count (ANC)
Answer: D
Rationale: Clozapine carries a significant risk of life-threatening agranulocytosis,
necessitating strict hematologic monitoring. Practitioners must monitor the Absolute
Neutrophil Count (ANC) through a national registry system to ensure patient safety. If the
ANC drops below specific thresholds, the medication must be discontinued immediately to
prevent severe infection.
3. Which of the following is a core requirement for diagnosing Attention-Deficit/Hyperactivity
Disorder (ADHD) in a child according to DSM-5-TR?
A. Symptoms must be present in at least two settings (e.g., home and school).
B. Symptoms must manifest before the age of 5 years.
C. The child must exhibit significant aggressive behavior.
D. Symptoms must be better explained by an anxiety disorder.
Answer: A
,Rationale: The DSM-5-TR specifies that ADHD symptoms of inattention or hyperactivity-
impulsivity must be present in two or more settings to confirm the diagnosis. This
requirement ensures that the behaviors are not simply a reaction to a specific environment
or teacher. Additionally, several symptoms must have been present before the age of 12
years.
4. An 82-year-old patient is brought to the emergency department with acute confusion,
fluctuating levels of consciousness, and visual hallucinations that developed over the last 48
hours. What is the priority differential diagnosis?
A. Delirium
B. Alzheimer’s Disease
C. Major Depressive Disorder
D. Vascular Dementia
Answer: A
Rationale: Delirium is characterized by an acute onset, a fluctuating course of cognitive
impairment, and disturbances in attention. Unlike dementia, which is progressive and
stable, delirium is often triggered by an underlying medical condition, such as a urinary
tract infection. It is considered a medical emergency that requires immediate identification
of the reversible cause.
, 5. A patient taking Phenelzine (an MAOI) is admitted with a severe headache, palpitations,
and a blood pressure of 210/120 mmHg after eating at a deli. What is the likely cause of this
hypertensive crisis?
A. Serotonin Syndrome
B. Ingestion of tyramine-rich foods
C. Overdose of Phenelzine
D. Neuroleptic Malignant Syndrome
Answer: B
Rationale: MAOIs inhibit the breakdown of tyramine, an amino acid found in aged and
fermented foods like deli meats and cheeses. High levels of tyramine cause a massive
release of norepinephrine, leading to dangerous vasoconstriction and hypertensive crisis.
Patients on MAOIs must adhere to a strict low-tyramine diet to prevent these life-
threatening cardiovascular events.
6. A 19-year-old college student reports excessive anxiety about exams, her social life, and
her health for the past 7 months. She struggles to control the worry and reports muscle
tension and irritability. What is the most likely diagnosis?
A. Panic Disorder
B. Generalized Anxiety Disorder (GAD)
C. Social Anxiety Disorder
D. Obsessive-Compulsive Disorder
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 6 Exam) | Chamberlain University
1. A 28-year-old female presents with a history of recurrent depressive episodes. She
describes a distinct period last year where she felt ‘on top of the world,’ required only 3 hours
of sleep for 5 days, and was much more talkative than usual, though she continued to work
effectively. What is the most likely diagnosis?
A. Bipolar II Disorder
B. Bipolar I Disorder
C. Cyclothymic Disorder
D. Major Depressive Disorder
Answer: A
Rationale: Bipolar II Disorder is characterized by at least one major depressive episode
and at least one hypomanic episode. Hypomania lasts at least 4 consecutive days and does
not cause marked impairment in social or occupational functioning. Bipolar I requires a full
manic episode lasting at least 7 days or requiring hospitalization.
,2. A 45-year-old patient being treated for Schizophrenia with Clozapine presents for a routine
follow-up. Which laboratory monitoring is strictly required by the FDA for this medication?
A. Liver Function Tests (LFTs)
B. Serum Creatinine
C. Thyroid Stimulating Hormone (TSH)
D. Absolute Neutrophil Count (ANC)
Answer: D
Rationale: Clozapine carries a significant risk of life-threatening agranulocytosis,
necessitating strict hematologic monitoring. Practitioners must monitor the Absolute
Neutrophil Count (ANC) through a national registry system to ensure patient safety. If the
ANC drops below specific thresholds, the medication must be discontinued immediately to
prevent severe infection.
3. Which of the following is a core requirement for diagnosing Attention-Deficit/Hyperactivity
Disorder (ADHD) in a child according to DSM-5-TR?
A. Symptoms must be present in at least two settings (e.g., home and school).
B. Symptoms must manifest before the age of 5 years.
C. The child must exhibit significant aggressive behavior.
D. Symptoms must be better explained by an anxiety disorder.
Answer: A
,Rationale: The DSM-5-TR specifies that ADHD symptoms of inattention or hyperactivity-
impulsivity must be present in two or more settings to confirm the diagnosis. This
requirement ensures that the behaviors are not simply a reaction to a specific environment
or teacher. Additionally, several symptoms must have been present before the age of 12
years.
4. An 82-year-old patient is brought to the emergency department with acute confusion,
fluctuating levels of consciousness, and visual hallucinations that developed over the last 48
hours. What is the priority differential diagnosis?
A. Delirium
B. Alzheimer’s Disease
C. Major Depressive Disorder
D. Vascular Dementia
Answer: A
Rationale: Delirium is characterized by an acute onset, a fluctuating course of cognitive
impairment, and disturbances in attention. Unlike dementia, which is progressive and
stable, delirium is often triggered by an underlying medical condition, such as a urinary
tract infection. It is considered a medical emergency that requires immediate identification
of the reversible cause.
, 5. A patient taking Phenelzine (an MAOI) is admitted with a severe headache, palpitations,
and a blood pressure of 210/120 mmHg after eating at a deli. What is the likely cause of this
hypertensive crisis?
A. Serotonin Syndrome
B. Ingestion of tyramine-rich foods
C. Overdose of Phenelzine
D. Neuroleptic Malignant Syndrome
Answer: B
Rationale: MAOIs inhibit the breakdown of tyramine, an amino acid found in aged and
fermented foods like deli meats and cheeses. High levels of tyramine cause a massive
release of norepinephrine, leading to dangerous vasoconstriction and hypertensive crisis.
Patients on MAOIs must adhere to a strict low-tyramine diet to prevent these life-
threatening cardiovascular events.
6. A 19-year-old college student reports excessive anxiety about exams, her social life, and
her health for the past 7 months. She struggles to control the worry and reports muscle
tension and irritability. What is the most likely diagnosis?
A. Panic Disorder
B. Generalized Anxiety Disorder (GAD)
C. Social Anxiety Disorder
D. Obsessive-Compulsive Disorder
