NR547 Week 6 Exam V3 | NR547
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 6 Exam) | Chamberlain University
1. A 9-year-old child presents with persistent irritability and frequent episodes of extreme
behavioral dysregulation occurring at least three times per week. Which diagnosis should the
PMHNP consider first according to DSM-5 criteria?
A. Disruptive Mood Dysregulation Disorder
B. Bipolar I Disorder
C. Oppositional Defiant Disorder
D. Attention-Deficit/Hyperactivity Disorder
Answer: A
Rationale: Disruptive Mood Dysregulation Disorder (DMDD) was introduced to address
concerns about the overdiagnosis of Bipolar Disorder in children. The core feature is
chronic, severe persistent irritability with frequent temper outbursts. To meet criteria,
these symptoms must be present for at least 12 months in at least two settings.
2. When evaluating a child for Autism Spectrum Disorder (ASD), which of the following is
considered a core deficit in social communication and social interaction?
A. Highly restricted, fixated interests
,B. Extreme sensitivity to loud noises
C. Inflexible adherence to routines
D. Failure of normal back-and-forth conversation
Answer: D
Rationale: Social-emotional reciprocity, such as the failure of normal back-and-forth
conversation, is a primary diagnostic criterion for ASD. While sensory sensitivity and rigid
routines are symptoms of ASD, they fall under the category of restricted, repetitive patterns
of behavior. A thorough assessment must identify deficits in all three sub-categories of
social communication for a diagnosis.
3. A PMHNP is assessing a 15-year-old who reports experiencing intrusive memories and
nightmares for the past 6 weeks following a car accident. What is the most likely diagnosis?
A. Acute Stress Disorder
B. Post-Traumatic Stress Disorder
C. Adjustment Disorder
D. Generalized Anxiety Disorder
Answer: B
Rationale: Post-Traumatic Stress Disorder (PTSD) is diagnosed when symptoms persist
for more than one month following exposure to a traumatic event. Acute Stress Disorder is
limited to a duration of 3 days to 1 month after the event. The presence of intrusive
, symptoms, avoidance, and negative alterations in cognition are hallmark signs of this
condition.
4. Which symptom is a requirement for the diagnosis of Attention-Deficit/Hyperactivity
Disorder (ADHD) in a child?
A. Symptoms must be present in at least two settings
B. Symptoms must be present before age 7
C. Presence of at least 9 symptoms of inattention
D. Symptoms must be related to an underlying medical condition
Answer: A
Rationale: The DSM-5 specifies that several inattentive or hyperactive-impulsive
symptoms must be present in two or more settings, such as home, school, or work.
Symptoms must also be present prior to age 12, not age 7 as in previous editions. This
requirement helps differentiate ADHD from situational behavioral issues.
5. A 5-year-old child is brought to the clinic because they have failed to speak in school for the
past 3 months, despite speaking normally at home. What is the appropriate diagnosis?
A. Social Anxiety Disorder
B. Communication Disorder
C. Autism Spectrum Disorder
D. Selective Mutism
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 6 Exam) | Chamberlain University
1. A 9-year-old child presents with persistent irritability and frequent episodes of extreme
behavioral dysregulation occurring at least three times per week. Which diagnosis should the
PMHNP consider first according to DSM-5 criteria?
A. Disruptive Mood Dysregulation Disorder
B. Bipolar I Disorder
C. Oppositional Defiant Disorder
D. Attention-Deficit/Hyperactivity Disorder
Answer: A
Rationale: Disruptive Mood Dysregulation Disorder (DMDD) was introduced to address
concerns about the overdiagnosis of Bipolar Disorder in children. The core feature is
chronic, severe persistent irritability with frequent temper outbursts. To meet criteria,
these symptoms must be present for at least 12 months in at least two settings.
2. When evaluating a child for Autism Spectrum Disorder (ASD), which of the following is
considered a core deficit in social communication and social interaction?
A. Highly restricted, fixated interests
,B. Extreme sensitivity to loud noises
C. Inflexible adherence to routines
D. Failure of normal back-and-forth conversation
Answer: D
Rationale: Social-emotional reciprocity, such as the failure of normal back-and-forth
conversation, is a primary diagnostic criterion for ASD. While sensory sensitivity and rigid
routines are symptoms of ASD, they fall under the category of restricted, repetitive patterns
of behavior. A thorough assessment must identify deficits in all three sub-categories of
social communication for a diagnosis.
3. A PMHNP is assessing a 15-year-old who reports experiencing intrusive memories and
nightmares for the past 6 weeks following a car accident. What is the most likely diagnosis?
A. Acute Stress Disorder
B. Post-Traumatic Stress Disorder
C. Adjustment Disorder
D. Generalized Anxiety Disorder
Answer: B
Rationale: Post-Traumatic Stress Disorder (PTSD) is diagnosed when symptoms persist
for more than one month following exposure to a traumatic event. Acute Stress Disorder is
limited to a duration of 3 days to 1 month after the event. The presence of intrusive
, symptoms, avoidance, and negative alterations in cognition are hallmark signs of this
condition.
4. Which symptom is a requirement for the diagnosis of Attention-Deficit/Hyperactivity
Disorder (ADHD) in a child?
A. Symptoms must be present in at least two settings
B. Symptoms must be present before age 7
C. Presence of at least 9 symptoms of inattention
D. Symptoms must be related to an underlying medical condition
Answer: A
Rationale: The DSM-5 specifies that several inattentive or hyperactive-impulsive
symptoms must be present in two or more settings, such as home, school, or work.
Symptoms must also be present prior to age 12, not age 7 as in previous editions. This
requirement helps differentiate ADHD from situational behavioral issues.
5. A 5-year-old child is brought to the clinic because they have failed to speak in school for the
past 3 months, despite speaking normally at home. What is the appropriate diagnosis?
A. Social Anxiety Disorder
B. Communication Disorder
C. Autism Spectrum Disorder
D. Selective Mutism
