NR547 Week 7 Exam V1 | NR547
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 7 Exam) | Chamberlain University
1. A 24-year-old patient presents with a history of at least one manic episode that lasted for
more than one week. The patient denies any previous major depressive episodes. According
to the DSM-5-TR, which diagnosis is most appropriate?
A. Bipolar I Disorder
B. Bipolar II Disorder
C. Cyclothymic Disorder
D. Schizoaffective Disorder
Answer: A
Rationale: Bipolar I Disorder is characterized by at least one manic episode that lasts at
least one week or requires hospitalization. While major depressive episodes are common
in Bipolar I, they are not a requirement for the diagnosis. This distinguishes it from Bipolar
II, which requires both a hypomanic episode and a major depressive episode.
2. When differentiating between Schizophreniform Disorder and Schizophrenia, what is the
primary diagnostic factor regarding the duration of symptoms?
A. Symptoms must be present for at least 2 years for Schizophrenia.
,B. Symptoms must last more than 6 months for Schizophreniform.
C. Symptoms must last at least 1 month but less than 6 months for Schizophreniform.
D. There is no duration difference; the distinction is based on the severity of hallucinations.
Answer: C
Rationale: Schizophreniform Disorder requires that the total duration of the illness be at
least one month but less than six months. If the symptoms persist beyond six months, the
diagnosis must be changed to Schizophrenia. This temporal threshold is a critical
component of the differential diagnosis process in psychotic disorders.
3. A 9-year-old child presents with chronic, severe irritability and frequent temper outbursts
that are out of proportion to the situation. These symptoms occur at least three times a week
across multiple settings. Which diagnosis is most likely?
A. Disruptive Mood Dysregulation Disorder (DMDD)
B. Attention-Deficit/Hyperactivity Disorder (ADHD)
C. Oppositional Defiant Disorder (ODD)
D. Pediatric Bipolar Disorder
Answer: A
Rationale: Disruptive Mood Dysregulation Disorder (DMDD) was introduced to address
the over-diagnosis of bipolar disorder in children. It is characterized by severe recurrent
temper outbursts and a persistently irritable or angry mood between outbursts. The
,symptoms must be present for 12 or more months and occur in at least two different
settings.
4. Which of the following personality disorders is characterized by a pervasive pattern of
social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation?
A. Schizoid Personality Disorder
B. Avoidant Personality Disorder
C. Dependent Personality Disorder
D. Borderline Personality Disorder
Answer: B
Rationale: Avoidant Personality Disorder involves a long-standing pattern of avoiding
social contact primarily due to a fear of rejection or criticism. Unlike Schizoid Personality
Disorder, where individuals prefer isolation, those with Avoidant Personality Disorder
often desire relationships but are too fearful to pursue them. The diagnosis requires the
presence of these symptoms starting by early adulthood across various contexts.
5. An elderly patient is brought to the clinic by family members who report a sudden onset of
confusion, fluctuating levels of consciousness, and visual hallucinations over the last 48
hours. What is the priority differential diagnosis?
A. Delirium
B. Major Neurocognitive Disorder (Dementia)
C. Late-Onset Schizophrenia
, D. Depression with Psychotic Features
Answer: A
Rationale: Delirium is characterized by an acute onset of cognitive impairment and a
fluctuating course of consciousness. It is often triggered by an underlying medical
condition, substance toxicity, or withdrawal, especially in the geriatric population.
Differentiating delirium from dementia is crucial because delirium is often reversible once
the underlying cause is treated.
6. A patient reports experiencing a traumatic event four weeks ago and has since been
suffering from intrusive memories, avoidance of reminders, and hypervigilance. What is the
most appropriate diagnosis if the symptoms have lasted exactly 28 days?
A. Post-Traumatic Stress Disorder (PTSD)
B. Acute Stress Disorder
C. Adjustment Disorder
D. Generalized Anxiety Disorder
Answer: B
Rationale: Acute Stress Disorder is diagnosed when symptoms occur within one month of
the traumatic event and last for at least three days but no more than one month. If the
symptoms persist beyond one month, the diagnosis is updated to Post-Traumatic Stress
Disorder (PTSD). Understanding this timeline is essential for accurate clinical coding and
treatment planning.
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 7 Exam) | Chamberlain University
1. A 24-year-old patient presents with a history of at least one manic episode that lasted for
more than one week. The patient denies any previous major depressive episodes. According
to the DSM-5-TR, which diagnosis is most appropriate?
A. Bipolar I Disorder
B. Bipolar II Disorder
C. Cyclothymic Disorder
D. Schizoaffective Disorder
Answer: A
Rationale: Bipolar I Disorder is characterized by at least one manic episode that lasts at
least one week or requires hospitalization. While major depressive episodes are common
in Bipolar I, they are not a requirement for the diagnosis. This distinguishes it from Bipolar
II, which requires both a hypomanic episode and a major depressive episode.
2. When differentiating between Schizophreniform Disorder and Schizophrenia, what is the
primary diagnostic factor regarding the duration of symptoms?
A. Symptoms must be present for at least 2 years for Schizophrenia.
,B. Symptoms must last more than 6 months for Schizophreniform.
C. Symptoms must last at least 1 month but less than 6 months for Schizophreniform.
D. There is no duration difference; the distinction is based on the severity of hallucinations.
Answer: C
Rationale: Schizophreniform Disorder requires that the total duration of the illness be at
least one month but less than six months. If the symptoms persist beyond six months, the
diagnosis must be changed to Schizophrenia. This temporal threshold is a critical
component of the differential diagnosis process in psychotic disorders.
3. A 9-year-old child presents with chronic, severe irritability and frequent temper outbursts
that are out of proportion to the situation. These symptoms occur at least three times a week
across multiple settings. Which diagnosis is most likely?
A. Disruptive Mood Dysregulation Disorder (DMDD)
B. Attention-Deficit/Hyperactivity Disorder (ADHD)
C. Oppositional Defiant Disorder (ODD)
D. Pediatric Bipolar Disorder
Answer: A
Rationale: Disruptive Mood Dysregulation Disorder (DMDD) was introduced to address
the over-diagnosis of bipolar disorder in children. It is characterized by severe recurrent
temper outbursts and a persistently irritable or angry mood between outbursts. The
,symptoms must be present for 12 or more months and occur in at least two different
settings.
4. Which of the following personality disorders is characterized by a pervasive pattern of
social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation?
A. Schizoid Personality Disorder
B. Avoidant Personality Disorder
C. Dependent Personality Disorder
D. Borderline Personality Disorder
Answer: B
Rationale: Avoidant Personality Disorder involves a long-standing pattern of avoiding
social contact primarily due to a fear of rejection or criticism. Unlike Schizoid Personality
Disorder, where individuals prefer isolation, those with Avoidant Personality Disorder
often desire relationships but are too fearful to pursue them. The diagnosis requires the
presence of these symptoms starting by early adulthood across various contexts.
5. An elderly patient is brought to the clinic by family members who report a sudden onset of
confusion, fluctuating levels of consciousness, and visual hallucinations over the last 48
hours. What is the priority differential diagnosis?
A. Delirium
B. Major Neurocognitive Disorder (Dementia)
C. Late-Onset Schizophrenia
, D. Depression with Psychotic Features
Answer: A
Rationale: Delirium is characterized by an acute onset of cognitive impairment and a
fluctuating course of consciousness. It is often triggered by an underlying medical
condition, substance toxicity, or withdrawal, especially in the geriatric population.
Differentiating delirium from dementia is crucial because delirium is often reversible once
the underlying cause is treated.
6. A patient reports experiencing a traumatic event four weeks ago and has since been
suffering from intrusive memories, avoidance of reminders, and hypervigilance. What is the
most appropriate diagnosis if the symptoms have lasted exactly 28 days?
A. Post-Traumatic Stress Disorder (PTSD)
B. Acute Stress Disorder
C. Adjustment Disorder
D. Generalized Anxiety Disorder
Answer: B
Rationale: Acute Stress Disorder is diagnosed when symptoms occur within one month of
the traumatic event and last for at least three days but no more than one month. If the
symptoms persist beyond one month, the diagnosis is updated to Post-Traumatic Stress
Disorder (PTSD). Understanding this timeline is essential for accurate clinical coding and
treatment planning.
