NR547 Week 7 Exam V3 | NR547
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 7 Exam) | Chamberlain University
1. A 25-year-old patient presents with a persistent pattern of social inhibition, feelings of
inadequacy, and hypersensitivity to negative evaluation. Which diagnosis should the PMHNP
prioritize?
A. Avoidant Personality Disorder
B. Schizoid Personality Disorder
C. Dependent Personality Disorder
D. Borderline Personality Disorder
Answer: A
Rationale: Avoidant Personality Disorder is characterized by extreme shyness and fear of
rejection. Unlike Schizoid personality, individuals with Avoidant personality actually desire
social relationships but are paralyzed by fear. The clinician must differentiate this from
social anxiety disorder based on the pervasiveness of the personality traits.
2. When evaluating a patient for Bipolar I Disorder, which clinical criterion is necessary for the
diagnosis?
A. At least one major depressive episode
,B. At least one manic episode
C. Hypomanic symptoms lasting at least 4 days
D. Cyclical mood swings for at least two years
Answer: B
Rationale: Bipolar I Disorder requires the occurrence of at least one manic episode that
lasts for at least one week. While depressive episodes are common, they are not a formal
requirement for the Bipolar I diagnosis in the DSM-5. The PMHNP must ensure that the
manic symptoms are not better explained by a substance or another medical condition.
3. The PMHNP is assessing a 10-year-old child for ADHD. Which setting must symptoms be
present in to meet DSM-5 criteria?
A. In two or more settings
B. Only in the home environment
C. Only in the school environment
D. In any setting where the child is under stress
Answer: A
Rationale: DSM-5 criteria for ADHD require that several inattentive or hyperactive-
impulsive symptoms are present in two or more settings, such as home, school, or work.
This ensures that the behaviors are pervasive and not just a reaction to a specific teacher or
, environment. The PMHNP should gather data from both parents and teachers to confirm
these findings.
4. A patient reports experiencing a sudden onset of intense fear, palpitations, and shortness
of breath that peaked within 10 minutes. Which screening tool is most appropriate for initial
assessment?
A. Panic Disorder Severity Scale (PDSS)
B. GAD-7
C. PHQ-9
D. MDQ
Answer: A
Rationale: The symptoms described are indicative of a panic attack, making the PDSS a
specific tool for assessing severity and frequency. While the GAD-7 screens for general
anxiety, it may not capture the specific physiological intensity of panic disorder. A thorough
assessment includes ruling out cardiac or thyroid issues that could mimic panic symptoms.
5. Which duration of symptoms is required to diagnose a patient with Schizophreniform
Disorder?
A. Between 1 and 6 months
B. Less than 1 month
C. Greater than 6 months
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 7 Exam) | Chamberlain University
1. A 25-year-old patient presents with a persistent pattern of social inhibition, feelings of
inadequacy, and hypersensitivity to negative evaluation. Which diagnosis should the PMHNP
prioritize?
A. Avoidant Personality Disorder
B. Schizoid Personality Disorder
C. Dependent Personality Disorder
D. Borderline Personality Disorder
Answer: A
Rationale: Avoidant Personality Disorder is characterized by extreme shyness and fear of
rejection. Unlike Schizoid personality, individuals with Avoidant personality actually desire
social relationships but are paralyzed by fear. The clinician must differentiate this from
social anxiety disorder based on the pervasiveness of the personality traits.
2. When evaluating a patient for Bipolar I Disorder, which clinical criterion is necessary for the
diagnosis?
A. At least one major depressive episode
,B. At least one manic episode
C. Hypomanic symptoms lasting at least 4 days
D. Cyclical mood swings for at least two years
Answer: B
Rationale: Bipolar I Disorder requires the occurrence of at least one manic episode that
lasts for at least one week. While depressive episodes are common, they are not a formal
requirement for the Bipolar I diagnosis in the DSM-5. The PMHNP must ensure that the
manic symptoms are not better explained by a substance or another medical condition.
3. The PMHNP is assessing a 10-year-old child for ADHD. Which setting must symptoms be
present in to meet DSM-5 criteria?
A. In two or more settings
B. Only in the home environment
C. Only in the school environment
D. In any setting where the child is under stress
Answer: A
Rationale: DSM-5 criteria for ADHD require that several inattentive or hyperactive-
impulsive symptoms are present in two or more settings, such as home, school, or work.
This ensures that the behaviors are pervasive and not just a reaction to a specific teacher or
, environment. The PMHNP should gather data from both parents and teachers to confirm
these findings.
4. A patient reports experiencing a sudden onset of intense fear, palpitations, and shortness
of breath that peaked within 10 minutes. Which screening tool is most appropriate for initial
assessment?
A. Panic Disorder Severity Scale (PDSS)
B. GAD-7
C. PHQ-9
D. MDQ
Answer: A
Rationale: The symptoms described are indicative of a panic attack, making the PDSS a
specific tool for assessing severity and frequency. While the GAD-7 screens for general
anxiety, it may not capture the specific physiological intensity of panic disorder. A thorough
assessment includes ruling out cardiac or thyroid issues that could mimic panic symptoms.
5. Which duration of symptoms is required to diagnose a patient with Schizophreniform
Disorder?
A. Between 1 and 6 months
B. Less than 1 month
C. Greater than 6 months
