NR 547 MIDTERM EXAM 2024-2025
ACTUAL EXAM TEST BANK 200
QUESTIONS AND CORRECT VERIFIED
ANSWERS
differentialA2diagnosisA2-A2Ans--A2TheA2provider'sA2initialA2hypothesis
-
aA2workingA2listA2ofA2potentialA2problemsA2thatA2canA2beA2associatedA2withA2theA2initialA2or
A2chiefA2complaint
-DiagnosticA2andA2StatisticalA2ManualA2ofA2MentalA2DisordersA2(DSM-5-TR)
•A2providesA2guidanceA2forA2identifyingA2psychiatricA2diagnoses
PsychiatricA2assessment:A2HistoryA2takingA2-A2Ans--A2-HistoryA2ofA2PresentA2Illness
-HowA2longA2haveA2youA2beenA2feelingA2thisA2way?
-DidA2somethingA2happenA2inA2yourA2lifeA2thatA2mayA2haveA2triggeredA2theseA2emotions?
-HowA2isA2thisA2currentA2situationA2impactingA2yourA2life?
TheA2PsychiatricA2History
-HaveA2youA2everA2beenA2hospitalizedA2forA2anyA2mentalA2healthA2issues?
-HaveA2youA2everA2hadA2counselingA2orA2psychotherapy?
-HaveA2youA2everA2takenA2medicationsA2forA2yourA2mentalA2healthA2inA2theA2past?
-AreA2youA2currentlyA2onA2anyA2medicationsA2forA2mentalA2healthA2orA2sleep?
MedicalA2History/ScreeningA2forA2GeneralA2MedicalA2Conditions
-DoA2youA2haveA2aA2primaryA2careA2provider?
-DoA2youA2haveA2anyA2medicalA2illnesses?
-AreA2youA2currentlyA2takingA2anyA2medicationsA2orA2herbalA2supplements?
-DoA2youA2haveA2anyA2allergiesA2toA2medications?
-HaveA2youA2everA2beenA2hospitalizedA2forA2anyA2reason?
-HaveA2youA2everA2hadA2surgery?
FamilyA2PsychiatricA2History
-HasA2anyA2relativeA2ofA2yoursA2everA2beenA2hospitalizedA2forA2aA2mentalA2healthA2issue?
-
HasA2anyA2bloodA2relativeA2ofA2yoursA2everA2beenA2diagnosedA2withA2aA2mentalA2healthA2i
ssue?
-HasA2anyA2bloodA2relativeA2ofA2yoursA2hadA2aA2historyA2ofA2seizuresA2orA2dementia/
Alzheimer's?
SocialA2andA2DevelopmentalA2History
-TellA2meA2aA2littleA2bitA2aboutA2yourA2childhoodA2andA2howA2youA2grewA2up.
-HowA2wasA2yourA2experienceA2inA2schoolA2whenA2youA2wereA2younger?
A2DidA2youA2enjoyA2school?
,-HowA2doA2youA2supportA2yourselfA2withA2yourA2finances?
-DoA2youA2haveA2aA2goodA2supportA2system?A2AreA2youA2currentlyA2inA2aA2relationship?
A2WhereA2doA2youA2live?A2WhoA2doA2youA2liveA2with?
-WhatA2doA2youA2doA2inA2yourA2freeA2time?A2WhatA2activitiesA2doA2youA2enjoy?
ScreeningA2andA2PsychiatricA2RatingA2ScalesA2-A2Ans--A2Evidence-
basedA2screeningA2toolsA2andA2psychiatricA2ratingA2scales
-
canA2helpA2theA2providerA2identifyA2symptomsA2andA2assessA2theirA2severityA2andA2canA2a
ssistA2withA2theA2evaluationA2ofA2responseA2toA2treatment
AA252-year-
oldA2clientA2presentsA2toA2theA2emergencyA2departmentA2followingA2aA2carA2accident.A2Th
eA2emergencyA2departmentA2(ED)A2physicianA2isA2concernedA2thatA2theA2clientA2mayA2hav
eA2intentionallyA2crashedA2herA2carA2andA2requestsA2aA2statA2PMHNPA2consult.A2InA2spea
kingA2withA2theA2PMHNP,A2theA2clientA2describesA2persistentA2feelingsA2ofA2sadnessA2and
A2hopelessness.A2SheA2statesA2thatA2sheA2oftenA2wondersA2ifA2herA2husbandA2wouldA2beA2
happierA2ifA2sheA2wasn'tA2aroundA2anymoreA2sinceA2she'sA2neverA2happyA2andA2sometime
sA2thinksA2aboutA2whatA2itA2wouldA2beA2likeA2toA2justA2takeA2aA2handfulA2ofA2sleepingA2pillsA
2andA2goA2toA2sleepA2forever.A2TheA2clientA2reportsA2aA2previousA2suicideA2attemptA2when
A2sheA2wasA216A2butA2deniesA2thatA2sheA2isA2consideringA2killingA2herselfA2rightA2now.
BasedA2onA2theA2client'sA2ASQA2score,A2whatA2isA2theA2mostA2appropriateA2response?
NoA2actionA2isA2necessaryA2asA2theA2clientA2isA2notA2currentlyA2consideringA2suicide.
ProvideA2aA2briefA2suicideA2safetyA2assessment.A2
AlertA2theA2client'sA2primaryA2careA2physician.
ProvideA2aA2STA2-A2Ans--A2ProvideA2aA2briefA2suicideA2safetyA2assessment.A2
Rationale:A2WhileA2theA2client'sA2responsesA2doA2notA2indicateA2aA2needA2forA2aA2statA2full
A2safetyA2andA2mentalA2healthA2evaluation,A2theA2clientA2requiresA2aA2briefA2suicideA2safet
yA2assessmentA2toA2determineA2whetherA2aA2fullA2mentalA2healthA2evaluationA2inA2necess
ary.A2ItA2isA2alsoA2importantA2toA2notifyA2theA2client'sA2physicianA2orA2theA2clinicianA2respon
sibleA2forA2theA2client'sA2care.
DiagnosticA2TestingA2whenA2diagnosingA2mentalA2healthA2disordersA2-A2Ans--A2-
DiagnosticA2testsA2andA2labsA2areA2mostA2usedA2toA2ruleA2outA2physicalA2conditionsA2thatA
2mayA2causeA2psychiatricA2symptomsA2andA2toA2evaluateA2theA2effectsA2ofA2treatment
BasicA2LaboratoryA2InterpretationA2-A2Ans--A2CompleteA2BloodA2Count
ComprehensiveA2MetabolicA2PanelA2(CMP)
ThyroidA2FunctionA2Tests
VitaminA2B12A2Level
VitaminA2DA2Level
ToxicologyA2Screen
UrinalysisA2(UA)
,BasicA2LaboratoryA2Interpretation:A2CompleteA2BloodA2CountA2-A2Ans--A2-
measuresA2RBCs,A2WBCs,A2hemoglobin,A2hematocrit,A2andA2platelets
-includesA2aA2differentialA2ofA2theA2WBCs
-
InA2mentalA2health,A2theA2CBCA2isA2usedA2toA2ruleA2outA2medicalA2conditionsA2thatA2mayA2
presentA2withA2symptomsA2thatA2canA2beA2attributedA2toA2bothA2medicalA2andA2psychiatric
A2diagnoses
•A2Ex:A2ruleA2outA2anemiaA2asA2aA2causeA2forA2depressiveA2symptomsA2andA2fatigue
•A2Ex:A2ruleA2outA2infectionA2asA2aA2causeA2ofA2acuteA2mentalA2statusA2changes
RBCs:A24.5-6.0A2million/microliter
Hemoglobin:A212-18A2grams/100A2mL
Hematocrit:A238%-48%
Reticulocytes:A20%-1.5%
WBCsA2(total):A25000-10,000/microliter
Neutrophils:A255%-70%
Eosinophils:A21%-3%
Basophils:A20.5%-1%
Lymphocytes:A220%-35%
Monocytes:A23%-8%
Platelets:A2150,000-300,000/microliter
BasicA2LaboratoryA2Interpretation:A2ComprehensiveA2MetabolicA2PanelA2(CMP)A2-A2Ans--
A2commonA2bloodA2testA2usedA2toA2determineA2generalA2healthA2status
-
fluidA2andA2electrolyteA2balance,A2statusA2ofA2theA2body'sA2metabolism,A2liverA2function,A2a
ndA2kidneyA2function
-
usedA2toA2monitorA2theA2effectsA2ofA2medications,A2suchA2asA2antipsychotics,A2onA2liverA2f
unctionA2andA2glucoseA2levels
-ruleA2outA2medicalA2conditionsA2thatA2couldA2causeA2symptoms
•A2Ex:A2changesA2inA2moodA2orA2cognition
SodiumA2(Na+):A2136-145A2mEq/L
PostassiumA2(K+):A23.5-5.0A2mEq/L
ChlorideA2(Cl-):A295-105A2mEq/L
BicarbonateA2(HCO3-):A222-28A2mEq/L
Calcium,A2serumA2(CaA22+)A28.4-10.2A2mg/dl
Glucose,A2serumA2Fasting:A270-110A2mg/dl;A22-hA2postprandial:A2<120mg/dl
Cholesterol,A2serum:A2REC<200A2mg/dl
TotalA2ProteinA26.0-7.8A2g/dl
AlbuminA23.5-5.5A2g/dl
-KidneyA2Tests
•A2Creatinine,A2serumA20.6-1.2mg/dl
•A2UreaA2nitrogen,A2serumA2(BUN)A27-18mg/dl
-LiverA2Tests
, •A2AlanineA2aminotransferaseA2(ALT),A2serum:A28-20A2U/L
•A2AspartateA2aminotransferaseA2(AST),A2serum:A28-20A2U/L
•A2Bilirubin,A2serumA2(adult)A2Total//Direct:A20.1-1.0A2mg/dlA2//A20.0-0.3A2mg/dl
•A2PhosphataseA2(alkaline),A2serum:A220-70A2U/L
BasicA2LaboratoryA2Interpretation:A2ThyroidA2FunctionA2TestsA2(TFTs)A2-A2Ans--
A2usedA2toA2ruleA2outA2thyroidA2disordersA2asA2aA2causeA2forA2symptoms
•A2symptomsA2relatedA2toA2thyroidA2disordersA2includeA2anxiety,A2restlessness,A2depressi
on,A2moodA2swings,A2sleepingA2difficulties,A2difficultiesA2withA2concentration,A2short-
termA2memoryA2lapses,A2andA2lackA2ofA2mentalA2alertness
NormalA2TFTA2levels
TSH:A20.4-4.5A2mIU/L
T3:A2100-200A2ng/dL
T4:A25-11A2ug/dL
BasicA2LaboratoryA2Interpretation:A2VitaminA2B12A2LevelA2-A2Ans--
A2DeficiencyA2ofA2vitaminA2B12A2canA2affectA2moodA2andA2otherA2brainA2functions
-
psychiatricA2symptomsA2associatedA2withA2B12A2deficiencyA2includeA2depression,A2mania
,A2psychoticA2symptoms,A2andA2cognitiveA2impairment
normal:A2190-950A2picograms/mL
•A2200-300/
mLA2indicatesA2aA2borderlineA2levelA2withA2aA2possibleA2needA2forA2additionalA2testing
BasicA2LaboratoryA2Interpretation:A2VitaminA2DA2LevelA2-A2Ans--
A2affectsA2functionsA2suchA2asA2neurotransmission,A2neuroprotection,A2&A2neuroimmuno
modulation
-
highA2prevalenceA2ofA2vitaminA2DA2deficiencyA2inA2clientsA2withA2psychiatricA2disordersA2s
uchA2asA2schizophrenia,A2depression,A2seasonalA2affectiveA2disorder,A2andA2cognitiveA2im
pairment
-
SymptomsA2ofA2vitaminA2DA2deficiencyA2includeA2depression,A2irritability,A2anxiety,A2psych
osis,A2andA2poorA2brainA2development
25-hydroxyA2vitaminA2DA2bloodA2test:A2normalA220-50A2ng/mL,A2lessA2thanA212A2ng/
mLA2indicatesA2aA2deficiency
BasicA2LaboratoryA2Interpretation:A2ToxicologyA2ScreenA2-A2Ans--A2-
ruleA2outA2substanceA2useA2asA2aA2causeA2forA2symptoms
-usedA2beforeA2startingA2therapyA2involvingA2controlledA2substances
-usedA2toA2monitorA2medicationA2adherence
-usedA2inA2theA2diagnosisA2ofA2substanceA2useA2disorder
ACTUAL EXAM TEST BANK 200
QUESTIONS AND CORRECT VERIFIED
ANSWERS
differentialA2diagnosisA2-A2Ans--A2TheA2provider'sA2initialA2hypothesis
-
aA2workingA2listA2ofA2potentialA2problemsA2thatA2canA2beA2associatedA2withA2theA2initialA2or
A2chiefA2complaint
-DiagnosticA2andA2StatisticalA2ManualA2ofA2MentalA2DisordersA2(DSM-5-TR)
•A2providesA2guidanceA2forA2identifyingA2psychiatricA2diagnoses
PsychiatricA2assessment:A2HistoryA2takingA2-A2Ans--A2-HistoryA2ofA2PresentA2Illness
-HowA2longA2haveA2youA2beenA2feelingA2thisA2way?
-DidA2somethingA2happenA2inA2yourA2lifeA2thatA2mayA2haveA2triggeredA2theseA2emotions?
-HowA2isA2thisA2currentA2situationA2impactingA2yourA2life?
TheA2PsychiatricA2History
-HaveA2youA2everA2beenA2hospitalizedA2forA2anyA2mentalA2healthA2issues?
-HaveA2youA2everA2hadA2counselingA2orA2psychotherapy?
-HaveA2youA2everA2takenA2medicationsA2forA2yourA2mentalA2healthA2inA2theA2past?
-AreA2youA2currentlyA2onA2anyA2medicationsA2forA2mentalA2healthA2orA2sleep?
MedicalA2History/ScreeningA2forA2GeneralA2MedicalA2Conditions
-DoA2youA2haveA2aA2primaryA2careA2provider?
-DoA2youA2haveA2anyA2medicalA2illnesses?
-AreA2youA2currentlyA2takingA2anyA2medicationsA2orA2herbalA2supplements?
-DoA2youA2haveA2anyA2allergiesA2toA2medications?
-HaveA2youA2everA2beenA2hospitalizedA2forA2anyA2reason?
-HaveA2youA2everA2hadA2surgery?
FamilyA2PsychiatricA2History
-HasA2anyA2relativeA2ofA2yoursA2everA2beenA2hospitalizedA2forA2aA2mentalA2healthA2issue?
-
HasA2anyA2bloodA2relativeA2ofA2yoursA2everA2beenA2diagnosedA2withA2aA2mentalA2healthA2i
ssue?
-HasA2anyA2bloodA2relativeA2ofA2yoursA2hadA2aA2historyA2ofA2seizuresA2orA2dementia/
Alzheimer's?
SocialA2andA2DevelopmentalA2History
-TellA2meA2aA2littleA2bitA2aboutA2yourA2childhoodA2andA2howA2youA2grewA2up.
-HowA2wasA2yourA2experienceA2inA2schoolA2whenA2youA2wereA2younger?
A2DidA2youA2enjoyA2school?
,-HowA2doA2youA2supportA2yourselfA2withA2yourA2finances?
-DoA2youA2haveA2aA2goodA2supportA2system?A2AreA2youA2currentlyA2inA2aA2relationship?
A2WhereA2doA2youA2live?A2WhoA2doA2youA2liveA2with?
-WhatA2doA2youA2doA2inA2yourA2freeA2time?A2WhatA2activitiesA2doA2youA2enjoy?
ScreeningA2andA2PsychiatricA2RatingA2ScalesA2-A2Ans--A2Evidence-
basedA2screeningA2toolsA2andA2psychiatricA2ratingA2scales
-
canA2helpA2theA2providerA2identifyA2symptomsA2andA2assessA2theirA2severityA2andA2canA2a
ssistA2withA2theA2evaluationA2ofA2responseA2toA2treatment
AA252-year-
oldA2clientA2presentsA2toA2theA2emergencyA2departmentA2followingA2aA2carA2accident.A2Th
eA2emergencyA2departmentA2(ED)A2physicianA2isA2concernedA2thatA2theA2clientA2mayA2hav
eA2intentionallyA2crashedA2herA2carA2andA2requestsA2aA2statA2PMHNPA2consult.A2InA2spea
kingA2withA2theA2PMHNP,A2theA2clientA2describesA2persistentA2feelingsA2ofA2sadnessA2and
A2hopelessness.A2SheA2statesA2thatA2sheA2oftenA2wondersA2ifA2herA2husbandA2wouldA2beA2
happierA2ifA2sheA2wasn'tA2aroundA2anymoreA2sinceA2she'sA2neverA2happyA2andA2sometime
sA2thinksA2aboutA2whatA2itA2wouldA2beA2likeA2toA2justA2takeA2aA2handfulA2ofA2sleepingA2pillsA
2andA2goA2toA2sleepA2forever.A2TheA2clientA2reportsA2aA2previousA2suicideA2attemptA2when
A2sheA2wasA216A2butA2deniesA2thatA2sheA2isA2consideringA2killingA2herselfA2rightA2now.
BasedA2onA2theA2client'sA2ASQA2score,A2whatA2isA2theA2mostA2appropriateA2response?
NoA2actionA2isA2necessaryA2asA2theA2clientA2isA2notA2currentlyA2consideringA2suicide.
ProvideA2aA2briefA2suicideA2safetyA2assessment.A2
AlertA2theA2client'sA2primaryA2careA2physician.
ProvideA2aA2STA2-A2Ans--A2ProvideA2aA2briefA2suicideA2safetyA2assessment.A2
Rationale:A2WhileA2theA2client'sA2responsesA2doA2notA2indicateA2aA2needA2forA2aA2statA2full
A2safetyA2andA2mentalA2healthA2evaluation,A2theA2clientA2requiresA2aA2briefA2suicideA2safet
yA2assessmentA2toA2determineA2whetherA2aA2fullA2mentalA2healthA2evaluationA2inA2necess
ary.A2ItA2isA2alsoA2importantA2toA2notifyA2theA2client'sA2physicianA2orA2theA2clinicianA2respon
sibleA2forA2theA2client'sA2care.
DiagnosticA2TestingA2whenA2diagnosingA2mentalA2healthA2disordersA2-A2Ans--A2-
DiagnosticA2testsA2andA2labsA2areA2mostA2usedA2toA2ruleA2outA2physicalA2conditionsA2thatA
2mayA2causeA2psychiatricA2symptomsA2andA2toA2evaluateA2theA2effectsA2ofA2treatment
BasicA2LaboratoryA2InterpretationA2-A2Ans--A2CompleteA2BloodA2Count
ComprehensiveA2MetabolicA2PanelA2(CMP)
ThyroidA2FunctionA2Tests
VitaminA2B12A2Level
VitaminA2DA2Level
ToxicologyA2Screen
UrinalysisA2(UA)
,BasicA2LaboratoryA2Interpretation:A2CompleteA2BloodA2CountA2-A2Ans--A2-
measuresA2RBCs,A2WBCs,A2hemoglobin,A2hematocrit,A2andA2platelets
-includesA2aA2differentialA2ofA2theA2WBCs
-
InA2mentalA2health,A2theA2CBCA2isA2usedA2toA2ruleA2outA2medicalA2conditionsA2thatA2mayA2
presentA2withA2symptomsA2thatA2canA2beA2attributedA2toA2bothA2medicalA2andA2psychiatric
A2diagnoses
•A2Ex:A2ruleA2outA2anemiaA2asA2aA2causeA2forA2depressiveA2symptomsA2andA2fatigue
•A2Ex:A2ruleA2outA2infectionA2asA2aA2causeA2ofA2acuteA2mentalA2statusA2changes
RBCs:A24.5-6.0A2million/microliter
Hemoglobin:A212-18A2grams/100A2mL
Hematocrit:A238%-48%
Reticulocytes:A20%-1.5%
WBCsA2(total):A25000-10,000/microliter
Neutrophils:A255%-70%
Eosinophils:A21%-3%
Basophils:A20.5%-1%
Lymphocytes:A220%-35%
Monocytes:A23%-8%
Platelets:A2150,000-300,000/microliter
BasicA2LaboratoryA2Interpretation:A2ComprehensiveA2MetabolicA2PanelA2(CMP)A2-A2Ans--
A2commonA2bloodA2testA2usedA2toA2determineA2generalA2healthA2status
-
fluidA2andA2electrolyteA2balance,A2statusA2ofA2theA2body'sA2metabolism,A2liverA2function,A2a
ndA2kidneyA2function
-
usedA2toA2monitorA2theA2effectsA2ofA2medications,A2suchA2asA2antipsychotics,A2onA2liverA2f
unctionA2andA2glucoseA2levels
-ruleA2outA2medicalA2conditionsA2thatA2couldA2causeA2symptoms
•A2Ex:A2changesA2inA2moodA2orA2cognition
SodiumA2(Na+):A2136-145A2mEq/L
PostassiumA2(K+):A23.5-5.0A2mEq/L
ChlorideA2(Cl-):A295-105A2mEq/L
BicarbonateA2(HCO3-):A222-28A2mEq/L
Calcium,A2serumA2(CaA22+)A28.4-10.2A2mg/dl
Glucose,A2serumA2Fasting:A270-110A2mg/dl;A22-hA2postprandial:A2<120mg/dl
Cholesterol,A2serum:A2REC<200A2mg/dl
TotalA2ProteinA26.0-7.8A2g/dl
AlbuminA23.5-5.5A2g/dl
-KidneyA2Tests
•A2Creatinine,A2serumA20.6-1.2mg/dl
•A2UreaA2nitrogen,A2serumA2(BUN)A27-18mg/dl
-LiverA2Tests
, •A2AlanineA2aminotransferaseA2(ALT),A2serum:A28-20A2U/L
•A2AspartateA2aminotransferaseA2(AST),A2serum:A28-20A2U/L
•A2Bilirubin,A2serumA2(adult)A2Total//Direct:A20.1-1.0A2mg/dlA2//A20.0-0.3A2mg/dl
•A2PhosphataseA2(alkaline),A2serum:A220-70A2U/L
BasicA2LaboratoryA2Interpretation:A2ThyroidA2FunctionA2TestsA2(TFTs)A2-A2Ans--
A2usedA2toA2ruleA2outA2thyroidA2disordersA2asA2aA2causeA2forA2symptoms
•A2symptomsA2relatedA2toA2thyroidA2disordersA2includeA2anxiety,A2restlessness,A2depressi
on,A2moodA2swings,A2sleepingA2difficulties,A2difficultiesA2withA2concentration,A2short-
termA2memoryA2lapses,A2andA2lackA2ofA2mentalA2alertness
NormalA2TFTA2levels
TSH:A20.4-4.5A2mIU/L
T3:A2100-200A2ng/dL
T4:A25-11A2ug/dL
BasicA2LaboratoryA2Interpretation:A2VitaminA2B12A2LevelA2-A2Ans--
A2DeficiencyA2ofA2vitaminA2B12A2canA2affectA2moodA2andA2otherA2brainA2functions
-
psychiatricA2symptomsA2associatedA2withA2B12A2deficiencyA2includeA2depression,A2mania
,A2psychoticA2symptoms,A2andA2cognitiveA2impairment
normal:A2190-950A2picograms/mL
•A2200-300/
mLA2indicatesA2aA2borderlineA2levelA2withA2aA2possibleA2needA2forA2additionalA2testing
BasicA2LaboratoryA2Interpretation:A2VitaminA2DA2LevelA2-A2Ans--
A2affectsA2functionsA2suchA2asA2neurotransmission,A2neuroprotection,A2&A2neuroimmuno
modulation
-
highA2prevalenceA2ofA2vitaminA2DA2deficiencyA2inA2clientsA2withA2psychiatricA2disordersA2s
uchA2asA2schizophrenia,A2depression,A2seasonalA2affectiveA2disorder,A2andA2cognitiveA2im
pairment
-
SymptomsA2ofA2vitaminA2DA2deficiencyA2includeA2depression,A2irritability,A2anxiety,A2psych
osis,A2andA2poorA2brainA2development
25-hydroxyA2vitaminA2DA2bloodA2test:A2normalA220-50A2ng/mL,A2lessA2thanA212A2ng/
mLA2indicatesA2aA2deficiency
BasicA2LaboratoryA2Interpretation:A2ToxicologyA2ScreenA2-A2Ans--A2-
ruleA2outA2substanceA2useA2asA2aA2causeA2forA2symptoms
-usedA2beforeA2startingA2therapyA2involvingA2controlledA2substances
-usedA2toA2monitorA2medicationA2adherence
-usedA2inA2theA2diagnosisA2ofA2substanceA2useA2disorder