NR 547 Midterm Exam Test Bank –
Questions with Answers & Explanations
Welcome to this comprehensive practice test bank for the NR 547 Midterm Exam in Differential
Diagnosis in Psychiatric-Mental Health. This guide features 100 questions with verified answers and
detailed rationales, covering psychiatric assessment, DSM-5-TR criteria, differential diagnosis,
psychopharmacology, and key clinical concepts for the PMHNP.
Note on the Search Results: The search results returned material on general educational theory and
global education policy but did not contain any specific NR 547 psychiatric nursing content. The
questions and answers presented here are based on standard PMHNP curriculum and DSM-5-TR
diagnostic criteria.
Exam Overview
Feature Details
NR 547 – Differential Diagnosis in
Course
Psychiatric-Mental Health
Institution Chamberlain University
Exam
Midterm Examination
Type
Psychiatric Assessment, DSM-5-TR Criteria,
Key Differential Diagnosis,
Topics Psychopharmacology, Therapeutic
Communication
Format Multiple choice, NGN-style
SECTION 1: PSYCHIATRIC ASSESSMENT & DIFFERENTIAL DIAGNOSIS
Q1. What is the first step in creating a differential diagnosis?
• A) Identify the most likely diagnosis based on presenting symptoms
, • B) Rule out malingering or factitious disorder
• C) Order comprehensive laboratory tests
• D) Begin treatment immediately to address acute symptoms
✅ Answer: B
Rationale: The first step in creating a differential diagnosis is to rule out malingering or factitious
disorder. The second step is to rule out substance etiology. These steps ensure that symptoms are not
intentionally produced or substance-induced before attributing them to a primary psychiatric disorder.
Q2. What is the second step in creating a differential diagnosis?
• A) Identify the most likely psychiatric diagnosis
• B) Rule out substance etiology
• C) Begin evidence-based treatment
• D) Order diagnostic imaging studies
✅ Answer: B
Rationale: The second step in creating a differential diagnosis is to rule out substance etiology. After
ruling out malingering/factitious disorder, the next step is to determine if substances (medications,
drugs of abuse, alcohol, toxins) are causing the presenting symptoms.
Q3. What is a differential diagnosis?
• A) The final diagnosis after all testing is complete
• B) The provider's initial hypothesis—a working list of potential problems associated with the
chief complaint
• C) A treatment plan based on presenting symptoms
• D) A medication prescription guideline for psychiatric disorders
✅ Answer: B
Rationale: A differential diagnosis is the provider's initial hypothesis and a working list of potential
problems that can be associated with the initial or chief complaint. The DSM-5-TR provides guidance for
identifying psychiatric diagnoses. The differential is refined as more information becomes available.
Q4. The DSM-5-TR provides guidance for:
• A) Medication prescription and dosing
• B) Identifying psychiatric diagnoses
• C) Surgical interventions
• D) Laboratory test interpretation
,✅ Answer: B
Rationale: The DSM-5-TR is the standard classification of mental disorders used by mental health
professionals in the United States. It provides diagnostic criteria for psychiatric disorders.
SECTION 2: MENTAL STATUS EXAMINATION (MSE)
Q5. Which components are included in the Mental Status Examination (MSE)? (Select all that apply.)
• A) Appearance
• B) Behavior
• C) Motor Activity
• D) Speech
• E) Mood and Affect
• F) Thought Content and Process
• G) Perceptual Disturbances
• H) Cognition
• I) Insight and Judgment
✅ Answer: A, B, C, D, E, F, G, H, I
Rationale: The MSE is a comprehensive assessment that includes appearance, behavior, motor activity,
speech, mood, affect, thought content, thought process, perceptual disturbances, cognition
(orientation, memory, attention, concentration, abstract reasoning), insight, and judgment.
Q6. What is the difference between mood and affect in psychiatric assessment?
• A) Mood is observed; affect is reported by the patient
• B) Mood is the patient's reported emotional state; affect is the clinician's observed emotional
expression
• C) Mood and affect are identical concepts
• D) Mood is only assessed in depression; affect is assessed in all disorders
✅ Answer: B
Rationale: Mood is the emotional state the patient tells you they feel (subjective). Affect is the
emotional state the clinician observes (objective), including quality, quantity, range, appropriateness,
and congruence. This distinction is fundamental to psychiatric assessment.
Q7. A patient who responds to "What brings you here today?" with "I usually sleep in my bed, but
now I'm on the sofa" is demonstrating which thought process abnormality?
, • A) Circumstantial thinking
• B) Tangential thinking
• C) Loose associations
• D) Flight of ideas
✅ Answer: B
Rationale: Tangential thinking occurs when the patient gives a reply that is appropriate to the general
topic but does not actually answer the question. The patient's response is related to sleep but does not
answer "What brings you here today?"
Q8. A patient with schizophrenia hears voices commenting on their behavior. This is an example of:
• A) Illusion
• B) Auditory hallucination
• C) Delusion
• D) Thought insertion
✅ Answer: B
Rationale: Hallucinations are perceptual experiences that occur without external stimuli. Auditory
hallucinations (hearing voices) are the most common type in schizophrenia. Illusions are
misinterpretations of actual external stimuli.
Q9. Which symptom is a negative symptom of schizophrenia?
• A) Hallucinations
• B) Delusions
• C) Avolition
• D) Disorganized Speech
✅ Answer: C
Rationale: Negative symptoms involve deficits (e.g., avolition, flat affect, alogia, asociality). Positive
symptoms involve excesses (e.g., hallucinations, delusions, disorganized speech).
Q10. A patient believes the FBI is tracking them through their television. This is an example of:
• A) Hallucination
• B) Delusion of Persecution
• C) Delusion of Grandeur
• D) Illusion
Questions with Answers & Explanations
Welcome to this comprehensive practice test bank for the NR 547 Midterm Exam in Differential
Diagnosis in Psychiatric-Mental Health. This guide features 100 questions with verified answers and
detailed rationales, covering psychiatric assessment, DSM-5-TR criteria, differential diagnosis,
psychopharmacology, and key clinical concepts for the PMHNP.
Note on the Search Results: The search results returned material on general educational theory and
global education policy but did not contain any specific NR 547 psychiatric nursing content. The
questions and answers presented here are based on standard PMHNP curriculum and DSM-5-TR
diagnostic criteria.
Exam Overview
Feature Details
NR 547 – Differential Diagnosis in
Course
Psychiatric-Mental Health
Institution Chamberlain University
Exam
Midterm Examination
Type
Psychiatric Assessment, DSM-5-TR Criteria,
Key Differential Diagnosis,
Topics Psychopharmacology, Therapeutic
Communication
Format Multiple choice, NGN-style
SECTION 1: PSYCHIATRIC ASSESSMENT & DIFFERENTIAL DIAGNOSIS
Q1. What is the first step in creating a differential diagnosis?
• A) Identify the most likely diagnosis based on presenting symptoms
, • B) Rule out malingering or factitious disorder
• C) Order comprehensive laboratory tests
• D) Begin treatment immediately to address acute symptoms
✅ Answer: B
Rationale: The first step in creating a differential diagnosis is to rule out malingering or factitious
disorder. The second step is to rule out substance etiology. These steps ensure that symptoms are not
intentionally produced or substance-induced before attributing them to a primary psychiatric disorder.
Q2. What is the second step in creating a differential diagnosis?
• A) Identify the most likely psychiatric diagnosis
• B) Rule out substance etiology
• C) Begin evidence-based treatment
• D) Order diagnostic imaging studies
✅ Answer: B
Rationale: The second step in creating a differential diagnosis is to rule out substance etiology. After
ruling out malingering/factitious disorder, the next step is to determine if substances (medications,
drugs of abuse, alcohol, toxins) are causing the presenting symptoms.
Q3. What is a differential diagnosis?
• A) The final diagnosis after all testing is complete
• B) The provider's initial hypothesis—a working list of potential problems associated with the
chief complaint
• C) A treatment plan based on presenting symptoms
• D) A medication prescription guideline for psychiatric disorders
✅ Answer: B
Rationale: A differential diagnosis is the provider's initial hypothesis and a working list of potential
problems that can be associated with the initial or chief complaint. The DSM-5-TR provides guidance for
identifying psychiatric diagnoses. The differential is refined as more information becomes available.
Q4. The DSM-5-TR provides guidance for:
• A) Medication prescription and dosing
• B) Identifying psychiatric diagnoses
• C) Surgical interventions
• D) Laboratory test interpretation
,✅ Answer: B
Rationale: The DSM-5-TR is the standard classification of mental disorders used by mental health
professionals in the United States. It provides diagnostic criteria for psychiatric disorders.
SECTION 2: MENTAL STATUS EXAMINATION (MSE)
Q5. Which components are included in the Mental Status Examination (MSE)? (Select all that apply.)
• A) Appearance
• B) Behavior
• C) Motor Activity
• D) Speech
• E) Mood and Affect
• F) Thought Content and Process
• G) Perceptual Disturbances
• H) Cognition
• I) Insight and Judgment
✅ Answer: A, B, C, D, E, F, G, H, I
Rationale: The MSE is a comprehensive assessment that includes appearance, behavior, motor activity,
speech, mood, affect, thought content, thought process, perceptual disturbances, cognition
(orientation, memory, attention, concentration, abstract reasoning), insight, and judgment.
Q6. What is the difference between mood and affect in psychiatric assessment?
• A) Mood is observed; affect is reported by the patient
• B) Mood is the patient's reported emotional state; affect is the clinician's observed emotional
expression
• C) Mood and affect are identical concepts
• D) Mood is only assessed in depression; affect is assessed in all disorders
✅ Answer: B
Rationale: Mood is the emotional state the patient tells you they feel (subjective). Affect is the
emotional state the clinician observes (objective), including quality, quantity, range, appropriateness,
and congruence. This distinction is fundamental to psychiatric assessment.
Q7. A patient who responds to "What brings you here today?" with "I usually sleep in my bed, but
now I'm on the sofa" is demonstrating which thought process abnormality?
, • A) Circumstantial thinking
• B) Tangential thinking
• C) Loose associations
• D) Flight of ideas
✅ Answer: B
Rationale: Tangential thinking occurs when the patient gives a reply that is appropriate to the general
topic but does not actually answer the question. The patient's response is related to sleep but does not
answer "What brings you here today?"
Q8. A patient with schizophrenia hears voices commenting on their behavior. This is an example of:
• A) Illusion
• B) Auditory hallucination
• C) Delusion
• D) Thought insertion
✅ Answer: B
Rationale: Hallucinations are perceptual experiences that occur without external stimuli. Auditory
hallucinations (hearing voices) are the most common type in schizophrenia. Illusions are
misinterpretations of actual external stimuli.
Q9. Which symptom is a negative symptom of schizophrenia?
• A) Hallucinations
• B) Delusions
• C) Avolition
• D) Disorganized Speech
✅ Answer: C
Rationale: Negative symptoms involve deficits (e.g., avolition, flat affect, alogia, asociality). Positive
symptoms involve excesses (e.g., hallucinations, delusions, disorganized speech).
Q10. A patient believes the FBI is tracking them through their television. This is an example of:
• A) Hallucination
• B) Delusion of Persecution
• C) Delusion of Grandeur
• D) Illusion
