NR547 PMHNP DIFFERENTIAL
DIAGNOSIS FINAL EXAM REVIEW
QUESTIONS AND ANSWERS
1. A 35-year-old patient presents with a two-week history of auditory hallucinations and
delusional thinking. The patient also exhibits symptoms of a major depressive episode during
this time. The patient has a history of these psychotic symptoms persisting for three weeks
without any mood symptoms in the past. What is the most likely diagnosis?
A. Schizoaffective Disorder
B. Major Depressive Disorder with Psychotic Features
C. Bipolar I Disorder with Psychotic Features
D. Schizophreniform Disorder
Answer: A
Conceptual Explanation: Schizoaffective disorder is characterized by a period of illness
where there is a major mood episode concurrent with Criterion A of schizophrenia, and
delusions or hallucinations for at least 2 weeks in the absence of a major mood episode.
,2. When differentiating between Serotonin Syndrome and Neuroleptic Malignant Syndrome
(NMS), which clinical finding is highly suggestive of Serotonin Syndrome?
A. Lead-pipe muscle rigidity
B. Hyperthermia
C. Hyperreflexia and myoclonus
D. Elevated Creatine Kinase (CK)
Answer: C
Conceptual Explanation: While both conditions involve hyperthermia, Serotonin
Syndrome is typically associated with hyperreflexia and myoclonus (especially in lower
extremities), whereas NMS is associated with ‘lead-pipe’ rigidity and bradyreflexia.
3. A 22-year-old female presents with recurrent episodes of binge eating followed by self-
induced vomiting and excessive exercise. Her BMI is 16.5 kg/m². What is the most
appropriate DSM-5-TR diagnosis?
A. Bulimia Nervosa
B. Anorexia Nervosa, Binge-eating/purging type
C. Binge Eating Disorder
D. Avoidant/Restrictive Food Intake Disorder (ARFID)
Answer: B
, Conceptual Explanation: The key differentiator between Bulimia Nervosa and Anorexia
Nervosa (Binge-eating/purging type) is the patient’s weight. A BMI below 18.5
(underweight) points toward Anorexia Nervosa.
4. Which assessment tool is specifically used to monitor and screen for involuntary
movements associated with long-term antipsychotic use?
A. AIMS
B. GAD-7
C. PHQ-9
D. CAGE-AID
Answer: A
Conceptual Explanation: The Abnormal Involuntary Movement Scale (AIMS) is the
standard tool for monitoring patients on antipsychotics for Tardive Dyskinesia.
5. In the differential diagnosis of Delirium versus Dementia, which feature is most
characteristic of Delirium?
A. Gradual, progressive onset
B. Intact level of consciousness
C. Fluctuating level of consciousness and acute onset
D. Permanent memory loss
Answer: C
DIAGNOSIS FINAL EXAM REVIEW
QUESTIONS AND ANSWERS
1. A 35-year-old patient presents with a two-week history of auditory hallucinations and
delusional thinking. The patient also exhibits symptoms of a major depressive episode during
this time. The patient has a history of these psychotic symptoms persisting for three weeks
without any mood symptoms in the past. What is the most likely diagnosis?
A. Schizoaffective Disorder
B. Major Depressive Disorder with Psychotic Features
C. Bipolar I Disorder with Psychotic Features
D. Schizophreniform Disorder
Answer: A
Conceptual Explanation: Schizoaffective disorder is characterized by a period of illness
where there is a major mood episode concurrent with Criterion A of schizophrenia, and
delusions or hallucinations for at least 2 weeks in the absence of a major mood episode.
,2. When differentiating between Serotonin Syndrome and Neuroleptic Malignant Syndrome
(NMS), which clinical finding is highly suggestive of Serotonin Syndrome?
A. Lead-pipe muscle rigidity
B. Hyperthermia
C. Hyperreflexia and myoclonus
D. Elevated Creatine Kinase (CK)
Answer: C
Conceptual Explanation: While both conditions involve hyperthermia, Serotonin
Syndrome is typically associated with hyperreflexia and myoclonus (especially in lower
extremities), whereas NMS is associated with ‘lead-pipe’ rigidity and bradyreflexia.
3. A 22-year-old female presents with recurrent episodes of binge eating followed by self-
induced vomiting and excessive exercise. Her BMI is 16.5 kg/m². What is the most
appropriate DSM-5-TR diagnosis?
A. Bulimia Nervosa
B. Anorexia Nervosa, Binge-eating/purging type
C. Binge Eating Disorder
D. Avoidant/Restrictive Food Intake Disorder (ARFID)
Answer: B
, Conceptual Explanation: The key differentiator between Bulimia Nervosa and Anorexia
Nervosa (Binge-eating/purging type) is the patient’s weight. A BMI below 18.5
(underweight) points toward Anorexia Nervosa.
4. Which assessment tool is specifically used to monitor and screen for involuntary
movements associated with long-term antipsychotic use?
A. AIMS
B. GAD-7
C. PHQ-9
D. CAGE-AID
Answer: A
Conceptual Explanation: The Abnormal Involuntary Movement Scale (AIMS) is the
standard tool for monitoring patients on antipsychotics for Tardive Dyskinesia.
5. In the differential diagnosis of Delirium versus Dementia, which feature is most
characteristic of Delirium?
A. Gradual, progressive onset
B. Intact level of consciousness
C. Fluctuating level of consciousness and acute onset
D. Permanent memory loss
Answer: C
