NR 547 FINAL EXAM – DIFFERENTIAL DIAGNOSIS IN
PSYCH-MENTAL HEALTH 100 COMPREHENSIVE
QUESTIONS & ANSWERS LATEST STUDY GUIDE (2026)
CHAMBERLAIN
1. Which statement describes the first step in the differential diagnosis process?
A) Rule out malingering or factitious disorder
B) Rule out substance or medication etiology
C) Determine the primary disorder using DSM-5-TR
D) Differentiate adjustment disorders from unspecified categories
Correct Answer: A) Rule out malingering or factitious disorder
Rationale: The differential diagnosis process begins by ruling out
malingering and factitious disorder because these conditions involve
intentional symptom production or secondary gain. Substance-induced and
medical causes are considered next. Only after excluding these causes
should the clinician determine the primary DSM-5-TR disorder.
2. When evaluating possible substance-induced psychiatric symptoms,
which statement is correct?
A) Symptoms persist indefinitely after stopping the substance
B) Symptoms stop within one month after stopping the substance
C) Symptoms always begin before substance use
D) Symptoms are unrelated to substance use
Correct Answer: B) Symptoms stop within one month after stopping
the substance
,Rationale: Substance-induced psychiatric symptoms typically resolve within
one month of discontinuation of the offending substance. This temporal
relationship helps distinguish substance-induced disorders from primary
psychiatric disorders. Persistent symptoms beyond one month suggest
another diagnosis.
3. Which finding suggests a psychiatric disorder due to a general
medical condition?
A) Symptoms begin after medical condition onset and vary with severity
B) Symptoms begin before the medical condition
C) Symptoms always remain constant regardless of medical status
D) Symptoms occur only during substance intoxication
Correct Answer: C) Symptoms begin after medical condition onset and vary with
severity
Rationale: In psychiatric disorders due to a general medical condition,
symptoms begin after the medical condition is diagnosed and fluctuate with
its severity. They usually improve or resolve when the medical condition is
treated. This temporal and severity relationship is key to diagnosis.
4. Which screening tool is used for suicide risk assessment?
A) GAD-7
B) HAM-A
C) MDQ
D) ASQ
Correct Answer: D) ASQ
,Rationale: The Ask Suicide-Screening Questions tool is a brief validated
screen for suicide risk. GAD-7 screens anxiety, HAM-A measures anxiety
severity, and MDQ screens bipolar disorder. The ASQ is appropriate
across clinical settings and age groups.
5. A patient has a GAD-7 score of 14. How should this be interpreted?
A) Moderate anxiety
B) Minimal anxiety
C) Mild anxiety
D) Severe anxiety
Correct Answer: A) Moderate anxiety
Rationale: A GAD-7 score of 10 to 14 indicates moderate anxiety. Scores
of 0 to 4 are minimal, 5 to 9 are mild, and 15 or higher are severe. The
GAD-7 is a brief self-report screening tool for generalized anxiety
disorder.
6. Which scale is specifically designed to evaluate both positive and
negative symptoms of schizophrenia?
A) BPRS
B) PANSS
C) GAD-7
D) HAM-A
Correct Answer: B) PANSS
, Rationale: The Positive and Negative Syndrome Scale is used primarily in
schizophrenia research and clinical trials. It evaluates positive symptoms,
negative symptoms, and general psychopathology. BPRS is used for
moderate to severe psychosis.
7. Which laboratory value indicates a need for referral before
initiating psychiatric treatment?
A) TSH of 6.8 mIU/L
B) TSH of 1.5 mIU/L
C) Vitamin D of 25 ng/mL
D) Vitamin B12 of 400 pg/mL
Correct Answer: A) TSH of 6.8 mIU/L
Rationale: A TSH above 4.5 mIU/L suggests hypothyroidism, which can
cause depressive symptoms. Referral for medical evaluation is appropriate
before starting psychiatric treatment. TSH of 1.5 is normal, vitamin D of 25
is in range, and B12 of 400 is normal.
8. Which vitamin deficiency is associated with depression, mania,
psychosis, and cognitive impairment?
A) Vitamin C
B) Vitamin B12
C) Vitamin A
D) Vitamin K
PSYCH-MENTAL HEALTH 100 COMPREHENSIVE
QUESTIONS & ANSWERS LATEST STUDY GUIDE (2026)
CHAMBERLAIN
1. Which statement describes the first step in the differential diagnosis process?
A) Rule out malingering or factitious disorder
B) Rule out substance or medication etiology
C) Determine the primary disorder using DSM-5-TR
D) Differentiate adjustment disorders from unspecified categories
Correct Answer: A) Rule out malingering or factitious disorder
Rationale: The differential diagnosis process begins by ruling out
malingering and factitious disorder because these conditions involve
intentional symptom production or secondary gain. Substance-induced and
medical causes are considered next. Only after excluding these causes
should the clinician determine the primary DSM-5-TR disorder.
2. When evaluating possible substance-induced psychiatric symptoms,
which statement is correct?
A) Symptoms persist indefinitely after stopping the substance
B) Symptoms stop within one month after stopping the substance
C) Symptoms always begin before substance use
D) Symptoms are unrelated to substance use
Correct Answer: B) Symptoms stop within one month after stopping
the substance
,Rationale: Substance-induced psychiatric symptoms typically resolve within
one month of discontinuation of the offending substance. This temporal
relationship helps distinguish substance-induced disorders from primary
psychiatric disorders. Persistent symptoms beyond one month suggest
another diagnosis.
3. Which finding suggests a psychiatric disorder due to a general
medical condition?
A) Symptoms begin after medical condition onset and vary with severity
B) Symptoms begin before the medical condition
C) Symptoms always remain constant regardless of medical status
D) Symptoms occur only during substance intoxication
Correct Answer: C) Symptoms begin after medical condition onset and vary with
severity
Rationale: In psychiatric disorders due to a general medical condition,
symptoms begin after the medical condition is diagnosed and fluctuate with
its severity. They usually improve or resolve when the medical condition is
treated. This temporal and severity relationship is key to diagnosis.
4. Which screening tool is used for suicide risk assessment?
A) GAD-7
B) HAM-A
C) MDQ
D) ASQ
Correct Answer: D) ASQ
,Rationale: The Ask Suicide-Screening Questions tool is a brief validated
screen for suicide risk. GAD-7 screens anxiety, HAM-A measures anxiety
severity, and MDQ screens bipolar disorder. The ASQ is appropriate
across clinical settings and age groups.
5. A patient has a GAD-7 score of 14. How should this be interpreted?
A) Moderate anxiety
B) Minimal anxiety
C) Mild anxiety
D) Severe anxiety
Correct Answer: A) Moderate anxiety
Rationale: A GAD-7 score of 10 to 14 indicates moderate anxiety. Scores
of 0 to 4 are minimal, 5 to 9 are mild, and 15 or higher are severe. The
GAD-7 is a brief self-report screening tool for generalized anxiety
disorder.
6. Which scale is specifically designed to evaluate both positive and
negative symptoms of schizophrenia?
A) BPRS
B) PANSS
C) GAD-7
D) HAM-A
Correct Answer: B) PANSS
, Rationale: The Positive and Negative Syndrome Scale is used primarily in
schizophrenia research and clinical trials. It evaluates positive symptoms,
negative symptoms, and general psychopathology. BPRS is used for
moderate to severe psychosis.
7. Which laboratory value indicates a need for referral before
initiating psychiatric treatment?
A) TSH of 6.8 mIU/L
B) TSH of 1.5 mIU/L
C) Vitamin D of 25 ng/mL
D) Vitamin B12 of 400 pg/mL
Correct Answer: A) TSH of 6.8 mIU/L
Rationale: A TSH above 4.5 mIU/L suggests hypothyroidism, which can
cause depressive symptoms. Referral for medical evaluation is appropriate
before starting psychiatric treatment. TSH of 1.5 is normal, vitamin D of 25
is in range, and B12 of 400 is normal.
8. Which vitamin deficiency is associated with depression, mania,
psychosis, and cognitive impairment?
A) Vitamin C
B) Vitamin B12
C) Vitamin A
D) Vitamin K
