NR 547 Midterm Exam Questions and Correct
Answers
250 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 NR 547 Midterm Exam Questions and Correct Answers
Page 1
,Q1
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 CORRECT
associated with the chief complaint
C) A treatment plan based on presenting symptoms
D) A medication prescription guideline for psychiatric disorders
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.
Q2
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 CORRECT
C) Order comprehensive laboratory tests
D) Begin treatment immediately to address acute symptoms
Rationale
The first step in creating a differential diagnosis is to rule out malingering or factitious disorder. This
ensures that symptoms are not intentionally produced before attributing them to a primary psychiatric
disorder.
Q3
What is the SECOND step in creating a differential diagnosis?
A) Identify the most likely psychiatric diagnosis
B) Rule out substance etiology CORRECT
C) Begin evidence-based treatment
D) Order diagnostic imaging studies
Page 2
,Rationale
The second step 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.
Q4
What are the components of the abstract thought process?
A) Observation, measurement, analysis
B) Introspection, intuition, reasoning CORRECT
C) Hypothesis, experiment, conclusion
D) Assessment, planning, implementation
Rationale
The three components of the abstract thought process are introspection (turning attention inward toward
thoughts), intuition (gut-based insight not strictly logical), and reasoning (processing and organizing ideas
to reach conclusions).
Q5
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 CORRECT
C) Loose associations
D) Flight of ideas
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?"
Page 3
, 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 CORRECT
observed emotional expression
C) Mood and affect are identical concepts
D) Mood is only assessed in depression; affect is assessed in all disorders
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.
Q7
What does the mental status exam component "insight" assess?
A) Thought content
B) The patient's awareness of their illness and need for treatment CORRECT
C) Judgment
D) Cognition
Rationale
Insight refers to the patient's awareness and understanding of their illness, including recognition of
symptoms as pathological and need for treatment. Judgment is the ability to make appropriate decisions.
Q8
A patient describes "racing thoughts" that move quickly between topics. Which mental status
exam component is being described?
A) Thought process CORRECT
B) Thought content
C) Mood
D) Affect
Page 4
Answers
250 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 NR 547 Midterm Exam Questions and Correct Answers
Page 1
,Q1
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 CORRECT
associated with the chief complaint
C) A treatment plan based on presenting symptoms
D) A medication prescription guideline for psychiatric disorders
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.
Q2
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 CORRECT
C) Order comprehensive laboratory tests
D) Begin treatment immediately to address acute symptoms
Rationale
The first step in creating a differential diagnosis is to rule out malingering or factitious disorder. This
ensures that symptoms are not intentionally produced before attributing them to a primary psychiatric
disorder.
Q3
What is the SECOND step in creating a differential diagnosis?
A) Identify the most likely psychiatric diagnosis
B) Rule out substance etiology CORRECT
C) Begin evidence-based treatment
D) Order diagnostic imaging studies
Page 2
,Rationale
The second step 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.
Q4
What are the components of the abstract thought process?
A) Observation, measurement, analysis
B) Introspection, intuition, reasoning CORRECT
C) Hypothesis, experiment, conclusion
D) Assessment, planning, implementation
Rationale
The three components of the abstract thought process are introspection (turning attention inward toward
thoughts), intuition (gut-based insight not strictly logical), and reasoning (processing and organizing ideas
to reach conclusions).
Q5
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 CORRECT
C) Loose associations
D) Flight of ideas
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?"
Page 3
, 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 CORRECT
observed emotional expression
C) Mood and affect are identical concepts
D) Mood is only assessed in depression; affect is assessed in all disorders
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.
Q7
What does the mental status exam component "insight" assess?
A) Thought content
B) The patient's awareness of their illness and need for treatment CORRECT
C) Judgment
D) Cognition
Rationale
Insight refers to the patient's awareness and understanding of their illness, including recognition of
symptoms as pathological and need for treatment. Judgment is the ability to make appropriate decisions.
Q8
A patient describes "racing thoughts" that move quickly between topics. Which mental status
exam component is being described?
A) Thought process CORRECT
B) Thought content
C) Mood
D) Affect
Page 4
