NR 547 Differential Dx Midterm – UPDATED Questions with 100%
Verified Answers
Chamberlain University-Illinois
NR 547
NR 547 Differential Dx Midterm
Study Questions and Answers
Q1 Differential Dx
A Diagnostic reasoning is the process of questioning one's thinking to determine if all possible avenues have been
explored and if the conclusions that are drawn are based on evidence. This is a critical step for providers who are
trying to uncover a cause, or diagnosis, for their clients' signs and symptoms. The provider's initial hypothesis is
known as the differential diagnosis. The differential diagnosis, or differential, is a working list of potential problems
that can be associated with the initial or chief complaint. Establishing a differential diagnosis is a critical step in
providing safe, quality care. This evolving process of clinical reasoning and decision making involves examining the
client's presentation, clinical data, and when appropriate, screening and diagnostic results to distinguish one
disease from another and arrive at the correct diagnosis. The Diagnostic and Statistical Manual of Mental Disorders
(DSM-5-TR)provides guidance for identifying psychiatric diagnosest
Q2 History of Present Illness
A How long have you been feeling this way? Did something happen in your life that may have triggered these
emotions? How is this current situation impacting your life?
Q3 The Psychiatric History
A Have you ever been hospitalized for any mental health issues? Have you ever had counseling or psychotherapy?
Have you ever taken medications for your mental health in the past? Are you currently on any medications for
mental health or sleep?
Q4 Medical History/Screening for General Medical Conditions
A Do you have a primary care provider? Do you have any medical illnesses? Are you currently taking any medications
or herbal supplements? Do you have any allergies to medications? Have you ever been hospitalized for any
reason? Have you ever had surgery?
Q5 Family Psychiatric History
A Has any relative of yours ever been hospitalized for a mental health issue? Has any blood relative of yours ever
been diagnosed with a mental health issue? Has any blood relative of yours had a history of seizures or
dementia/Alzheimer's?
Q6 Social and Developmental History
NR 547 Differential Dx Midterm 1
, A Tell me a little bit about your childhood and how you grew up. How was your experience in school when you were
younger? Did you enjoy school? How do you support yourself with your finances? Do you have a good support
system? Are you currently in a relationship? Where do you live? Who do you live with? What do you do in your free
time? What activities do you enjoy?
Q7 Which of the following should be included when providing client education about medication regimens?
Select all that apply.
A A)Explain how the medication targets the symptoms, specific benefits, and expected time course. (Correct answer)
B)Identify potential side effects, duration of side effects, and adverse effects. (Correct answer) C)Explain the
instructions, dosing, and special requirements. (Correct answer) D)Use teach-back methods to ensure client
understanding. (Correct answer)
Q8 Apply the Ask Suicide-Screening Questions (ASQ) Suicide Risk Screening Tool (Links to an external site.)
to the scenario below. A 52-year-old client presents to the emergency department following a car accident.
The emergency department (ED) physician is concerned that the client may have intentionally crashed her
car and requests a stat PMHNP consult. In speaking with the PMHNP, the client describes persistent
feelings of sadness and hopelessness. She states that she often wonders if her husband would be happier
if she wasn't around anymore since she's never happy and sometimes thinks about what it would be like to
just take a handful of sleeping pills and go to sleep forever. The client reports a previous suicide attempt
when she was 16 but denies that she is considering killing herself right now. Based on the client's ASQ
score, what is the most appropriate response?
A) No action is necessary as the client is not currently considering suicide. B)Provide a brief suicide safety
assessment. C)Alert the client's primary care physician. D)Provide a STAT safety and full mental health
evaluation.
A B)Provide a brief suicide safety assessment. Rationale: While the client's responses do not indicate a need for a stat
full safety and mental health evaluation, the client requires a brief suicide safety assessment to determine whether a
full mental health evaluation in necessary. It is also important to notify the client's physician or the clinician
responsible for the client's care.
Q9 Complete Blood Count
A The CBC is a serum diagnostic that measures red blood cells, white blood cells, hemoglobin, hematocrit, and
platelets. The CBC includes a differential of the white blood cells. A CBC is often included as part of routine health
screening or to obtain information related to specific conditions. In mental health, the CBC is used to rule out
medical conditions that may present with symptoms that can be attributed to both medical and psychiatric
diagnoses. For example, the CBC can help rule out anemia as a cause for depressive symptoms and fatigue or rule
out infection as a cause of acute mental status changes. The CBC is also used to monitor certain treatment
regimens. For example, some medications, such as clozapine, require routine analysis of absolute neutrophil count
and platelet levels.
Q10 Normal Range of: Red blood cells Hemoglobin Hematocrit Reticulocytes
A Red blood cells: 4.5-6.0 million/microliter Hemoglobin: 12-18 grams/100 mL Hematocrit: 38%-48% Reticulocytes:
0%-1.5%
NR 547 Differential Dx Midterm 2
, Q11 Normal Range of? White blood cells (total): Neutrophils: Eosinophils: Basophils: Lymphocytes: Monocytes:
Platelets:
A White blood cells (total): 5000-10,000/microliter Neutrophils: 55%-70% Eosinophils: 1%-3% Basophils: 0.5%-1%
Lymphocytes: 20%-35% Monocytes: 3%-8% Platelets: 150,000-300,000/microliter
Q12 Comprehensive Metabolic Panel (CMP)
A The CMP is another common blood used to determine general health status. The CMP includes several tests that
provide information about fluid and electrolyte balance as well as the status of the body's metabolism, liver function,
and kidney function. In psychiatric care, the CMP may be used to rule out medical conditions that could cause
symptoms such as changes in mood or cognition. The CMP is also used to monitor the effects of medications, such
as antipsychotics, on liver function and glucose levels.
Q13 Normal CMP Levels Electrolytes Sodium (Na+): Postassium (K+): Chloride (Cl-): Bicarbonate (HCO3-):
A Normal CMP Levels Electrolytes Sodium (Na+): 136-145 mEq/L Postassium (K+): 3.5-5.0 mEq/L Chloride (Cl-):
95-105 mEq/L Bicarbonate (HCO3-): 22-28 mEq/L
Q14 Normal CMP levels Misc. Calcium, serum (Ca 2+) Glucose, serum Fasting: 2-h postprandial: Cholesterol,
serum: Total Protein Albumin
A Calcium, serum (Ca 2+) 8.4-10.2 mg/dl Glucose, serum Fasting: 70-110 mg/dl; 2-h postprandial: <120mg/dl
Cholesterol, serum: REC<200 mg/dl Total Protein 6.0-7.8 g/dl Albumin 3.5-5.5 g/dl
Q15 Kidney Tests Creatinine, serum Urea nitrogen, serum (BUN)
A Creatinine, serum 0.6-1.2mg/dl Urea nitrogen, serum (BUN) 7-18mg/dl
Q16 Liver Tests Alanine aminotransferase (ALT), serum: Aspartate aminotransferase (AST), Bilirubin, serum
(adult) Total//Direct: Phosphatase (alkaline), serum:
A Liver Tests Alanine aminotransferase (ALT), serum: 8-20 U/L Aspartate aminotransferase (AST), serum: 8-20 U/L
Bilirubin, serum (adult) Total//Direct: 0.1-1.0 mg/dl // 0.0-0.3 mg/dl Phosphatase (alkaline), serum: 20-70 U/L
Q17 Normal TFT levels TSH: T3: T4:
A Normal TFT levels TSH: 0.4-4.5 mIU/L T3: 100-200 ng/dL T4: 5-11 ug/dL
Q18 Vitamin B12 Level
A Providers may choose to check vitamin B12 levels. Deficiency of vitamin B12 can affect mood and other brain
functions. Common psychiatric symptoms associated with B12 deficiency include depression, mania, psychotic
symptoms, and cognitive impairment ( A normal vitamin B12 level is between 190-950 picograms/mL. Between
200-300/mL indicates a borderline level with a possible need for additional testing.
Q19 Vitamin D Level
NR 547 Differential Dx Midterm 3
Verified Answers
Chamberlain University-Illinois
NR 547
NR 547 Differential Dx Midterm
Study Questions and Answers
Q1 Differential Dx
A Diagnostic reasoning is the process of questioning one's thinking to determine if all possible avenues have been
explored and if the conclusions that are drawn are based on evidence. This is a critical step for providers who are
trying to uncover a cause, or diagnosis, for their clients' signs and symptoms. The provider's initial hypothesis is
known as the differential diagnosis. The differential diagnosis, or differential, is a working list of potential problems
that can be associated with the initial or chief complaint. Establishing a differential diagnosis is a critical step in
providing safe, quality care. This evolving process of clinical reasoning and decision making involves examining the
client's presentation, clinical data, and when appropriate, screening and diagnostic results to distinguish one
disease from another and arrive at the correct diagnosis. The Diagnostic and Statistical Manual of Mental Disorders
(DSM-5-TR)provides guidance for identifying psychiatric diagnosest
Q2 History of Present Illness
A How long have you been feeling this way? Did something happen in your life that may have triggered these
emotions? How is this current situation impacting your life?
Q3 The Psychiatric History
A Have you ever been hospitalized for any mental health issues? Have you ever had counseling or psychotherapy?
Have you ever taken medications for your mental health in the past? Are you currently on any medications for
mental health or sleep?
Q4 Medical History/Screening for General Medical Conditions
A Do you have a primary care provider? Do you have any medical illnesses? Are you currently taking any medications
or herbal supplements? Do you have any allergies to medications? Have you ever been hospitalized for any
reason? Have you ever had surgery?
Q5 Family Psychiatric History
A Has any relative of yours ever been hospitalized for a mental health issue? Has any blood relative of yours ever
been diagnosed with a mental health issue? Has any blood relative of yours had a history of seizures or
dementia/Alzheimer's?
Q6 Social and Developmental History
NR 547 Differential Dx Midterm 1
, A Tell me a little bit about your childhood and how you grew up. How was your experience in school when you were
younger? Did you enjoy school? How do you support yourself with your finances? Do you have a good support
system? Are you currently in a relationship? Where do you live? Who do you live with? What do you do in your free
time? What activities do you enjoy?
Q7 Which of the following should be included when providing client education about medication regimens?
Select all that apply.
A A)Explain how the medication targets the symptoms, specific benefits, and expected time course. (Correct answer)
B)Identify potential side effects, duration of side effects, and adverse effects. (Correct answer) C)Explain the
instructions, dosing, and special requirements. (Correct answer) D)Use teach-back methods to ensure client
understanding. (Correct answer)
Q8 Apply the Ask Suicide-Screening Questions (ASQ) Suicide Risk Screening Tool (Links to an external site.)
to the scenario below. A 52-year-old client presents to the emergency department following a car accident.
The emergency department (ED) physician is concerned that the client may have intentionally crashed her
car and requests a stat PMHNP consult. In speaking with the PMHNP, the client describes persistent
feelings of sadness and hopelessness. She states that she often wonders if her husband would be happier
if she wasn't around anymore since she's never happy and sometimes thinks about what it would be like to
just take a handful of sleeping pills and go to sleep forever. The client reports a previous suicide attempt
when she was 16 but denies that she is considering killing herself right now. Based on the client's ASQ
score, what is the most appropriate response?
A) No action is necessary as the client is not currently considering suicide. B)Provide a brief suicide safety
assessment. C)Alert the client's primary care physician. D)Provide a STAT safety and full mental health
evaluation.
A B)Provide a brief suicide safety assessment. Rationale: While the client's responses do not indicate a need for a stat
full safety and mental health evaluation, the client requires a brief suicide safety assessment to determine whether a
full mental health evaluation in necessary. It is also important to notify the client's physician or the clinician
responsible for the client's care.
Q9 Complete Blood Count
A The CBC is a serum diagnostic that measures red blood cells, white blood cells, hemoglobin, hematocrit, and
platelets. The CBC includes a differential of the white blood cells. A CBC is often included as part of routine health
screening or to obtain information related to specific conditions. In mental health, the CBC is used to rule out
medical conditions that may present with symptoms that can be attributed to both medical and psychiatric
diagnoses. For example, the CBC can help rule out anemia as a cause for depressive symptoms and fatigue or rule
out infection as a cause of acute mental status changes. The CBC is also used to monitor certain treatment
regimens. For example, some medications, such as clozapine, require routine analysis of absolute neutrophil count
and platelet levels.
Q10 Normal Range of: Red blood cells Hemoglobin Hematocrit Reticulocytes
A Red blood cells: 4.5-6.0 million/microliter Hemoglobin: 12-18 grams/100 mL Hematocrit: 38%-48% Reticulocytes:
0%-1.5%
NR 547 Differential Dx Midterm 2
, Q11 Normal Range of? White blood cells (total): Neutrophils: Eosinophils: Basophils: Lymphocytes: Monocytes:
Platelets:
A White blood cells (total): 5000-10,000/microliter Neutrophils: 55%-70% Eosinophils: 1%-3% Basophils: 0.5%-1%
Lymphocytes: 20%-35% Monocytes: 3%-8% Platelets: 150,000-300,000/microliter
Q12 Comprehensive Metabolic Panel (CMP)
A The CMP is another common blood used to determine general health status. The CMP includes several tests that
provide information about fluid and electrolyte balance as well as the status of the body's metabolism, liver function,
and kidney function. In psychiatric care, the CMP may be used to rule out medical conditions that could cause
symptoms such as changes in mood or cognition. The CMP is also used to monitor the effects of medications, such
as antipsychotics, on liver function and glucose levels.
Q13 Normal CMP Levels Electrolytes Sodium (Na+): Postassium (K+): Chloride (Cl-): Bicarbonate (HCO3-):
A Normal CMP Levels Electrolytes Sodium (Na+): 136-145 mEq/L Postassium (K+): 3.5-5.0 mEq/L Chloride (Cl-):
95-105 mEq/L Bicarbonate (HCO3-): 22-28 mEq/L
Q14 Normal CMP levels Misc. Calcium, serum (Ca 2+) Glucose, serum Fasting: 2-h postprandial: Cholesterol,
serum: Total Protein Albumin
A Calcium, serum (Ca 2+) 8.4-10.2 mg/dl Glucose, serum Fasting: 70-110 mg/dl; 2-h postprandial: <120mg/dl
Cholesterol, serum: REC<200 mg/dl Total Protein 6.0-7.8 g/dl Albumin 3.5-5.5 g/dl
Q15 Kidney Tests Creatinine, serum Urea nitrogen, serum (BUN)
A Creatinine, serum 0.6-1.2mg/dl Urea nitrogen, serum (BUN) 7-18mg/dl
Q16 Liver Tests Alanine aminotransferase (ALT), serum: Aspartate aminotransferase (AST), Bilirubin, serum
(adult) Total//Direct: Phosphatase (alkaline), serum:
A Liver Tests Alanine aminotransferase (ALT), serum: 8-20 U/L Aspartate aminotransferase (AST), serum: 8-20 U/L
Bilirubin, serum (adult) Total//Direct: 0.1-1.0 mg/dl // 0.0-0.3 mg/dl Phosphatase (alkaline), serum: 20-70 U/L
Q17 Normal TFT levels TSH: T3: T4:
A Normal TFT levels TSH: 0.4-4.5 mIU/L T3: 100-200 ng/dL T4: 5-11 ug/dL
Q18 Vitamin B12 Level
A Providers may choose to check vitamin B12 levels. Deficiency of vitamin B12 can affect mood and other brain
functions. Common psychiatric symptoms associated with B12 deficiency include depression, mania, psychotic
symptoms, and cognitive impairment ( A normal vitamin B12 level is between 190-950 picograms/mL. Between
200-300/mL indicates a borderline level with a possible need for additional testing.
Q19 Vitamin D Level
NR 547 Differential Dx Midterm 3
