NR 547 DIFFERENTIAL DX MIDTERM
EXAM 2025/2026 QUESTIONS AND
VERIFIED SOLUTIONS GRADED A+
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.
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.
Differential Dx
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 test 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
History of Present Illness
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?
The Psychiatric History
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?
Medical History/Screening for General Medical Conditions
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?
Family Psychiatric History
,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?
Social and Developmental History
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?
Which of the following should be included when providing client education about medication
regimens? Select all that apply.
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)
Complete Blood Count
The CBC is a serum diagnostic test 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.
Normal Range of:
Red blood cells
Hemoglobin
Hematocrit
Reticulocytes
Red blood cells: 4.5-6.0 million/microliter
Hemoglobin: 12-18 grams/100 mL
Hematocrit: 38%-48%
Reticulocytes: 0%-1.5%
Normal Range of?
White blood cells (total):
Neutrophils:
Eosinophils:
Basophils:
Lymphocytes:
Monocytes:
Platelets:
White blood cells (total): 5000-10,000/microliter
Neutrophils: 55%-70%
Eosinophils: 1%-3%
Basophils: 0.5%-1%
EXAM 2025/2026 QUESTIONS AND
VERIFIED SOLUTIONS GRADED A+
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.
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.
Differential Dx
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 test 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
History of Present Illness
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?
The Psychiatric History
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?
Medical History/Screening for General Medical Conditions
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?
Family Psychiatric History
,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?
Social and Developmental History
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?
Which of the following should be included when providing client education about medication
regimens? Select all that apply.
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)
Complete Blood Count
The CBC is a serum diagnostic test 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.
Normal Range of:
Red blood cells
Hemoglobin
Hematocrit
Reticulocytes
Red blood cells: 4.5-6.0 million/microliter
Hemoglobin: 12-18 grams/100 mL
Hematocrit: 38%-48%
Reticulocytes: 0%-1.5%
Normal Range of?
White blood cells (total):
Neutrophils:
Eosinophils:
Basophils:
Lymphocytes:
Monocytes:
Platelets:
White blood cells (total): 5000-10,000/microliter
Neutrophils: 55%-70%
Eosinophils: 1%-3%
Basophils: 0.5%-1%