NR 547 Final Exam Test Bank 2025/2026 |
Chamberlain PMHNP Differential Diagnosis
Across the Lifespan | 50 Verified Questions &
Answers | Graduate Nursing Exam Prep Guide
Q1. A 28-year-old patient reports a 3-week period of pervasive
low mood, anhedonia, hypersomnia, increased appetite, and
marked psychomotor retardation. There is no history of manic
or hypomanic episodes. Which diagnosis is most consistent with
DSM-5-TR criteria?
A. Major Depressive Disorder, single episode
B. Persistent Depressive Disorder (Dysthymia)
C. Bipolar II Disorder
D. Adjustment Disorder with depressed mood
Correct Answer: A
Rationale: Symptoms meet a major depressive episode (≥2
weeks) with vegetative signs and functional impairment; no
history of hypomania excludes Bipolar II; dysthymia requires ≥2
,years of symptoms; adjustment disorder requires an identifiable
stressor with shorter duration and subthreshold criteria.
Q2. A 42-year-old reports 8 months of excessive worry about
work and multiple life domains, difficulty controlling worry,
irritability, muscle tension, and sleep onset difficulty nearly
every day. Which feature most strongly favors Generalized
Anxiety Disorder over Major Depressive Disorder with anxious
distress?
A. Irritability
B. Excessive, uncontrollable worry across multiple domains for
≥6 months
C. Sleep disturbance
D. Reduced interest in usual activities
Correct Answer: B
Rationale: Chronic, excessive worry across multiple domains for
≥6 months with difficulty controlling worry is the hallmark of
GAD per DSM-5-TR and distinguishes it from anxiety as a
component of depressive episodes.
Q3. A 9-year-old presents with persistent angry outbursts,
defiance toward authority, and spiteful behavior occurring
multiple times per week for 8 months. There are no physical
aggression toward people or animals and no rule violations like
theft. The most likely diagnosis is:
, A. Conduct Disorder
B. Oppositional Defiant Disorder
C. Intermittent Explosive Disorder
D. Disruptive Mood Dysregulation Disorder
Correct Answer: B
Rationale: Chronic pattern of defiance, angry/irritable mood,
and vindictiveness in a child fits ODD; conduct disorder involves
violation of rights (e.g., aggression, theft); intermittent
explosive disorder features discrete episodes of
disproportionate aggression; DMDD requires severe recurrent
temper outbursts and persistent irritable mood onset before
age 10.
Q4. A 35-year-old veteran reports intrusive memories,
nightmares, avoidance of reminders, negative alterations in
cognition/mood, and hypervigilance persisting 10 months after
combat exposure. Which diagnosis is correct?
A. Acute Stress Disorder
B. Posttraumatic Stress Disorder (PTSD)
C. Adjustment Disorder
D. Major Depressive Disorder
Correct Answer: B
Rationale: Symptoms meeting intrusion, avoidance, negative
alterations, and hyperarousal persisting >1 month after trauma
meet PTSD; acute stress disorder is <1 month; adjustment
Chamberlain PMHNP Differential Diagnosis
Across the Lifespan | 50 Verified Questions &
Answers | Graduate Nursing Exam Prep Guide
Q1. A 28-year-old patient reports a 3-week period of pervasive
low mood, anhedonia, hypersomnia, increased appetite, and
marked psychomotor retardation. There is no history of manic
or hypomanic episodes. Which diagnosis is most consistent with
DSM-5-TR criteria?
A. Major Depressive Disorder, single episode
B. Persistent Depressive Disorder (Dysthymia)
C. Bipolar II Disorder
D. Adjustment Disorder with depressed mood
Correct Answer: A
Rationale: Symptoms meet a major depressive episode (≥2
weeks) with vegetative signs and functional impairment; no
history of hypomania excludes Bipolar II; dysthymia requires ≥2
,years of symptoms; adjustment disorder requires an identifiable
stressor with shorter duration and subthreshold criteria.
Q2. A 42-year-old reports 8 months of excessive worry about
work and multiple life domains, difficulty controlling worry,
irritability, muscle tension, and sleep onset difficulty nearly
every day. Which feature most strongly favors Generalized
Anxiety Disorder over Major Depressive Disorder with anxious
distress?
A. Irritability
B. Excessive, uncontrollable worry across multiple domains for
≥6 months
C. Sleep disturbance
D. Reduced interest in usual activities
Correct Answer: B
Rationale: Chronic, excessive worry across multiple domains for
≥6 months with difficulty controlling worry is the hallmark of
GAD per DSM-5-TR and distinguishes it from anxiety as a
component of depressive episodes.
Q3. A 9-year-old presents with persistent angry outbursts,
defiance toward authority, and spiteful behavior occurring
multiple times per week for 8 months. There are no physical
aggression toward people or animals and no rule violations like
theft. The most likely diagnosis is:
, A. Conduct Disorder
B. Oppositional Defiant Disorder
C. Intermittent Explosive Disorder
D. Disruptive Mood Dysregulation Disorder
Correct Answer: B
Rationale: Chronic pattern of defiance, angry/irritable mood,
and vindictiveness in a child fits ODD; conduct disorder involves
violation of rights (e.g., aggression, theft); intermittent
explosive disorder features discrete episodes of
disproportionate aggression; DMDD requires severe recurrent
temper outbursts and persistent irritable mood onset before
age 10.
Q4. A 35-year-old veteran reports intrusive memories,
nightmares, avoidance of reminders, negative alterations in
cognition/mood, and hypervigilance persisting 10 months after
combat exposure. Which diagnosis is correct?
A. Acute Stress Disorder
B. Posttraumatic Stress Disorder (PTSD)
C. Adjustment Disorder
D. Major Depressive Disorder
Correct Answer: B
Rationale: Symptoms meeting intrusion, avoidance, negative
alterations, and hyperarousal persisting >1 month after trauma
meet PTSD; acute stress disorder is <1 month; adjustment
