NR 547 Final Exam 2025/2026 Test Bank |
Chamberlain Nursing | Differential
Diagnosis in Psychiatric–Mental Health
Across the Lifespan | 50 PMHNP Q&A
Study Guide
Q1. A 28-year-old presents with 3 months of pervasive low
mood, anhedonia, insomnia, significant weight loss, feelings of
worthlessness, and recurrent passive suicidal ideation. She
reports no history of manic or hypomanic episodes. Which
diagnosis is most appropriate?
A. Major Depressive Disorder, single episode
B. Persistent Depressive Disorder (dysthymia)
C. Adjustment Disorder with depressed mood
D. Bipolar II disorder
Correct Answer: A
Rationale: Duration (≥2 weeks) and symptom count (multiple
core depressive symptoms including anhedonia) fit a Major
,Depressive Episode. Absence of chronicity (>2 years) rules out
Persistent Depressive Disorder; no hypomania rules out Bipolar
II. Adjustment disorder is time-limited and linked to an
identifiable stressor with less severe symptom threshold.
Q2. A 22-year-old college student reports 5 days of markedly
elevated mood, increased goal-directed activity, decreased
need for sleep (sleeping 2–3 hours nightly), grandiose ideas,
pressured speech, and risky behaviors leading to emergency
room presentation. Which diagnosis is most consistent?
A. Hypomanic episode
B. Manic episode
C. Cyclothymic disorder
D. Substance-induced mood disorder
Correct Answer: B
Rationale: Symptoms include marked impairment and risky
behavior with duration ≥1 week (or requiring hospitalization);
these indicate a manic episode. Hypomania requires ≥4 days
without marked impairment. Substance-induced should be
considered only if temporal relation to substance use is present.
Q3. Which feature most reliably differentiates Bipolar II disorder
from Cyclothymic disorder in adults?
A. Presence of major depressive episodes
B. Lifetime history of at least one hypomanic episode
,C. Duration of mood symptoms being at least 2 years
D. Psychotic features during mood episodes
Correct Answer: B
Rationale: Bipolar II requires at least one hypomanic episode
plus major depressive episodes. Cyclothymic disorder involves
numerous hypomanic-like and depressive symptoms that do
not meet full criteria for hypomanic or major depressive
episodes and lasts ≥2 years.
Q4. A 45-year-old presents with persistent excessive worry
about multiple domains for >6 months with restlessness,
muscle tension, difficulty concentrating, and sleep disturbance.
Which diagnosis is most appropriate?
A. Panic disorder
B. Generalized anxiety disorder (GAD)
C. Adjustment disorder with anxiety
D. Social anxiety disorder
Correct Answer: B
Rationale: GAD requires excessive anxiety/worry occurring
more days than not for at least 6 months with associated
symptoms (≥3 in adults). Panic disorder features discrete
unexpected panic attacks; social anxiety is specific to social
situations; adjustment disorder is temporally linked to stressor
onset and less chronic.
, Q5. A patient reports recurrent unexpected panic attacks and
persistent worry about future attacks for the past 2 months,
with avoidance of leaving home. He denies agoraphobic
symptoms prior to attacks. Best diagnosis?
A. Panic disorder
B. Agoraphobia
C. Specific phobia
D. PTSD
Correct Answer: A
Rationale: Panic disorder is characterized by recurrent
unexpected panic attacks and persistent concern/worry about
additional attacks and consequences for ≥1 month. Avoidance
may develop secondary to panic disorder but diagnosis is panic
disorder when panic attacks are primary.
Q6. Select all that apply. Features that help distinguish PTSD
from Acute Stress Disorder (ASD):
A. Duration of symptoms >1 month
B. Presence of dissociative symptoms as core feature
C. Requirement for exposure to actual or threatened death,
serious injury, or sexual violence
D. Onset within 3 days to 1 month after trauma
Correct Answer: A, C, D
Rationale: PTSD requires symptoms persisting >1 month after
trauma; ASD occurs from 3 days to 1 month. Both require
Chamberlain Nursing | Differential
Diagnosis in Psychiatric–Mental Health
Across the Lifespan | 50 PMHNP Q&A
Study Guide
Q1. A 28-year-old presents with 3 months of pervasive low
mood, anhedonia, insomnia, significant weight loss, feelings of
worthlessness, and recurrent passive suicidal ideation. She
reports no history of manic or hypomanic episodes. Which
diagnosis is most appropriate?
A. Major Depressive Disorder, single episode
B. Persistent Depressive Disorder (dysthymia)
C. Adjustment Disorder with depressed mood
D. Bipolar II disorder
Correct Answer: A
Rationale: Duration (≥2 weeks) and symptom count (multiple
core depressive symptoms including anhedonia) fit a Major
,Depressive Episode. Absence of chronicity (>2 years) rules out
Persistent Depressive Disorder; no hypomania rules out Bipolar
II. Adjustment disorder is time-limited and linked to an
identifiable stressor with less severe symptom threshold.
Q2. A 22-year-old college student reports 5 days of markedly
elevated mood, increased goal-directed activity, decreased
need for sleep (sleeping 2–3 hours nightly), grandiose ideas,
pressured speech, and risky behaviors leading to emergency
room presentation. Which diagnosis is most consistent?
A. Hypomanic episode
B. Manic episode
C. Cyclothymic disorder
D. Substance-induced mood disorder
Correct Answer: B
Rationale: Symptoms include marked impairment and risky
behavior with duration ≥1 week (or requiring hospitalization);
these indicate a manic episode. Hypomania requires ≥4 days
without marked impairment. Substance-induced should be
considered only if temporal relation to substance use is present.
Q3. Which feature most reliably differentiates Bipolar II disorder
from Cyclothymic disorder in adults?
A. Presence of major depressive episodes
B. Lifetime history of at least one hypomanic episode
,C. Duration of mood symptoms being at least 2 years
D. Psychotic features during mood episodes
Correct Answer: B
Rationale: Bipolar II requires at least one hypomanic episode
plus major depressive episodes. Cyclothymic disorder involves
numerous hypomanic-like and depressive symptoms that do
not meet full criteria for hypomanic or major depressive
episodes and lasts ≥2 years.
Q4. A 45-year-old presents with persistent excessive worry
about multiple domains for >6 months with restlessness,
muscle tension, difficulty concentrating, and sleep disturbance.
Which diagnosis is most appropriate?
A. Panic disorder
B. Generalized anxiety disorder (GAD)
C. Adjustment disorder with anxiety
D. Social anxiety disorder
Correct Answer: B
Rationale: GAD requires excessive anxiety/worry occurring
more days than not for at least 6 months with associated
symptoms (≥3 in adults). Panic disorder features discrete
unexpected panic attacks; social anxiety is specific to social
situations; adjustment disorder is temporally linked to stressor
onset and less chronic.
, Q5. A patient reports recurrent unexpected panic attacks and
persistent worry about future attacks for the past 2 months,
with avoidance of leaving home. He denies agoraphobic
symptoms prior to attacks. Best diagnosis?
A. Panic disorder
B. Agoraphobia
C. Specific phobia
D. PTSD
Correct Answer: A
Rationale: Panic disorder is characterized by recurrent
unexpected panic attacks and persistent concern/worry about
additional attacks and consequences for ≥1 month. Avoidance
may develop secondary to panic disorder but diagnosis is panic
disorder when panic attacks are primary.
Q6. Select all that apply. Features that help distinguish PTSD
from Acute Stress Disorder (ASD):
A. Duration of symptoms >1 month
B. Presence of dissociative symptoms as core feature
C. Requirement for exposure to actual or threatened death,
serious injury, or sexual violence
D. Onset within 3 days to 1 month after trauma
Correct Answer: A, C, D
Rationale: PTSD requires symptoms persisting >1 month after
trauma; ASD occurs from 3 days to 1 month. Both require
