NR 547 Final Exam 2025/2026 Test Bank |
Chamberlain PMHNP Differential Diagnosis
Across the Lifespan | 50 Graduate-Level
Questions & Answers | Nursing Exam Prep
Guide
Q1. A 32-year-old woman presents with a 3-week history of
depressed mood, anhedonia, hypersomnia, increased appetite,
and weight gain. She reports feeling worthless and tearful most
days; symptoms began 2 weeks after a breakup. No history of
manic or hypomanic episodes. Which diagnosis is most
appropriate?
A. Major Depressive Disorder, single episode, moderate
B. Persistent Depressive Disorder (dysthymia)
C. Adjustment disorder with depressed mood
D. Bipolar II disorder, depressed episode
Correct Answer: C
Rationale: The symptoms began within 2 weeks of an
identifiable stressor (breakup) and are of recent onset; duration
,(<6 months) and temporal relation favor Adjustment Disorder
with depressed mood per DSM-5-TR. Major Depressive
Disorder requires 2+ weeks but diagnosis must consider
severity and context; persistent depressive disorder requires ≥2
years. Absence of hypomania rules out Bipolar II.
Q2. A 45-year-old man has had two discrete periods of at least 1
week of markedly elevated mood, decreased need for sleep,
pressured speech, grandiose ideas, and risky behavior requiring
hospitalization; between episodes he is euthymic. Best
diagnosis?
A. Bipolar I disorder
B. Bipolar II disorder
C. Cyclothymic disorder
D. Schizoaffective disorder, bipolar type
Correct Answer: A
Rationale: DSM-5-TR requires at least one manic episode (≥1
week or requiring hospitalization) for Bipolar I. Bipolar II
requires hypomania (not full mania) and major depressive
episodes. Cyclothymic is chronic fluctuating subthreshold
symptoms. Schizoaffective requires mood and psychotic
symptoms with psychosis for ≥2 weeks without mood
symptoms.
Q3. A 19-year-old college student reports 6 months of pervasive
worry about academic performance, difficulty concentrating,
restlessness, muscle tension, and sleep disturbance. Symptoms
,occur most days, are not limited to examinations, and cause
impairment. Best diagnosis?
A. Generalized Anxiety Disorder (GAD)
B. Social Anxiety Disorder
C. Adjustment disorder with anxiety
D. Specific phobia
Correct Answer: A
Rationale: GAD is characterized by excessive anxiety and worry
occurring more days than not for ≥6 months with associated
symptoms (restlessness, concentration difficulty, muscle
tension, sleep disturbance). Social anxiety and specific phobia
are situational; adjustment disorder has shorter duration and
identifiable stressor.
Q4. A 28-year-old woman experiences recurrent panic attacks
with palpitations, sweating, trembling, shortness of breath, and
derealization. For 7 months she avoids leaving home except
with a companion. Which pair of diagnoses explains the
presentation?
A. Panic disorder with agoraphobia
B. Panic disorder without agoraphobia
C. Specific phobia (open spaces)
D. Social anxiety disorder with panic attacks
Correct Answer: A
Rationale: Recurrent unexpected panic attacks plus persistent
concern/avoidance and marked behavioral change (avoiding
, leaving home) meet criteria for Panic Disorder with
Agoraphobia per DSM-5-TR. Social anxiety is situational; specific
phobia is more circumscribed.
Q5. A 10-year-old child presents with irritability, temper
outbursts grossly out of proportion to provocation, and
persistent irritable mood between outbursts for 12 months
across settings. What is the most appropriate diagnosis?
A. Disruptive Mood Dysregulation Disorder (DMDD)
B. Oppositional Defiant Disorder (ODD)
C. Conduct disorder
D. Pediatric bipolar disorder
Correct Answer: A
Rationale: DMDD describes severe, recurrent temper outbursts
and persistent irritable mood for ≥12 months beginning before
age 10. ODD lacks pervasive severe mood symptoms; conduct
disorder has violations of rights of others. Pediatric bipolar
disorder requires distinct manic/hypomanic episodes, not
chronic irritability.
Q6. A 67-year-old woman exhibits progressive memory
impairment over 18 months, difficulty with word-finding,
impaired executive function, and MRI shows cortical atrophy.
Which diagnosis is most likely?
A. Major Neurocognitive Disorder (major NCD) due to
Alzheimer’s disease
B. Mild Neurocognitive Disorder due to normal aging
Chamberlain PMHNP Differential Diagnosis
Across the Lifespan | 50 Graduate-Level
Questions & Answers | Nursing Exam Prep
Guide
Q1. A 32-year-old woman presents with a 3-week history of
depressed mood, anhedonia, hypersomnia, increased appetite,
and weight gain. She reports feeling worthless and tearful most
days; symptoms began 2 weeks after a breakup. No history of
manic or hypomanic episodes. Which diagnosis is most
appropriate?
A. Major Depressive Disorder, single episode, moderate
B. Persistent Depressive Disorder (dysthymia)
C. Adjustment disorder with depressed mood
D. Bipolar II disorder, depressed episode
Correct Answer: C
Rationale: The symptoms began within 2 weeks of an
identifiable stressor (breakup) and are of recent onset; duration
,(<6 months) and temporal relation favor Adjustment Disorder
with depressed mood per DSM-5-TR. Major Depressive
Disorder requires 2+ weeks but diagnosis must consider
severity and context; persistent depressive disorder requires ≥2
years. Absence of hypomania rules out Bipolar II.
Q2. A 45-year-old man has had two discrete periods of at least 1
week of markedly elevated mood, decreased need for sleep,
pressured speech, grandiose ideas, and risky behavior requiring
hospitalization; between episodes he is euthymic. Best
diagnosis?
A. Bipolar I disorder
B. Bipolar II disorder
C. Cyclothymic disorder
D. Schizoaffective disorder, bipolar type
Correct Answer: A
Rationale: DSM-5-TR requires at least one manic episode (≥1
week or requiring hospitalization) for Bipolar I. Bipolar II
requires hypomania (not full mania) and major depressive
episodes. Cyclothymic is chronic fluctuating subthreshold
symptoms. Schizoaffective requires mood and psychotic
symptoms with psychosis for ≥2 weeks without mood
symptoms.
Q3. A 19-year-old college student reports 6 months of pervasive
worry about academic performance, difficulty concentrating,
restlessness, muscle tension, and sleep disturbance. Symptoms
,occur most days, are not limited to examinations, and cause
impairment. Best diagnosis?
A. Generalized Anxiety Disorder (GAD)
B. Social Anxiety Disorder
C. Adjustment disorder with anxiety
D. Specific phobia
Correct Answer: A
Rationale: GAD is characterized by excessive anxiety and worry
occurring more days than not for ≥6 months with associated
symptoms (restlessness, concentration difficulty, muscle
tension, sleep disturbance). Social anxiety and specific phobia
are situational; adjustment disorder has shorter duration and
identifiable stressor.
Q4. A 28-year-old woman experiences recurrent panic attacks
with palpitations, sweating, trembling, shortness of breath, and
derealization. For 7 months she avoids leaving home except
with a companion. Which pair of diagnoses explains the
presentation?
A. Panic disorder with agoraphobia
B. Panic disorder without agoraphobia
C. Specific phobia (open spaces)
D. Social anxiety disorder with panic attacks
Correct Answer: A
Rationale: Recurrent unexpected panic attacks plus persistent
concern/avoidance and marked behavioral change (avoiding
, leaving home) meet criteria for Panic Disorder with
Agoraphobia per DSM-5-TR. Social anxiety is situational; specific
phobia is more circumscribed.
Q5. A 10-year-old child presents with irritability, temper
outbursts grossly out of proportion to provocation, and
persistent irritable mood between outbursts for 12 months
across settings. What is the most appropriate diagnosis?
A. Disruptive Mood Dysregulation Disorder (DMDD)
B. Oppositional Defiant Disorder (ODD)
C. Conduct disorder
D. Pediatric bipolar disorder
Correct Answer: A
Rationale: DMDD describes severe, recurrent temper outbursts
and persistent irritable mood for ≥12 months beginning before
age 10. ODD lacks pervasive severe mood symptoms; conduct
disorder has violations of rights of others. Pediatric bipolar
disorder requires distinct manic/hypomanic episodes, not
chronic irritability.
Q6. A 67-year-old woman exhibits progressive memory
impairment over 18 months, difficulty with word-finding,
impaired executive function, and MRI shows cortical atrophy.
Which diagnosis is most likely?
A. Major Neurocognitive Disorder (major NCD) due to
Alzheimer’s disease
B. Mild Neurocognitive Disorder due to normal aging
