NR 547 MIDTERM EXAM
COMPLETE QUESTIONS AND DETAILED SOLUTIONS LATEST UPDATE THIS
YEAR JUST RELEASED
Question 1: Minh is a 19-year-old who presents to the emergency
department after a suicide attempt. She is medically stable. She
states that she has experienced auditory hallucinations for the past
3-4 weeks and "could not take them anymore." She also complains
of depressed mood, loss of interest in activities, and feelings of
hopelessness for the past few months. Her toxicology reports on
admission were negative.
Based on the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5-TR), what is the most appropriate diagnosis for Minh? include
ICD-10 code:
Answer:
schizoaffective disorder depressive type F25.1
Rationale: Minh presents with major depressive episode concurrent with
hallucinations. This disturbance is not attributable to a substance. The most
appropriate diagnosis for Minh is schizoaffective disorder depressive type
F25.1
Question 2: Schizophreniform Disorder
Answer:
characterized by schizophrenia-like symptoms that last for more than 1
month but less than 6 months
-differentiated from schizophrenia based on the length of time symptoms
have been present
,Question 3: Holden is a 14-year-old who presents to the clinic with
his parents. His mother notes that he has stopped showering,
seems disinterested in activities in which he had previously
engaged and in peer interaction, and echoes words that others
have said. These behaviors have increased over the past two
months. Holden's urine toxicology is negative. Based on the
DSM-5-TR, does Holden meet diagnostic criteria for
schizophreniform disorder?
yes
no
Unable to determine
Answer:
No
Rationale: Holden's behaviors have lasted for at least one month, but less
than six months. His behaviors are not attributable to a substance. Holden
displays two of the five required symptoms for the diagnosis of
schizophreniform disorder. He displays catatonic behavior with echolalia
and has negative symptoms of asociality and avolition. He does not,
however, display one of the three required behaviors for diagnosis:
delusions, hallucinations, or disorganized speech. An alternate diagnosis
should be considered.
Question 4: Brief Psychotic Disorder
Answer:
an acute psychosis, often precipitated by stress
-Symptoms last for less than 1 month
-clients experience full remission with a full return to function
Question 5: Shelby is a 31-year-old who presents to the emergency
department with her husband. She is 32 weeks pregnant. Her
,husband noted that a few days ago, she began having bizarre
behaviors, including avoiding eye contact, exhibiting tangential
speech, and expressing delusions that she is being followed and
tracked by the CIA and that they are planning to steal her baby.
Shelby has no medical or psychiatric history, and she is not on any
medications. She has abstained from alcohol during pregnancy
and does not use other drugs. Based on DMS-5-TR, does Shelby
meet the criteria for brief psychotic disorder?
yes
no
Unable to determine
Answer:
Unable to determine
Rationale: Shelby may meet diagnostic criteria for brief psychotic disorder
(298.8) with peripartum onset, but a diagnosis cannot be confirmed at this
time. Shelby exhibits delusions and disorganized speech. The symptoms
cannot be better explained by another medical or psychiatric illness or
substance. Shelby's symptoms began a few days ago. If symptoms resolve
within one month, this is an appropriate diagnosis. If not, an alternate
diagnosis should be considered.
Question 6: Delusional Disorder
Answer:
involves a person having prominent delusions without hallucinations
-tend to have false beliefs that involve real-life situations
• ex: belief that they are being followed or that others are plotting against
them
-often retain their personalities and are more functional socially
, Question 7: Geoff is two days post-op from knee surgery. He has
been awake, alert, oriented, and pleasant over the last few days and
has shown no signs of mental distress. The surgical team asked for
a psychiatric consult after Geoff became increasingly angry,
argumentative, and agitated with nursing staff when he was offered
a flu shot. Geoff states that he was given a flu shot against his will
at work several years ago, and since then the government has been
tracking him and listening in on private conversations. He states
that taking another shot will "triple the power" of the surveillance.
Upon follow-up, Geoff's wife confirms that he has held this belief
for many years. He believes the same is true for other vaccines, but
he does not hold other delusions. He has maintained employment,
relationships, and social interactions. Based on the DSM-5-TR,
does Geoff meet diagnostic criteria for delusional disorder?
yes
no
unable to
Answer:
Yes
Rationale: Geoff has one belief that is irrational and fixed and has held the
delusion for several years. His functioning is not impaired. He meets
diagnostic criteria for delusional disorder
Question 8: Catatonia
Answer:
COMPLETE QUESTIONS AND DETAILED SOLUTIONS LATEST UPDATE THIS
YEAR JUST RELEASED
Question 1: Minh is a 19-year-old who presents to the emergency
department after a suicide attempt. She is medically stable. She
states that she has experienced auditory hallucinations for the past
3-4 weeks and "could not take them anymore." She also complains
of depressed mood, loss of interest in activities, and feelings of
hopelessness for the past few months. Her toxicology reports on
admission were negative.
Based on the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5-TR), what is the most appropriate diagnosis for Minh? include
ICD-10 code:
Answer:
schizoaffective disorder depressive type F25.1
Rationale: Minh presents with major depressive episode concurrent with
hallucinations. This disturbance is not attributable to a substance. The most
appropriate diagnosis for Minh is schizoaffective disorder depressive type
F25.1
Question 2: Schizophreniform Disorder
Answer:
characterized by schizophrenia-like symptoms that last for more than 1
month but less than 6 months
-differentiated from schizophrenia based on the length of time symptoms
have been present
,Question 3: Holden is a 14-year-old who presents to the clinic with
his parents. His mother notes that he has stopped showering,
seems disinterested in activities in which he had previously
engaged and in peer interaction, and echoes words that others
have said. These behaviors have increased over the past two
months. Holden's urine toxicology is negative. Based on the
DSM-5-TR, does Holden meet diagnostic criteria for
schizophreniform disorder?
yes
no
Unable to determine
Answer:
No
Rationale: Holden's behaviors have lasted for at least one month, but less
than six months. His behaviors are not attributable to a substance. Holden
displays two of the five required symptoms for the diagnosis of
schizophreniform disorder. He displays catatonic behavior with echolalia
and has negative symptoms of asociality and avolition. He does not,
however, display one of the three required behaviors for diagnosis:
delusions, hallucinations, or disorganized speech. An alternate diagnosis
should be considered.
Question 4: Brief Psychotic Disorder
Answer:
an acute psychosis, often precipitated by stress
-Symptoms last for less than 1 month
-clients experience full remission with a full return to function
Question 5: Shelby is a 31-year-old who presents to the emergency
department with her husband. She is 32 weeks pregnant. Her
,husband noted that a few days ago, she began having bizarre
behaviors, including avoiding eye contact, exhibiting tangential
speech, and expressing delusions that she is being followed and
tracked by the CIA and that they are planning to steal her baby.
Shelby has no medical or psychiatric history, and she is not on any
medications. She has abstained from alcohol during pregnancy
and does not use other drugs. Based on DMS-5-TR, does Shelby
meet the criteria for brief psychotic disorder?
yes
no
Unable to determine
Answer:
Unable to determine
Rationale: Shelby may meet diagnostic criteria for brief psychotic disorder
(298.8) with peripartum onset, but a diagnosis cannot be confirmed at this
time. Shelby exhibits delusions and disorganized speech. The symptoms
cannot be better explained by another medical or psychiatric illness or
substance. Shelby's symptoms began a few days ago. If symptoms resolve
within one month, this is an appropriate diagnosis. If not, an alternate
diagnosis should be considered.
Question 6: Delusional Disorder
Answer:
involves a person having prominent delusions without hallucinations
-tend to have false beliefs that involve real-life situations
• ex: belief that they are being followed or that others are plotting against
them
-often retain their personalities and are more functional socially
, Question 7: Geoff is two days post-op from knee surgery. He has
been awake, alert, oriented, and pleasant over the last few days and
has shown no signs of mental distress. The surgical team asked for
a psychiatric consult after Geoff became increasingly angry,
argumentative, and agitated with nursing staff when he was offered
a flu shot. Geoff states that he was given a flu shot against his will
at work several years ago, and since then the government has been
tracking him and listening in on private conversations. He states
that taking another shot will "triple the power" of the surveillance.
Upon follow-up, Geoff's wife confirms that he has held this belief
for many years. He believes the same is true for other vaccines, but
he does not hold other delusions. He has maintained employment,
relationships, and social interactions. Based on the DSM-5-TR,
does Geoff meet diagnostic criteria for delusional disorder?
yes
no
unable to
Answer:
Yes
Rationale: Geoff has one belief that is irrational and fixed and has held the
delusion for several years. His functioning is not impaired. He meets
diagnostic criteria for delusional disorder
Question 8: Catatonia
Answer:
