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NR 547 DIFFERENTIAL DIAGNOSIS IN PSYCHIATRIC-MENTAL
HEALTH ACROSS THE LIFESPAN PRACTICUM EXAM 2026
QUESTIONS WITH VERIFIED QUESTIONS DETAILED RATIONALES
GRADED A+
Question 1
What is the first step in the six-step differential diagnosis process?
A. Rule out substance etiology
B. Rule out malingering or factitious disorder
C. Apply DSM-5-TR criteria
D. Determine the specific primary disorder
Answer: B
Rationale: The first step in the six-step differential diagnosis process is to rule out malingering
or factitious disorder. This involves excluding intentional symptom production for external gain
(malingering) or the sick role (factitious disorder) before considering other causes.
Question 2
What is the second step in the six-step differential diagnosis process?
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A. Rule out malingering or factitious disorder
B. Rule out substance etiology
C. Rule out disorder due to a medical condition
D. Determine the specific primary disorder
Answer: B
Rationale: After ruling out malingering and factitious disorder, the second step is to rule out
substance etiology. Psychiatric symptoms can be attributed to substance use if they stop within
one month of stopping the substance.
Question 3
What is the third step in the six-step differential diagnosis process?
A. Rule out substance etiology
B. Rule out disorder due to a medical condition
C. Determine the specific primary disorder
D. Differentiate adjustment disorders
Answer: B
Rationale: The third step is to rule out disorder due to a medical condition. If psychiatric
symptoms begin following the onset of a medical condition, vary in severity with the medical
condition, or disappear when the medical condition resolves, they are likely caused by the
medical condition.
Question 4
What is the fourth step in the six-step differential diagnosis process?
A. Rule out medical etiology
B. Determine the specific primary disorder using the DSM-5
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C. Differentiate adjustment disorders
D. Establish a boundary with no mental disorder
Answer: B
Rationale: After ruling out malingering, substance etiology, and medical conditions, the fourth
step is to determine the specific primary disorder using the DSM-5-TR.
Question 5
What is the fifth step in the six-step differential diagnosis process?
A. Determine the specific primary disorder
B. Differentiate adjustment disorders from other specified/unspecified disorders
C. Establish a boundary with no mental disorder
D. Rule out substance etiology
Answer: B
Rationale: The fifth step is to differentiate adjustment disorders from residual "other specified"
and "unspecified" disorders.
Question 6
What is the sixth step in the six-step differential diagnosis process?
A. Determine the specific primary disorder
B. Establish a boundary with no mental disorder
C. Rule out substance etiology
D. Differentiate adjustment disorders
Answer: B
Rationale: The sixth and final step is to establish a boundary with no mental disorder. Not
everyone qualifies for a mental health diagnosis, and it is important to recognize when
symptoms do not meet diagnostic thresholds.
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Question 7
When is a general medical condition most important to consider in the differential diagnosis?
A. When the patient has a known chronic illness
B. When the psychiatric presentation is atypical in symptom pattern, age at onset, or course
C. When the patient is elderly
D. When the patient requests medical testing
Answer: B
Rationale: A general medical condition should be considered when the psychiatric presentation
is atypical in symptom pattern, age at onset, or course. For example, severe memory loss
accompanying depression is unusual and may suggest a medical issue.
Question 8
What is the rule of thumb for determining that psychiatric symptoms are caused by a medical
condition?
A. Symptoms begin before the medical condition
B. Symptoms are consistent with the patient's age
C. Symptoms vary in severity with the medical condition and disappear when it resolves
D. Symptoms respond to psychiatric medication
Answer: C
Rationale: Psychiatric symptoms are likely caused by a medical condition if they begin following
the onset of the medical condition, vary in severity with the severity of the medical condition,
and disappear when the medical condition resolves.
Question 9
What is the DSM-5-TR criteria for substance-induced psychiatric presentations?
NR 547 DIFFERENTIAL DIAGNOSIS IN PSYCHIATRIC-MENTAL
HEALTH ACROSS THE LIFESPAN PRACTICUM EXAM 2026
QUESTIONS WITH VERIFIED QUESTIONS DETAILED RATIONALES
GRADED A+
Question 1
What is the first step in the six-step differential diagnosis process?
A. Rule out substance etiology
B. Rule out malingering or factitious disorder
C. Apply DSM-5-TR criteria
D. Determine the specific primary disorder
Answer: B
Rationale: The first step in the six-step differential diagnosis process is to rule out malingering
or factitious disorder. This involves excluding intentional symptom production for external gain
(malingering) or the sick role (factitious disorder) before considering other causes.
Question 2
What is the second step in the six-step differential diagnosis process?
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A. Rule out malingering or factitious disorder
B. Rule out substance etiology
C. Rule out disorder due to a medical condition
D. Determine the specific primary disorder
Answer: B
Rationale: After ruling out malingering and factitious disorder, the second step is to rule out
substance etiology. Psychiatric symptoms can be attributed to substance use if they stop within
one month of stopping the substance.
Question 3
What is the third step in the six-step differential diagnosis process?
A. Rule out substance etiology
B. Rule out disorder due to a medical condition
C. Determine the specific primary disorder
D. Differentiate adjustment disorders
Answer: B
Rationale: The third step is to rule out disorder due to a medical condition. If psychiatric
symptoms begin following the onset of a medical condition, vary in severity with the medical
condition, or disappear when the medical condition resolves, they are likely caused by the
medical condition.
Question 4
What is the fourth step in the six-step differential diagnosis process?
A. Rule out medical etiology
B. Determine the specific primary disorder using the DSM-5
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C. Differentiate adjustment disorders
D. Establish a boundary with no mental disorder
Answer: B
Rationale: After ruling out malingering, substance etiology, and medical conditions, the fourth
step is to determine the specific primary disorder using the DSM-5-TR.
Question 5
What is the fifth step in the six-step differential diagnosis process?
A. Determine the specific primary disorder
B. Differentiate adjustment disorders from other specified/unspecified disorders
C. Establish a boundary with no mental disorder
D. Rule out substance etiology
Answer: B
Rationale: The fifth step is to differentiate adjustment disorders from residual "other specified"
and "unspecified" disorders.
Question 6
What is the sixth step in the six-step differential diagnosis process?
A. Determine the specific primary disorder
B. Establish a boundary with no mental disorder
C. Rule out substance etiology
D. Differentiate adjustment disorders
Answer: B
Rationale: The sixth and final step is to establish a boundary with no mental disorder. Not
everyone qualifies for a mental health diagnosis, and it is important to recognize when
symptoms do not meet diagnostic thresholds.
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Question 7
When is a general medical condition most important to consider in the differential diagnosis?
A. When the patient has a known chronic illness
B. When the psychiatric presentation is atypical in symptom pattern, age at onset, or course
C. When the patient is elderly
D. When the patient requests medical testing
Answer: B
Rationale: A general medical condition should be considered when the psychiatric presentation
is atypical in symptom pattern, age at onset, or course. For example, severe memory loss
accompanying depression is unusual and may suggest a medical issue.
Question 8
What is the rule of thumb for determining that psychiatric symptoms are caused by a medical
condition?
A. Symptoms begin before the medical condition
B. Symptoms are consistent with the patient's age
C. Symptoms vary in severity with the medical condition and disappear when it resolves
D. Symptoms respond to psychiatric medication
Answer: C
Rationale: Psychiatric symptoms are likely caused by a medical condition if they begin following
the onset of the medical condition, vary in severity with the severity of the medical condition,
and disappear when the medical condition resolves.
Question 9
What is the DSM-5-TR criteria for substance-induced psychiatric presentations?
