NR 547 MIDTERM STUDY GUIDE
The NR547 exam questions are taken from the Course
Activities, lectures, linked resources and required readings.
Mid-Term Exam: The Mid-Term has 75 questions worth two points each. You will have one
attempt to complete the exam with a time limit of 75 minutes.
Week 1: Foundations in Differential Diagnosis Formulation
1. The differential diagnosis:
1. Importance of the differential diagnosis
2. Analysis of:
a) presenting symptoms
b) clinical data such as physical exam
c) laboratory analysis.
d) Medical history including medications
3. Evidence-based screening tools and psychiatric rating scales
a) Scoring
b) Advantages and disadvantages
c) Components
d) When to use (i.e., when is a brief screening tool inappropriate)
4. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) (American Psychiatric
Association [APA], 2022) criteria.
a) Know diagnostic criteria for various problems, such as Schizophrenia, sleep disorder, sexual
disorders and anxiety disorders
5. Rule out physical and substance-related causes for psychological symptoms.
6. Understand differences between the workup and treatment for new onset symptoms versus pre-
existing symptoms
a) New patients or new onset symptoms require full workup
b) Pre-existing conditions and diagnosis should be taken into account when formulating your
differentials
c) Pre-existing conditions may exclude some differentials
2. Social determinants of health and the psychiatric mental health nurse practitioners (PMHNPs) role in
addressing SDOH at the individual and population levels. SDOH have a significant impact on health, quality of
life, and life expectancy in relation to mental health. Social and environmental factors can influence genetic
determinants of health and illness and affect the risk for mental illness and substance use disorders.
3. Review basics of laboratory analysis including:
1. CBC – WBCs 5-10k, platelets 150-300k, RBCs 4.5-6, Hgb 12-18, Hct 38-48%
2. CMP – Na 136-145,K 3.5-5, Cl 95-205, Ca 8.4-10.2, Create 0.6-1.2, BUN 7-18, ALT 8-20, AST 8-
20, Bili 0.1-1.0, Phos 20-70
3. Thyroid function tests – TSH 0.4-4.5, T3 100-200, T4 5-11
4. Vitamin B12 levels – 190-950
5. Vitamin D levels – 20-50, deficiency <12
4. Know terms
1. Alogia – lack of speech caused by disruption in the thougt process. “poverty of speech” seen in
dementia, schizophrenia, and some mood disorders.
2. Avolition – total lack of motivation making it difficult to get things done. Considered a “negative”
symptom.
, 3. Anosognosia – deficit of self-awareness.
4. Affective flattening – gross lack of emotional response to a given situation.
Week 2: Differential Diagnosis of Anxiety
1. Anxiety
a) GAD
1. Depression is a common comorbidity
b) OCD - characterized by persistent, uncontrollable thoughts or actions that occur over an hour or
more per day, know comorbidities
1. Compulsions typically performed in response to an obsessive thought
2. Subclinical versus clinical symptoms
c) Panic disorder – know diagnostic criteria and physiological symptoms
d) Social phobias – know various phobias and diagnostic criteria
e) Agorophobia – know definition and symptoms
f) General phobias
1. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) (American
Psychiatric Association [APA], 2022) criteria.
2. Remember to rule out physical and substance-related causes. for psychological symptoms.
g) Please review general anxiety versus your specific anxieties/phobias
h) Know definition of
1. Excoriation disorder –picking skin
2. Hoarding disorder – keeping items
3. Body dysmorphic disorder – distorted view of oneself
4. Trichotillomania disorder – hair pulling
i) Tourette’s – remember this is closely related to OCD and anxiety
j) Review lifespan manifestations and treatment of various anxiety disorders.
k) Role of social determinants in the development of anxiety
2. Non-pharmacological treatments of anxiety, including counseling methods
3. Pharmacological management including antidepressants and beta-blockers
4. Medications (including antidepressants) to avoid with acute anxiety.
5. Screening Tools for various anxiety disorders
a) KNOW SCORING
b) Know strengths and shortcomings of screening tools
c) HAM-A
d) GAD-7
e) YBOC
3. Basic treatment options including counseling strategies
a) Treatments often reflect concomitant depression treatment
b) Review which antidepressants are effective as anxiety management
c) Review basic counseling strategies
The NR547 exam questions are taken from the Course
Activities, lectures, linked resources and required readings.
Mid-Term Exam: The Mid-Term has 75 questions worth two points each. You will have one
attempt to complete the exam with a time limit of 75 minutes.
Week 1: Foundations in Differential Diagnosis Formulation
1. The differential diagnosis:
1. Importance of the differential diagnosis
2. Analysis of:
a) presenting symptoms
b) clinical data such as physical exam
c) laboratory analysis.
d) Medical history including medications
3. Evidence-based screening tools and psychiatric rating scales
a) Scoring
b) Advantages and disadvantages
c) Components
d) When to use (i.e., when is a brief screening tool inappropriate)
4. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) (American Psychiatric
Association [APA], 2022) criteria.
a) Know diagnostic criteria for various problems, such as Schizophrenia, sleep disorder, sexual
disorders and anxiety disorders
5. Rule out physical and substance-related causes for psychological symptoms.
6. Understand differences between the workup and treatment for new onset symptoms versus pre-
existing symptoms
a) New patients or new onset symptoms require full workup
b) Pre-existing conditions and diagnosis should be taken into account when formulating your
differentials
c) Pre-existing conditions may exclude some differentials
2. Social determinants of health and the psychiatric mental health nurse practitioners (PMHNPs) role in
addressing SDOH at the individual and population levels. SDOH have a significant impact on health, quality of
life, and life expectancy in relation to mental health. Social and environmental factors can influence genetic
determinants of health and illness and affect the risk for mental illness and substance use disorders.
3. Review basics of laboratory analysis including:
1. CBC – WBCs 5-10k, platelets 150-300k, RBCs 4.5-6, Hgb 12-18, Hct 38-48%
2. CMP – Na 136-145,K 3.5-5, Cl 95-205, Ca 8.4-10.2, Create 0.6-1.2, BUN 7-18, ALT 8-20, AST 8-
20, Bili 0.1-1.0, Phos 20-70
3. Thyroid function tests – TSH 0.4-4.5, T3 100-200, T4 5-11
4. Vitamin B12 levels – 190-950
5. Vitamin D levels – 20-50, deficiency <12
4. Know terms
1. Alogia – lack of speech caused by disruption in the thougt process. “poverty of speech” seen in
dementia, schizophrenia, and some mood disorders.
2. Avolition – total lack of motivation making it difficult to get things done. Considered a “negative”
symptom.
, 3. Anosognosia – deficit of self-awareness.
4. Affective flattening – gross lack of emotional response to a given situation.
Week 2: Differential Diagnosis of Anxiety
1. Anxiety
a) GAD
1. Depression is a common comorbidity
b) OCD - characterized by persistent, uncontrollable thoughts or actions that occur over an hour or
more per day, know comorbidities
1. Compulsions typically performed in response to an obsessive thought
2. Subclinical versus clinical symptoms
c) Panic disorder – know diagnostic criteria and physiological symptoms
d) Social phobias – know various phobias and diagnostic criteria
e) Agorophobia – know definition and symptoms
f) General phobias
1. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) (American
Psychiatric Association [APA], 2022) criteria.
2. Remember to rule out physical and substance-related causes. for psychological symptoms.
g) Please review general anxiety versus your specific anxieties/phobias
h) Know definition of
1. Excoriation disorder –picking skin
2. Hoarding disorder – keeping items
3. Body dysmorphic disorder – distorted view of oneself
4. Trichotillomania disorder – hair pulling
i) Tourette’s – remember this is closely related to OCD and anxiety
j) Review lifespan manifestations and treatment of various anxiety disorders.
k) Role of social determinants in the development of anxiety
2. Non-pharmacological treatments of anxiety, including counseling methods
3. Pharmacological management including antidepressants and beta-blockers
4. Medications (including antidepressants) to avoid with acute anxiety.
5. Screening Tools for various anxiety disorders
a) KNOW SCORING
b) Know strengths and shortcomings of screening tools
c) HAM-A
d) GAD-7
e) YBOC
3. Basic treatment options including counseling strategies
a) Treatments often reflect concomitant depression treatment
b) Review which antidepressants are effective as anxiety management
c) Review basic counseling strategies
