NR-547 Midterm question and answer by A+ solutions
1. Name the 6 of a differential diagnosis - Correct Answer
1.) RULE OUT Malingering or Factitous disorder
2.)Ruling out substance etiology
3.) ruling out a medical etiology
4.) Determining the specific primary disorder
5.) Differentiating adjustment disorder from the residual "other specified" and "unspecified" conditions
6.) Establishing the boundary with no mental disorder
Remember with step 5, the PMHNP can use "other specified" in the diagnosis when they want to
indicate the specific reason for a diagnosis.
They use "unspecified" if:
the information doesnt conform to DSM5
there is insufficient info to make a specific diagnosis
2. there is more info the be revealed with time OR they want to help the patient avoid stigmas -
Correct Answer
The PMHNP wants to rule out anemia as a cause for a patients fatigue and lack of motivation. What lab
should she order? - Correct Answer a CBC with iron studies
hg-12-18
hematocrit: 38-48%
3. What is normal creat/BUN level? - Correct Answer BUN: 7-18
creat: 0.6-1.2
4. A patient presents with brain fog, lack of focus, insomnia & mood swing, lack of mental
alertness. What lab should the PMHNP order? - Correct Answer THYROID FUNCTION TEST
TSH: 0.4-4.5
T3: 100-200
T4: 5-11
, 5. The patient has a b12 level of 126 picograms/mL. what symptoms may the patient experience? -
Correct Answer normal B12: 190-950 picograms/mL
but borderline is 200-300 & will need additional testing.
depression, mania, psychotic symptoms, cognitive impairment
6. Name the normal vitamin D levels: - Correct Answer 20-50 ng/ML
7. Tell me about the HAM-A - Correct Answer This is the Hamilton Anxiety Scale, creates to assess
somatic/cognitive anxiety symptoms. MAINLY TO ASSESS ANXIETY. It does not help to assess the
worry aspect usually found with GAD.
less than 17- mild
18-23- mod
25-30 mod-severe
1. _____ shows there is an INCREASE activation of the amygdala which is an increase in the fear
response. There is a decreased activation of the pre-frontal cortex which results in lessened
reasoning. - Correct Answer Generalized Anxiety Disorder
2. Explain GAD - Correct Answer This is characterized when a person WORRY about ORDINARY,
everyday situations. These patients have a hard time getting over the what ifs and hyperfixate.
Due to this they are unable to get more of their pressing tasks done
3. What is the DSM criteria for GAD? - Correct Answer WORRY about everyday tasks, sleep
disturbance, restlessness, fatigue and immanent fear, muscle tension or difficulty concentrating
has to be persistent for six months or GREATER
Name the first line treatment for GAD. - Correct Answer SSRIs
1. Name the 6 of a differential diagnosis - Correct Answer
1.) RULE OUT Malingering or Factitous disorder
2.)Ruling out substance etiology
3.) ruling out a medical etiology
4.) Determining the specific primary disorder
5.) Differentiating adjustment disorder from the residual "other specified" and "unspecified" conditions
6.) Establishing the boundary with no mental disorder
Remember with step 5, the PMHNP can use "other specified" in the diagnosis when they want to
indicate the specific reason for a diagnosis.
They use "unspecified" if:
the information doesnt conform to DSM5
there is insufficient info to make a specific diagnosis
2. there is more info the be revealed with time OR they want to help the patient avoid stigmas -
Correct Answer
The PMHNP wants to rule out anemia as a cause for a patients fatigue and lack of motivation. What lab
should she order? - Correct Answer a CBC with iron studies
hg-12-18
hematocrit: 38-48%
3. What is normal creat/BUN level? - Correct Answer BUN: 7-18
creat: 0.6-1.2
4. A patient presents with brain fog, lack of focus, insomnia & mood swing, lack of mental
alertness. What lab should the PMHNP order? - Correct Answer THYROID FUNCTION TEST
TSH: 0.4-4.5
T3: 100-200
T4: 5-11
, 5. The patient has a b12 level of 126 picograms/mL. what symptoms may the patient experience? -
Correct Answer normal B12: 190-950 picograms/mL
but borderline is 200-300 & will need additional testing.
depression, mania, psychotic symptoms, cognitive impairment
6. Name the normal vitamin D levels: - Correct Answer 20-50 ng/ML
7. Tell me about the HAM-A - Correct Answer This is the Hamilton Anxiety Scale, creates to assess
somatic/cognitive anxiety symptoms. MAINLY TO ASSESS ANXIETY. It does not help to assess the
worry aspect usually found with GAD.
less than 17- mild
18-23- mod
25-30 mod-severe
1. _____ shows there is an INCREASE activation of the amygdala which is an increase in the fear
response. There is a decreased activation of the pre-frontal cortex which results in lessened
reasoning. - Correct Answer Generalized Anxiety Disorder
2. Explain GAD - Correct Answer This is characterized when a person WORRY about ORDINARY,
everyday situations. These patients have a hard time getting over the what ifs and hyperfixate.
Due to this they are unable to get more of their pressing tasks done
3. What is the DSM criteria for GAD? - Correct Answer WORRY about everyday tasks, sleep
disturbance, restlessness, fatigue and immanent fear, muscle tension or difficulty concentrating
has to be persistent for six months or GREATER
Name the first line treatment for GAD. - Correct Answer SSRIs
