1 | Page
NR 547 FINAL EXAM 2025/2026 – DIFFERENTIAL DIAGNOSIS IN
PSYCHIATRIC-MENTAL HEALTH | 160 QUESTIONS & VERIFIED
ANSWERS WITH RATIONALES,100% CORRECT ALREADY GRADED
A+
1.
A 32-year-old woman presents with persistent low mood, lack of energy, and loss
of interest in activities for the past 8 months. She denies psychosis and manic
episodes. Which is the most appropriate diagnosis?
A. Major depressive disorder
B. Dysthymia (Persistent Depressive Disorder)
C. Bipolar II disorder
D. Cyclothymic disorder
Answer: B. Dysthymia (Persistent Depressive Disorder)
Rationale: Symptoms lasting >2 years (≥1 year in children) without
mania/hypomania fit persistent depressive disorder, not major depression.
2.
A 10-year-old boy is referred for irritability, temper outbursts, and persistent angry
mood for more than 12 months in school and home settings. What is the likely
diagnosis?
A. Oppositional defiant disorder
B. Disruptive mood dysregulation disorder
C. Intermittent explosive disorder
D. Conduct disorder
Answer: B. Disruptive mood dysregulation disorder
Rationale: DMDD is diagnosed in children 6–18 years with chronic irritability
and frequent temper outbursts.
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3.
A 45-year-old man presents with alternating episodes of depressed mood and
elevated energy lasting days, but none meeting full criteria for major depressive or
manic episodes. What is the best diagnosis?
A. Cyclothymic disorder
B. Bipolar I disorder
C. Persistent depressive disorder
D. Generalized anxiety disorder
Answer: A. Cyclothymic disorder
Rationale: Chronic mood fluctuations without full episodes suggest cyclothymia.
4.
A 70-year-old woman has progressive memory loss, difficulty managing finances,
and word-finding problems. MMSE shows impaired recall. What is the most likely
diagnosis?
A. Alzheimer’s disease
B. Vascular dementia
C. Normal aging
D. Frontotemporal dementia
Answer: A. Alzheimer’s disease
Rationale: Insidious onset and memory impairment with language deficits suggest
Alzheimer’s dementia.
5.
A 28-year-old man with schizophrenia reports tremors, rigidity, and shuffling gait
after months on haloperidol. Which is the diagnosis?
A. Tardive dyskinesia
B. Acute dystonia
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C. Parkinsonism
D. Akathisia
Answer: C. Parkinsonism
Rationale: Drug-induced parkinsonism includes tremor, rigidity, and bradykinesia.
6.
A 7-year-old girl is inattentive, forgetful, and has poor academic performance. Her
teacher reports frequent daydreaming. What is the likely diagnosis?
A. ADHD, predominantly inattentive type
B. ADHD, hyperactive type
C. Specific learning disorder
D. Oppositional defiant disorder
Answer: A. ADHD, predominantly inattentive type
Rationale: Primary symptoms are inattention without hyperactivity.
7.
A 40-year-old man reports multiple unexplained physical complaints such as
headaches, chest pain, and stomach upset for over 6 months. Workup is negative.
What is the most likely diagnosis?
A. Illness anxiety disorder
B. Somatic symptom disorder
C. Conversion disorder
D. Factitious disorder
Answer: B. Somatic symptom disorder
Rationale: Multiple distressing somatic symptoms with excessive thoughts about
illness define SSD.
8.
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A 26-year-old woman has sudden paralysis of her right leg after a stressful
breakup. Neurological exam and imaging are normal. What is the likely diagnosis?
A. Factitious disorder
B. Malingering
C. Conversion disorder
D. Somatic symptom disorder
Answer: C. Conversion disorder
Rationale: Sudden neurological symptom inconsistent with pathology following
stress suggests conversion disorder.
9.
A 54-year-old man has persistent suspiciousness that coworkers are plotting against
him, despite no evidence. He has maintained work performance. Which is the
diagnosis?
A. Schizoid personality disorder
B. Schizophrenia
C. Paranoid personality disorder
D. Delusional disorder
Answer: C. Paranoid personality disorder
Rationale: Lifelong mistrust without psychosis or deterioration suggests paranoid
personality disorder.
10.
A 33-year-old woman has episodes of palpitations, sweating, trembling, and fear of
dying that peak within minutes. Which diagnosis is most appropriate?
A. Panic disorder
B. Generalized anxiety disorder
C. PTSD
D. Social anxiety disorder
NR 547 FINAL EXAM 2025/2026 – DIFFERENTIAL DIAGNOSIS IN
PSYCHIATRIC-MENTAL HEALTH | 160 QUESTIONS & VERIFIED
ANSWERS WITH RATIONALES,100% CORRECT ALREADY GRADED
A+
1.
A 32-year-old woman presents with persistent low mood, lack of energy, and loss
of interest in activities for the past 8 months. She denies psychosis and manic
episodes. Which is the most appropriate diagnosis?
A. Major depressive disorder
B. Dysthymia (Persistent Depressive Disorder)
C. Bipolar II disorder
D. Cyclothymic disorder
Answer: B. Dysthymia (Persistent Depressive Disorder)
Rationale: Symptoms lasting >2 years (≥1 year in children) without
mania/hypomania fit persistent depressive disorder, not major depression.
2.
A 10-year-old boy is referred for irritability, temper outbursts, and persistent angry
mood for more than 12 months in school and home settings. What is the likely
diagnosis?
A. Oppositional defiant disorder
B. Disruptive mood dysregulation disorder
C. Intermittent explosive disorder
D. Conduct disorder
Answer: B. Disruptive mood dysregulation disorder
Rationale: DMDD is diagnosed in children 6–18 years with chronic irritability
and frequent temper outbursts.
,2 | Page
3.
A 45-year-old man presents with alternating episodes of depressed mood and
elevated energy lasting days, but none meeting full criteria for major depressive or
manic episodes. What is the best diagnosis?
A. Cyclothymic disorder
B. Bipolar I disorder
C. Persistent depressive disorder
D. Generalized anxiety disorder
Answer: A. Cyclothymic disorder
Rationale: Chronic mood fluctuations without full episodes suggest cyclothymia.
4.
A 70-year-old woman has progressive memory loss, difficulty managing finances,
and word-finding problems. MMSE shows impaired recall. What is the most likely
diagnosis?
A. Alzheimer’s disease
B. Vascular dementia
C. Normal aging
D. Frontotemporal dementia
Answer: A. Alzheimer’s disease
Rationale: Insidious onset and memory impairment with language deficits suggest
Alzheimer’s dementia.
5.
A 28-year-old man with schizophrenia reports tremors, rigidity, and shuffling gait
after months on haloperidol. Which is the diagnosis?
A. Tardive dyskinesia
B. Acute dystonia
,3 | Page
C. Parkinsonism
D. Akathisia
Answer: C. Parkinsonism
Rationale: Drug-induced parkinsonism includes tremor, rigidity, and bradykinesia.
6.
A 7-year-old girl is inattentive, forgetful, and has poor academic performance. Her
teacher reports frequent daydreaming. What is the likely diagnosis?
A. ADHD, predominantly inattentive type
B. ADHD, hyperactive type
C. Specific learning disorder
D. Oppositional defiant disorder
Answer: A. ADHD, predominantly inattentive type
Rationale: Primary symptoms are inattention without hyperactivity.
7.
A 40-year-old man reports multiple unexplained physical complaints such as
headaches, chest pain, and stomach upset for over 6 months. Workup is negative.
What is the most likely diagnosis?
A. Illness anxiety disorder
B. Somatic symptom disorder
C. Conversion disorder
D. Factitious disorder
Answer: B. Somatic symptom disorder
Rationale: Multiple distressing somatic symptoms with excessive thoughts about
illness define SSD.
8.
, 4 | Page
A 26-year-old woman has sudden paralysis of her right leg after a stressful
breakup. Neurological exam and imaging are normal. What is the likely diagnosis?
A. Factitious disorder
B. Malingering
C. Conversion disorder
D. Somatic symptom disorder
Answer: C. Conversion disorder
Rationale: Sudden neurological symptom inconsistent with pathology following
stress suggests conversion disorder.
9.
A 54-year-old man has persistent suspiciousness that coworkers are plotting against
him, despite no evidence. He has maintained work performance. Which is the
diagnosis?
A. Schizoid personality disorder
B. Schizophrenia
C. Paranoid personality disorder
D. Delusional disorder
Answer: C. Paranoid personality disorder
Rationale: Lifelong mistrust without psychosis or deterioration suggests paranoid
personality disorder.
10.
A 33-year-old woman has episodes of palpitations, sweating, trembling, and fear of
dying that peak within minutes. Which diagnosis is most appropriate?
A. Panic disorder
B. Generalized anxiety disorder
C. PTSD
D. Social anxiety disorder
