NR547 Week 9 Exam V3 | NR547
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 9 Exam) | Chamberlain University
1. A 25-year-old male presents with a one-week history of elevated mood, decreased need
for sleep, and racing thoughts. He has no prior psychiatric history. Which diagnosis is most
likely according to DSM-5-TR criteria?
A. Bipolar I Disorder
B. Bipolar II Disorder
C. Cyclothymic Disorder
D. Major Depressive Disorder with psychotic features
Answer: A
Rationale: Bipolar I Disorder requires at least one manic episode that lasts at least one
week and is present most of the day, nearly every day. Bipolar II requires a hypomanic
episode and a major depressive episode, which is not described here. Proper identification
of mania is critical for the PMHNP to initiate mood stabilizers and avoid SSRI-induced
mania.
,2. When screening for Bipolar Disorder in a primary care setting, which tool is considered
most appropriate for initial assessment?
A. PHQ-9
B. MDQ
C. GAD-7
D. CAGE
Answer: B
Rationale: The Mood Disorder Questionnaire (MDQ) is a validated screening tool designed
specifically to identify symptoms of Bipolar Spectrum Disorders. While the PHQ-9 screens
for depression and GAD-7 for anxiety, neither captures the hypomanic or manic symptoms
necessary for a Bipolar diagnosis. Utilizing the MDQ helps the PMHNP differentiate
between unipolar and bipolar depression.
3. A 35-year-old patient reports feeling ‘on edge’ for the past 8 months, accompanied by
muscle tension and difficulty concentrating. What is the minimum duration of symptoms
required for a diagnosis of Generalized Anxiety Disorder (GAD)?
A. 1 month
B. 3 months
C. 12 months
D. 6 months
,Answer: D
Rationale: According to the DSM-5-TR, GAD requires excessive anxiety and worry
occurring more days than not for at least 6 months. The symptoms must be associated with
at least three of the six specified clinical features such as restlessness or sleep disturbance.
Establishing the duration is a key step in the differential diagnosis to rule out adjustment
disorders.
4. A PMHNP is evaluating a child who displays a persistent pattern of angry/irritable mood
and argumentative behavior toward authority figures for 7 months. The child does not violate
the basic rights of others. Which diagnosis is most appropriate?
A. Conduct Disorder
B. Attention-Deficit/Hyperactivity Disorder
C. Disruptive Mood Dysregulation Disorder (DMDD)
D. Oppositional Defiant Disorder (ODD)
Answer: D
Rationale: Oppositional Defiant Disorder is characterized by a pattern of angry/irritable
mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months. Unlike
Conduct Disorder, ODD does not typically involve aggression toward people or animals or
destruction of property. The PMHNP must distinguish these to implement the correct
behavioral and family interventions.
, 5. A patient presents with sudden episodes of intense fear, palpitations, and shortness of
breath that peak within 10 minutes. These episodes are unexpected. Which additional finding
is required for a diagnosis of Panic Disorder?
A. Persistent concern or worry about additional panic attacks or their consequences
B. Symptoms occurring for at least 6 months
C. Fear of being in open spaces
D. History of a traumatic event
Answer: A
Rationale: Panic Disorder requires recurrent unexpected panic attacks followed by at least
one month of persistent concern about future attacks or a significant maladaptive change
in behavior. This distinguishes Panic Disorder from isolated panic attacks that may occur in
other anxiety disorders. Accurate diagnosis ensures the clinician focuses on panic-specific
CBT and pharmacological management.
6. Which of the following is a ‘negative symptom’ of Schizophrenia?
A. Anhedonia
B. Hallucinations
C. Delusions
D. Disorganized speech
Answer: A
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 9 Exam) | Chamberlain University
1. A 25-year-old male presents with a one-week history of elevated mood, decreased need
for sleep, and racing thoughts. He has no prior psychiatric history. Which diagnosis is most
likely according to DSM-5-TR criteria?
A. Bipolar I Disorder
B. Bipolar II Disorder
C. Cyclothymic Disorder
D. Major Depressive Disorder with psychotic features
Answer: A
Rationale: Bipolar I Disorder requires at least one manic episode that lasts at least one
week and is present most of the day, nearly every day. Bipolar II requires a hypomanic
episode and a major depressive episode, which is not described here. Proper identification
of mania is critical for the PMHNP to initiate mood stabilizers and avoid SSRI-induced
mania.
,2. When screening for Bipolar Disorder in a primary care setting, which tool is considered
most appropriate for initial assessment?
A. PHQ-9
B. MDQ
C. GAD-7
D. CAGE
Answer: B
Rationale: The Mood Disorder Questionnaire (MDQ) is a validated screening tool designed
specifically to identify symptoms of Bipolar Spectrum Disorders. While the PHQ-9 screens
for depression and GAD-7 for anxiety, neither captures the hypomanic or manic symptoms
necessary for a Bipolar diagnosis. Utilizing the MDQ helps the PMHNP differentiate
between unipolar and bipolar depression.
3. A 35-year-old patient reports feeling ‘on edge’ for the past 8 months, accompanied by
muscle tension and difficulty concentrating. What is the minimum duration of symptoms
required for a diagnosis of Generalized Anxiety Disorder (GAD)?
A. 1 month
B. 3 months
C. 12 months
D. 6 months
,Answer: D
Rationale: According to the DSM-5-TR, GAD requires excessive anxiety and worry
occurring more days than not for at least 6 months. The symptoms must be associated with
at least three of the six specified clinical features such as restlessness or sleep disturbance.
Establishing the duration is a key step in the differential diagnosis to rule out adjustment
disorders.
4. A PMHNP is evaluating a child who displays a persistent pattern of angry/irritable mood
and argumentative behavior toward authority figures for 7 months. The child does not violate
the basic rights of others. Which diagnosis is most appropriate?
A. Conduct Disorder
B. Attention-Deficit/Hyperactivity Disorder
C. Disruptive Mood Dysregulation Disorder (DMDD)
D. Oppositional Defiant Disorder (ODD)
Answer: D
Rationale: Oppositional Defiant Disorder is characterized by a pattern of angry/irritable
mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months. Unlike
Conduct Disorder, ODD does not typically involve aggression toward people or animals or
destruction of property. The PMHNP must distinguish these to implement the correct
behavioral and family interventions.
, 5. A patient presents with sudden episodes of intense fear, palpitations, and shortness of
breath that peak within 10 minutes. These episodes are unexpected. Which additional finding
is required for a diagnosis of Panic Disorder?
A. Persistent concern or worry about additional panic attacks or their consequences
B. Symptoms occurring for at least 6 months
C. Fear of being in open spaces
D. History of a traumatic event
Answer: A
Rationale: Panic Disorder requires recurrent unexpected panic attacks followed by at least
one month of persistent concern about future attacks or a significant maladaptive change
in behavior. This distinguishes Panic Disorder from isolated panic attacks that may occur in
other anxiety disorders. Accurate diagnosis ensures the clinician focuses on panic-specific
CBT and pharmacological management.
6. Which of the following is a ‘negative symptom’ of Schizophrenia?
A. Anhedonia
B. Hallucinations
C. Delusions
D. Disorganized speech
Answer: A
