NR547 Week 6 Exam V2 | NR547
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 6 Exam) | Chamberlain University
1. A 28-year-old female presents with a 2-year history of low mood, fatigue, and low self-
esteem on most days. She states she has never gone more than two months without these
symptoms, but they do not meet the full severity of a major depressive episode. What is the
most likely diagnosis?
A. Major Depressive Disorder
B. Adjustment Disorder with Depressed Mood
C. Cyclothymic Disorder
D. Persistent Depressive Disorder (Dysthymia)
Answer: D
Rationale: Persistent Depressive Disorder is characterized by a depressed mood that
occurs for most of the day, for more days than not, for at least 2 years in adults. The
patient’s description of low self-esteem and fatigue over this duration without meeting full
MDD criteria fits the clinical picture of Dysthymia. Unlike MDD, the symptoms are chronic
but usually less severe, though they significantly impair functioning over time.
,2. When differentiating Bipolar I Disorder from Bipolar II Disorder, which of the following is
the defining clinical feature?
A. The occurrence of at least one manic episode.
B. The duration of depressive symptoms lasting longer than two weeks.
C. The presence of at least one major depressive episode.
D. The presence of hypomanic symptoms for at least four days.
Answer: A
Rationale: Bipolar I Disorder requires the occurrence of at least one manic episode, which
typically lasts at least one week and may require hospitalization. Bipolar II Disorder,
conversely, requires at least one hypomanic episode and at least one major depressive
episode, but never a full manic episode. Identification of mania is critical because it changes
the treatment trajectory and risk assessment for the patient.
3. A 19-year-old male is brought to the clinic by his parents because he has become
increasingly withdrawn and suspicious over the last four months. He claims he can hear
‘whispers from the walls’ and his academic performance has plummeted. His symptoms have
not yet lasted six months. What is the most appropriate provisional diagnosis?
A. Schizophrenia
B. Schizophreniform Disorder
C. Brief Psychotic Disorder
D. Schizoaffective Disorder
,Answer: B
Rationale: Schizophreniform disorder is diagnosed when the symptoms of schizophrenia
are present for at least one month but less than six months. If the symptoms persist beyond
the six-month mark, the diagnosis is typically updated to Schizophrenia. This intermediate
diagnosis allows clinicians to monitor the progression of the illness while initiating
appropriate early intervention.
4. Which of the following screening tools is most appropriate for initially assessing the
severity of a patient’s depressive symptoms in a primary care or psychiatric setting?
A. GAD-7
B. CAGE-AID
C. MDQ
D. PHQ-9
Answer: D
Rationale: The Patient Health Questionnaire-9 (PHQ-9) is a validated 9-item tool used to
screen, diagnose, and monitor the severity of depression. It aligns with DSM-5 criteria and
provides a score that helps clinicians determine the intensity of the depressive episode.
Other tools like the GAD-7 focus on anxiety, while the MDQ is specifically used for bipolar
screening.
, 5. A 45-year-old male reports sudden episodes of intense fear accompanied by palpitations,
shortness of breath, and a fear of losing control. These episodes peak within 10 minutes and
have occurred unexpectedly three times in the last month. Between episodes, he constantly
worries about when the next one will occur. What is the most likely diagnosis?
A. Social Anxiety Disorder
B. Generalized Anxiety Disorder
C. Specific Phobia
D. Panic Disorder
Answer: D
Rationale: Panic Disorder is characterized by recurrent unexpected panic attacks followed
by at least one month of persistent concern about additional attacks or their consequences.
The physical symptoms described are hallmark signs of a panic attack, and the anticipatory
anxiety confirms the diagnosis. It is distinguished from GAD by the episodic, acute nature of
the fear versus a constant state of worry.
6. According to the DSM-5-TR, what is the minimum duration of symptoms required to
diagnose an adult with Generalized Anxiety Disorder (GAD)?
A. 1 month
B. 6 months
C. 3 months
D. 12 months
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 6 Exam) | Chamberlain University
1. A 28-year-old female presents with a 2-year history of low mood, fatigue, and low self-
esteem on most days. She states she has never gone more than two months without these
symptoms, but they do not meet the full severity of a major depressive episode. What is the
most likely diagnosis?
A. Major Depressive Disorder
B. Adjustment Disorder with Depressed Mood
C. Cyclothymic Disorder
D. Persistent Depressive Disorder (Dysthymia)
Answer: D
Rationale: Persistent Depressive Disorder is characterized by a depressed mood that
occurs for most of the day, for more days than not, for at least 2 years in adults. The
patient’s description of low self-esteem and fatigue over this duration without meeting full
MDD criteria fits the clinical picture of Dysthymia. Unlike MDD, the symptoms are chronic
but usually less severe, though they significantly impair functioning over time.
,2. When differentiating Bipolar I Disorder from Bipolar II Disorder, which of the following is
the defining clinical feature?
A. The occurrence of at least one manic episode.
B. The duration of depressive symptoms lasting longer than two weeks.
C. The presence of at least one major depressive episode.
D. The presence of hypomanic symptoms for at least four days.
Answer: A
Rationale: Bipolar I Disorder requires the occurrence of at least one manic episode, which
typically lasts at least one week and may require hospitalization. Bipolar II Disorder,
conversely, requires at least one hypomanic episode and at least one major depressive
episode, but never a full manic episode. Identification of mania is critical because it changes
the treatment trajectory and risk assessment for the patient.
3. A 19-year-old male is brought to the clinic by his parents because he has become
increasingly withdrawn and suspicious over the last four months. He claims he can hear
‘whispers from the walls’ and his academic performance has plummeted. His symptoms have
not yet lasted six months. What is the most appropriate provisional diagnosis?
A. Schizophrenia
B. Schizophreniform Disorder
C. Brief Psychotic Disorder
D. Schizoaffective Disorder
,Answer: B
Rationale: Schizophreniform disorder is diagnosed when the symptoms of schizophrenia
are present for at least one month but less than six months. If the symptoms persist beyond
the six-month mark, the diagnosis is typically updated to Schizophrenia. This intermediate
diagnosis allows clinicians to monitor the progression of the illness while initiating
appropriate early intervention.
4. Which of the following screening tools is most appropriate for initially assessing the
severity of a patient’s depressive symptoms in a primary care or psychiatric setting?
A. GAD-7
B. CAGE-AID
C. MDQ
D. PHQ-9
Answer: D
Rationale: The Patient Health Questionnaire-9 (PHQ-9) is a validated 9-item tool used to
screen, diagnose, and monitor the severity of depression. It aligns with DSM-5 criteria and
provides a score that helps clinicians determine the intensity of the depressive episode.
Other tools like the GAD-7 focus on anxiety, while the MDQ is specifically used for bipolar
screening.
, 5. A 45-year-old male reports sudden episodes of intense fear accompanied by palpitations,
shortness of breath, and a fear of losing control. These episodes peak within 10 minutes and
have occurred unexpectedly three times in the last month. Between episodes, he constantly
worries about when the next one will occur. What is the most likely diagnosis?
A. Social Anxiety Disorder
B. Generalized Anxiety Disorder
C. Specific Phobia
D. Panic Disorder
Answer: D
Rationale: Panic Disorder is characterized by recurrent unexpected panic attacks followed
by at least one month of persistent concern about additional attacks or their consequences.
The physical symptoms described are hallmark signs of a panic attack, and the anticipatory
anxiety confirms the diagnosis. It is distinguished from GAD by the episodic, acute nature of
the fear versus a constant state of worry.
6. According to the DSM-5-TR, what is the minimum duration of symptoms required to
diagnose an adult with Generalized Anxiety Disorder (GAD)?
A. 1 month
B. 6 months
C. 3 months
D. 12 months
