NR547 Week 3 Exam V3 | NR547
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 3 Exam) | Chamberlain University
1. A 28-year-old female presents with recurrent, unexpected panic attacks. To meet the DSM-
5-TR criteria for Panic Disorder, which of the following must occur for at least one month
following an attack?
A. Development of agoraphobic avoidance behaviors
B. A significant increase in social anxiety and fear of judgment
C. Persistent concern or worry about additional panic attacks or their consequences
D. The presence of at least six physical symptoms during the attacks
Answer: C
Rationale: According to the DSM-5-TR, 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 criteria ensures that the disorder is
characterized by the psychological impact of the attacks rather than just the physiological
events. Isolated or infrequent panic attacks without this month-long period of worry do not
meet the threshold for this specific diagnosis.
,2. When evaluating a patient for Generalized Anxiety Disorder (GAD), which screening tool is
considered the gold standard for assessing symptom severity?
A. PHQ-9
B. CAGE-AID
C. GAD-7
D. MDQ
Answer: C
Rationale: The GAD-7 (Generalized Anxiety Disorder 7-item scale) is the most widely
utilized and validated tool for screening and measuring the severity of GAD in clinical
practice. While the PHQ-9 focuses on depression, the GAD-7 specifically targets the somatic
and cognitive symptoms associated with chronic worry. It is highly sensitive to changes in a
patient’s condition over time, making it an essential component of evidence-based
psychiatric assessment.
3. A patient reports experiencing intrusive memories and nightmares for three weeks
following a severe motor vehicle accident. Which diagnosis is most appropriate given the
duration of symptoms?
A. Post-Traumatic Stress Disorder (PTSD)
B. Acute Stress Disorder (ASD)
C. Adjustment Disorder with Anxiety
D. Brief Psychotic Disorder
,Answer: B
Rationale: Acute Stress Disorder is diagnosed when symptoms of trauma occur and last for
a minimum of 3 days and a maximum of 1 month following the event. If the symptoms
persist beyond the one-month mark, the diagnosis would then be transitioned to Post-
Traumatic Stress Disorder (PTSD). Understanding this temporal requirement is critical for
accurate differential diagnosis in trauma-related cases.
4. In the differential diagnosis of Obsessive-Compulsive Disorder (OCD), how are the
obsessions typically characterized compared to those in Obsessive-Compulsive Personality
Disorder (OCPD)?
A. OCD obsessions are ego-syntonic, whereas OCPD traits are ego-dystonic
B. There is no clinical distinction between the two regarding the patient’s perception
C. OCD involves personality quirks, while OCPD involves intrusive thoughts
D. OCD obsessions are ego-dystonic, whereas OCPD traits are ego-syntonic
Answer: D
Rationale: In OCD, the obsessions are ego-dystonic, meaning the patient finds the thoughts
intrusive, unwanted, and inconsistent with their self-image. Conversely, OCPD involves
personality traits that are ego-syntonic, where the individual perceives their rigidity and
perfectionism as desirable or correct. This distinction is vital for determining the
appropriate therapeutic approach and understanding the patient’s level of insight.
, 5. Which physical symptom is most commonly associated with Generalized Anxiety Disorder
(GAD) in children?
A. Chest pain and shortness of breath
B. Stomachaches and headaches
C. Muscle rigidity and tremors
D. Persistent bradycardia
Answer: B
Rationale: Children with GAD often present with somatic complaints such as
stomachaches, headaches, and muscle tension rather than articulating psychological worry.
These physical symptoms frequently lead to school absenteeism and multiple visits to
primary care providers. Clinicians must maintain a high index of suspicion for anxiety
when medical workups for these somatic issues are negative.
6. A 35-year-old patient fears social situations where they might be scrutinized by others,
specifically during public speaking or eating in front of others. This has persisted for 8
months. What is the most likely diagnosis?
A. Social Anxiety Disorder
B. Panic Disorder
C. Agoraphobia
D. Avoidant Personality Disorder
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 3 Exam) | Chamberlain University
1. A 28-year-old female presents with recurrent, unexpected panic attacks. To meet the DSM-
5-TR criteria for Panic Disorder, which of the following must occur for at least one month
following an attack?
A. Development of agoraphobic avoidance behaviors
B. A significant increase in social anxiety and fear of judgment
C. Persistent concern or worry about additional panic attacks or their consequences
D. The presence of at least six physical symptoms during the attacks
Answer: C
Rationale: According to the DSM-5-TR, 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 criteria ensures that the disorder is
characterized by the psychological impact of the attacks rather than just the physiological
events. Isolated or infrequent panic attacks without this month-long period of worry do not
meet the threshold for this specific diagnosis.
,2. When evaluating a patient for Generalized Anxiety Disorder (GAD), which screening tool is
considered the gold standard for assessing symptom severity?
A. PHQ-9
B. CAGE-AID
C. GAD-7
D. MDQ
Answer: C
Rationale: The GAD-7 (Generalized Anxiety Disorder 7-item scale) is the most widely
utilized and validated tool for screening and measuring the severity of GAD in clinical
practice. While the PHQ-9 focuses on depression, the GAD-7 specifically targets the somatic
and cognitive symptoms associated with chronic worry. It is highly sensitive to changes in a
patient’s condition over time, making it an essential component of evidence-based
psychiatric assessment.
3. A patient reports experiencing intrusive memories and nightmares for three weeks
following a severe motor vehicle accident. Which diagnosis is most appropriate given the
duration of symptoms?
A. Post-Traumatic Stress Disorder (PTSD)
B. Acute Stress Disorder (ASD)
C. Adjustment Disorder with Anxiety
D. Brief Psychotic Disorder
,Answer: B
Rationale: Acute Stress Disorder is diagnosed when symptoms of trauma occur and last for
a minimum of 3 days and a maximum of 1 month following the event. If the symptoms
persist beyond the one-month mark, the diagnosis would then be transitioned to Post-
Traumatic Stress Disorder (PTSD). Understanding this temporal requirement is critical for
accurate differential diagnosis in trauma-related cases.
4. In the differential diagnosis of Obsessive-Compulsive Disorder (OCD), how are the
obsessions typically characterized compared to those in Obsessive-Compulsive Personality
Disorder (OCPD)?
A. OCD obsessions are ego-syntonic, whereas OCPD traits are ego-dystonic
B. There is no clinical distinction between the two regarding the patient’s perception
C. OCD involves personality quirks, while OCPD involves intrusive thoughts
D. OCD obsessions are ego-dystonic, whereas OCPD traits are ego-syntonic
Answer: D
Rationale: In OCD, the obsessions are ego-dystonic, meaning the patient finds the thoughts
intrusive, unwanted, and inconsistent with their self-image. Conversely, OCPD involves
personality traits that are ego-syntonic, where the individual perceives their rigidity and
perfectionism as desirable or correct. This distinction is vital for determining the
appropriate therapeutic approach and understanding the patient’s level of insight.
, 5. Which physical symptom is most commonly associated with Generalized Anxiety Disorder
(GAD) in children?
A. Chest pain and shortness of breath
B. Stomachaches and headaches
C. Muscle rigidity and tremors
D. Persistent bradycardia
Answer: B
Rationale: Children with GAD often present with somatic complaints such as
stomachaches, headaches, and muscle tension rather than articulating psychological worry.
These physical symptoms frequently lead to school absenteeism and multiple visits to
primary care providers. Clinicians must maintain a high index of suspicion for anxiety
when medical workups for these somatic issues are negative.
6. A 35-year-old patient fears social situations where they might be scrutinized by others,
specifically during public speaking or eating in front of others. This has persisted for 8
months. What is the most likely diagnosis?
A. Social Anxiety Disorder
B. Panic Disorder
C. Agoraphobia
D. Avoidant Personality Disorder
