NR547 Week 4 Exam V3 | NR547
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 4 Exam) | Chamberlain University
1. A 7-year-old male is brought to the clinic for an evaluation due to concerns about his
inability to stay seated in class and frequent interruptions. His mother reports these
behaviors occur at home as well. Which DSM-5-TR requirement for ADHD is demonstrated by
these reports?
A. Symptoms must be present before age 7.
B. Symptoms must be present in two or more settings.
C. Symptoms must be present for at least 12 months.
D. Symptoms must involve both inattention and hyperactivity.
Answer: B
Rationale: The DSM-5-TR requires that several inattentive or hyperactive-impulsive
symptoms be present in two or more settings, such as home and school. In this case, the
mother’s report confirms that behaviors are not limited to the classroom environment. This
criterion ensures that the impairment is pervasive rather than situational.
,2. When evaluating a 3-year-old child for Autism Spectrum Disorder (ASD), which of the
following screening tools is most appropriate for initial assessment?
A. Vanderbilt Assessment Scale
B. PHQ-9 Modified for Adolescents
C. SCARED Tool
D. M-CHAT-R/F
Answer: D
Rationale: The Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-
CHAT-R/F) is specifically designed for children between 16 and 30 months of age. It is a
validated parent-report screening tool used to identify children who may be at risk for ASD.
Other tools like the Vanderbilt are specifically for ADHD, while the PHQ-9 is for depression.
3. A PMHNP is assessing a child who displays a persistent pattern of angry/irritable mood,
argumentative/defiant behavior, and vindictiveness lasting at least 6 months. What is the
most likely diagnosis?
A. Conduct Disorder
B. Disruptive Mood Dysregulation Disorder
C. Intermittent Explosive Disorder
D. Oppositional Defiant Disorder
Answer: D
,Rationale: Oppositional Defiant Disorder (ODD) is characterized by a pattern of
angry/irritable mood and defiant behavior toward authority figures. Unlike Conduct
Disorder, ODD does not typically involve aggression toward people or animals or the
destruction of property. This diagnosis requires at least four symptoms from the specified
categories for at least six months.
4. Which of the following is a core diagnostic criterion for Disruptive Mood Dysregulation
Disorder (DMDD)?
A. Physical aggression toward peers occurring twice a year.
B. Severe recurrent temper outbursts that are out of proportion to the situation.
C. Symptoms must begin after the age of 12.
D. Persistent sadness and withdrawal from social activities.
Answer: B
Rationale: DMDD is characterized by severe recurrent temper outbursts manifested
verbally or behaviorally that occur, on average, three or more times per week. Between
outbursts, the child’s mood is persistently irritable or angry most of the day, nearly every
day. The diagnosis should not be made for the first time before age 6 or after age 18.
5. A 10-year-old child presents with both multiple motor tics and at least one vocal tic that
have persisted for more than one year. Which diagnosis is most appropriate?
A. Provisional Tic Disorder
B. Persistent Motor Tic Disorder
, C. Tourette’s Disorder
D. Stereotypic Movement Disorder
Answer: C
Rationale: Tourette’s Disorder requires the presence of multiple motor tics and one or
more vocal tics at some time during the illness, though not necessarily concurrently. These
tics must persist for more than one year since the first tic onset. If only motor or only vocal
tics are present for more than a year, the diagnosis would be Persistent Motor or Vocal Tic
Disorder.
6. An 8-year-old girl exhibits extreme distress when separating from her mother, refuses to go
to school, and has frequent nightmares about being kidnapped. What is the primary
differential diagnosis?
A. Social Anxiety Disorder
B. Separation Anxiety Disorder
C. Generalized Anxiety Disorder
D. Agoraphobia
Answer: B
Rationale: Separation Anxiety Disorder involves developmentally inappropriate and
excessive fear or anxiety concerning separation from those to whom the individual is
attached. Common symptoms include refusal to go out or to school and persistent worry
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 4 Exam) | Chamberlain University
1. A 7-year-old male is brought to the clinic for an evaluation due to concerns about his
inability to stay seated in class and frequent interruptions. His mother reports these
behaviors occur at home as well. Which DSM-5-TR requirement for ADHD is demonstrated by
these reports?
A. Symptoms must be present before age 7.
B. Symptoms must be present in two or more settings.
C. Symptoms must be present for at least 12 months.
D. Symptoms must involve both inattention and hyperactivity.
Answer: B
Rationale: The DSM-5-TR requires that several inattentive or hyperactive-impulsive
symptoms be present in two or more settings, such as home and school. In this case, the
mother’s report confirms that behaviors are not limited to the classroom environment. This
criterion ensures that the impairment is pervasive rather than situational.
,2. When evaluating a 3-year-old child for Autism Spectrum Disorder (ASD), which of the
following screening tools is most appropriate for initial assessment?
A. Vanderbilt Assessment Scale
B. PHQ-9 Modified for Adolescents
C. SCARED Tool
D. M-CHAT-R/F
Answer: D
Rationale: The Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-
CHAT-R/F) is specifically designed for children between 16 and 30 months of age. It is a
validated parent-report screening tool used to identify children who may be at risk for ASD.
Other tools like the Vanderbilt are specifically for ADHD, while the PHQ-9 is for depression.
3. A PMHNP is assessing a child who displays a persistent pattern of angry/irritable mood,
argumentative/defiant behavior, and vindictiveness lasting at least 6 months. What is the
most likely diagnosis?
A. Conduct Disorder
B. Disruptive Mood Dysregulation Disorder
C. Intermittent Explosive Disorder
D. Oppositional Defiant Disorder
Answer: D
,Rationale: Oppositional Defiant Disorder (ODD) is characterized by a pattern of
angry/irritable mood and defiant behavior toward authority figures. Unlike Conduct
Disorder, ODD does not typically involve aggression toward people or animals or the
destruction of property. This diagnosis requires at least four symptoms from the specified
categories for at least six months.
4. Which of the following is a core diagnostic criterion for Disruptive Mood Dysregulation
Disorder (DMDD)?
A. Physical aggression toward peers occurring twice a year.
B. Severe recurrent temper outbursts that are out of proportion to the situation.
C. Symptoms must begin after the age of 12.
D. Persistent sadness and withdrawal from social activities.
Answer: B
Rationale: DMDD is characterized by severe recurrent temper outbursts manifested
verbally or behaviorally that occur, on average, three or more times per week. Between
outbursts, the child’s mood is persistently irritable or angry most of the day, nearly every
day. The diagnosis should not be made for the first time before age 6 or after age 18.
5. A 10-year-old child presents with both multiple motor tics and at least one vocal tic that
have persisted for more than one year. Which diagnosis is most appropriate?
A. Provisional Tic Disorder
B. Persistent Motor Tic Disorder
, C. Tourette’s Disorder
D. Stereotypic Movement Disorder
Answer: C
Rationale: Tourette’s Disorder requires the presence of multiple motor tics and one or
more vocal tics at some time during the illness, though not necessarily concurrently. These
tics must persist for more than one year since the first tic onset. If only motor or only vocal
tics are present for more than a year, the diagnosis would be Persistent Motor or Vocal Tic
Disorder.
6. An 8-year-old girl exhibits extreme distress when separating from her mother, refuses to go
to school, and has frequent nightmares about being kidnapped. What is the primary
differential diagnosis?
A. Social Anxiety Disorder
B. Separation Anxiety Disorder
C. Generalized Anxiety Disorder
D. Agoraphobia
Answer: B
Rationale: Separation Anxiety Disorder involves developmentally inappropriate and
excessive fear or anxiety concerning separation from those to whom the individual is
attached. Common symptoms include refusal to go out or to school and persistent worry
