NR547 Week 5 Exam V1 | NR547
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 5 Exam) | Chamberlain University
1. A 75-year-old patient presents with acute onset of confusion, fluctuating levels of
consciousness, and visual hallucinations over the last 48 hours. Which of the following is the
most likely diagnosis?
A. Major Depressive Disorder
B. Vascular Dementia
C. Alzheimer’s Disease
D. Delirium
Answer: D
Rationale: Delirium is characterized by an acute onset and a fluctuating course of
symptoms, particularly impairment in attention and consciousness. In contrast, dementias
like Alzheimer’s typically involve a slow, progressive decline over several years. The
presence of visual hallucinations and confusion in a geriatric patient should immediately
prompt an evaluation for underlying medical causes of delirium.
,2. Which personality disorder is characterized by a pervasive pattern of detachment from
social relationships and a restricted range of expression of emotions in interpersonal
settings?
A. Schizotypal Personality Disorder
B. Avoidant Personality Disorder
C. Schizoid Personality Disorder
D. Borderline Personality Disorder
Answer: C
Rationale: Schizoid personality disorder involves a lack of interest in social relationships
and a limited emotional range. Unlike Schizotypal PD, it does not involve cognitive or
perceptual distortions or eccentricities. Avoidant PD differs because those individuals
desire relationships but fear rejection, whereas Schizoid individuals generally prefer
solitude.
3. A 19-year-old college student describes a period of one week where she felt ‘on top of the
world,’ had a decreased need for sleep, was talking constantly, and spent her entire savings
on a new car. She has no prior history of depressive episodes. What is the most appropriate
diagnosis?
A. Major Depressive Disorder
B. Bipolar II Disorder
C. Cyclothymic Disorder
,D. Bipolar I Disorder
Answer: D
Rationale: Bipolar I Disorder requires the occurrence of at least one manic episode, which
this patient demonstrates through her grandiosity, decreased need for sleep, and impulsive
spending. A manic episode must last at least one week and cause significant impairment in
functioning. Bipolar II would require a history of a major depressive episode and only
hypomanic episodes, which are not as severe as the one described.
4. To meet the DSM-5 criteria for Antisocial Personality Disorder, the individual must be at
least how many years old?
A. 15 years
B. 18 years
C. 16 years
D. 21 years
Answer: B
Rationale: According to the DSM-5, a diagnosis of Antisocial Personality Disorder cannot
be given until the individual is 18 years of age. However, there must be evidence of Conduct
Disorder with onset before age 15. This distinction ensures that the pattern of behavior is
long-standing and persists into adulthood.
, 5. In differentiating between Schizoaffective Disorder and Major Depressive Disorder with
Psychotic Features, what is the key diagnostic requirement?
A. The presence of hallucinations for at least 6 months
B. The presence of a manic episode at any point in the illness
C. Delusions or hallucinations for 2 weeks in the absence of a major mood episode
D. Psychotic symptoms that only occur during a mood episode
Answer: C
Rationale: For Schizoaffective Disorder, the DSM-5 requires a period of at least two weeks
where delusions or hallucinations occur without a major mood episode (depressive or
manic). If the psychotic symptoms only occur during the mood episode, the diagnosis
would be MDD or Bipolar Disorder with Psychotic Features. This criterion helps clinicians
distinguish primary psychotic disorders from mood disorders.
6. A 32-year-old patient reports a persistent fear of being in crowds or using public
transportation because escape might be difficult. This has lasted for over 7 months. Which
diagnosis is most likely?
A. Social Anxiety Disorder
B. Panic Disorder
C. Agoraphobia
D. Generalized Anxiety Disorder
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 5 Exam) | Chamberlain University
1. A 75-year-old patient presents with acute onset of confusion, fluctuating levels of
consciousness, and visual hallucinations over the last 48 hours. Which of the following is the
most likely diagnosis?
A. Major Depressive Disorder
B. Vascular Dementia
C. Alzheimer’s Disease
D. Delirium
Answer: D
Rationale: Delirium is characterized by an acute onset and a fluctuating course of
symptoms, particularly impairment in attention and consciousness. In contrast, dementias
like Alzheimer’s typically involve a slow, progressive decline over several years. The
presence of visual hallucinations and confusion in a geriatric patient should immediately
prompt an evaluation for underlying medical causes of delirium.
,2. Which personality disorder is characterized by a pervasive pattern of detachment from
social relationships and a restricted range of expression of emotions in interpersonal
settings?
A. Schizotypal Personality Disorder
B. Avoidant Personality Disorder
C. Schizoid Personality Disorder
D. Borderline Personality Disorder
Answer: C
Rationale: Schizoid personality disorder involves a lack of interest in social relationships
and a limited emotional range. Unlike Schizotypal PD, it does not involve cognitive or
perceptual distortions or eccentricities. Avoidant PD differs because those individuals
desire relationships but fear rejection, whereas Schizoid individuals generally prefer
solitude.
3. A 19-year-old college student describes a period of one week where she felt ‘on top of the
world,’ had a decreased need for sleep, was talking constantly, and spent her entire savings
on a new car. She has no prior history of depressive episodes. What is the most appropriate
diagnosis?
A. Major Depressive Disorder
B. Bipolar II Disorder
C. Cyclothymic Disorder
,D. Bipolar I Disorder
Answer: D
Rationale: Bipolar I Disorder requires the occurrence of at least one manic episode, which
this patient demonstrates through her grandiosity, decreased need for sleep, and impulsive
spending. A manic episode must last at least one week and cause significant impairment in
functioning. Bipolar II would require a history of a major depressive episode and only
hypomanic episodes, which are not as severe as the one described.
4. To meet the DSM-5 criteria for Antisocial Personality Disorder, the individual must be at
least how many years old?
A. 15 years
B. 18 years
C. 16 years
D. 21 years
Answer: B
Rationale: According to the DSM-5, a diagnosis of Antisocial Personality Disorder cannot
be given until the individual is 18 years of age. However, there must be evidence of Conduct
Disorder with onset before age 15. This distinction ensures that the pattern of behavior is
long-standing and persists into adulthood.
, 5. In differentiating between Schizoaffective Disorder and Major Depressive Disorder with
Psychotic Features, what is the key diagnostic requirement?
A. The presence of hallucinations for at least 6 months
B. The presence of a manic episode at any point in the illness
C. Delusions or hallucinations for 2 weeks in the absence of a major mood episode
D. Psychotic symptoms that only occur during a mood episode
Answer: C
Rationale: For Schizoaffective Disorder, the DSM-5 requires a period of at least two weeks
where delusions or hallucinations occur without a major mood episode (depressive or
manic). If the psychotic symptoms only occur during the mood episode, the diagnosis
would be MDD or Bipolar Disorder with Psychotic Features. This criterion helps clinicians
distinguish primary psychotic disorders from mood disorders.
6. A 32-year-old patient reports a persistent fear of being in crowds or using public
transportation because escape might be difficult. This has lasted for over 7 months. Which
diagnosis is most likely?
A. Social Anxiety Disorder
B. Panic Disorder
C. Agoraphobia
D. Generalized Anxiety Disorder
