Differential Diagnosis Across the Lifespan
Practicum NR 547 CEA Final Exam
(2026) Actual Questions & Answers
(Chamberlain) 100% Guarantee Pass
Questions 1–10: Foundations of Differential Diagnosis
1. What is the FIRST step in the six-step differential diagnosis
process according to the DSM-5-TR?
A) Determine the specific primary disorder
B) Rule out substance/medication etiology
C) Rule out malingering or factitious disorder
D) Differentiate adjustment disorder from residual conditions
Answer: C) Rule out malingering or factitious disorder
Rationale: The six-step DSM-5-TR differential diagnosis process
begins with ruling out malingering or factitious disorder (Step 1).
This ensures that the presenting symptoms are not intentionally
produced or feigned before proceeding to other etiologies.
Substance/medication etiology is ruled out in Step 2, and the
specific primary disorder is determined in Step 4.
,2. A 45-year-old patient presents with depressive symptoms.
Laboratory results show elevated TSH and low free T4. What
is the MOST appropriate next step?
A) Start an SSRI antidepressant
B) Refer for psychotherapy
C) Treat the underlying hypothyroidism
D) Diagnose major depressive disorder
Answer: C) Treat the underlying hypothyroidism
Rationale: This scenario illustrates Step 3 of the differential
diagnosis process: rule out a general medical condition.
Hypothyroidism commonly presents with depressive symptoms
(fatigue, low mood, weight gain). Treating the underlying medical
condition should precede or occur concurrently with psychiatric
intervention, as the depression may be secondary to the
endocrine disorder.
3. Which of the following is a key feature that distinguishes
adjustment disorder from major depressive disorder (MDD)?
A) Presence of suicidal ideation
B) Onset within 3 months of a stressor
C) Duration of symptoms greater than 2 years
D) Psychotic features
Answer: B) Onset within 3 months of a stressor
,Rationale: Adjustment disorder is characterized by the
development of emotional or behavioral symptoms in response to
an identifiable stressor occurring within 3 months of the onset of
the stressor (Step 5). MDD does not require a specific stressor and
has different duration and severity criteria. If symptoms persist
beyond 6 months after the stressor has terminated, the diagnosis
may no longer be adjustment disorder.
4. A patient reports auditory hallucinations and paranoid
delusions. Urine toxicology is positive for amphetamines.
According to the DSM-5-TR differential diagnosis steps, what
should be the initial diagnostic consideration?
A) Schizophrenia
B) Schizoaffective disorder
C) Substance-induced psychotic disorder
D) Delusional disorder
Answer: C) Substance-induced psychotic disorder
Rationale: Step 2 of the differential diagnosis process requires
ruling out substance/medication etiology. Amphetamines are
known to induce psychotic symptoms, including hallucinations
and delusions. A substance-induced disorder should be the
primary consideration when symptoms are temporally related to
substance use.
, 5. The Mental Status Examination (MSE) includes all of the
following domains EXCEPT:
A) Appearance and behavior
B) Speech and language
C) Complete blood count (CBC)
D) Thought process and content
Answer: C) Complete blood count (CBC)
Rationale: The MSE is a clinical assessment tool that evaluates
appearance, behavior, speech, mood, affect, thought process,
thought content, cognition, and insight/judgment. Laboratory
tests like CBC are part of the physical/medical workup, not the
MSE.
6. What is the minimum duration of symptoms required for a
diagnosis of generalized anxiety disorder (GAD) in adults?
A) 1 month
B) 3 months
C) 6 months
D) 12 months
Answer: C) 6 months
Rationale: According to DSM-5-TR criteria, GAD requires
excessive anxiety and worry occurring more days than not for at
least 6 months, about a number of events or activities. The worry
Practicum NR 547 CEA Final Exam
(2026) Actual Questions & Answers
(Chamberlain) 100% Guarantee Pass
Questions 1–10: Foundations of Differential Diagnosis
1. What is the FIRST step in the six-step differential diagnosis
process according to the DSM-5-TR?
A) Determine the specific primary disorder
B) Rule out substance/medication etiology
C) Rule out malingering or factitious disorder
D) Differentiate adjustment disorder from residual conditions
Answer: C) Rule out malingering or factitious disorder
Rationale: The six-step DSM-5-TR differential diagnosis process
begins with ruling out malingering or factitious disorder (Step 1).
This ensures that the presenting symptoms are not intentionally
produced or feigned before proceeding to other etiologies.
Substance/medication etiology is ruled out in Step 2, and the
specific primary disorder is determined in Step 4.
,2. A 45-year-old patient presents with depressive symptoms.
Laboratory results show elevated TSH and low free T4. What
is the MOST appropriate next step?
A) Start an SSRI antidepressant
B) Refer for psychotherapy
C) Treat the underlying hypothyroidism
D) Diagnose major depressive disorder
Answer: C) Treat the underlying hypothyroidism
Rationale: This scenario illustrates Step 3 of the differential
diagnosis process: rule out a general medical condition.
Hypothyroidism commonly presents with depressive symptoms
(fatigue, low mood, weight gain). Treating the underlying medical
condition should precede or occur concurrently with psychiatric
intervention, as the depression may be secondary to the
endocrine disorder.
3. Which of the following is a key feature that distinguishes
adjustment disorder from major depressive disorder (MDD)?
A) Presence of suicidal ideation
B) Onset within 3 months of a stressor
C) Duration of symptoms greater than 2 years
D) Psychotic features
Answer: B) Onset within 3 months of a stressor
,Rationale: Adjustment disorder is characterized by the
development of emotional or behavioral symptoms in response to
an identifiable stressor occurring within 3 months of the onset of
the stressor (Step 5). MDD does not require a specific stressor and
has different duration and severity criteria. If symptoms persist
beyond 6 months after the stressor has terminated, the diagnosis
may no longer be adjustment disorder.
4. A patient reports auditory hallucinations and paranoid
delusions. Urine toxicology is positive for amphetamines.
According to the DSM-5-TR differential diagnosis steps, what
should be the initial diagnostic consideration?
A) Schizophrenia
B) Schizoaffective disorder
C) Substance-induced psychotic disorder
D) Delusional disorder
Answer: C) Substance-induced psychotic disorder
Rationale: Step 2 of the differential diagnosis process requires
ruling out substance/medication etiology. Amphetamines are
known to induce psychotic symptoms, including hallucinations
and delusions. A substance-induced disorder should be the
primary consideration when symptoms are temporally related to
substance use.
, 5. The Mental Status Examination (MSE) includes all of the
following domains EXCEPT:
A) Appearance and behavior
B) Speech and language
C) Complete blood count (CBC)
D) Thought process and content
Answer: C) Complete blood count (CBC)
Rationale: The MSE is a clinical assessment tool that evaluates
appearance, behavior, speech, mood, affect, thought process,
thought content, cognition, and insight/judgment. Laboratory
tests like CBC are part of the physical/medical workup, not the
MSE.
6. What is the minimum duration of symptoms required for a
diagnosis of generalized anxiety disorder (GAD) in adults?
A) 1 month
B) 3 months
C) 6 months
D) 12 months
Answer: C) 6 months
Rationale: According to DSM-5-TR criteria, GAD requires
excessive anxiety and worry occurring more days than not for at
least 6 months, about a number of events or activities. The worry
