NR547 WEEK 4 EXAM: DIFFERENTIAL
DIAGNOSIS OF
NEURODEVELOPMENTAL DISORDERS.
EXAM QUESTIONS AND ANSWERS
1. A 7-year-old child presents with symptoms of inattention and hyperactivity that are
present both at home and in school. According to the DSM-5-TR, which of the following is a
mandatory requirement for an ADHD diagnosis?
A. Symptoms must be present in at least two or more settings.
B. Symptoms must have been present before age 7.
C. Evidence of significant developmental delay in motor skills.
D. The presence of a comorbid learning disability.
Answer: A
Conceptual Explanation: DSM-5-TR criteria for ADHD require that symptoms be present
in two or more settings (e.g., home, school, work) and that several symptoms were present
before age 12.
,2. Which assessment tool is considered the gold standard for screening ADHD in children aged
6 to 12 in the primary care or psychiatric setting?
A. M-CHAT-R/F
B. PHQ-9 Modified for Adolescents
C. Vanderbilt Assessment Scales
D. GADS (Gilliam Autism Rating Scale)
Answer: C
Conceptual Explanation: The Vanderbilt Assessment Scales are widely used and validated
for diagnosing ADHD and tracking treatment response in children.
3. When differentiating between ADHD and Bipolar Disorder in a pediatric patient, which
feature most strongly suggests a diagnosis of Bipolar Disorder?
A. Pressured speech and grandiosity.
B. Poor concentration and distractibility.
C. Increased motor activity.
D. Interrupting others during conversation.
Answer: A
Conceptual Explanation: While ADHD involves distractibility and high activity,
grandiosity, euphoria, and pressured speech are hallmark features of mania/hypomania in
Bipolar Disorder, distinguishing it from the chronic course of ADHD.
, 4. A 3-year-old child shows deficits in social-emotional reciprocity and repetitive patterns of
behavior. Which tool should the PMHNP use first to screen for Autism Spectrum Disorder?
A. M-CHAT-R/F
B. ADOS-2
C. ASQ-3
D. Conners 3
Answer: A
Conceptual Explanation: The Modified Checklist for Autism in Toddlers, Revised with
Follow-Up (M-CHAT-R/F) is the standard screening tool for children aged 16 to 30 months.
5. In the diagnosis of Intellectual Disability (Intellectual Developmental Disorder), the DSM-5-
TR emphasizes that the severity level is determined by which factor?
A. Adaptive functioning in conceptual, social, and practical domains.
B. Measured IQ score below 70.
C. The presence of genetic markers like Trisomy 21.
D. The age of onset of physical developmental milestones.
Answer: A
Conceptual Explanation: The DSM-5-TR moved away from IQ scores alone to define
severity; it now focuses on how well the individual functions in adaptive domains
(conceptual, social, and practical).
DIAGNOSIS OF
NEURODEVELOPMENTAL DISORDERS.
EXAM QUESTIONS AND ANSWERS
1. A 7-year-old child presents with symptoms of inattention and hyperactivity that are
present both at home and in school. According to the DSM-5-TR, which of the following is a
mandatory requirement for an ADHD diagnosis?
A. Symptoms must be present in at least two or more settings.
B. Symptoms must have been present before age 7.
C. Evidence of significant developmental delay in motor skills.
D. The presence of a comorbid learning disability.
Answer: A
Conceptual Explanation: DSM-5-TR criteria for ADHD require that symptoms be present
in two or more settings (e.g., home, school, work) and that several symptoms were present
before age 12.
,2. Which assessment tool is considered the gold standard for screening ADHD in children aged
6 to 12 in the primary care or psychiatric setting?
A. M-CHAT-R/F
B. PHQ-9 Modified for Adolescents
C. Vanderbilt Assessment Scales
D. GADS (Gilliam Autism Rating Scale)
Answer: C
Conceptual Explanation: The Vanderbilt Assessment Scales are widely used and validated
for diagnosing ADHD and tracking treatment response in children.
3. When differentiating between ADHD and Bipolar Disorder in a pediatric patient, which
feature most strongly suggests a diagnosis of Bipolar Disorder?
A. Pressured speech and grandiosity.
B. Poor concentration and distractibility.
C. Increased motor activity.
D. Interrupting others during conversation.
Answer: A
Conceptual Explanation: While ADHD involves distractibility and high activity,
grandiosity, euphoria, and pressured speech are hallmark features of mania/hypomania in
Bipolar Disorder, distinguishing it from the chronic course of ADHD.
, 4. A 3-year-old child shows deficits in social-emotional reciprocity and repetitive patterns of
behavior. Which tool should the PMHNP use first to screen for Autism Spectrum Disorder?
A. M-CHAT-R/F
B. ADOS-2
C. ASQ-3
D. Conners 3
Answer: A
Conceptual Explanation: The Modified Checklist for Autism in Toddlers, Revised with
Follow-Up (M-CHAT-R/F) is the standard screening tool for children aged 16 to 30 months.
5. In the diagnosis of Intellectual Disability (Intellectual Developmental Disorder), the DSM-5-
TR emphasizes that the severity level is determined by which factor?
A. Adaptive functioning in conceptual, social, and practical domains.
B. Measured IQ score below 70.
C. The presence of genetic markers like Trisomy 21.
D. The age of onset of physical developmental milestones.
Answer: A
Conceptual Explanation: The DSM-5-TR moved away from IQ scores alone to define
severity; it now focuses on how well the individual functions in adaptive domains
(conceptual, social, and practical).
