NR547 WEEK 4 EXAM V1 |
DIFFERENTIAL DIAGNOSIS IN
PSYCHIATRIC MENTAL HEALTH.
EXAM QUESTIONS AND ANSWERS
1. A 45-year-old female presents with complaints of persistent sadness, loss of interest in
hobbies, and difficulty sleeping for the past 3 weeks. To meet the DSM-5 criteria for Major
Depressive Disorder (MDD), how many symptoms must be present during the same 2-week
period?
A. At least 3 symptoms
B. At least 9 symptoms
C. At least 7 symptoms
D. At least 5 symptoms
Answer: D
Conceptual Explanation: DSM-5 requires at least five symptoms to be present during the
same 2-week period, and at least one of the symptoms must be either depressed mood or
loss of interest/pleasure.
,2. Which of the following clinical features is the primary differentiator between Bipolar I and
Bipolar II disorder?
A. The presence of at least one major depressive episode.
B. The occurrence of a full manic episode vs. a hypomanic episode.
C. The duration of depressive symptoms.
D. The presence of psychotic features during depression.
Answer: B
Conceptual Explanation: Bipolar I Disorder requires the occurrence of at least one manic
episode (lasting at least 1 week or requiring hospitalization). Bipolar II requires at least
one hypomanic episode (4 days) and one major depressive episode, but never a full manic
episode.
3. A patient scores a 16 on the PHQ-9 (Patient Health Questionnaire). How should the PMHNP
interpret this score and what is the recommended next step?
A. Moderately severe depression; initiate pharmacotherapy or psychotherapy.
B. Moderate depression; start counseling.
C. Mild depression; monitoring only.
D. Severe depression; immediate hospitalization.
Answer: A
, Conceptual Explanation: A score of 15-19 on the PHQ-9 indicates moderately severe
depression, which typically warrants the initiation of treatment via medication, therapy, or
both.
4. When evaluating a patient for Generalized Anxiety Disorder (GAD), which medical
condition must be ruled out as a potential cause of anxiety symptoms?
A. Hypothyroidism
B. Type 2 Diabetes
C. Hyperthyroidism
D. Osteoarthritis
Answer: C
Conceptual Explanation: Hyperthyroidism can mimic anxiety symptoms, including
palpitations, sweating, tremors, and nervousness, and must be ruled out via TSH testing.
5. A 28-year-old male reports ‘feeling on top of the world’ for the last 5 days. He has slept
only 3 hours per night, is talking faster than usual, and spent $5,000 on a new watch he
cannot afford. He is still able to work and has not required hospitalization. What is the most
likely diagnosis?
A. Bipolar I Disorder, Manic Episode
B. Cyclothymic Disorder
C. Schizoaffective Disorder
DIFFERENTIAL DIAGNOSIS IN
PSYCHIATRIC MENTAL HEALTH.
EXAM QUESTIONS AND ANSWERS
1. A 45-year-old female presents with complaints of persistent sadness, loss of interest in
hobbies, and difficulty sleeping for the past 3 weeks. To meet the DSM-5 criteria for Major
Depressive Disorder (MDD), how many symptoms must be present during the same 2-week
period?
A. At least 3 symptoms
B. At least 9 symptoms
C. At least 7 symptoms
D. At least 5 symptoms
Answer: D
Conceptual Explanation: DSM-5 requires at least five symptoms to be present during the
same 2-week period, and at least one of the symptoms must be either depressed mood or
loss of interest/pleasure.
,2. Which of the following clinical features is the primary differentiator between Bipolar I and
Bipolar II disorder?
A. The presence of at least one major depressive episode.
B. The occurrence of a full manic episode vs. a hypomanic episode.
C. The duration of depressive symptoms.
D. The presence of psychotic features during depression.
Answer: B
Conceptual Explanation: Bipolar I Disorder requires the occurrence of at least one manic
episode (lasting at least 1 week or requiring hospitalization). Bipolar II requires at least
one hypomanic episode (4 days) and one major depressive episode, but never a full manic
episode.
3. A patient scores a 16 on the PHQ-9 (Patient Health Questionnaire). How should the PMHNP
interpret this score and what is the recommended next step?
A. Moderately severe depression; initiate pharmacotherapy or psychotherapy.
B. Moderate depression; start counseling.
C. Mild depression; monitoring only.
D. Severe depression; immediate hospitalization.
Answer: A
, Conceptual Explanation: A score of 15-19 on the PHQ-9 indicates moderately severe
depression, which typically warrants the initiation of treatment via medication, therapy, or
both.
4. When evaluating a patient for Generalized Anxiety Disorder (GAD), which medical
condition must be ruled out as a potential cause of anxiety symptoms?
A. Hypothyroidism
B. Type 2 Diabetes
C. Hyperthyroidism
D. Osteoarthritis
Answer: C
Conceptual Explanation: Hyperthyroidism can mimic anxiety symptoms, including
palpitations, sweating, tremors, and nervousness, and must be ruled out via TSH testing.
5. A 28-year-old male reports ‘feeling on top of the world’ for the last 5 days. He has slept
only 3 hours per night, is talking faster than usual, and spent $5,000 on a new watch he
cannot afford. He is still able to work and has not required hospitalization. What is the most
likely diagnosis?
A. Bipolar I Disorder, Manic Episode
B. Cyclothymic Disorder
C. Schizoaffective Disorder
