NR 547 Week 8 Final Exam Complete Study Bundle (Latest 2026/2027 Comprehensive PMHNP Differential Diagnosis Guide)

NR 547 Week 8 Final Exam COMPLETE 2026



QUESTION 1
A PMHNP student is conducting a diagnostic interview. The patient describes feeling
"down" for the past month. Which interviewing technique is most appropriate to clarify
the diagnostic picture?

A) Immediately diagnosing major depressive disorder based on the statement
B) Using open-ended questions followed by clarifying and summarizing to gather
specific symptoms and duration
C) Asking only yes/no questions to speed up the interview
D) Focusing exclusively on family history without exploring current symptoms




CORRECT ANSWER: B) Using open-ended questions followed by clarifying and
summarizing to gather specific symptoms and duration

RATIONALE: Effective diagnostic interviewing uses open-ended questions to elicit
narrative, followed by clarifying questions to establish specific symptoms, duration, and
functional impairment. Summarizing ensures accuracy. This approach prevents premature
diagnosis and ensures DSM-5-TR criteria are thoroughly evaluated. Yes/no questions limit
information; premature diagnosis is diagnostically unsound.




QUESTION 2
What is the definition of differential diagnosis in psychiatric-mental health practice?

A) A definitive diagnosis based on a single symptom
B) The provider's initial hypothesis and working list of potential problems associated

,with the chief complaint
C) A treatment plan developed after the first patient visit
D) A medication selection process




CORRECT ANSWER: B) The provider's initial hypothesis and working list of
potential problems associated with the chief complaint

RATIONALE: Differential diagnosis is the provider's initial hypothesis—a working list of
potential problems that can be associated with the initial or chief complaint. The DSM-5-
TR provides guidance for identifying psychiatric diagnoses within this process.




QUESTION 3
What is the first step in the differential diagnosis process?

A) Rule out substance-induced causes
B) Rule out malingering or factitious disorder
C) Consider psychiatric diagnoses
D) Order laboratory tests




CORRECT ANSWER: B) Rule out malingering or factitious disorder

RATIONALE: Step 1 of the differential diagnosis process is to rule out malingering or
factitious disorder. This ensures that the provider is not misled by intentional symptom
fabrication before proceeding with other diagnostic considerations.




QUESTION 4
What are the six steps of the differential diagnosis process in their correct order?

,A) Rule out substance-induced → Rule out medical causes → Primary psychiatric →
Other psychiatric → Definitive diagnosis → Rule out malingering
B) Rule out malingering → Rule out substance-induced → Rule out medical causes →
Primary psychiatric → Other psychiatric → Definitive diagnosis
C) Primary psychiatric → Rule out medical causes → Rule out substance-induced →
Definitive diagnosis → Other psychiatric → Rule out malingering
D) Rule out medical causes → Rule out malingering → Rule out substance-induced →
Primary psychiatric → Other psychiatric → Definitive diagnosis




CORRECT ANSWER: B) Rule out malingering → Rule out substance-induced → Rule
out medical causes → Primary psychiatric → Other psychiatric → Definitive
diagnosis

RATIONALE: The six-step diagnostic process is: 1) Rule out malingering or factitious
disorder, 2) Rule out substance-induced causes, 3) Rule out medical causes, 4) Determine
the specific primary disorder, 5) Differentiate adjustment disorder from residual "other
specified" disorders, 6) Establish the definitive diagnosis.




QUESTION 5
A patient presents with depressed mood. The PMHNP is considering the hierarchical
diagnostic approach. Which condition should be ruled out first before making a
psychiatric diagnosis?

A) Adjustment disorder with depressed mood
B) Substance-induced or medical condition causing depressive symptoms
C) Persistent depressive disorder
D) Major depressive disorder with anxious distress




CORRECT ANSWER: B) Substance-induced or medical condition causing depressive
symptoms

, RATIONALE: The hierarchical approach requires ruling out substance/medication-
induced disorders and disorders due to another medical condition before primary
psychiatric diagnoses. This follows DSM-5-TR diagnostic principles: if symptoms are
attributable to substance use (intoxication/withdrawal) or medical condition
(hypothyroidism), that diagnosis takes precedence.




QUESTION 6
Which of the following is the most accurate statement regarding the DSM-5-TR in
psychiatric diagnosis?

A) It provides treatment algorithms for psychiatric disorders
B) It provides guidance for identifying psychiatric diagnoses
C) It is primarily used for billing purposes only
D) It replaces the need for clinical judgment




CORRECT ANSWER: B) It provides guidance for identifying psychiatric diagnoses

RATIONALE: The DSM-5-TR provides guidance for identifying psychiatric diagnoses. It
serves as a diagnostic tool but does not replace clinical judgment or provide treatment
algorithms.




QUESTION 7
During a mental status examination, the PMHNP notes the patient has looseness of
associations, flight of ideas, and tangential responses. Which MSE component is being
assessed?

A) Mood and affect
B) Thought process
C) Thought content
D) Insight and judgment