NR547 Comprehensive Exam – Differential
Diagnosis in Psychiatric-Mental Health Across
the Lifespan Practicum Practice Exam
2026/2027 | Practice Questions & Study
Guide | Complete Exam-Style Questions with
Correct Detailed Answers & Rationales
(Reliable Answers) | Latest Updated Version |
Instant Download PDf
Question 1
A 9-year-old child has difficulty sustaining attention, frequently
loses school materials, makes careless mistakes, and requires
repeated reminders to complete assignments. The symptoms
have been present for more than 6 months and occur at both
school and home. The child does not demonstrate significant
hyperactivity or impulsivity. Which diagnosis best explains this
presentation?
A. Oppositional defiant disorder
B. Generalized anxiety disorder
C. Attention-deficit/hyperactivity disorder, predominantly
,inattentive presentation
D. Specific learning disorder
Correct Answer: C. Attention-deficit/hyperactivity disorder,
predominantly inattentive presentation
Rationale: The child demonstrates a persistent pattern of
developmentally inappropriate inattention that occurs across
more than one setting and has been present for longer than 6
months. Losing materials, careless mistakes, difficulty sustaining
attention, and failure to follow through are characteristic
inattentive symptoms of ADHD. The absence of prominent
hyperactive or impulsive symptoms supports the predominantly
inattentive presentation. Specific learning disorder can produce
academic difficulty, but the broader pattern of organizational
and attentional problems across settings favors ADHD.
Question 2
A 15-year-old adolescent has become increasingly socially
withdrawn and has stopped participating in previously enjoyed
activities. Over the past month, the adolescent reports hearing
a voice commenting on behavior and expresses a fixed belief
that classmates are monitoring them through their phones.
There is no history of substance use or a medical disorder.
Which diagnostic category should be prioritized?
,A. Schizophrenia spectrum and other psychotic disorder
B. Generalized anxiety disorder
C. Adjustment disorder
D. Obsessive-compulsive disorder
Correct Answer: A. Schizophrenia spectrum and other
psychotic disorder
Rationale: Hallucinations and fixed delusional beliefs represent
psychotic symptoms. The clinician should prioritize evaluation
for a schizophrenia-spectrum disorder while determining the
duration of symptoms and excluding substance-induced,
medical, mood-related, and other causes. Social withdrawal and
functional deterioration further increase concern for an
emerging psychotic disorder. Anxiety and adjustment disorders
do not ordinarily produce persistent hallucinations and fixed
delusions.
Question 3
A 32-year-old patient reports excessive worry about finances,
health, employment, and family safety. The worry occurs most
days and has been difficult to control for more than 6 months.
The patient also reports muscle tension, irritability, fatigue, and
difficulty sleeping. Which diagnosis is most appropriate?
, A. Panic disorder
B. Generalized anxiety disorder
C. Illness anxiety disorder
D. Obsessive-compulsive disorder
Correct Answer: B. Generalized anxiety disorder
Rationale: Generalized anxiety disorder is characterized by
excessive anxiety and worry about multiple areas of life that are
difficult to control and persist for at least 6 months. Associated
symptoms commonly include restlessness, fatigue, impaired
concentration, irritability, muscle tension, and sleep
disturbance. Panic disorder instead centers on recurrent
unexpected panic attacks and concern about their recurrence,
while illness anxiety disorder focuses predominantly on fears of
serious illness.
Question 4
A patient experiences recurrent episodes of sudden intense fear
accompanied by palpitations, shortness of breath, trembling,
chest discomfort, and fear of dying. The attacks occur
unexpectedly. After several episodes, the patient begins
avoiding stores because of concern about having another
attack. Which diagnosis is most likely?
Diagnosis in Psychiatric-Mental Health Across
the Lifespan Practicum Practice Exam
2026/2027 | Practice Questions & Study
Guide | Complete Exam-Style Questions with
Correct Detailed Answers & Rationales
(Reliable Answers) | Latest Updated Version |
Instant Download PDf
Question 1
A 9-year-old child has difficulty sustaining attention, frequently
loses school materials, makes careless mistakes, and requires
repeated reminders to complete assignments. The symptoms
have been present for more than 6 months and occur at both
school and home. The child does not demonstrate significant
hyperactivity or impulsivity. Which diagnosis best explains this
presentation?
A. Oppositional defiant disorder
B. Generalized anxiety disorder
C. Attention-deficit/hyperactivity disorder, predominantly
,inattentive presentation
D. Specific learning disorder
Correct Answer: C. Attention-deficit/hyperactivity disorder,
predominantly inattentive presentation
Rationale: The child demonstrates a persistent pattern of
developmentally inappropriate inattention that occurs across
more than one setting and has been present for longer than 6
months. Losing materials, careless mistakes, difficulty sustaining
attention, and failure to follow through are characteristic
inattentive symptoms of ADHD. The absence of prominent
hyperactive or impulsive symptoms supports the predominantly
inattentive presentation. Specific learning disorder can produce
academic difficulty, but the broader pattern of organizational
and attentional problems across settings favors ADHD.
Question 2
A 15-year-old adolescent has become increasingly socially
withdrawn and has stopped participating in previously enjoyed
activities. Over the past month, the adolescent reports hearing
a voice commenting on behavior and expresses a fixed belief
that classmates are monitoring them through their phones.
There is no history of substance use or a medical disorder.
Which diagnostic category should be prioritized?
,A. Schizophrenia spectrum and other psychotic disorder
B. Generalized anxiety disorder
C. Adjustment disorder
D. Obsessive-compulsive disorder
Correct Answer: A. Schizophrenia spectrum and other
psychotic disorder
Rationale: Hallucinations and fixed delusional beliefs represent
psychotic symptoms. The clinician should prioritize evaluation
for a schizophrenia-spectrum disorder while determining the
duration of symptoms and excluding substance-induced,
medical, mood-related, and other causes. Social withdrawal and
functional deterioration further increase concern for an
emerging psychotic disorder. Anxiety and adjustment disorders
do not ordinarily produce persistent hallucinations and fixed
delusions.
Question 3
A 32-year-old patient reports excessive worry about finances,
health, employment, and family safety. The worry occurs most
days and has been difficult to control for more than 6 months.
The patient also reports muscle tension, irritability, fatigue, and
difficulty sleeping. Which diagnosis is most appropriate?
, A. Panic disorder
B. Generalized anxiety disorder
C. Illness anxiety disorder
D. Obsessive-compulsive disorder
Correct Answer: B. Generalized anxiety disorder
Rationale: Generalized anxiety disorder is characterized by
excessive anxiety and worry about multiple areas of life that are
difficult to control and persist for at least 6 months. Associated
symptoms commonly include restlessness, fatigue, impaired
concentration, irritability, muscle tension, and sleep
disturbance. Panic disorder instead centers on recurrent
unexpected panic attacks and concern about their recurrence,
while illness anxiety disorder focuses predominantly on fears of
serious illness.
Question 4
A patient experiences recurrent episodes of sudden intense fear
accompanied by palpitations, shortness of breath, trembling,
chest discomfort, and fear of dying. The attacks occur
unexpectedly. After several episodes, the patient begins
avoiding stores because of concern about having another
attack. Which diagnosis is most likely?
