NR547 Final 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
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NR547 Final Exam Practice
Question 1
A 34-year-old patient reports depressed mood, anhedonia,
fatigue, impaired concentration, insomnia, and feelings of
worthlessness for 3 weeks. The symptoms have caused
significant impairment at work. There is no history of mania or
hypomania. Which diagnosis is most appropriate?
A. Persistent depressive disorder
B. Adjustment disorder with depressed mood
C. Major depressive disorder
D. Bipolar II disorder
Correct Answer: C. Major depressive disorder
,Rationale: Major depressive disorder is characterized by a major
depressive episode involving at least 5 depressive symptoms
during the same 2-week period, including depressed mood or
loss of interest/pleasure, with clinically significant distress or
impairment. This patient has multiple qualifying symptoms
lasting 3 weeks and no history suggesting bipolarity. Persistent
depressive disorder requires a much longer duration of
depressed mood, while adjustment disorder requires symptoms
to occur in response to an identifiable stressor without meeting
criteria for another disorder. Bipolar II disorder requires at least
one hypomanic episode in addition to a major depressive
episode.
Question 2
A patient completes the PHQ-9 and receives a score of 17. How
should this score generally be interpreted?
A. Mild depressive symptoms
B. Moderate depressive symptoms
C. Moderately severe depressive symptoms
D. Severe depressive symptoms
Correct Answer: C. Moderately severe depressive symptoms
Rationale: The PHQ-9 uses a 0–27 scoring range. Scores of 5–9
generally indicate mild symptoms, 10–14 moderate symptoms,
,15–19 moderately severe symptoms, and 20–27 severe
symptoms. A score of 17 therefore falls within the moderately
severe range. The score helps quantify symptom burden and
monitor change over time, but it should not be used alone to
establish a psychiatric diagnosis.
Question 3
A patient with depression states, “My family would be better off
without me.” What is the PMHNP's most appropriate next
action?
A. Ask directly about suicidal thoughts, intent, plan, and access
to means
B. Reassure the patient that the statement is common in
depression
C. Immediately begin antidepressant therapy
D. Ask the patient's family to monitor the patient without
further assessment
Correct Answer: A. Ask directly about suicidal thoughts,
intent, plan, and access to means
Rationale: Statements suggesting hopelessness,
burdensomeness, or wishing to be absent require direct suicide-
risk assessment. Asking about suicidal thoughts does not create
suicidal behavior; instead, it provides an opportunity to
, determine immediacy and severity of risk. Assessment should
include suicidal ideation, intent, plan, access to lethal means,
previous attempts, protective factors, substance use, and other
relevant risk factors. Medication selection may follow the safety
assessment but should not replace it.
Question 4
Which finding most strongly supports bipolar I disorder rather
than major depressive disorder alone?
A. Recurrent insomnia during depressive episodes
B. A history of a manic episode
C. Family history of depression
D. Anxiety occurring during depressive episodes
Correct Answer: B. A history of a manic episode
Rationale: Bipolar I disorder is defined by the occurrence of at
least one manic episode, although depressive episodes are
common. Mania involves a distinct period of abnormally
elevated, expansive, or irritable mood and increased activity or
energy with associated symptoms and significant functional
disturbance. Insomnia, anxiety, and family history of depression
can occur in many psychiatric conditions and do not establish
bipolar I disorder.
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
NR547 Final Exam Practice
Question 1
A 34-year-old patient reports depressed mood, anhedonia,
fatigue, impaired concentration, insomnia, and feelings of
worthlessness for 3 weeks. The symptoms have caused
significant impairment at work. There is no history of mania or
hypomania. Which diagnosis is most appropriate?
A. Persistent depressive disorder
B. Adjustment disorder with depressed mood
C. Major depressive disorder
D. Bipolar II disorder
Correct Answer: C. Major depressive disorder
,Rationale: Major depressive disorder is characterized by a major
depressive episode involving at least 5 depressive symptoms
during the same 2-week period, including depressed mood or
loss of interest/pleasure, with clinically significant distress or
impairment. This patient has multiple qualifying symptoms
lasting 3 weeks and no history suggesting bipolarity. Persistent
depressive disorder requires a much longer duration of
depressed mood, while adjustment disorder requires symptoms
to occur in response to an identifiable stressor without meeting
criteria for another disorder. Bipolar II disorder requires at least
one hypomanic episode in addition to a major depressive
episode.
Question 2
A patient completes the PHQ-9 and receives a score of 17. How
should this score generally be interpreted?
A. Mild depressive symptoms
B. Moderate depressive symptoms
C. Moderately severe depressive symptoms
D. Severe depressive symptoms
Correct Answer: C. Moderately severe depressive symptoms
Rationale: The PHQ-9 uses a 0–27 scoring range. Scores of 5–9
generally indicate mild symptoms, 10–14 moderate symptoms,
,15–19 moderately severe symptoms, and 20–27 severe
symptoms. A score of 17 therefore falls within the moderately
severe range. The score helps quantify symptom burden and
monitor change over time, but it should not be used alone to
establish a psychiatric diagnosis.
Question 3
A patient with depression states, “My family would be better off
without me.” What is the PMHNP's most appropriate next
action?
A. Ask directly about suicidal thoughts, intent, plan, and access
to means
B. Reassure the patient that the statement is common in
depression
C. Immediately begin antidepressant therapy
D. Ask the patient's family to monitor the patient without
further assessment
Correct Answer: A. Ask directly about suicidal thoughts,
intent, plan, and access to means
Rationale: Statements suggesting hopelessness,
burdensomeness, or wishing to be absent require direct suicide-
risk assessment. Asking about suicidal thoughts does not create
suicidal behavior; instead, it provides an opportunity to
, determine immediacy and severity of risk. Assessment should
include suicidal ideation, intent, plan, access to lethal means,
previous attempts, protective factors, substance use, and other
relevant risk factors. Medication selection may follow the safety
assessment but should not replace it.
Question 4
Which finding most strongly supports bipolar I disorder rather
than major depressive disorder alone?
A. Recurrent insomnia during depressive episodes
B. A history of a manic episode
C. Family history of depression
D. Anxiety occurring during depressive episodes
Correct Answer: B. A history of a manic episode
Rationale: Bipolar I disorder is defined by the occurrence of at
least one manic episode, although depressive episodes are
common. Mania involves a distinct period of abnormally
elevated, expansive, or irritable mood and increased activity or
energy with associated symptoms and significant functional
disturbance. Insomnia, anxiety, and family history of depression
can occur in many psychiatric conditions and do not establish
bipolar I disorder.
