Have you ever had surgery?
NR 547 DIFFERENTIAL DX MIDTERM EXAM FULLY
SOLVED (ALREADY PASSED) UPDATED 2025
Family Psychiatric History - answer Has any relative of yours ever been
GRADED A+ hospitalized for a mental health issue?
Has any blood relative of yours ever been diagnosed with a mental health issue?
Differential Dx - answer Diagnostic reasoning is the process of questioning one's Has any blood relative of yours had a history of seizures or dementia/Alzheimer's?
thinking to determine if all possible avenues have been explored and if the
conclusions that are drawn are based on evidence. This is a critical step for
providers who are trying to uncover a cause, or diagnosis, for their clients' signs Social and Developmental History - answer Tell me a little bit about your childhood
and symptoms. The provider's initial hypothesis is known as the differential and how you grew up.
diagnosis. The differential diagnosis, or differential, is a working list of potential
problems that can be associated with the initial or chief complaint. Establishing a How was your experience in school when you were younger? Did you enjoy
differential diagnosis is a critical step in providing safe, quality care. This evolving school?
process of clinical reasoning and decision making involves examining the client's
How do you support yourself with your finances?
presentation, clinical data, and when appropriate, screening and diagnostic test
results to distinguish one disease from another and arrive at the correct diagnosis. Do you have a good support system? Are you currently in a relationship? Where do
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)provides you live? Who do you live with?
guidance for identifying psychiatric diagnosest
What do you do in your free time? What activities do you enjoy?
History of Present Illness - answer How long have you been feeling this way?
Which of the following should be included when providing client education about
Did something happen in your life that may have triggered these emotions? medication regimens? Select all that apply. - answer A)Explain how the medication
targets the symptoms, specific benefits, and expected time course. (Correct answer)
How is this current situation impacting your life?
B)Identify potential side effects, duration of side effects, and adverse effects.
(Correct answer)
The Psychiatric History - answer Have you ever been hospitalized for any mental
C)Explain the instructions, dosing, and special requirements. (Correct answer)
health issues?
D)Use teach-back methods to ensure client understanding. (Correct answer)
Have you ever had counseling or psychotherapy?
Have you ever taken medications for your mental health in the past?
Apply the Ask Suicide-Screening Questions (ASQ) Suicide Risk Screening Tool
Are you currently on any medications for mental health or sleep?
(Links to an external site.) to the scenario below.
A 52-year-old client presents to the emergency department following a car accident.
Medical History/Screening for General Medical Conditions - answer Do you have a The emergency department (ED) physician is concerned that the client may have
primary care provider? intentionally crashed her car and requests a stat PMHNP consult. In speaking with
the PMHNP, the client describes persistent feelings of sadness and hopelessness.
Do you have any medical illnesses? She states that she often wonders if her husband would be happier if she wasn't
Are you currently taking any medications or herbal supplements? around anymore since she's never happy and sometimes thinks about what it
would be like to just take a handful of sleeping pills and go to sleep forever. The
Do you have any allergies to medications? client reports a previous suicide attempt when she was 16 but denies that she is
Have you ever been hospitalized for any reason? considering killing herself right now.
,Based on the client's ASQ score, what is the most appropriate response? Basophils:
A) No action is necessary as the client is not - answer B)Provide a brief suicide Lymphocytes:
safety assessment.
Monocytes:
Platelets: - answer White blood cells (total): 5000-10,000/microliter
Rationale: While the client's responses do not indicate a need for a stat full safety
Neutrophils: 55%-70%
and mental health evaluation, the client requires a brief suicide safety assessment
to determine whether a full mental health evaluation in necessary. It is also Eosinophils: 1%-3%
important to notify the client's physician or the clinician responsible for the client's
care. Basophils: 0.5%-1%
Lymphocytes: 20%-35%
Complete Blood Count - answer The CBC is a serum diagnostic test that measures Monocytes: 3%-8%
red blood cells, white blood cells, hemoglobin, hematocrit, and platelets. The CBC Platelets: 150,000-300,000/microliter
includes a differential of the white blood cells. A CBC is often included as part of
routine health screening or to obtain information related to specific conditions. In
mental health, the CBC is used to rule out medical conditions that may present with
Comprehensive Metabolic Panel (CMP) - answer The CMP is another common blood
symptoms that can be attributed to both medical and psychiatric diagnoses. For
test used to determine general health status. The CMP includes several tests that
example, the CBC can help rule out anemia as a cause for depressive symptoms and
provide information about fluid and electrolyte balance as well as the status of the
fatigue or rule out infection as a cause of acute mental status changes. The CBC is
body's metabolism, liver function, and kidney function. In psychiatric care, the CMP
also used to monitor certain treatment regimens. For example, some medications,
may be used to rule out medical conditions that could cause symptoms such as
such as clozapine, require routine analysis of absolute neutrophil count and platelet
changes in mood or cognition. The CMP is also used to monitor the effects of
levels.
medications, such as antipsychotics, on liver function and glucose levels.
Normal Range of:
Normal CMP Levels
Red blood cells
Electrolytes
Hemoglobin
Sodium (Na+):
Hematocrit
Postassium (K+):
Reticulocytes - answer Red blood cells: 4.5-6.0 million/microliter
Chloride (Cl-):
Hemoglobin: 12-18 grams/100 mL
Bicarbonate (HCO3-): - answer Normal CMP Levels
Hematocrit: 38%-48%
Electrolytes
Reticulocytes: 0%-1.5%
Sodium (Na+): 136-145 mEq/L
Postassium (K+): 3.5-5.0 mEq/L
Normal Range of?
Chloride (Cl-): 95-105 mEq/L
White blood cells (total):
Bicarbonate (HCO3-): 22-28 mEq/L
Neutrophils:
Eosinophils:
Normal CMP levels
, Misc. TSH:
Calcium, serum (Ca 2+) T3:
Glucose, serum Fasting: T4: - answer Normal TFT levels
2-h postprandial: TSH: 0.4-4.5 mIU/L
Cholesterol, serum: T3: 100-200 ng/dL
Total Protein T4: 5-11 ug/dL
Albumin - answer Calcium, serum (Ca 2+) 8.4-10.2 mg/dl
Glucose, serum Fasting: 70-110 mg/dl; Vitamin B12 Level - answer Providers may choose to check vitamin B12 levels.
Deficiency of vitamin B12 can affect mood and other brain functions. Common
2-h postprandial: <120mg/dl
psychiatric symptoms associated with B12 deficiency include depression, mania,
Cholesterol, serum: REC<200 mg/dl psychotic symptoms, and cognitive impairment (
Total Protein 6.0-7.8 g/dl
Albumin 3.5-5.5 g/dl A normal vitamin B12 level is between 190-950 picograms/mL. Between 200-
300/mL indicates a borderline level with a possible need for additional testing.
Kidney Tests
Vitamin D Level - answer Vitamin D affects functions such as neurotransmission,
Creatinine, serum neuroprotection, and neuroimmunomodulation. Studies have indicated a high
Urea nitrogen, serum (BUN) - answer Creatinine, serum 0.6-1.2mg/dl prevalence of vitamin D deficiency in clients with psychiatric disorders such as
schizophrenia, depression, seasonal affective disorder, and cognitive impairment
Urea nitrogen, serum (BUN) 7-18mg/dl (Cuomo et al., 2019). Symptoms of vitamin D deficiency include depression,
irritability, anxiety, psychosis, and poor brain development.
Liver Tests
A vitamin D level can be measured via the 25-hydroxy vitamin D blood test. A
Alanine aminotransferase (ALT), serum:
normal level is between 20-50 ng/mL. A level less than 12 ng/mL indicates a
Aspartate aminotransferase (AST), deficiency.
Bilirubin, serum (adult) Total//Direct:
Phosphatase (alkaline), serum: - answer Liver Tests Toxicology Screen - answer When diagnosing psychiatric conditions, providers may
use toxicology screenings to rule out substance use as a cause for symptoms.
Alanine aminotransferase (ALT), serum: 8-20 U/L
Toxicology screenings are also used before starting therapy involving controlled
Aspartate aminotransferase (AST), serum: 8-20 U/L substances, to monitor medication adherence, and in the diagnosis of substance use
disorder.
Bilirubin, serum (adult) Total//Direct: 0.1-1.0 mg/dl // 0.0-0.3 mg/dl
Phosphatase (alkaline), serum: 20-70 U/L
Urinalysis (UA) - answer Urinary tract infections are associated with a variety of
neuropsychiatric symptoms (Lee et al., 2019). When clients present with acute
Normal TFT levels mental status changes, a urinalysis may be used to rule out a urinary tract infection
as the cause.
NR 547 DIFFERENTIAL DX MIDTERM EXAM FULLY
SOLVED (ALREADY PASSED) UPDATED 2025
Family Psychiatric History - answer Has any relative of yours ever been
GRADED A+ hospitalized for a mental health issue?
Has any blood relative of yours ever been diagnosed with a mental health issue?
Differential Dx - answer Diagnostic reasoning is the process of questioning one's Has any blood relative of yours had a history of seizures or dementia/Alzheimer's?
thinking to determine if all possible avenues have been explored and if the
conclusions that are drawn are based on evidence. This is a critical step for
providers who are trying to uncover a cause, or diagnosis, for their clients' signs Social and Developmental History - answer Tell me a little bit about your childhood
and symptoms. The provider's initial hypothesis is known as the differential and how you grew up.
diagnosis. The differential diagnosis, or differential, is a working list of potential
problems that can be associated with the initial or chief complaint. Establishing a How was your experience in school when you were younger? Did you enjoy
differential diagnosis is a critical step in providing safe, quality care. This evolving school?
process of clinical reasoning and decision making involves examining the client's
How do you support yourself with your finances?
presentation, clinical data, and when appropriate, screening and diagnostic test
results to distinguish one disease from another and arrive at the correct diagnosis. Do you have a good support system? Are you currently in a relationship? Where do
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)provides you live? Who do you live with?
guidance for identifying psychiatric diagnosest
What do you do in your free time? What activities do you enjoy?
History of Present Illness - answer How long have you been feeling this way?
Which of the following should be included when providing client education about
Did something happen in your life that may have triggered these emotions? medication regimens? Select all that apply. - answer A)Explain how the medication
targets the symptoms, specific benefits, and expected time course. (Correct answer)
How is this current situation impacting your life?
B)Identify potential side effects, duration of side effects, and adverse effects.
(Correct answer)
The Psychiatric History - answer Have you ever been hospitalized for any mental
C)Explain the instructions, dosing, and special requirements. (Correct answer)
health issues?
D)Use teach-back methods to ensure client understanding. (Correct answer)
Have you ever had counseling or psychotherapy?
Have you ever taken medications for your mental health in the past?
Apply the Ask Suicide-Screening Questions (ASQ) Suicide Risk Screening Tool
Are you currently on any medications for mental health or sleep?
(Links to an external site.) to the scenario below.
A 52-year-old client presents to the emergency department following a car accident.
Medical History/Screening for General Medical Conditions - answer Do you have a The emergency department (ED) physician is concerned that the client may have
primary care provider? intentionally crashed her car and requests a stat PMHNP consult. In speaking with
the PMHNP, the client describes persistent feelings of sadness and hopelessness.
Do you have any medical illnesses? She states that she often wonders if her husband would be happier if she wasn't
Are you currently taking any medications or herbal supplements? around anymore since she's never happy and sometimes thinks about what it
would be like to just take a handful of sleeping pills and go to sleep forever. The
Do you have any allergies to medications? client reports a previous suicide attempt when she was 16 but denies that she is
Have you ever been hospitalized for any reason? considering killing herself right now.
,Based on the client's ASQ score, what is the most appropriate response? Basophils:
A) No action is necessary as the client is not - answer B)Provide a brief suicide Lymphocytes:
safety assessment.
Monocytes:
Platelets: - answer White blood cells (total): 5000-10,000/microliter
Rationale: While the client's responses do not indicate a need for a stat full safety
Neutrophils: 55%-70%
and mental health evaluation, the client requires a brief suicide safety assessment
to determine whether a full mental health evaluation in necessary. It is also Eosinophils: 1%-3%
important to notify the client's physician or the clinician responsible for the client's
care. Basophils: 0.5%-1%
Lymphocytes: 20%-35%
Complete Blood Count - answer The CBC is a serum diagnostic test that measures Monocytes: 3%-8%
red blood cells, white blood cells, hemoglobin, hematocrit, and platelets. The CBC Platelets: 150,000-300,000/microliter
includes a differential of the white blood cells. A CBC is often included as part of
routine health screening or to obtain information related to specific conditions. In
mental health, the CBC is used to rule out medical conditions that may present with
Comprehensive Metabolic Panel (CMP) - answer The CMP is another common blood
symptoms that can be attributed to both medical and psychiatric diagnoses. For
test used to determine general health status. The CMP includes several tests that
example, the CBC can help rule out anemia as a cause for depressive symptoms and
provide information about fluid and electrolyte balance as well as the status of the
fatigue or rule out infection as a cause of acute mental status changes. The CBC is
body's metabolism, liver function, and kidney function. In psychiatric care, the CMP
also used to monitor certain treatment regimens. For example, some medications,
may be used to rule out medical conditions that could cause symptoms such as
such as clozapine, require routine analysis of absolute neutrophil count and platelet
changes in mood or cognition. The CMP is also used to monitor the effects of
levels.
medications, such as antipsychotics, on liver function and glucose levels.
Normal Range of:
Normal CMP Levels
Red blood cells
Electrolytes
Hemoglobin
Sodium (Na+):
Hematocrit
Postassium (K+):
Reticulocytes - answer Red blood cells: 4.5-6.0 million/microliter
Chloride (Cl-):
Hemoglobin: 12-18 grams/100 mL
Bicarbonate (HCO3-): - answer Normal CMP Levels
Hematocrit: 38%-48%
Electrolytes
Reticulocytes: 0%-1.5%
Sodium (Na+): 136-145 mEq/L
Postassium (K+): 3.5-5.0 mEq/L
Normal Range of?
Chloride (Cl-): 95-105 mEq/L
White blood cells (total):
Bicarbonate (HCO3-): 22-28 mEq/L
Neutrophils:
Eosinophils:
Normal CMP levels
, Misc. TSH:
Calcium, serum (Ca 2+) T3:
Glucose, serum Fasting: T4: - answer Normal TFT levels
2-h postprandial: TSH: 0.4-4.5 mIU/L
Cholesterol, serum: T3: 100-200 ng/dL
Total Protein T4: 5-11 ug/dL
Albumin - answer Calcium, serum (Ca 2+) 8.4-10.2 mg/dl
Glucose, serum Fasting: 70-110 mg/dl; Vitamin B12 Level - answer Providers may choose to check vitamin B12 levels.
Deficiency of vitamin B12 can affect mood and other brain functions. Common
2-h postprandial: <120mg/dl
psychiatric symptoms associated with B12 deficiency include depression, mania,
Cholesterol, serum: REC<200 mg/dl psychotic symptoms, and cognitive impairment (
Total Protein 6.0-7.8 g/dl
Albumin 3.5-5.5 g/dl A normal vitamin B12 level is between 190-950 picograms/mL. Between 200-
300/mL indicates a borderline level with a possible need for additional testing.
Kidney Tests
Vitamin D Level - answer Vitamin D affects functions such as neurotransmission,
Creatinine, serum neuroprotection, and neuroimmunomodulation. Studies have indicated a high
Urea nitrogen, serum (BUN) - answer Creatinine, serum 0.6-1.2mg/dl prevalence of vitamin D deficiency in clients with psychiatric disorders such as
schizophrenia, depression, seasonal affective disorder, and cognitive impairment
Urea nitrogen, serum (BUN) 7-18mg/dl (Cuomo et al., 2019). Symptoms of vitamin D deficiency include depression,
irritability, anxiety, psychosis, and poor brain development.
Liver Tests
A vitamin D level can be measured via the 25-hydroxy vitamin D blood test. A
Alanine aminotransferase (ALT), serum:
normal level is between 20-50 ng/mL. A level less than 12 ng/mL indicates a
Aspartate aminotransferase (AST), deficiency.
Bilirubin, serum (adult) Total//Direct:
Phosphatase (alkaline), serum: - answer Liver Tests Toxicology Screen - answer When diagnosing psychiatric conditions, providers may
use toxicology screenings to rule out substance use as a cause for symptoms.
Alanine aminotransferase (ALT), serum: 8-20 U/L
Toxicology screenings are also used before starting therapy involving controlled
Aspartate aminotransferase (AST), serum: 8-20 U/L substances, to monitor medication adherence, and in the diagnosis of substance use
disorder.
Bilirubin, serum (adult) Total//Direct: 0.1-1.0 mg/dl // 0.0-0.3 mg/dl
Phosphatase (alkaline), serum: 20-70 U/L
Urinalysis (UA) - answer Urinary tract infections are associated with a variety of
neuropsychiatric symptoms (Lee et al., 2019). When clients present with acute
Normal TFT levels mental status changes, a urinalysis may be used to rule out a urinary tract infection
as the cause.
