NR-547 Midterm test 4 Final Assessment Questions
2025 | Full Verified Guide | A+ Rated
Name the 6 of a differential diagnosis - 1.) RULE OUT Malingering or Factitous
disorder
2.)Ruling out substance etiology
3.) ruling out a medical etiology
4.) Determining the specific primary disorder
5.) Differentiating adjustment disorder from the residual "other specified" and
"unspecified" conditions
6.) Establishing the boundary with no mental disorder
Remember with step 5, the PMHNP can use "other specified" in the diagnosis when they
want to indicate the specific reason for a diagnosis.
They use "unspecified" if:
the information doesnt conform to DSM5
there is insufficient info to make a specific diagnosis
there is more info the be revealed with time OR they want to help the patient avoid
stigmas -
The PMHNP wants to rule out anemia as a cause for a patients fatigue and lack of
motivation. What lab should she order? - a CBC with iron studies
hg-12-18
hematocrit: 38-48%
What is normal creat/BUN level? - BUN: 7-18
creat: 0.6-1.2
A patient presents with brain fog, lack of focus, insomnia & mood swing, lack of mental
alertness. What lab should the PMHNP order? - THYROID FUNCTION TEST
TSH: 0.4-4.5
T3: 100-200
, T4: 5-11
The patient has a b12 level of 126 picograms/mL. what symptoms may the patient
experience? - normal B12: 190-950 picograms/mL
but borderline is 200-300 & will need additional testing.
depression, mania, psychotic symptoms, cognitive impairment
Name the normal vitamin D levels: - 20-50 ng/ML
Tell me about the HAM-A - This is the Hamilton Anxiety Scale, creates to assess
somatic/cognitive anxiety symptoms. MAINLY TO ASSESS ANXIETY. It does not help to assess the
worry aspect usually found with GAD.
less than 17- mild
18-23- mod
25-30 mod-severe
_____ shows there is an INCREASE activation of the amygdala which is an increase in the
fear response. There is a decreased activation of the pre-frontal cortex which results in lessened
reasoning. - Generalized Anxiety Disorder
Explain GAD - This is characterized when a person WORRY about ORDINARY,
everyday situations. These patients have a hard time getting over the what ifs and hyperfixate.
Due to this they are unable to get more of their pressing tasks done
What is the DSM criteria for GAD? - WORRY about everyday tasks, sleep
disturbance, restlessness, fatigue and immanent fear, muscle tension or difficulty concentrating
has to be persistent for six months or GREATER
Name the first line treatment for GAD. - SSRIs
What are some s/e of SSRIS? - hyponatremia, weight loss, weight gain, anxiety in
the initial stages.
What is another adjunct treatment or PRN medication used as a treatment for GAD? -
Buspirone- This is an anxiolytic with decreased adverse effects & drug interactions. It can
take about 2-4 weeks to work and it is pretty weak however effective when used as an adjunct.
2025 | Full Verified Guide | A+ Rated
Name the 6 of a differential diagnosis - 1.) RULE OUT Malingering or Factitous
disorder
2.)Ruling out substance etiology
3.) ruling out a medical etiology
4.) Determining the specific primary disorder
5.) Differentiating adjustment disorder from the residual "other specified" and
"unspecified" conditions
6.) Establishing the boundary with no mental disorder
Remember with step 5, the PMHNP can use "other specified" in the diagnosis when they
want to indicate the specific reason for a diagnosis.
They use "unspecified" if:
the information doesnt conform to DSM5
there is insufficient info to make a specific diagnosis
there is more info the be revealed with time OR they want to help the patient avoid
stigmas -
The PMHNP wants to rule out anemia as a cause for a patients fatigue and lack of
motivation. What lab should she order? - a CBC with iron studies
hg-12-18
hematocrit: 38-48%
What is normal creat/BUN level? - BUN: 7-18
creat: 0.6-1.2
A patient presents with brain fog, lack of focus, insomnia & mood swing, lack of mental
alertness. What lab should the PMHNP order? - THYROID FUNCTION TEST
TSH: 0.4-4.5
T3: 100-200
, T4: 5-11
The patient has a b12 level of 126 picograms/mL. what symptoms may the patient
experience? - normal B12: 190-950 picograms/mL
but borderline is 200-300 & will need additional testing.
depression, mania, psychotic symptoms, cognitive impairment
Name the normal vitamin D levels: - 20-50 ng/ML
Tell me about the HAM-A - This is the Hamilton Anxiety Scale, creates to assess
somatic/cognitive anxiety symptoms. MAINLY TO ASSESS ANXIETY. It does not help to assess the
worry aspect usually found with GAD.
less than 17- mild
18-23- mod
25-30 mod-severe
_____ shows there is an INCREASE activation of the amygdala which is an increase in the
fear response. There is a decreased activation of the pre-frontal cortex which results in lessened
reasoning. - Generalized Anxiety Disorder
Explain GAD - This is characterized when a person WORRY about ORDINARY,
everyday situations. These patients have a hard time getting over the what ifs and hyperfixate.
Due to this they are unable to get more of their pressing tasks done
What is the DSM criteria for GAD? - WORRY about everyday tasks, sleep
disturbance, restlessness, fatigue and immanent fear, muscle tension or difficulty concentrating
has to be persistent for six months or GREATER
Name the first line treatment for GAD. - SSRIs
What are some s/e of SSRIS? - hyponatremia, weight loss, weight gain, anxiety in
the initial stages.
What is another adjunct treatment or PRN medication used as a treatment for GAD? -
Buspirone- This is an anxiolytic with decreased adverse effects & drug interactions. It can
take about 2-4 weeks to work and it is pretty weak however effective when used as an adjunct.
