Page 1 of 177
NR 547 FINAL EXAM (CHAMBERLAIN) NEWEST 2025 TEST
BANK| NR 547 DIFFERENTIAL DIAGNOSIS IN PSYCHIATRIC-
MENTAL HEALTH ACROSS THE LIFESPAN PRACTICUM
FINAL EXAM REVIEW WITH 500 REAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+
A 42-year-old patient with a long history of recurrent major depressive
episodes has not responded adequately to multiple trials of
antidepressant medications. They also report severe melancholic features
and significant functional impairment. Which of the following treatment
options should be considered, given their treatment resistance and severe
symptoms?
A) Increasing the current antidepressant dose indefinitely
B) Adding an anxiolytic like lorazepam as monotherapy
C) Electroconvulsive Therapy (ECT)
D) Switching to a different SSRI not previously tried, as monotherapy –
Correct Answer - C) Electroconvulsive Therapy (ECT)
Which of the following symptoms is represented by the 'A' in the
DIGFAST mnemonic for manic or hypomanic episodes?
A) Anhedonia
B) Agitation/Increased Goal-Directed Activity
C) Appetite changes
D) Anxiety – Correct Answer - B) Agitation/Increased Goal-Directed
Activity
pg. 1
,Page 2 of 177
The 'A' in DIGFAST stands for either increased Activity (specifically,
increased goal-directed activity such as work, school, social, or sexual
activity) or psychomotor Agitation (purposeless, non-goal-directed
activity like pacing or fidgeting).
According to the DSM-5 criteria, what is the minimum duration required
for the presence of a depressed mood for a diagnosis of Persistent
Depressive Disorder (Dysthymia) in an adult?
A) 2 weeks
B) 6 months
C) 1 year
D) 2 years – Correct Answer - D) 2 years
For adults, the DSM-5 criteria for Persistent Depressive Disorder
(Dysthymia) requires a depressed mood for most of the day, for more
days than not, for at least 2 years. During this period, the individual
cannot have been without the symptoms for more than 2 months at a
time.
Which of the following is a common anticholinergic side effect
associated with Tricyclic Antidepressants (TCAs)?
A) Orthostatic hypotension
B) Weight gain
C) Constipation
D) Sedation – Correct Answer - C) Constipation
pg. 2
,Page 3 of 177
Constipation is a classic anticholinergic side effect of TCAs.
Anticholinergic effects stem from the blockade of muscarinic
acetylcholine receptors. Other common anticholinergic side effects
include: Dry mouth (xerostomia) Blurred vision (due to impaired
accommodation) Urinary retention Cognitive impairment (e.g.,
confusion, memory problems, especially in older adults)
A 28-year-old female patient with Major Depressive Disorder (MDD) is
considering starting an antidepressant. Before initiating an SSRI, the
provider must prioritize ruling out which of the following conditions due
to the potential for adverse effects?
A) Generalized Anxiety Disorder (GAD)
B) Obsessive-Compulsive Disorder (OCD)
C) Bipolar I Disorder
D) Post-Traumatic Stress Disorder (PTSD) – Correct Answer - C)
Bipolar I Disorder
It is crucial to rule out bipolar disorder (especially Bipolar I) before
initiating an SSRI for suspected depression. SSRIs can induce mania,
hypomania, mixed episodes, or rapid cycling in individuals with
undiagnosed bipolar disorder. This can have serious consequences. A
thorough mood history (including family history) and screening tools
like the MDQ are essential.
A patient presents with a history of recurrent mood swings that do not
meet the full criteria for either a hypomanic or major depressive episode,
but have persisted for more than two years. These mood fluctuations
pg. 3
, Page 4 of 177
cause significant distress. Which diagnosis is most consistent with this
presentation?
A) Bipolar I Disorder
B) Bipolar II Disorder
C) Cyclothymic Disorder
D) Persistent Depressive Disorder – Correct Answer - C) Cyclothymic
Disorder
Cyclothymia is characterized by a chronic, fluctuating mood disturbance
involving numerous periods of hypomanic symptoms (that do not meet
full criteria for a hypomanic episode) and numerous periods of
depressive symptoms (that do not meet full criteria for a major
depressive episode), lasting for at least 2 years (1 year in
children/adolescents).
A 75-year-old female is diagnosed with Lewy Body Dementia (LBD).
Her symptoms include fluctuating attention and alertness, recurrent well-
formed visual hallucinations, and new-onset, mild parkinsonian features.
Her family is concerned about her cognitive decline and the disturbing
hallucinations. Which of the following medications is generally
considered first-line for managing her cognitive and behavioral
symptoms in LBD?
A) Memantine
B) Donepezil
C) Quetiapine
D) Levodopa – Correct Answer - B) Donepezil
pg. 4
NR 547 FINAL EXAM (CHAMBERLAIN) NEWEST 2025 TEST
BANK| NR 547 DIFFERENTIAL DIAGNOSIS IN PSYCHIATRIC-
MENTAL HEALTH ACROSS THE LIFESPAN PRACTICUM
FINAL EXAM REVIEW WITH 500 REAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+
A 42-year-old patient with a long history of recurrent major depressive
episodes has not responded adequately to multiple trials of
antidepressant medications. They also report severe melancholic features
and significant functional impairment. Which of the following treatment
options should be considered, given their treatment resistance and severe
symptoms?
A) Increasing the current antidepressant dose indefinitely
B) Adding an anxiolytic like lorazepam as monotherapy
C) Electroconvulsive Therapy (ECT)
D) Switching to a different SSRI not previously tried, as monotherapy –
Correct Answer - C) Electroconvulsive Therapy (ECT)
Which of the following symptoms is represented by the 'A' in the
DIGFAST mnemonic for manic or hypomanic episodes?
A) Anhedonia
B) Agitation/Increased Goal-Directed Activity
C) Appetite changes
D) Anxiety – Correct Answer - B) Agitation/Increased Goal-Directed
Activity
pg. 1
,Page 2 of 177
The 'A' in DIGFAST stands for either increased Activity (specifically,
increased goal-directed activity such as work, school, social, or sexual
activity) or psychomotor Agitation (purposeless, non-goal-directed
activity like pacing or fidgeting).
According to the DSM-5 criteria, what is the minimum duration required
for the presence of a depressed mood for a diagnosis of Persistent
Depressive Disorder (Dysthymia) in an adult?
A) 2 weeks
B) 6 months
C) 1 year
D) 2 years – Correct Answer - D) 2 years
For adults, the DSM-5 criteria for Persistent Depressive Disorder
(Dysthymia) requires a depressed mood for most of the day, for more
days than not, for at least 2 years. During this period, the individual
cannot have been without the symptoms for more than 2 months at a
time.
Which of the following is a common anticholinergic side effect
associated with Tricyclic Antidepressants (TCAs)?
A) Orthostatic hypotension
B) Weight gain
C) Constipation
D) Sedation – Correct Answer - C) Constipation
pg. 2
,Page 3 of 177
Constipation is a classic anticholinergic side effect of TCAs.
Anticholinergic effects stem from the blockade of muscarinic
acetylcholine receptors. Other common anticholinergic side effects
include: Dry mouth (xerostomia) Blurred vision (due to impaired
accommodation) Urinary retention Cognitive impairment (e.g.,
confusion, memory problems, especially in older adults)
A 28-year-old female patient with Major Depressive Disorder (MDD) is
considering starting an antidepressant. Before initiating an SSRI, the
provider must prioritize ruling out which of the following conditions due
to the potential for adverse effects?
A) Generalized Anxiety Disorder (GAD)
B) Obsessive-Compulsive Disorder (OCD)
C) Bipolar I Disorder
D) Post-Traumatic Stress Disorder (PTSD) – Correct Answer - C)
Bipolar I Disorder
It is crucial to rule out bipolar disorder (especially Bipolar I) before
initiating an SSRI for suspected depression. SSRIs can induce mania,
hypomania, mixed episodes, or rapid cycling in individuals with
undiagnosed bipolar disorder. This can have serious consequences. A
thorough mood history (including family history) and screening tools
like the MDQ are essential.
A patient presents with a history of recurrent mood swings that do not
meet the full criteria for either a hypomanic or major depressive episode,
but have persisted for more than two years. These mood fluctuations
pg. 3
, Page 4 of 177
cause significant distress. Which diagnosis is most consistent with this
presentation?
A) Bipolar I Disorder
B) Bipolar II Disorder
C) Cyclothymic Disorder
D) Persistent Depressive Disorder – Correct Answer - C) Cyclothymic
Disorder
Cyclothymia is characterized by a chronic, fluctuating mood disturbance
involving numerous periods of hypomanic symptoms (that do not meet
full criteria for a hypomanic episode) and numerous periods of
depressive symptoms (that do not meet full criteria for a major
depressive episode), lasting for at least 2 years (1 year in
children/adolescents).
A 75-year-old female is diagnosed with Lewy Body Dementia (LBD).
Her symptoms include fluctuating attention and alertness, recurrent well-
formed visual hallucinations, and new-onset, mild parkinsonian features.
Her family is concerned about her cognitive decline and the disturbing
hallucinations. Which of the following medications is generally
considered first-line for managing her cognitive and behavioral
symptoms in LBD?
A) Memantine
B) Donepezil
C) Quetiapine
D) Levodopa – Correct Answer - B) Donepezil
pg. 4
