NR 547 Final Exam 2025/2026 |
Chamberlain PMHNP Differential Diagnosis
Test Bank | 50 Graduate-Level Questions &
Answers | Psychiatric–Mental Health Exam
Prep Guide
Q1. A 28-year-old woman presents with a 3-week history of
depressed mood, anhedonia, hypersomnia, increased appetite,
and weight gain. She reports feeling hopeless but denies
suicidal intent. She notes these symptoms began 2 weeks after
a breakup. On exam there is no psychosis, and she has normal
concentration. Which diagnosis is most appropriate?
A. Major Depressive Disorder, single episode, moderate
B. Persistent Depressive Disorder (Dysthymia)
,C. Adjustment Disorder with Depressed Mood
D. Bereavement (Normal grief)
Correct Answer: C
Rationale: The 3-week onset after a psychosocial stressor
(breakup) and shorter duration (<6 months) with functional
impairment points to Adjustment Disorder with depressed
mood. MDD requires ≥2 weeks of 5+ symptoms including
significant functional impairment (but relationship to a stressor
and proportionality favor adjustment). Dysthymia requires ≥2
years. Normal bereavement typically features waves of positive
memories and is differentiated by cultural/contextual factors.
Q2. A 45-year-old man presents with 5 months of pervasive
worry about multiple domains (work, finances, health) that is
difficult to control, accompanied by restlessness, muscle
tension, and insomnia. He reports these symptoms have been
present for years but worse for the past 5 months. He denies
panic attacks, obsessions, or compulsions. What is the most
likely diagnosis?
A. Generalized Anxiety Disorder (GAD)
B. Panic Disorder
C. Major Depressive Disorder with anxious distress
D. Adjustment Disorder with anxious mood
Correct Answer: A
Rationale: Chronic excessive worry about multiple domains with
,associated physiological symptoms (restlessness, muscle
tension, insomnia) lasting >6 months is consistent with GAD.
Panic disorder would require recurrent unexpected panic
attacks. MDD with anxious distress requires core depressive
symptoms. Adjustment disorder is time-limited after a stressor
and less likely with multi-year history.
Q3. A 22-year-old college student reports recurrent, unexpected
panic attacks with chest pain, derealization, and fear of losing
control. Between attacks she avoids crowded classrooms and
the campus gym. Which diagnosis best fits?
A. Panic Disorder with Agoraphobia
B. Panic Disorder without Agoraphobia
C. Specific Phobia (situational)
D. Social Anxiety Disorder
Correct Answer: A
Rationale: Presence of recurrent unexpected panic attacks plus
avoidance of places/situations (crowded classrooms, gym) due
to fear of having an attack meets Panic Disorder with
Agoraphobia. Panic disorder without agoraphobia would lack
the avoidance; specific phobia and social anxiety disorder have
different fear foci.
Q4. A 60-year-old woman has a 6-month history of progressive
memory impairment, executive dysfunction, and difficulty
, managing finances. Symptoms began insidiously and are
gradually worsening. Neuro exam shows impaired delayed recall
and naming; no fluctuating consciousness or prominent visual
hallucinations. Most likely diagnosis?
A. Alzheimer’s disease (Major Neurocognitive Disorder,
probable)
B. Dementia with Lewy Bodies
C. Vascular Neurocognitive Disorder
D. Major Depressive Disorder, pseudodementia
Correct Answer: A
Rationale: Insidious, progressive memory and language decline
with prominent anterograde memory impairment and no
fluctuating cognition or hallucinations points to Alzheimer’s-
type major neurocognitive disorder. DLB has fluctuating
cognition, visual hallucinations, and parkinsonism. Vascular NCD
often has stepwise decline and focal deficits. Pseudodementia
due to depression may show effort variability and more rapid
onset.
Q5. A 7-year-old child shows inattentive symptoms (easily
distracted, forgetful), struggles to finish tasks at school, and has
symptoms present at home and school for 9 months causing
impairment. No hyperactivity. Best diagnosis?
A. ADHD, Predominantly Inattentive Presentation
B. ADHD, Predominantly Hyperactive/Impulsive Presentation
Chamberlain PMHNP Differential Diagnosis
Test Bank | 50 Graduate-Level Questions &
Answers | Psychiatric–Mental Health Exam
Prep Guide
Q1. A 28-year-old woman presents with a 3-week history of
depressed mood, anhedonia, hypersomnia, increased appetite,
and weight gain. She reports feeling hopeless but denies
suicidal intent. She notes these symptoms began 2 weeks after
a breakup. On exam there is no psychosis, and she has normal
concentration. Which diagnosis is most appropriate?
A. Major Depressive Disorder, single episode, moderate
B. Persistent Depressive Disorder (Dysthymia)
,C. Adjustment Disorder with Depressed Mood
D. Bereavement (Normal grief)
Correct Answer: C
Rationale: The 3-week onset after a psychosocial stressor
(breakup) and shorter duration (<6 months) with functional
impairment points to Adjustment Disorder with depressed
mood. MDD requires ≥2 weeks of 5+ symptoms including
significant functional impairment (but relationship to a stressor
and proportionality favor adjustment). Dysthymia requires ≥2
years. Normal bereavement typically features waves of positive
memories and is differentiated by cultural/contextual factors.
Q2. A 45-year-old man presents with 5 months of pervasive
worry about multiple domains (work, finances, health) that is
difficult to control, accompanied by restlessness, muscle
tension, and insomnia. He reports these symptoms have been
present for years but worse for the past 5 months. He denies
panic attacks, obsessions, or compulsions. What is the most
likely diagnosis?
A. Generalized Anxiety Disorder (GAD)
B. Panic Disorder
C. Major Depressive Disorder with anxious distress
D. Adjustment Disorder with anxious mood
Correct Answer: A
Rationale: Chronic excessive worry about multiple domains with
,associated physiological symptoms (restlessness, muscle
tension, insomnia) lasting >6 months is consistent with GAD.
Panic disorder would require recurrent unexpected panic
attacks. MDD with anxious distress requires core depressive
symptoms. Adjustment disorder is time-limited after a stressor
and less likely with multi-year history.
Q3. A 22-year-old college student reports recurrent, unexpected
panic attacks with chest pain, derealization, and fear of losing
control. Between attacks she avoids crowded classrooms and
the campus gym. Which diagnosis best fits?
A. Panic Disorder with Agoraphobia
B. Panic Disorder without Agoraphobia
C. Specific Phobia (situational)
D. Social Anxiety Disorder
Correct Answer: A
Rationale: Presence of recurrent unexpected panic attacks plus
avoidance of places/situations (crowded classrooms, gym) due
to fear of having an attack meets Panic Disorder with
Agoraphobia. Panic disorder without agoraphobia would lack
the avoidance; specific phobia and social anxiety disorder have
different fear foci.
Q4. A 60-year-old woman has a 6-month history of progressive
memory impairment, executive dysfunction, and difficulty
, managing finances. Symptoms began insidiously and are
gradually worsening. Neuro exam shows impaired delayed recall
and naming; no fluctuating consciousness or prominent visual
hallucinations. Most likely diagnosis?
A. Alzheimer’s disease (Major Neurocognitive Disorder,
probable)
B. Dementia with Lewy Bodies
C. Vascular Neurocognitive Disorder
D. Major Depressive Disorder, pseudodementia
Correct Answer: A
Rationale: Insidious, progressive memory and language decline
with prominent anterograde memory impairment and no
fluctuating cognition or hallucinations points to Alzheimer’s-
type major neurocognitive disorder. DLB has fluctuating
cognition, visual hallucinations, and parkinsonism. Vascular NCD
often has stepwise decline and focal deficits. Pseudodementia
due to depression may show effort variability and more rapid
onset.
Q5. A 7-year-old child shows inattentive symptoms (easily
distracted, forgetful), struggles to finish tasks at school, and has
symptoms present at home and school for 9 months causing
impairment. No hyperactivity. Best diagnosis?
A. ADHD, Predominantly Inattentive Presentation
B. ADHD, Predominantly Hyperactive/Impulsive Presentation
