NR 547 Final Exam 2025/2026 Test Bank |
Chamberlain PMHNP Differential Diagnosis
Across the Lifespan | 50 Graduate-Level
Questions, Answers & Rationales | Nursing
Exam Prep Guide
Q1. A 28-year-old woman reports a 10-month history of
depressed mood, low energy, hypersomnia, increased appetite
with 10-lb weight gain, low self-esteem, and difficulty
concentrating. Symptoms are present most days and are worse
in fall and winter, remitting somewhat in spring. No history of
manic or hypomanic episodes. Which diagnosis best fits?
A. Major Depressive Disorder, single episode, severe without
psychotic features
B. Persistent Depressive Disorder (Dysthymia)
C. Major Depressive Disorder with seasonal pattern (Major
,Depressive Disorder, recurrent)
D. Cyclothymic disorder
Correct Answer: C
Rationale: The recurrent seasonal timing, typical symptoms of
major depression, and absence of mania point to MDD with
seasonal pattern per DSM-5-TR; duration and severity exceed
dysthymia criteria.
Q2. A 45-year-old man with chronic generalized anxiety,
difficulty concentrating, sleep disturbance, and muscle tension
for 10 months presents. He also reports episodic panic attacks
without agoraphobic avoidance. Which formulation best
captures his diagnoses?
A. Generalized Anxiety Disorder only
B. Panic disorder only
C. Generalized Anxiety Disorder and Panic disorder comorbid
D. Social Anxiety Disorder comorbid with GAD
Correct Answer: C
Rationale: GAD requires ≥6 months of pervasive anxiety with
associated symptoms; discrete panic attacks meeting criteria
indicate comorbid panic disorder rather than one diagnosis
explaining both.
Q3. A 70-year-old woman with gradual cognitive decline over 3
years exhibits memory impairment, language difficulties, and
executive dysfunction; MRI shows medial temporal lobe
atrophy. Which neurocognitive disorder is most likely?
, A. Major neurocognitive disorder due to Alzheimer’s disease
B. Major neurocognitive disorder due to vascular disease
C. Major neurocognitive disorder with Lewy bodies
D. Mild neurocognitive disorder due to normal aging
Correct Answer: A
Rationale: Progressive memory and language decline with
medial temporal atrophy fit Alzheimer’s disease
neuropathology; vascular and Lewy body disorders have
different clinical features (stepwise decline, fluctuating
cognition, visual hallucinations).
Q4. A 16-year-old adolescent presents with persistent
irritability, temper outbursts occurring three times weekly
across home and school for 14 months, and no symptom-free
period longer than 3 months. What is the most appropriate
diagnosis?
A. Oppositional Defiant Disorder
B. Disruptive Mood Dysregulation Disorder
C. Major Depressive Disorder, recurrent
D. Intermittent Explosive Disorder
Correct Answer: B
Rationale: Chronic severe irritability with frequent temper
outbursts beginning in childhood/adolescence and duration >12
months suggests DMDD; ODD lacks pervasive mood symptoms,
IED is episodic aggression.
Chamberlain PMHNP Differential Diagnosis
Across the Lifespan | 50 Graduate-Level
Questions, Answers & Rationales | Nursing
Exam Prep Guide
Q1. A 28-year-old woman reports a 10-month history of
depressed mood, low energy, hypersomnia, increased appetite
with 10-lb weight gain, low self-esteem, and difficulty
concentrating. Symptoms are present most days and are worse
in fall and winter, remitting somewhat in spring. No history of
manic or hypomanic episodes. Which diagnosis best fits?
A. Major Depressive Disorder, single episode, severe without
psychotic features
B. Persistent Depressive Disorder (Dysthymia)
C. Major Depressive Disorder with seasonal pattern (Major
,Depressive Disorder, recurrent)
D. Cyclothymic disorder
Correct Answer: C
Rationale: The recurrent seasonal timing, typical symptoms of
major depression, and absence of mania point to MDD with
seasonal pattern per DSM-5-TR; duration and severity exceed
dysthymia criteria.
Q2. A 45-year-old man with chronic generalized anxiety,
difficulty concentrating, sleep disturbance, and muscle tension
for 10 months presents. He also reports episodic panic attacks
without agoraphobic avoidance. Which formulation best
captures his diagnoses?
A. Generalized Anxiety Disorder only
B. Panic disorder only
C. Generalized Anxiety Disorder and Panic disorder comorbid
D. Social Anxiety Disorder comorbid with GAD
Correct Answer: C
Rationale: GAD requires ≥6 months of pervasive anxiety with
associated symptoms; discrete panic attacks meeting criteria
indicate comorbid panic disorder rather than one diagnosis
explaining both.
Q3. A 70-year-old woman with gradual cognitive decline over 3
years exhibits memory impairment, language difficulties, and
executive dysfunction; MRI shows medial temporal lobe
atrophy. Which neurocognitive disorder is most likely?
, A. Major neurocognitive disorder due to Alzheimer’s disease
B. Major neurocognitive disorder due to vascular disease
C. Major neurocognitive disorder with Lewy bodies
D. Mild neurocognitive disorder due to normal aging
Correct Answer: A
Rationale: Progressive memory and language decline with
medial temporal atrophy fit Alzheimer’s disease
neuropathology; vascular and Lewy body disorders have
different clinical features (stepwise decline, fluctuating
cognition, visual hallucinations).
Q4. A 16-year-old adolescent presents with persistent
irritability, temper outbursts occurring three times weekly
across home and school for 14 months, and no symptom-free
period longer than 3 months. What is the most appropriate
diagnosis?
A. Oppositional Defiant Disorder
B. Disruptive Mood Dysregulation Disorder
C. Major Depressive Disorder, recurrent
D. Intermittent Explosive Disorder
Correct Answer: B
Rationale: Chronic severe irritability with frequent temper
outbursts beginning in childhood/adolescence and duration >12
months suggests DMDD; ODD lacks pervasive mood symptoms,
IED is episodic aggression.
