NR 547 Final Exam 2025/2026 Test Bank |
Chamberlain PMHNP Differential Diagnosis
Across the Lifespan | 50 Graduate-Level
Questions & Answers | Nursing Exam Prep
Guide
Q1. A 28-year-old graduate student reports a 3-week history of
depressed mood, insomnia, poor concentration, and thoughts
that life is “meaningless.” He had a similar 2-week episode 6
months ago. No history of mania or hypomania. Which
diagnosis best fits?
A. Major Depressive Disorder, single episode
B. Persistent Depressive Disorder (Dysthymia)
C. Recurrent Major Depressive Disorder
D. Cyclothymic Disorder
Correct Answer: C
Rationale: Two discrete episodes of depressive symptoms
,separated by a symptom-free interval suggest recurrent MDD.
Duration (≥2 weeks) and symptom severity point to MDD rather
than persistent depressive disorder (which requires ≥2 years of
chronic, less severe symptoms). No hypomania/mania excludes
bipolar/cyclothymia.
Q2. A 45-year-old presents with episodic palpitations, sweating,
fear of dying, and derealization occurring unexpectedly for 3
months with concern about future attacks leading to avoidance
of exercise. Best diagnosis?
A. Specific Phobia
B. Panic Disorder
C. Generalized Anxiety Disorder
D. Agoraphobia
Correct Answer: B
Rationale: Recurrent unexpected panic attacks and subsequent
persistent concern/behavior change for ≥1 month defines panic
disorder. Avoidance of exercise is common due to fear of panic
triggers; agoraphobia requires marked fear/avoidance of
specific situations like public spaces.
Q3. An 8-year-old with restricted interests, poor peer
reciprocity, repetitive hand flapping, and average language
development—what is the most likely diagnosis?
,A. Social (Pragmatic) Communication Disorder
B. Autism Spectrum Disorder
C. Intellectual Disability
D. ADHD, Combined Presentation
Correct Answer: B
Rationale: Repetitive behaviors, restricted interests, and deficits
in social reciprocity meet ASD criteria. Average language and
cognition do not preclude ASD; Social Communication Disorder
lacks restricted/repetitive behaviors.
Q4. A 68-year-old with fluctuating attention and disorganized
thinking over 48 hours after surgery—how should this be
classified?
A. Major Neurocognitive Disorder due to Alzheimer's disease
B. Mild Neurocognitive Disorder
C. Delirium
D. Medication-induced psychotic disorder
Correct Answer: C
Rationale: Acute onset, fluctuating course, inattention, and
disorganized thinking after a medical event are characteristic of
delirium (distinguishes it from NCDs which have insidious onset
and stable course).
Q5. A 30-year-old reports two weeks of low energy,
hypersomnia, increased appetite, weight gain, leaden paralysis,
, and rejection sensitivity for years. Which diagnosis best
accounts for both current and long-standing features?
A. Major Depressive Disorder with atypical features
B. Persistent Depressive Disorder (with intermittent major
depressive episodes)
C. Cyclothymic Disorder
D. Bipolar II Disorder
Correct Answer: B
Rationale: Chronic interpersonal sensitivity and long-term
depressive symptoms with intermittent major episodes fit
persistent depressive disorder (dysthymia) with pure dysthymic
or intermittent major episodes; atypical features describe
episodic presentation only, not chronicity.
Q6. A teenager presents after a motor vehicle accident with
intrusive memories, nightmares, hypervigilance, avoidance of
reminders, and difficulty concentrating for 4 weeks. Diagnosis?
A. Adjustment Disorder with anxiety
B. Acute Stress Disorder
C. Posttraumatic Stress Disorder
D. Dissociative Amnesia
Correct Answer: B
Rationale: Symptoms beginning after trauma and present for
less than one month (4 weeks) are consistent with acute stress
disorder; PTSD requires symptoms for >1 month.
Chamberlain PMHNP Differential Diagnosis
Across the Lifespan | 50 Graduate-Level
Questions & Answers | Nursing Exam Prep
Guide
Q1. A 28-year-old graduate student reports a 3-week history of
depressed mood, insomnia, poor concentration, and thoughts
that life is “meaningless.” He had a similar 2-week episode 6
months ago. No history of mania or hypomania. Which
diagnosis best fits?
A. Major Depressive Disorder, single episode
B. Persistent Depressive Disorder (Dysthymia)
C. Recurrent Major Depressive Disorder
D. Cyclothymic Disorder
Correct Answer: C
Rationale: Two discrete episodes of depressive symptoms
,separated by a symptom-free interval suggest recurrent MDD.
Duration (≥2 weeks) and symptom severity point to MDD rather
than persistent depressive disorder (which requires ≥2 years of
chronic, less severe symptoms). No hypomania/mania excludes
bipolar/cyclothymia.
Q2. A 45-year-old presents with episodic palpitations, sweating,
fear of dying, and derealization occurring unexpectedly for 3
months with concern about future attacks leading to avoidance
of exercise. Best diagnosis?
A. Specific Phobia
B. Panic Disorder
C. Generalized Anxiety Disorder
D. Agoraphobia
Correct Answer: B
Rationale: Recurrent unexpected panic attacks and subsequent
persistent concern/behavior change for ≥1 month defines panic
disorder. Avoidance of exercise is common due to fear of panic
triggers; agoraphobia requires marked fear/avoidance of
specific situations like public spaces.
Q3. An 8-year-old with restricted interests, poor peer
reciprocity, repetitive hand flapping, and average language
development—what is the most likely diagnosis?
,A. Social (Pragmatic) Communication Disorder
B. Autism Spectrum Disorder
C. Intellectual Disability
D. ADHD, Combined Presentation
Correct Answer: B
Rationale: Repetitive behaviors, restricted interests, and deficits
in social reciprocity meet ASD criteria. Average language and
cognition do not preclude ASD; Social Communication Disorder
lacks restricted/repetitive behaviors.
Q4. A 68-year-old with fluctuating attention and disorganized
thinking over 48 hours after surgery—how should this be
classified?
A. Major Neurocognitive Disorder due to Alzheimer's disease
B. Mild Neurocognitive Disorder
C. Delirium
D. Medication-induced psychotic disorder
Correct Answer: C
Rationale: Acute onset, fluctuating course, inattention, and
disorganized thinking after a medical event are characteristic of
delirium (distinguishes it from NCDs which have insidious onset
and stable course).
Q5. A 30-year-old reports two weeks of low energy,
hypersomnia, increased appetite, weight gain, leaden paralysis,
, and rejection sensitivity for years. Which diagnosis best
accounts for both current and long-standing features?
A. Major Depressive Disorder with atypical features
B. Persistent Depressive Disorder (with intermittent major
depressive episodes)
C. Cyclothymic Disorder
D. Bipolar II Disorder
Correct Answer: B
Rationale: Chronic interpersonal sensitivity and long-term
depressive symptoms with intermittent major episodes fit
persistent depressive disorder (dysthymia) with pure dysthymic
or intermittent major episodes; atypical features describe
episodic presentation only, not chronicity.
Q6. A teenager presents after a motor vehicle accident with
intrusive memories, nightmares, hypervigilance, avoidance of
reminders, and difficulty concentrating for 4 weeks. Diagnosis?
A. Adjustment Disorder with anxiety
B. Acute Stress Disorder
C. Posttraumatic Stress Disorder
D. Dissociative Amnesia
Correct Answer: B
Rationale: Symptoms beginning after trauma and present for
less than one month (4 weeks) are consistent with acute stress
disorder; PTSD requires symptoms for >1 month.
