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 presents with 6 weeks of depressed mood,
anhedonia, sleep disturbance, low energy, and difficulty
concentrating. No history of mania or hypomania. Symptoms
began after job loss but persist daily, causing marked
impairment. Which diagnosis best fits?
A. Major Depressive Disorder, single episode
B. Adjustment disorder with depressed mood
C. Persistent Depressive Disorder (Dysthymia)
D. Bipolar II disorder
Correct Answer: A
Rationale: Duration (≥2 weeks), symptom cluster and marked
,functional impairment without prior hypomanic/manic
episodes fit DSM-5-TR criteria for Major Depressive Disorder.
Adjustment disorder is typically <6 months and proportional to
stressor; Persistent Depressive Disorder requires ≥2 years
duration.
Q2. A 45-year-old reports excessive worry most days for the
past 10 months about work, finances, and health, with difficulty
controlling the worry, muscle tension, and sleep disturbance.
No panic attacks, no specific phobias. Which is the most likely
diagnosis?
A. Generalized Anxiety Disorder (GAD)
B. Adjustment disorder with anxiety
C. Panic disorder
D. Social anxiety disorder
Correct Answer: A
Rationale: Worry present more days than not for ≥6 months
with associated symptoms (muscle tension, sleep disturbance)
and difficulty controlling worry meet DSM-5-TR criteria for GAD;
other options do not match chronic, generalized worry.
Q3. A 9-year-old boy exhibits inattention, fails to follow
instructions at school, loses items, and is often forgetful for 10
months. Symptoms are present at home and school and cause
academic decline. No hyperactivity. Best diagnosis?
,A. ADHD, Predominantly Inattentive Presentation
B. Specific learning disorder
C. Autism spectrum disorder
D. Oppositional defiant disorder
Correct Answer: A
Rationale: DSM-5-TR requires symptoms in ≥2 settings, duration
≥6 months, and impairment; primarily inattentive presentation
fits. Learning disorder targets specific academic skills; ASD has
social communication deficits and restricted/repetitive
behaviors.
Q4. A 65-year-old develops disorientation, fluctuating attention,
and hallucinations after urinary tract infection and initiation of
high-dose opioids. Which diagnosis is most appropriate?
A. Major neurocognitive disorder due to Alzheimer’s disease
B. Delirium
C. Mild neurocognitive disorder
D. Schizophrenia, late onset
Correct Answer: B
Rationale: Acute onset, fluctuating consciousness, attentional
disturbance, perceptual disturbances, and known precipitating
medical/medication cause align with DSM-5-TR delirium rather
than chronic neurocognitive disorders.
, Q5. A 22-year-old reports 3 months of recurrent intrusive
memories, nightmares, hypervigilance, avoidance, and negative
mood after surviving a sexual assault. Symptoms began
immediately after the event and cause marked impairment.
What is the best diagnosis?
A. Acute stress disorder
B. Posttraumatic stress disorder (PTSD)
C. Adjustment disorder with disturbance of conduct
D. Major depressive disorder
Correct Answer: B
Rationale: Symptoms persisting >1 month with intrusion,
avoidance, negative alterations, and hyperarousal after trauma
meet DSM-5-TR criteria for PTSD. Acute stress disorder is
diagnosed when symptoms last 3 days to 1 month.
Q6. A 34-year-old reports episodes of intense fear peaking
within 10 minutes, with palpitations, sweating, and fear of
losing control, occurring unexpectedly and causing worry about
future attacks for the past 4 months. Best diagnosis?
A. Generalized Anxiety Disorder
B. Panic disorder
C. Agoraphobia
D. Specific phobia
Correct Answer: B
Rationale: Recurrent unexpected panic attacks with ongoing
Chamberlain PMHNP Differential Diagnosis
Across the Lifespan | 50 Graduate-Level
Questions & Answers | Nursing Exam Prep
Guide
Q1. A 28-year-old presents with 6 weeks of depressed mood,
anhedonia, sleep disturbance, low energy, and difficulty
concentrating. No history of mania or hypomania. Symptoms
began after job loss but persist daily, causing marked
impairment. Which diagnosis best fits?
A. Major Depressive Disorder, single episode
B. Adjustment disorder with depressed mood
C. Persistent Depressive Disorder (Dysthymia)
D. Bipolar II disorder
Correct Answer: A
Rationale: Duration (≥2 weeks), symptom cluster and marked
,functional impairment without prior hypomanic/manic
episodes fit DSM-5-TR criteria for Major Depressive Disorder.
Adjustment disorder is typically <6 months and proportional to
stressor; Persistent Depressive Disorder requires ≥2 years
duration.
Q2. A 45-year-old reports excessive worry most days for the
past 10 months about work, finances, and health, with difficulty
controlling the worry, muscle tension, and sleep disturbance.
No panic attacks, no specific phobias. Which is the most likely
diagnosis?
A. Generalized Anxiety Disorder (GAD)
B. Adjustment disorder with anxiety
C. Panic disorder
D. Social anxiety disorder
Correct Answer: A
Rationale: Worry present more days than not for ≥6 months
with associated symptoms (muscle tension, sleep disturbance)
and difficulty controlling worry meet DSM-5-TR criteria for GAD;
other options do not match chronic, generalized worry.
Q3. A 9-year-old boy exhibits inattention, fails to follow
instructions at school, loses items, and is often forgetful for 10
months. Symptoms are present at home and school and cause
academic decline. No hyperactivity. Best diagnosis?
,A. ADHD, Predominantly Inattentive Presentation
B. Specific learning disorder
C. Autism spectrum disorder
D. Oppositional defiant disorder
Correct Answer: A
Rationale: DSM-5-TR requires symptoms in ≥2 settings, duration
≥6 months, and impairment; primarily inattentive presentation
fits. Learning disorder targets specific academic skills; ASD has
social communication deficits and restricted/repetitive
behaviors.
Q4. A 65-year-old develops disorientation, fluctuating attention,
and hallucinations after urinary tract infection and initiation of
high-dose opioids. Which diagnosis is most appropriate?
A. Major neurocognitive disorder due to Alzheimer’s disease
B. Delirium
C. Mild neurocognitive disorder
D. Schizophrenia, late onset
Correct Answer: B
Rationale: Acute onset, fluctuating consciousness, attentional
disturbance, perceptual disturbances, and known precipitating
medical/medication cause align with DSM-5-TR delirium rather
than chronic neurocognitive disorders.
, Q5. A 22-year-old reports 3 months of recurrent intrusive
memories, nightmares, hypervigilance, avoidance, and negative
mood after surviving a sexual assault. Symptoms began
immediately after the event and cause marked impairment.
What is the best diagnosis?
A. Acute stress disorder
B. Posttraumatic stress disorder (PTSD)
C. Adjustment disorder with disturbance of conduct
D. Major depressive disorder
Correct Answer: B
Rationale: Symptoms persisting >1 month with intrusion,
avoidance, negative alterations, and hyperarousal after trauma
meet DSM-5-TR criteria for PTSD. Acute stress disorder is
diagnosed when symptoms last 3 days to 1 month.
Q6. A 34-year-old reports episodes of intense fear peaking
within 10 minutes, with palpitations, sweating, and fear of
losing control, occurring unexpectedly and causing worry about
future attacks for the past 4 months. Best diagnosis?
A. Generalized Anxiety Disorder
B. Panic disorder
C. Agoraphobia
D. Specific phobia
Correct Answer: B
Rationale: Recurrent unexpected panic attacks with ongoing
