NR 547 Final Exam Test Bank 2025/2026
| Chamberlain PMHNP Differential
Diagnosis Across the Lifespan | 50
Graduate-Level Questions & Answers |
Psychiatric Nursing Prep Guide
Q1. A 28-year-old presents with a 10-day history of depressed
mood, anhedonia, insomnia, decreased appetite, poor
concentration, and passive thoughts that life is “not worth
living,” causing marked occupational impairment. There is no
prior history of mania or hypomania. Which diagnosis is most
appropriate?
A. Major Depressive Disorder, single episode, moderate
B. Persistent Depressive Disorder (Dysthymia)
C. Bipolar II Disorder, current depressive episode
D. Adjustment Disorder with depressed mood
,Correct Answer: A
Rationale: Symptoms meet DSM-5-TR criteria for a Major
Depressive Episode (≥2 weeks, core symptoms plus functional
impairment) with no history of hypomania/mania, making MDD
most appropriate; dysthymia requires ≥2 years of chronic low
mood; bipolar requires hypomanic history; adjustment disorder
has onset tied to identifiable stressor and is less severe.
Q2. A 17-year-old reports episodes of sudden palpitations,
sweating, derealization, and fear of “losing control” lasting 20–
30 minutes, with worry about future attacks leading to
avoidance of social situations. What diagnosis best fits?
A. Specific phobia
B. Panic disorder with agoraphobia
C. Social anxiety disorder (social phobia)
D. Generalized anxiety disorder
Correct Answer: B
Rationale: Recurrent unexpected panic attacks and persistent
concern/behavioral change (avoidance) following attacks define
panic disorder with expected agoraphobia; social anxiety is
anxiety limited to social situations; GAD involves pervasive
excessive worry >6 months without discrete panic attacks.
Q3. A 35-year-old veteran has intrusive memories, nightmares,
hypervigilance, exaggerated startle, and avoidance of reminders
for 8 weeks after a combat-related traumatic event. Which is
the most accurate DSM-5-TR diagnosis?
, A. Acute Stress Disorder
B. Posttraumatic Stress Disorder
C. Adjustment Disorder with anxiety
D. Major Depressive Disorder
Correct Answer: B
Rationale: Persistent PTSD requires symptoms lasting >1 month
with intrusion, avoidance, negative alterations, and
hyperarousal; acute stress disorder is ≤1 month; adjustment
disorder lacks the specific intrusion and hyperarousal cluster.
Q4. A 23-year-old reports 3 months of persecutory delusions
and disorganized speech but preserved social and occupational
functioning until 6 weeks ago, when decline began. No mood
symptoms. Best diagnosis?
A. Schizophrenia
B. Schizophreniform disorder
C. Schizoaffective disorder
D. Brief psychotic disorder
Correct Answer: B
Rationale: Psychotic symptoms present >1 month but <6
months fits schizophreniform; schizophrenia requires ≥6
months; schizoaffective requires mood episode concurrent with
psychosis; brief psychotic disorder is <1 month.
Q5. An 82-year-old hospitalized patient shows fluctuating
attention, disorientation, and visual hallucinations over 48
hours after a UTI. Which diagnosis is most likely?
| Chamberlain PMHNP Differential
Diagnosis Across the Lifespan | 50
Graduate-Level Questions & Answers |
Psychiatric Nursing Prep Guide
Q1. A 28-year-old presents with a 10-day history of depressed
mood, anhedonia, insomnia, decreased appetite, poor
concentration, and passive thoughts that life is “not worth
living,” causing marked occupational impairment. There is no
prior history of mania or hypomania. Which diagnosis is most
appropriate?
A. Major Depressive Disorder, single episode, moderate
B. Persistent Depressive Disorder (Dysthymia)
C. Bipolar II Disorder, current depressive episode
D. Adjustment Disorder with depressed mood
,Correct Answer: A
Rationale: Symptoms meet DSM-5-TR criteria for a Major
Depressive Episode (≥2 weeks, core symptoms plus functional
impairment) with no history of hypomania/mania, making MDD
most appropriate; dysthymia requires ≥2 years of chronic low
mood; bipolar requires hypomanic history; adjustment disorder
has onset tied to identifiable stressor and is less severe.
Q2. A 17-year-old reports episodes of sudden palpitations,
sweating, derealization, and fear of “losing control” lasting 20–
30 minutes, with worry about future attacks leading to
avoidance of social situations. What diagnosis best fits?
A. Specific phobia
B. Panic disorder with agoraphobia
C. Social anxiety disorder (social phobia)
D. Generalized anxiety disorder
Correct Answer: B
Rationale: Recurrent unexpected panic attacks and persistent
concern/behavioral change (avoidance) following attacks define
panic disorder with expected agoraphobia; social anxiety is
anxiety limited to social situations; GAD involves pervasive
excessive worry >6 months without discrete panic attacks.
Q3. A 35-year-old veteran has intrusive memories, nightmares,
hypervigilance, exaggerated startle, and avoidance of reminders
for 8 weeks after a combat-related traumatic event. Which is
the most accurate DSM-5-TR diagnosis?
, A. Acute Stress Disorder
B. Posttraumatic Stress Disorder
C. Adjustment Disorder with anxiety
D. Major Depressive Disorder
Correct Answer: B
Rationale: Persistent PTSD requires symptoms lasting >1 month
with intrusion, avoidance, negative alterations, and
hyperarousal; acute stress disorder is ≤1 month; adjustment
disorder lacks the specific intrusion and hyperarousal cluster.
Q4. A 23-year-old reports 3 months of persecutory delusions
and disorganized speech but preserved social and occupational
functioning until 6 weeks ago, when decline began. No mood
symptoms. Best diagnosis?
A. Schizophrenia
B. Schizophreniform disorder
C. Schizoaffective disorder
D. Brief psychotic disorder
Correct Answer: B
Rationale: Psychotic symptoms present >1 month but <6
months fits schizophreniform; schizophrenia requires ≥6
months; schizoaffective requires mood episode concurrent with
psychosis; brief psychotic disorder is <1 month.
Q5. An 82-year-old hospitalized patient shows fluctuating
attention, disorientation, and visual hallucinations over 48
hours after a UTI. Which diagnosis is most likely?
