NR 547 Final Exam Test Bank 2025/2026
| Chamberlain PMHNP Differential
Diagnosis Across the Lifespan | 50
Graduate-Level Questions & Answers |
Nursing Exam Prep Guide
Q1. A 28-year-old woman presents with 6 weeks of pervasive
depressed mood, anhedonia, significant weight loss, early
morning awakening, and excessive guilt. She reports previous
hypomanic episodes lasting 4 days each that did not cause
marked impairment. Which diagnosis best fits?
A. Major Depressive Disorder, single episode
B. Bipolar II Disorder, current episode depressed
C. Cyclothymic Disorder
D. Persistent Depressive Disorder (dysthymia)
Correct Answer: B
Rationale: History of hypomanic episodes (≥4 days, not fully
,impairing) plus current major depressive episode meets Bipolar
II per DSM-5-TR. MDD lacks hypomanic history; cyclothymia
involves ≥2 years of subthreshold mood swings; dysthymia is
chronic subthreshold depression for ≥2 years.
Q2. A 63-year-old man has progressive memory decline for 18
months with impaired episodic memory, visuospatial deficits,
and preserved attention early on. Neurological exam shows no
fluctuation, and symptoms progressed gradually. Most likely
diagnosis?
A. Major Neurocognitive Disorder due to Alzheimer's disease
B. Major Neurocognitive Disorder due to Lewy body disease
C. Mild Neurocognitive Disorder due to Vascular disease
D. Delirium
Correct Answer: A
Rationale: Gradual progressive episodic memory impairment
and visuospatial deficits are typical early Alzheimer’s. Lewy
body disease shows early visual hallucinations, REM sleep
behavior, and fluctuating cognition. Vascular NCD often shows
stepwise deficits and focal signs. Delirium is acute, fluctuating.
Q3. A 9-year-old boy exhibits inattentiveness in class for 8
months, difficulty sustaining attention, careless mistakes, and
poor organization; symptoms present across home and school.
No hyperactivity. Best diagnosis?
A. ADHD, predominantly inattentive presentation
B. Autism Spectrum Disorder
, C. Specific Learning Disorder
D. Oppositional Defiant Disorder
Correct Answer: A
Rationale: ADHD requires ≥6 months of symptoms present in
multiple settings with onset by childhood; inattentive
presentation fits. ASD presents with social communication
deficits and restricted interests. Specific learning disorder
targets academic skill impairment, not global attention. ODD
involves defiant behavior.
Q4. A 45-year-old patient reports sudden episodes of intense
fear with palpitations, derealization, trembling, and fear of
dying occurring unpredictably for 3 months. She avoids driving
for fear of having a panic attack while alone. Diagnosis?
A. Panic Disorder without agoraphobia
B. Panic Disorder with agoraphobia
C. Specific Phobia
D. Generalized Anxiety Disorder
Correct Answer: B
Rationale: Recurrent unexpected panic attacks plus persistent
concern and avoidance behaviors (avoiding driving) indicates
Panic Disorder with agoraphobia per DSM-5-TR. Specific phobia
has circumscribed triggers; GAD is chronic worry without
discrete panic attacks.
Q5. A 23-year-old man hears running commentary voices that
comment on his actions, has disorganized speech, social
| Chamberlain PMHNP Differential
Diagnosis Across the Lifespan | 50
Graduate-Level Questions & Answers |
Nursing Exam Prep Guide
Q1. A 28-year-old woman presents with 6 weeks of pervasive
depressed mood, anhedonia, significant weight loss, early
morning awakening, and excessive guilt. She reports previous
hypomanic episodes lasting 4 days each that did not cause
marked impairment. Which diagnosis best fits?
A. Major Depressive Disorder, single episode
B. Bipolar II Disorder, current episode depressed
C. Cyclothymic Disorder
D. Persistent Depressive Disorder (dysthymia)
Correct Answer: B
Rationale: History of hypomanic episodes (≥4 days, not fully
,impairing) plus current major depressive episode meets Bipolar
II per DSM-5-TR. MDD lacks hypomanic history; cyclothymia
involves ≥2 years of subthreshold mood swings; dysthymia is
chronic subthreshold depression for ≥2 years.
Q2. A 63-year-old man has progressive memory decline for 18
months with impaired episodic memory, visuospatial deficits,
and preserved attention early on. Neurological exam shows no
fluctuation, and symptoms progressed gradually. Most likely
diagnosis?
A. Major Neurocognitive Disorder due to Alzheimer's disease
B. Major Neurocognitive Disorder due to Lewy body disease
C. Mild Neurocognitive Disorder due to Vascular disease
D. Delirium
Correct Answer: A
Rationale: Gradual progressive episodic memory impairment
and visuospatial deficits are typical early Alzheimer’s. Lewy
body disease shows early visual hallucinations, REM sleep
behavior, and fluctuating cognition. Vascular NCD often shows
stepwise deficits and focal signs. Delirium is acute, fluctuating.
Q3. A 9-year-old boy exhibits inattentiveness in class for 8
months, difficulty sustaining attention, careless mistakes, and
poor organization; symptoms present across home and school.
No hyperactivity. Best diagnosis?
A. ADHD, predominantly inattentive presentation
B. Autism Spectrum Disorder
, C. Specific Learning Disorder
D. Oppositional Defiant Disorder
Correct Answer: A
Rationale: ADHD requires ≥6 months of symptoms present in
multiple settings with onset by childhood; inattentive
presentation fits. ASD presents with social communication
deficits and restricted interests. Specific learning disorder
targets academic skill impairment, not global attention. ODD
involves defiant behavior.
Q4. A 45-year-old patient reports sudden episodes of intense
fear with palpitations, derealization, trembling, and fear of
dying occurring unpredictably for 3 months. She avoids driving
for fear of having a panic attack while alone. Diagnosis?
A. Panic Disorder without agoraphobia
B. Panic Disorder with agoraphobia
C. Specific Phobia
D. Generalized Anxiety Disorder
Correct Answer: B
Rationale: Recurrent unexpected panic attacks plus persistent
concern and avoidance behaviors (avoiding driving) indicates
Panic Disorder with agoraphobia per DSM-5-TR. Specific phobia
has circumscribed triggers; GAD is chronic worry without
discrete panic attacks.
Q5. A 23-year-old man hears running commentary voices that
comment on his actions, has disorganized speech, social
