NR 547 MIDTERM EXAM 2025-2026 ACTUAL EXAM TEST BANK 200
QUESTIONS AND CORRECT DETAILED ANSWERS
differential diagnosis -CORRECT ANSWER The provider's initial hypothesis
-a working list of potential problems that can be associated with the initial or
chief complaint
-Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)
• provides guidance for identifying psychiatric diagnoses
Psychiatric assessment: History taking -CORRECT ANSWER -History of
Present Illness
-How long have you been feeling this way?
-Did something happen in your life that may have triggered these emotions?
-How is this current situation impacting your life?
The Psychiatric History
-Have you ever been hospitalized for any mental health issues?
-Have you ever had counseling or psychotherapy?
-Have you ever taken medications for your mental health in the past?
-Are you currently on any medications for mental health or sleep?
Medical History/Screening for General Medical Conditions
-Do you have a primary care provider?
-Do you have any medical illnesses?
-Are you currently taking any medications or herbal supplements?
-Do you have any allergies to medications?
-Have you ever been hospitalized for any reason?
,-Have you ever had surgery?
Family Psychiatric History
-Has any relative of yours ever been hospitalized for a mental health issue?
-Has any blood relative of yours ever been diagnosed with a mental health
issue?
-Has any blood relative of yours had a history of seizures or
dementia/Alzheimer's?
Social and Developmental History
-Tell me a little bit about your childhood and how you grew up.
-How was your experience in school when you were younger? Did you enjoy
school?
-How do you support yourself with your finances?
-Do you have a good support system? Are you currently in a relationship?
Where do you live? Who do you live with?
-What do you do in your free time? What activities do you enjoy?
Screening and Psychiatric Rating Scales -CORRECT ANSWER Evidence-
based screening tools and psychiatric rating scales
-can help the provider identify symptoms and assess their severity and can assist
with the evaluation of response to treatment
A 52-year-old client presents to the emergency department following a car
accident. The emergency department (ED) physician is concerned that the client
may have intentionally crashed her car and requests a stat PMHNP consult. In
speaking with the PMHNP, the client describes persistent feelings of sadness
and hopelessness. She states that she often wonders if her husband would be
happier if she wasn't around anymore since she's never happy and sometimes
thinks about what it would be like to just take a handful of sleeping pills and go
,to sleep forever. The client reports a previous suicide attempt when she was 16
but denies that she is considering killing herself right now.
Based on the client's ASQ score, what is the most appropriate response?
No action is necessary as the client is not currently considering suicide.
Provide a brief suicide safety assessment.
Alert the client's primary care physician.
Provide a ST -CORRECT ANSWER Provide a brief suicide safety assessment.
Rationale: While the client's responses do not indicate a need for a stat full
safety and mental health evaluation, the client requires a brief suicide safety
assessment to determine whether a full mental health evaluation in necessary. It
is also important to notify the client's physician or the clinician responsible for
the client's care.
Diagnostic Testing when diagnosing mental health disorders -CORRECT
ANSWER -Diagnostic tests and labs are most used to rule out physical
conditions that may cause psychiatric symptoms and to evaluate the effects of
treatment
Basic Laboratory Interpretation -CORRECT ANSWER Complete Blood
Count
Comprehensive Metabolic Panel (CMP)
Thyroid Function Tests
Vitamin B12 Level
Vitamin D Level
Toxicology Screen
Urinalysis (UA)
, Basic Laboratory Interpretation: Complete Blood Count -CORRECT
ANSWER -measures RBCs, WBCs, hemoglobin, hematocrit, and platelets
-includes a differential of the WBCs
-In mental health, the CBC is used to rule out medical conditions that may
present with symptoms that can be attributed to both medical and psychiatric
diagnoses
• Ex: rule out anemia as a cause for depressive symptoms and fatigue
• Ex: rule out infection as a cause of acute mental status changes
RBCs: 4.5-6.0 million/microliter
Hemoglobin: 12-18 grams/100 mL
Hematocrit: 38%-48%
Reticulocytes: 0%-1.5%
WBCs (total): 5000-10,000/microliter
Neutrophils: 55%-70%
Eosinophils: 1%-3%
Basophils: 0.5%-1%
Lymphocytes: 20%-35%
Monocytes: 3%-8%
Platelets: 150,000-300,000/microliter
Basic Laboratory Interpretation: Comprehensive Metabolic Panel (CMP) -
CORRECT ANSWER common blood test used to determine general health
status
-fluid and electrolyte balance, status of the body's metabolism, liver function,
and kidney function
-used to monitor the effects of medications, such as antipsychotics, on liver
function and glucose levels
QUESTIONS AND CORRECT DETAILED ANSWERS
differential diagnosis -CORRECT ANSWER The provider's initial hypothesis
-a working list of potential problems that can be associated with the initial or
chief complaint
-Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)
• provides guidance for identifying psychiatric diagnoses
Psychiatric assessment: History taking -CORRECT ANSWER -History of
Present Illness
-How long have you been feeling this way?
-Did something happen in your life that may have triggered these emotions?
-How is this current situation impacting your life?
The Psychiatric History
-Have you ever been hospitalized for any mental health issues?
-Have you ever had counseling or psychotherapy?
-Have you ever taken medications for your mental health in the past?
-Are you currently on any medications for mental health or sleep?
Medical History/Screening for General Medical Conditions
-Do you have a primary care provider?
-Do you have any medical illnesses?
-Are you currently taking any medications or herbal supplements?
-Do you have any allergies to medications?
-Have you ever been hospitalized for any reason?
,-Have you ever had surgery?
Family Psychiatric History
-Has any relative of yours ever been hospitalized for a mental health issue?
-Has any blood relative of yours ever been diagnosed with a mental health
issue?
-Has any blood relative of yours had a history of seizures or
dementia/Alzheimer's?
Social and Developmental History
-Tell me a little bit about your childhood and how you grew up.
-How was your experience in school when you were younger? Did you enjoy
school?
-How do you support yourself with your finances?
-Do you have a good support system? Are you currently in a relationship?
Where do you live? Who do you live with?
-What do you do in your free time? What activities do you enjoy?
Screening and Psychiatric Rating Scales -CORRECT ANSWER Evidence-
based screening tools and psychiatric rating scales
-can help the provider identify symptoms and assess their severity and can assist
with the evaluation of response to treatment
A 52-year-old client presents to the emergency department following a car
accident. The emergency department (ED) physician is concerned that the client
may have intentionally crashed her car and requests a stat PMHNP consult. In
speaking with the PMHNP, the client describes persistent feelings of sadness
and hopelessness. She states that she often wonders if her husband would be
happier if she wasn't around anymore since she's never happy and sometimes
thinks about what it would be like to just take a handful of sleeping pills and go
,to sleep forever. The client reports a previous suicide attempt when she was 16
but denies that she is considering killing herself right now.
Based on the client's ASQ score, what is the most appropriate response?
No action is necessary as the client is not currently considering suicide.
Provide a brief suicide safety assessment.
Alert the client's primary care physician.
Provide a ST -CORRECT ANSWER Provide a brief suicide safety assessment.
Rationale: While the client's responses do not indicate a need for a stat full
safety and mental health evaluation, the client requires a brief suicide safety
assessment to determine whether a full mental health evaluation in necessary. It
is also important to notify the client's physician or the clinician responsible for
the client's care.
Diagnostic Testing when diagnosing mental health disorders -CORRECT
ANSWER -Diagnostic tests and labs are most used to rule out physical
conditions that may cause psychiatric symptoms and to evaluate the effects of
treatment
Basic Laboratory Interpretation -CORRECT ANSWER Complete Blood
Count
Comprehensive Metabolic Panel (CMP)
Thyroid Function Tests
Vitamin B12 Level
Vitamin D Level
Toxicology Screen
Urinalysis (UA)
, Basic Laboratory Interpretation: Complete Blood Count -CORRECT
ANSWER -measures RBCs, WBCs, hemoglobin, hematocrit, and platelets
-includes a differential of the WBCs
-In mental health, the CBC is used to rule out medical conditions that may
present with symptoms that can be attributed to both medical and psychiatric
diagnoses
• Ex: rule out anemia as a cause for depressive symptoms and fatigue
• Ex: rule out infection as a cause of acute mental status changes
RBCs: 4.5-6.0 million/microliter
Hemoglobin: 12-18 grams/100 mL
Hematocrit: 38%-48%
Reticulocytes: 0%-1.5%
WBCs (total): 5000-10,000/microliter
Neutrophils: 55%-70%
Eosinophils: 1%-3%
Basophils: 0.5%-1%
Lymphocytes: 20%-35%
Monocytes: 3%-8%
Platelets: 150,000-300,000/microliter
Basic Laboratory Interpretation: Comprehensive Metabolic Panel (CMP) -
CORRECT ANSWER common blood test used to determine general health
status
-fluid and electrolyte balance, status of the body's metabolism, liver function,
and kidney function
-used to monitor the effects of medications, such as antipsychotics, on liver
function and glucose levels
