NRNP 6635 Psychopathology and
Diagnostic Reasoning – Midterm
Exam – Walden University (2025/2026)
complete exam material
Section 1: Foundations of Psychopathology & Diagnostic
Reasoning (20 Questions)
1. What is the first step in creating a differential diagnosis for psychiatric symptoms?
Rule out malingering or factitious disorder
Rationale: DSM-5-TR prioritizes assessing intentional symptom production (malingering for
external gain, factitious for attention) before other etiologies.
2. What defines a substance/medication-induced psychiatric disorder?
Symptoms resolve within 1 month of substance cessation
Rationale: Persistence beyond 1 month suggests an independent psychiatric disorder. (Module 1:
DSM-5-TR p. 21).
3. What is required to attribute psychiatric symptoms to a medical condition?
Temporal relationship; symptoms improve with medical treatment
Rationale: E.g., hypothyroidism causing depression; TSH testing and treatment response guide
diagnosis. (Module 1).
4. Which factors are considered social determinants of health (SDOH)?
Economic stability, education access, healthcare access, neighborhood environment
Rationale: SDOH influence mental health outcomes; PMHNPs advocate for resource access.
(Module 1: Healthy People 2030).
, 5. What is a key question in the history of present illness (HPI) during a psychiatric
interview?
How long have you been feeling this way?
Rationale: Captures onset, duration, and triggers; essential for diagnostic timeline. (Module 1:
Kaplan & Sadock).
6. What components are included in a psychiatric history?
Past hospitalizations, counseling, family psychiatric history
Rationale: Comprehensive history informs risk (e.g., family history of schizophrenia). (Module
1).
7. What is the purpose of the Brief Psychiatric Rating Scale (BPRS)?
Assess schizophrenia symptom severity
Rationale: 18-item clinician-rated scale; evaluates positive/negative symptoms. (Module 1).
8. What does the Calgary Depression Scale for Schizophrenia (CDSS) measure?
Depression in schizophrenia patients
Rationale: 9-item scale distinguishes depression from negative symptoms. (Module 1).
9. What is a key ethical principle for PMHNPs in diagnostic reasoning?
Autonomy, beneficence, nonmaleficence, justice
Rationale: Guides informed consent, confidentiality, and duty to warn (Tarasoff). (Module 1).
10. What labs help rule out medical causes of psychiatric symptoms?
TSH, B12, folate, CBC, urine toxicology
Rationale: Hypothyroidism, B12 deficiency, or substances mimic psychosis/depression.
(Module 1).
11. What is the goal of the Mental Status Exam (MSE)?
Assess appearance, mood, thought process, cognition, insight
Rationale: Provides a snapshot of mental state; informs differential diagnosis. (Module 1).
Diagnostic Reasoning – Midterm
Exam – Walden University (2025/2026)
complete exam material
Section 1: Foundations of Psychopathology & Diagnostic
Reasoning (20 Questions)
1. What is the first step in creating a differential diagnosis for psychiatric symptoms?
Rule out malingering or factitious disorder
Rationale: DSM-5-TR prioritizes assessing intentional symptom production (malingering for
external gain, factitious for attention) before other etiologies.
2. What defines a substance/medication-induced psychiatric disorder?
Symptoms resolve within 1 month of substance cessation
Rationale: Persistence beyond 1 month suggests an independent psychiatric disorder. (Module 1:
DSM-5-TR p. 21).
3. What is required to attribute psychiatric symptoms to a medical condition?
Temporal relationship; symptoms improve with medical treatment
Rationale: E.g., hypothyroidism causing depression; TSH testing and treatment response guide
diagnosis. (Module 1).
4. Which factors are considered social determinants of health (SDOH)?
Economic stability, education access, healthcare access, neighborhood environment
Rationale: SDOH influence mental health outcomes; PMHNPs advocate for resource access.
(Module 1: Healthy People 2030).
, 5. What is a key question in the history of present illness (HPI) during a psychiatric
interview?
How long have you been feeling this way?
Rationale: Captures onset, duration, and triggers; essential for diagnostic timeline. (Module 1:
Kaplan & Sadock).
6. What components are included in a psychiatric history?
Past hospitalizations, counseling, family psychiatric history
Rationale: Comprehensive history informs risk (e.g., family history of schizophrenia). (Module
1).
7. What is the purpose of the Brief Psychiatric Rating Scale (BPRS)?
Assess schizophrenia symptom severity
Rationale: 18-item clinician-rated scale; evaluates positive/negative symptoms. (Module 1).
8. What does the Calgary Depression Scale for Schizophrenia (CDSS) measure?
Depression in schizophrenia patients
Rationale: 9-item scale distinguishes depression from negative symptoms. (Module 1).
9. What is a key ethical principle for PMHNPs in diagnostic reasoning?
Autonomy, beneficence, nonmaleficence, justice
Rationale: Guides informed consent, confidentiality, and duty to warn (Tarasoff). (Module 1).
10. What labs help rule out medical causes of psychiatric symptoms?
TSH, B12, folate, CBC, urine toxicology
Rationale: Hypothyroidism, B12 deficiency, or substances mimic psychosis/depression.
(Module 1).
11. What is the goal of the Mental Status Exam (MSE)?
Assess appearance, mood, thought process, cognition, insight
Rationale: Provides a snapshot of mental state; informs differential diagnosis. (Module 1).
