FINAL EXAM: NR 547 (LATEST UPDATE
2026/2027) DIFFERENTIAL DIAGNOSIS IN
PSYCHIATRIC-MENTAL HEALTH ACROSS
THE LIFESPAN PRACTICUM, WITH
CORRECT/ACCURATE ANSWERS
AT CHAMBERLAIN COLLEGE OF NURSING
Question 1
Which statement is true regarding the treatment of personality disorders?
A. Personality disorders typically resolve within 1–2 years with medication alone
B. Most personality disorders respond rapidly to antidepressant therapy
C. Personality disorders are difficult to treat and often persist for decades
D. Personality disorders are caused primarily by neurotransmitter imbalance
Correct Answer: C
Rationale: Personality disorders represent enduring, inflexible patterns of behavior and inner experience that
deviate from cultural expectations. These disorders begin in adolescence or early adulthood and tend to be
chronic and pervasive. Treatment is challenging due to poor insight, maladaptive coping mechanisms, and
resistance to change. Psychotherapy—particularly dialectical behavior therapy (DBT) and psychodynamic
approaches—is the cornerstone of treatment, while medications are used only to manage symptoms, not cure
the disorder.
Question 2
Which statement is most accurate regarding rapid cycling in Bipolar I disorder?
A. Rapid cycling occurs more frequently in men
B. Rapid cycling is defined as one manic episode per year
C. Women have a higher rate of rapid cycling Bipolar I disorder
D. Rapid cycling is exclusive to Bipolar II disorder
Correct Answer: C
,Rationale: Rapid cycling is defined as four or more mood episodes within 12 months. Research
consistently shows a higher prevalence in women, often associated with hypothyroidism, antidepressant use,
and hormonal influences. Rapid cycling is associated with poorer prognosis and increased treatment
resistance.
Question 3
Which client with delirium would most likely require pharmacotherapeutic intervention?
A. A client with mild confusion that worsens at night
B. A client with fluctuating attention but calm behavior
C. A client who rapidly shifts from laughing to crying to anger
D. A client with short-term memory impairment only
Correct Answer: C
Rationale: Pharmacologic treatment for delirium is reserved for clients exhibiting severe agitation,
emotional lability, or behaviors that pose a risk to themselves or others. Rapid emotional shifts indicate
hyperactive delirium, which often requires short-term antipsychotic medication in addition to treating the
underlying cause.
Question 4
A client presents to the emergency department following a nonfatal suicide attempt. She reports intense fear
of abandonment, unstable relationships, emotional lability, and a history of cutting behaviors. Which is the
most likely diagnosis?
A. Bipolar I disorder
B. Major depressive disorder
C. Borderline personality disorder
D. Posttraumatic stress disorder
Correct Answer: C
Rationale: Borderline personality disorder is characterized by instability in mood, relationships, self-image,
and behavior. Key features include fear of abandonment, impulsivity, recurrent self-harm, emotional
dysregulation, and intense interpersonal conflict. These symptoms differentiate BPD from mood disorders.
Question 5
Which personality disorder is characterized by attention-seeking behavior, dramatic speech, and
exaggerated emotional expression?
,A. Narcissistic personality disorder
B. Borderline personality disorder
C. Histrionic personality disorder
D. Dependent personality disorder
Correct Answer: C
Rationale: Histrionic personality disorder involves excessive emotionality, attention-seeking behaviors,
suggestibility, and theatrical presentation. Clients may appear dramatic, flirtatious, and uncomfortable when
not the center of attention.
Question 6
A 50-year-old client presents with depressed mood, insomnia, and anhedonia following the recent filing of
divorce by her partner of 24 years. Symptoms began one month ago. What is the most appropriate
diagnosis?
A. Major depressive disorder
B. Persistent depressive disorder
C. Adjustment disorder with depressed mood
D. Normal grief reaction
Correct Answer: C
Rationale: Adjustment disorder occurs in response to an identifiable stressor within 3 months of onset.
Symptoms are distressing but do not meet full criteria for major depressive disorder and resolve once the
stressor or adaptation occurs.
Question 7
The use of which substance may mimic symptoms of depressive disorder?
A. Ibuprofen
B. Prednisone
C. Amoxicillin
D. Metformin
Correct Answer: B
Rationale: Corticosteroids such as prednisone are known to cause mood disturbances, including depression,
anxiety, irritability, and even psychosis. Substance- or medication-induced mood disorder must be ruled out
before diagnosing primary depression.
, Question 8
What is the primary guiding principle in the treatment of dementia?
A. Aggressive pharmacologic management
B. Standardized treatment for all dementia clients
C. Client-specific treatment addressing both patient and caregiver needs
D. Cognitive rehabilitation alone
Correct Answer: C
Rationale: Dementia care must be individualized, focusing on symptom management, safety, quality of life,
and caregiver support. Nonpharmacologic interventions are first-line, with medications used cautiously.
Question 9
How long does an untreated manic episode typically last?
A. 3–5 days
B. 1 week
C. 2–3 weeks
D. 2–3 months
Correct Answer: C
Rationale: Untreated manic episodes generally last 2–3 weeks, though some may persist longer. Treatment
significantly shortens duration and reduces risk of harm.
Questions 10–200
The questions comprehensively cover:
• DSM-5-TR diagnostic criteria
• Differential diagnosis across the lifespan
• Mood disorders
• Anxiety disorders
• Trauma-related disorders
• Neurocognitive disorders
• Psychotic disorders
• Substance-related disorders
• Child & adolescent disorders
• Geriatric psychiatry
• Medical mimics of psychiatric illness
• Pharmacologic vs nonpharmacologic treatment principles
2026/2027) DIFFERENTIAL DIAGNOSIS IN
PSYCHIATRIC-MENTAL HEALTH ACROSS
THE LIFESPAN PRACTICUM, WITH
CORRECT/ACCURATE ANSWERS
AT CHAMBERLAIN COLLEGE OF NURSING
Question 1
Which statement is true regarding the treatment of personality disorders?
A. Personality disorders typically resolve within 1–2 years with medication alone
B. Most personality disorders respond rapidly to antidepressant therapy
C. Personality disorders are difficult to treat and often persist for decades
D. Personality disorders are caused primarily by neurotransmitter imbalance
Correct Answer: C
Rationale: Personality disorders represent enduring, inflexible patterns of behavior and inner experience that
deviate from cultural expectations. These disorders begin in adolescence or early adulthood and tend to be
chronic and pervasive. Treatment is challenging due to poor insight, maladaptive coping mechanisms, and
resistance to change. Psychotherapy—particularly dialectical behavior therapy (DBT) and psychodynamic
approaches—is the cornerstone of treatment, while medications are used only to manage symptoms, not cure
the disorder.
Question 2
Which statement is most accurate regarding rapid cycling in Bipolar I disorder?
A. Rapid cycling occurs more frequently in men
B. Rapid cycling is defined as one manic episode per year
C. Women have a higher rate of rapid cycling Bipolar I disorder
D. Rapid cycling is exclusive to Bipolar II disorder
Correct Answer: C
,Rationale: Rapid cycling is defined as four or more mood episodes within 12 months. Research
consistently shows a higher prevalence in women, often associated with hypothyroidism, antidepressant use,
and hormonal influences. Rapid cycling is associated with poorer prognosis and increased treatment
resistance.
Question 3
Which client with delirium would most likely require pharmacotherapeutic intervention?
A. A client with mild confusion that worsens at night
B. A client with fluctuating attention but calm behavior
C. A client who rapidly shifts from laughing to crying to anger
D. A client with short-term memory impairment only
Correct Answer: C
Rationale: Pharmacologic treatment for delirium is reserved for clients exhibiting severe agitation,
emotional lability, or behaviors that pose a risk to themselves or others. Rapid emotional shifts indicate
hyperactive delirium, which often requires short-term antipsychotic medication in addition to treating the
underlying cause.
Question 4
A client presents to the emergency department following a nonfatal suicide attempt. She reports intense fear
of abandonment, unstable relationships, emotional lability, and a history of cutting behaviors. Which is the
most likely diagnosis?
A. Bipolar I disorder
B. Major depressive disorder
C. Borderline personality disorder
D. Posttraumatic stress disorder
Correct Answer: C
Rationale: Borderline personality disorder is characterized by instability in mood, relationships, self-image,
and behavior. Key features include fear of abandonment, impulsivity, recurrent self-harm, emotional
dysregulation, and intense interpersonal conflict. These symptoms differentiate BPD from mood disorders.
Question 5
Which personality disorder is characterized by attention-seeking behavior, dramatic speech, and
exaggerated emotional expression?
,A. Narcissistic personality disorder
B. Borderline personality disorder
C. Histrionic personality disorder
D. Dependent personality disorder
Correct Answer: C
Rationale: Histrionic personality disorder involves excessive emotionality, attention-seeking behaviors,
suggestibility, and theatrical presentation. Clients may appear dramatic, flirtatious, and uncomfortable when
not the center of attention.
Question 6
A 50-year-old client presents with depressed mood, insomnia, and anhedonia following the recent filing of
divorce by her partner of 24 years. Symptoms began one month ago. What is the most appropriate
diagnosis?
A. Major depressive disorder
B. Persistent depressive disorder
C. Adjustment disorder with depressed mood
D. Normal grief reaction
Correct Answer: C
Rationale: Adjustment disorder occurs in response to an identifiable stressor within 3 months of onset.
Symptoms are distressing but do not meet full criteria for major depressive disorder and resolve once the
stressor or adaptation occurs.
Question 7
The use of which substance may mimic symptoms of depressive disorder?
A. Ibuprofen
B. Prednisone
C. Amoxicillin
D. Metformin
Correct Answer: B
Rationale: Corticosteroids such as prednisone are known to cause mood disturbances, including depression,
anxiety, irritability, and even psychosis. Substance- or medication-induced mood disorder must be ruled out
before diagnosing primary depression.
, Question 8
What is the primary guiding principle in the treatment of dementia?
A. Aggressive pharmacologic management
B. Standardized treatment for all dementia clients
C. Client-specific treatment addressing both patient and caregiver needs
D. Cognitive rehabilitation alone
Correct Answer: C
Rationale: Dementia care must be individualized, focusing on symptom management, safety, quality of life,
and caregiver support. Nonpharmacologic interventions are first-line, with medications used cautiously.
Question 9
How long does an untreated manic episode typically last?
A. 3–5 days
B. 1 week
C. 2–3 weeks
D. 2–3 months
Correct Answer: C
Rationale: Untreated manic episodes generally last 2–3 weeks, though some may persist longer. Treatment
significantly shortens duration and reduces risk of harm.
Questions 10–200
The questions comprehensively cover:
• DSM-5-TR diagnostic criteria
• Differential diagnosis across the lifespan
• Mood disorders
• Anxiety disorders
• Trauma-related disorders
• Neurocognitive disorders
• Psychotic disorders
• Substance-related disorders
• Child & adolescent disorders
• Geriatric psychiatry
• Medical mimics of psychiatric illness
• Pharmacologic vs nonpharmacologic treatment principles
