MENTAL HEALTH EXAM vc vc
Exam Solution vc
Week 4 Midterm Exam: NR547 / NR 547 (Latest / ) Diffe
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rential Diagnosis in Psychiatric Mental Health across th
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e Lifespan Practicum/ EXAM LATEST VERSION QUESTIO
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NS AND CORRECT DETAILED ANSWERS (VERIFIED ANS
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WERS) ALREADY GRADED A 2026 A+ GRADE ASSURED C vc vc vc vc vc vc vc vc
OMPLETE SOLUTIONS AND VERIFIED ANSWERS (D8BB9 vc vc vc vc vc
)
QUESTION 1 vc
Differential diagnosis vc
ANSWER
The provider's initial hypothesis -
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a working list of potential problems that can be associated with the initial or chief complaint -
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Diagnostic and Statistical Manual of Mental Disorders (DSM-5-
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TR) • provides guidance for identifying psychiatric diagnoses
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QUESTION 2 vc
Screening and Psychiatric Rating Scales vc vc vc vc
ANSWER
Evidence-based screening tools and psychiatric rating scales - vc vc vc vc vc vc vc
can help the provider identify symptoms and assess their severity and can assist with the evaluation of
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response to treatment vc vc
QUESTION 3 vc
Diagnostic Testing when diagnosing mental health disorders
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ANSWER
,-
Diagnostic tests and labs are most used to rule out physical conditions that may cause psychiatric sympt
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oms and to evaluate the effects of treatment
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QUESTION 4 vc
Basic Laboratory Interpretation
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ANSWER
Complete Blood Count Comprehensive Metabolic Panel (CMP) Thyroid Function Tests Vitamin B12 Level
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Vitamin D Level Toxicology Screen Urinalysis (UA)
vc vc vc vc vc vc vc
QUESTION 5 vc
Basic Laboratory Interpretation: Complete Blood Count
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ANSWER
-measures RBCs, WBCs, hemoglobin, hematocrit, and platelets -includes a differential of the WBCs -
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In mental health, the CBC is used to rule out medical conditions that may present with symptoms that c
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an be attributed to both medical and psychiatric diagnoses • Ex: rule out anemia as a cause for depressi
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ve symptoms and fatigue • Ex: rule out infection as a cause of acute mental status changes RBCs: 4.5-
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6.0 million/microliter Hemoglobin: 12-18 grams/100 mL Hematocrit: 38%-48% Reticulocytes: 0%-
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1.5% WBCs (total): 5000-10,000/microliter Neutrophils: 55%-70% Eosinophils: 1%-
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3% Basophils: 0.5%-1% Lymphocytes: 20%-35% Monocytes: 3%-8% Platelets: 150,000-
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300,000/microliter
QUESTION 6 vc
Basic Laboratory Interpretation: Thyroid Function Tests (TFTs)
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ANSWER
used to rule out thyroid disorders as a cause for symptoms • symptoms related to thyroid disorders incl
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ude anxiety, restlessness, depression, mood swings, sleeping difficulties, difficulties with concentration, s
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hort-term memory lapses, and lack of mental alertness Normal TFT levels TSH: 0.4-4.5 mIU/L T3: 100-
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200 ng/dL T4: 5-11 ug/dL
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QUESTION 7 vc
Basic Laboratory Interpretation: Vitamin B12 Level
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ANSWER
Deficiency of vitamin B12 can affect mood and other brain functions -
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psychiatric symptoms associated with B12 deficiency include depression, mania, psychotic symptoms, a
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nd cognitive impairment normal: 190-950 picograms/mL • 200-
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300/mL indicates a borderline level with a possible need for additional testing
vc vc vc vc vc vc vc vc vc vc vc
,QUESTION 8 vc
Basic Laboratory Interpretation: Vitamin D Level
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ANSWER
affects functions such as neurotransmission, neuroprotection, & neuroimmunomodulation -
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high prevalence of vitamin D deficiency in clients with psychiatric disorders such as schizophrenia, depr
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ession, seasonal affective disorder, and cognitive impairment -
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Symptoms of vitamin D deficiency include depression, irritability, anxiety, psychosis, and poor brain dev
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elopment 25-hydroxy vitamin D blood test: normal 20-
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50 ng/mL, less than 12 ng/mL indicates a deficiency
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QUESTION 9 vc
Basic Laboratory Interpretation: Toxicology Screen
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ANSWER
-rule out substance use as a cause for symptoms -
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used before starting therapy involving controlled substances -used to monitor medication adherence -
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used in the diagnosis of substance use disorder
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QUESTION 10 vc
Basic Laboratory Interpretation: Urinalysis (UA)
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ANSWER
Urinary tract infections are associated with a variety of neuropsychiatric symptoms -
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acute mental status changes • UA may be used to rule out a UTI as the cause.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 11 vc
Treat or Refer: Toni is a 58-year-old who presents with fatigue. Her TSH is 6.3 mIU/L.
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ANSWER
Refer Rationale: A TSH level >4.0 is indicative of hypothyroidism, which is associated with fatigue. A ref
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erral for treatment of hypothyroidism is required. Client can be reevaluated for fatigue if symptoms per
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sist after hypothyroid treatment has been initiated, TSH levels are within normal limits.
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QUESTION 12 vc
Treat or Refer: Leo is a 49-year-
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old who presents with fatigue. His hemoglobin is 15 g/dL and hematocrit is 42%.
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ANSWER
, Begin treatment Rationale: The hemoglobin and hematocrit are within normal limits. This client's compl
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aint of fatigue is not due to anemia. Begin treatment based on a complete evaluation.
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QUESTION 13 vc
Treat or Refer: Terri is a 79-
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year old who presents with confusion. She has positive urine leukocyte esterase.
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ANSWER
Refer Rationale: A positive Urine Leukocyte Esterase indicates the presence of a urinary tract infection (
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UTI) , which may cause confusion. Refer this client for treatment of the UTI.
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QUESTION 14 vc
Treat or Refer: Julio is a 66-year-
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old who presents with depression. His vitamin D level 11 ng/mL.
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ANSWER
Refer Rationale: Vitamin D deficiency is associated with depressive symptoms. The PMHNP may refer or
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
treat vitamin D deficiency depending on the level of comfort of the provider.
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QUESTION 15 vc
Treat or Refer: Beth is a 24-year-old who presents with anxiety. Her T3 is 260 ng/dL.
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ANSWER
Refer Rationale: Clients with hyperthyroidism have elevated T3 levels. Hyperthyroidism is associated wi
vc vc vc vc vc vc vc vc vc vc vc vc
th anxiety symptoms. Client can be reevaluated for anxiety once hyperthyroid treatment has been initiat
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ed and T3 levels are within normal limits.
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QUESTION 16 vc
Treat or Refer: Fred is a 19-year-
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old who presents with psychosis. His vitamin B12 level is 900 picograms/mL.
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ANSWER
Begin treatment Rationale: The B12 level is within normal limits. Treatment for symptoms of psychosis
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should be initiated. vc vc
QUESTION 17 vc
Treat or Refer: Ted is a 64-year-
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old who presents with confusion. His serum creatinine is 7.0 mg/dL and BUN is 32.
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Exam Solution vc
Week 4 Midterm Exam: NR547 / NR 547 (Latest / ) Diffe
vc vc vc vc vc vc vc vc vc vc vc
rential Diagnosis in Psychiatric Mental Health across th
vc vc vc vc vc vc vc
e Lifespan Practicum/ EXAM LATEST VERSION QUESTIO
vc vc vc vc vc vc
NS AND CORRECT DETAILED ANSWERS (VERIFIED ANS
vc vc vc vc vc vc
WERS) ALREADY GRADED A 2026 A+ GRADE ASSURED C vc vc vc vc vc vc vc vc
OMPLETE SOLUTIONS AND VERIFIED ANSWERS (D8BB9 vc vc vc vc vc
)
QUESTION 1 vc
Differential diagnosis vc
ANSWER
The provider's initial hypothesis -
vc vc vc vc
a working list of potential problems that can be associated with the initial or chief complaint -
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
Diagnostic and Statistical Manual of Mental Disorders (DSM-5-
vc vc vc vc vc vc vc
TR) • provides guidance for identifying psychiatric diagnoses
vc vc vc vc vc vc vc
QUESTION 2 vc
Screening and Psychiatric Rating Scales vc vc vc vc
ANSWER
Evidence-based screening tools and psychiatric rating scales - vc vc vc vc vc vc vc
can help the provider identify symptoms and assess their severity and can assist with the evaluation of
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
response to treatment vc vc
QUESTION 3 vc
Diagnostic Testing when diagnosing mental health disorders
vc vc vc vc vc vc
ANSWER
,-
Diagnostic tests and labs are most used to rule out physical conditions that may cause psychiatric sympt
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
oms and to evaluate the effects of treatment
vc vc vc vc vc vc vc
QUESTION 4 vc
Basic Laboratory Interpretation
vc vc
ANSWER
Complete Blood Count Comprehensive Metabolic Panel (CMP) Thyroid Function Tests Vitamin B12 Level
vc vc vc vc vc vc vc vc vc vc vc vc
Vitamin D Level Toxicology Screen Urinalysis (UA)
vc vc vc vc vc vc vc
QUESTION 5 vc
Basic Laboratory Interpretation: Complete Blood Count
vc vc vc vc vc
ANSWER
-measures RBCs, WBCs, hemoglobin, hematocrit, and platelets -includes a differential of the WBCs -
vc vc vc vc vc vc vc vc vc vc vc vc vc
In mental health, the CBC is used to rule out medical conditions that may present with symptoms that c
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
an be attributed to both medical and psychiatric diagnoses • Ex: rule out anemia as a cause for depressi
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ve symptoms and fatigue • Ex: rule out infection as a cause of acute mental status changes RBCs: 4.5-
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
6.0 million/microliter Hemoglobin: 12-18 grams/100 mL Hematocrit: 38%-48% Reticulocytes: 0%-
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1.5% WBCs (total): 5000-10,000/microliter Neutrophils: 55%-70% Eosinophils: 1%-
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3% Basophils: 0.5%-1% Lymphocytes: 20%-35% Monocytes: 3%-8% Platelets: 150,000-
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300,000/microliter
QUESTION 6 vc
Basic Laboratory Interpretation: Thyroid Function Tests (TFTs)
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ANSWER
used to rule out thyroid disorders as a cause for symptoms • symptoms related to thyroid disorders incl
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ude anxiety, restlessness, depression, mood swings, sleeping difficulties, difficulties with concentration, s
vc vc vc vc vc vc vc vc vc vc vc
hort-term memory lapses, and lack of mental alertness Normal TFT levels TSH: 0.4-4.5 mIU/L T3: 100-
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200 ng/dL T4: 5-11 ug/dL
vc vc vc vc
QUESTION 7 vc
Basic Laboratory Interpretation: Vitamin B12 Level
vc vc vc vc vc
ANSWER
Deficiency of vitamin B12 can affect mood and other brain functions -
vc vc vc vc vc vc vc vc vc vc vc
psychiatric symptoms associated with B12 deficiency include depression, mania, psychotic symptoms, a
vc vc vc vc vc vc vc vc vc vc vc
nd cognitive impairment normal: 190-950 picograms/mL • 200-
vc vc vc vc vc vc vc
300/mL indicates a borderline level with a possible need for additional testing
vc vc vc vc vc vc vc vc vc vc vc
,QUESTION 8 vc
Basic Laboratory Interpretation: Vitamin D Level
vc vc vc vc vc
ANSWER
affects functions such as neurotransmission, neuroprotection, & neuroimmunomodulation -
vc vc vc vc vc vc vc vc
high prevalence of vitamin D deficiency in clients with psychiatric disorders such as schizophrenia, depr
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ession, seasonal affective disorder, and cognitive impairment -
vc vc vc vc vc vc vc
Symptoms of vitamin D deficiency include depression, irritability, anxiety, psychosis, and poor brain dev
vc vc vc vc vc vc vc vc vc vc vc vc vc
elopment 25-hydroxy vitamin D blood test: normal 20-
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50 ng/mL, less than 12 ng/mL indicates a deficiency
vc vc vc vc vc vc vc vc
QUESTION 9 vc
Basic Laboratory Interpretation: Toxicology Screen
vc vc vc vc
ANSWER
-rule out substance use as a cause for symptoms -
vc vc vc vc vc vc vc vc vc
used before starting therapy involving controlled substances -used to monitor medication adherence -
vc vc vc vc vc vc vc vc vc vc vc vc
used in the diagnosis of substance use disorder
vc vc vc vc vc vc vc
QUESTION 10 vc
Basic Laboratory Interpretation: Urinalysis (UA)
vc vc vc vc
ANSWER
Urinary tract infections are associated with a variety of neuropsychiatric symptoms -
vc vc vc vc vc vc vc vc vc vc vc
acute mental status changes • UA may be used to rule out a UTI as the cause.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 11 vc
Treat or Refer: Toni is a 58-year-old who presents with fatigue. Her TSH is 6.3 mIU/L.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ANSWER
Refer Rationale: A TSH level >4.0 is indicative of hypothyroidism, which is associated with fatigue. A ref
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
erral for treatment of hypothyroidism is required. Client can be reevaluated for fatigue if symptoms per
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
sist after hypothyroid treatment has been initiated, TSH levels are within normal limits.
vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 12 vc
Treat or Refer: Leo is a 49-year-
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old who presents with fatigue. His hemoglobin is 15 g/dL and hematocrit is 42%.
vc vc vc vc vc vc vc vc vc vc vc vc vc
ANSWER
, Begin treatment Rationale: The hemoglobin and hematocrit are within normal limits. This client's compl
vc vc vc vc vc vc vc vc vc vc vc vc vc
aint of fatigue is not due to anemia. Begin treatment based on a complete evaluation.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 13 vc
Treat or Refer: Terri is a 79-
vc vc vc vc vc vc
year old who presents with confusion. She has positive urine leukocyte esterase.
vc vc vc vc vc vc vc vc vc vc vc
ANSWER
Refer Rationale: A positive Urine Leukocyte Esterase indicates the presence of a urinary tract infection (
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
UTI) , which may cause confusion. Refer this client for treatment of the UTI.
vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 14 vc
Treat or Refer: Julio is a 66-year-
vc vc vc vc vc vc
old who presents with depression. His vitamin D level 11 ng/mL.
vc vc vc vc vc vc vc vc vc vc
ANSWER
Refer Rationale: Vitamin D deficiency is associated with depressive symptoms. The PMHNP may refer or
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
treat vitamin D deficiency depending on the level of comfort of the provider.
vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 15 vc
Treat or Refer: Beth is a 24-year-old who presents with anxiety. Her T3 is 260 ng/dL.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ANSWER
Refer Rationale: Clients with hyperthyroidism have elevated T3 levels. Hyperthyroidism is associated wi
vc vc vc vc vc vc vc vc vc vc vc vc
th anxiety symptoms. Client can be reevaluated for anxiety once hyperthyroid treatment has been initiat
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ed and T3 levels are within normal limits.
vc vc vc vc vc vc vc
QUESTION 16 vc
Treat or Refer: Fred is a 19-year-
vc vc vc vc vc vc
old who presents with psychosis. His vitamin B12 level is 900 picograms/mL.
vc vc vc vc vc vc vc vc vc vc vc
ANSWER
Begin treatment Rationale: The B12 level is within normal limits. Treatment for symptoms of psychosis
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
should be initiated. vc vc
QUESTION 17 vc
Treat or Refer: Ted is a 64-year-
vc vc vc vc vc vc
old who presents with confusion. His serum creatinine is 7.0 mg/dL and BUN is 32.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
