NR547 FINAL EXAM LATEST 2026/2027 |
Differential Diagnosis Psychiatric-Mental
Health Across Lifespan | Weeks 5-8
Practicum Exam Review | Complete
Guide | Chamberlain | Pass Guaranteed -
A+ Graded
DOMAIN 1: DIFFERENTIAL DIAGNOSIS FOUNDATIONS (Questions 1-
20)
Question 1: A PMHNP is conducting an initial psychiatric evaluation. Which of
the following best describes the primary purpose of the "differential diagnosis"
process?
A) To confirm the patient's self-reported diagnosis
B) To develop a working list of potential disorders that could explain the
patient's symptoms
C) To rule out all medical causes of psychiatric symptoms before considering any
mental health diagnosis
D) To assign a single diagnosis that will guide all future treatment decisions
Correct Answer: B
Rationale: Differential diagnosis involves developing a working hypothesis or list
of potential disorders that could account for the presenting symptoms. This list is
,prioritized, and each potential diagnosis is systematically ruled in or out based on
diagnostic criteria, history, and assessment findings .
Question 2: According to the DSM-5-TR, which of the following must be ruled
out before assigning most psychiatric diagnoses?
A) Substance use and other medical conditions
B) Childhood trauma history
C) Family history of mental illness
D) Recent stressful life events
Correct Answer: A
Rationale: The DSM-5-TR requires clinicians to rule out substance/medication-
induced conditions and other medical conditions as the primary cause of symptoms
before assigning a primary psychiatric diagnosis .
Question 3: A holistic approach to psychiatric assessment recognizes that mental
health is influenced by:
A) Only biological and genetic factors
B) Only psychological and emotional factors
C) Social, spiritual, lifestyle, behavioral, and medical factors in addition to
psychiatric considerations
D) Only environmental stressors
Correct Answer: C
,Rationale: A comprehensive psychiatric assessment must consider
biopsychosocial factors including social determinants, spiritual beliefs, lifestyle
behaviors, medical comorbidities, and psychiatric symptoms .
Question 4: The Mental Status Exam (MSE) is a structured assessment of which
of the following domains?
A) Family history and social support only
B) Appearance, behavior, speech, mood, affect, thought process, thought
content, perception, cognition, and insight
C) Vital signs and laboratory values only
D) Past psychiatric hospitalizations and medication trials
Correct Answer: B
Rationale: The MSE is a systematic tool that evaluates multiple domains of
mental functioning: appearance, behavior/psychomotor activity, speech, mood,
affect, thought process, thought content, perceptual disturbances, cognition, and
insight/judgment .
Question 5: Which of the following screening tools is a clinician-rated scale used
to monitor severity of depression symptoms?
A) PHQ-9
B) HAM-D (Hamilton Depression Rating Scale)
C) GAD-7
D) MDQ
, Correct Answer: B
Rationale: The HAM-D is a clinician-administered rating scale that measures
depression severity with a focus on both psychological and physical symptoms
(mood, guilt, insomnia, anxiety, somatic symptoms, weight loss, and insight) .
Question 6: A patient scores a 10 on the 30-point Geriatric Depression Scale
(GDS). This indicates:
A) No depression
B) Mild depression
C) Moderate depression
D) Severe depression
Correct Answer: A
Rationale: On the 30-point GDS, a score of 0-10 is considered normal (no
depression), 11-20 indicates mild depression, and 21-30 indicates severe
depression .
Question 7: A 45-year-old patient presents with depressed mood, fatigue, weight
gain, and cold intolerance. Initial laboratory tests show an elevated TSH level
(>4.0 mIU/L). The most appropriate next step is:
A) Prescribe an antidepressant for major depressive disorder
B) Refer to primary care for treatment of hypothyroidism before reassessing
mood symptoms
Differential Diagnosis Psychiatric-Mental
Health Across Lifespan | Weeks 5-8
Practicum Exam Review | Complete
Guide | Chamberlain | Pass Guaranteed -
A+ Graded
DOMAIN 1: DIFFERENTIAL DIAGNOSIS FOUNDATIONS (Questions 1-
20)
Question 1: A PMHNP is conducting an initial psychiatric evaluation. Which of
the following best describes the primary purpose of the "differential diagnosis"
process?
A) To confirm the patient's self-reported diagnosis
B) To develop a working list of potential disorders that could explain the
patient's symptoms
C) To rule out all medical causes of psychiatric symptoms before considering any
mental health diagnosis
D) To assign a single diagnosis that will guide all future treatment decisions
Correct Answer: B
Rationale: Differential diagnosis involves developing a working hypothesis or list
of potential disorders that could account for the presenting symptoms. This list is
,prioritized, and each potential diagnosis is systematically ruled in or out based on
diagnostic criteria, history, and assessment findings .
Question 2: According to the DSM-5-TR, which of the following must be ruled
out before assigning most psychiatric diagnoses?
A) Substance use and other medical conditions
B) Childhood trauma history
C) Family history of mental illness
D) Recent stressful life events
Correct Answer: A
Rationale: The DSM-5-TR requires clinicians to rule out substance/medication-
induced conditions and other medical conditions as the primary cause of symptoms
before assigning a primary psychiatric diagnosis .
Question 3: A holistic approach to psychiatric assessment recognizes that mental
health is influenced by:
A) Only biological and genetic factors
B) Only psychological and emotional factors
C) Social, spiritual, lifestyle, behavioral, and medical factors in addition to
psychiatric considerations
D) Only environmental stressors
Correct Answer: C
,Rationale: A comprehensive psychiatric assessment must consider
biopsychosocial factors including social determinants, spiritual beliefs, lifestyle
behaviors, medical comorbidities, and psychiatric symptoms .
Question 4: The Mental Status Exam (MSE) is a structured assessment of which
of the following domains?
A) Family history and social support only
B) Appearance, behavior, speech, mood, affect, thought process, thought
content, perception, cognition, and insight
C) Vital signs and laboratory values only
D) Past psychiatric hospitalizations and medication trials
Correct Answer: B
Rationale: The MSE is a systematic tool that evaluates multiple domains of
mental functioning: appearance, behavior/psychomotor activity, speech, mood,
affect, thought process, thought content, perceptual disturbances, cognition, and
insight/judgment .
Question 5: Which of the following screening tools is a clinician-rated scale used
to monitor severity of depression symptoms?
A) PHQ-9
B) HAM-D (Hamilton Depression Rating Scale)
C) GAD-7
D) MDQ
, Correct Answer: B
Rationale: The HAM-D is a clinician-administered rating scale that measures
depression severity with a focus on both psychological and physical symptoms
(mood, guilt, insomnia, anxiety, somatic symptoms, weight loss, and insight) .
Question 6: A patient scores a 10 on the 30-point Geriatric Depression Scale
(GDS). This indicates:
A) No depression
B) Mild depression
C) Moderate depression
D) Severe depression
Correct Answer: A
Rationale: On the 30-point GDS, a score of 0-10 is considered normal (no
depression), 11-20 indicates mild depression, and 21-30 indicates severe
depression .
Question 7: A 45-year-old patient presents with depressed mood, fatigue, weight
gain, and cold intolerance. Initial laboratory tests show an elevated TSH level
(>4.0 mIU/L). The most appropriate next step is:
A) Prescribe an antidepressant for major depressive disorder
B) Refer to primary care for treatment of hypothyroidism before reassessing
mood symptoms
