1
NR 547 DIFFERENTIAL DX MIDTERM
EXAM QUESTIONS WITH VERIFIED
SOLUTIONS
Differential Dx - correct-answer -Diagnostic reasoning is the process of
questioning one's thinking to determine if all possible avenues have been
explored and if the conclusions that are drawn are based on evidence. This is a
critical step for providers who are trying to uncover a cause, or diagnosis, for their
clients' signs and symptoms. The provider's initial hypothesis is known as the
differential diagnosis. The differential diagnosis, or differential, is a working list of
potential problems that can be associated with the initial or chief complaint.
Establishing a differential diagnosis is a critical step in providing safe, quality care.
This evolving process of clinical reasoning and decision making involves examining
the client's presentation, clinical data, and when appropriate, screening and
diagnostic test results to distinguish one disease from another and arrive at the
correct diagnosis. The Diagnostic and Statistical Manual of Mental Disorders
(DSM-5-TR)provides guidance for identifying psychiatric diagnosest
History of Present Illness - correct-answer -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 - correct-answer -Have you ever been hospitalized for any
mental health issues?
Have you ever had counseling or psychotherapy?
, 2
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 - correct-answer -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 - correct-answer -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 - correct-answer -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?
Which of the following should be included when providing client education about
medication regimens? Select all that apply. - correct-answer -A)Explain how the
medication targets the symptoms, specific benefits, and expected time course.
(Correct answer)
, 3
B)Identify potential side effects, duration of side effects, and adverse effects.
(Correct answer)
C)Explain the instructions, dosing, and special requirements. (Correct answer)
D)Use teach-back methods to ensure client understanding. (Correct answer)
Apply the Ask Suicide-Screening Questions (ASQ) Suicide Risk Screening Tool
(Links to an external site.) to the scenario below.
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?
A) No action is necessary as the client is not - correct-answer -B)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.
Complete Blood Count - correct-answer -The CBC is a serum diagnostic test that
measures red blood cells, white blood cells, hemoglobin, hematocrit, and
platelets. The CBC includes a differential of the white blood cells. A CBC is often
included as part of routine health screening or to obtain information related to
specific conditions. 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. For example, the CBC can help rule out anemia
, 4
as a cause for depressive symptoms and fatigue or rule out infection as a cause of
acute mental status changes. The CBC is also used to monitor certain treatment
regimens. For example, some medications, such as clozapine, require routine
analysis of absolute neutrophil count and platelet levels.
Normal Range of:
Red blood cells
Hemoglobin
Hematocrit
Reticulocytes - correct-answer -Red blood cells: 4.5-6.0 million/microliter
Hemoglobin: 12-18 grams/100 mL
Hematocrit: 38%-48%
Reticulocytes: 0%-1.5%
Normal Range of?
White blood cells (total):
Neutrophils:
Eosinophils:
Basophils:
Lymphocytes:
Monocytes:
Platelets: - correct-answer -White blood cells (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
Comprehensive Metabolic Panel (CMP) - correct-answer -The CMP is another
common blood test used to determine general health status. The CMP includes
NR 547 DIFFERENTIAL DX MIDTERM
EXAM QUESTIONS WITH VERIFIED
SOLUTIONS
Differential Dx - correct-answer -Diagnostic reasoning is the process of
questioning one's thinking to determine if all possible avenues have been
explored and if the conclusions that are drawn are based on evidence. This is a
critical step for providers who are trying to uncover a cause, or diagnosis, for their
clients' signs and symptoms. The provider's initial hypothesis is known as the
differential diagnosis. The differential diagnosis, or differential, is a working list of
potential problems that can be associated with the initial or chief complaint.
Establishing a differential diagnosis is a critical step in providing safe, quality care.
This evolving process of clinical reasoning and decision making involves examining
the client's presentation, clinical data, and when appropriate, screening and
diagnostic test results to distinguish one disease from another and arrive at the
correct diagnosis. The Diagnostic and Statistical Manual of Mental Disorders
(DSM-5-TR)provides guidance for identifying psychiatric diagnosest
History of Present Illness - correct-answer -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 - correct-answer -Have you ever been hospitalized for any
mental health issues?
Have you ever had counseling or psychotherapy?
, 2
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 - correct-answer -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 - correct-answer -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 - correct-answer -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?
Which of the following should be included when providing client education about
medication regimens? Select all that apply. - correct-answer -A)Explain how the
medication targets the symptoms, specific benefits, and expected time course.
(Correct answer)
, 3
B)Identify potential side effects, duration of side effects, and adverse effects.
(Correct answer)
C)Explain the instructions, dosing, and special requirements. (Correct answer)
D)Use teach-back methods to ensure client understanding. (Correct answer)
Apply the Ask Suicide-Screening Questions (ASQ) Suicide Risk Screening Tool
(Links to an external site.) to the scenario below.
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?
A) No action is necessary as the client is not - correct-answer -B)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.
Complete Blood Count - correct-answer -The CBC is a serum diagnostic test that
measures red blood cells, white blood cells, hemoglobin, hematocrit, and
platelets. The CBC includes a differential of the white blood cells. A CBC is often
included as part of routine health screening or to obtain information related to
specific conditions. 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. For example, the CBC can help rule out anemia
, 4
as a cause for depressive symptoms and fatigue or rule out infection as a cause of
acute mental status changes. The CBC is also used to monitor certain treatment
regimens. For example, some medications, such as clozapine, require routine
analysis of absolute neutrophil count and platelet levels.
Normal Range of:
Red blood cells
Hemoglobin
Hematocrit
Reticulocytes - correct-answer -Red blood cells: 4.5-6.0 million/microliter
Hemoglobin: 12-18 grams/100 mL
Hematocrit: 38%-48%
Reticulocytes: 0%-1.5%
Normal Range of?
White blood cells (total):
Neutrophils:
Eosinophils:
Basophils:
Lymphocytes:
Monocytes:
Platelets: - correct-answer -White blood cells (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
Comprehensive Metabolic Panel (CMP) - correct-answer -The CMP is another
common blood test used to determine general health status. The CMP includes
