NR 547 Midterm Exam 2026/2027
Chamberlain University | Actual Exam
Questions with Correct Answers
1. What is a differential diagnosis in psychiatric-mental health practice?
• A. A final confirmed diagnosis based on DSM-5-TR criteria
• B. A working list of potential problems associated with the initial or chief
complaint
• C. A treatment plan for the identified disorder
• D. A prognosis for the client's recovery
Answer: B
Rationale: Differential diagnosis is the provider's initial hypothesis—a working list of
potential problems that can be associated with the initial or chief complaint .
2. The DSM-5-TR provides guidance for:
• A. Treatment planning only
• B. Identifying psychiatric diagnoses
• C. Prescribing psychotropic medications
• D. Conducting physical examinations
Answer: B
Rationale: The DSM-5-TR provides guidance for identifying psychiatric diagnoses and is
essential for differential diagnosis formulation .
3. Which of the following is a key component of the psychiatric assessment when
taking a history?
, • A. Family psychiatric history only
• B. History of Present Illness (HPI)
• C. Social and developmental history
• D. All of the above
Answer: D
Rationale: A comprehensive psychiatric assessment includes History of Present Illness,
psychiatric history, medical history, family psychiatric history, and social/developmental
history .
4. In the SNAPPS method for clinical reasoning, the first step is to:
• A. Narrow the differential to 2-3 possibilities
• B. Analyze the differential by comparing possibilities
• C. Summarize the history and findings
• D. Probe the preceptor about uncertainties
Answer: C
Rationale: The SNAPPS method begins with summarizing the history and findings, then
narrowing the differential diagnosis to 2-3 possibilities, analyzing the differential by
comparing and contrasting .
5. A 52-year-old client presents after a car accident. She reports persistent sadness,
hopelessness, and thoughts that her husband "would be happier if she wasn't
around." She reports a previous suicide attempt at age 16 but denies current
suicidal intent. Based on her responses, what is the most appropriate action?
• A. No action is necessary as the client is not currently considering suicide
• B. Provide a brief suicide safety assessment
• C. Alert the client's primary care physician
• D. Provide a STAT full mental health evaluation
,Answer: B
Rationale: While the responses do not indicate a need for a STAT full evaluation, the
client requires a brief suicide safety assessment to determine whether a full mental
health evaluation is necessary .
6. Which laboratory test is used to rule out anemia as a cause for depressive
symptoms and fatigue?
• A. Comprehensive Metabolic Panel (CMP)
• B. Complete Blood Count (CBC)
• C. Thyroid Function Tests (TFTs)
• D. Vitamin B12 Level
Answer: B
Rationale: The CBC measures RBCs, hemoglobin, and hematocrit. In mental health, CBC
is used to rule out medical conditions such as anemia that may present with depressive
symptoms and fatigue .
7. The normal range for TSH is:
• A. 0.1-1.0 mIU/L
• B. 0.4-4.5 mIU/L
• C. 5.0-10.0 mIU/L
• D. 10.0-20.0 mIU/L
Answer: B
Rationale: Normal TSH levels range from 0.4-4.5 mIU/L. TSH >4.0 is indicative of
hypothyroidism .
8. A client with fatigue has a TSH of 6.3 mIU/L. The PMHNP should:
• A. Begin treatment for fatigue
, • B. Refer for treatment of hypothyroidism
• C. Order additional psychiatric testing
• D. Prescribe an antidepressant
Answer: B
Rationale: A TSH level >4.0 indicates hypothyroidism, which is associated with fatigue.
The client should be referred for treatment of hypothyroidism .
9. Vitamin D deficiency is associated with all of the following psychiatric
conditions EXCEPT:
• A. Schizophrenia
• B. Depression
• C. Seasonal affective disorder
• D. Personality disorders
Answer: D
Rationale: Vitamin D deficiency is associated with schizophrenia, depression, seasonal
affective disorder, and cognitive impairment. Personality disorders are not typically
associated with vitamin D deficiency .
10. The normal range for vitamin D level (25-hydroxy) is:
• A. 5-10 ng/mL
• B. 10-15 ng/mL
• C. 20-50 ng/mL
• D. 50-100 ng/mL
Answer: C
Rationale: Normal vitamin D level is 20-50 ng/mL. A level less than 12 ng/mL indicates
deficiency .
Chamberlain University | Actual Exam
Questions with Correct Answers
1. What is a differential diagnosis in psychiatric-mental health practice?
• A. A final confirmed diagnosis based on DSM-5-TR criteria
• B. A working list of potential problems associated with the initial or chief
complaint
• C. A treatment plan for the identified disorder
• D. A prognosis for the client's recovery
Answer: B
Rationale: Differential diagnosis is the provider's initial hypothesis—a working list of
potential problems that can be associated with the initial or chief complaint .
2. The DSM-5-TR provides guidance for:
• A. Treatment planning only
• B. Identifying psychiatric diagnoses
• C. Prescribing psychotropic medications
• D. Conducting physical examinations
Answer: B
Rationale: The DSM-5-TR provides guidance for identifying psychiatric diagnoses and is
essential for differential diagnosis formulation .
3. Which of the following is a key component of the psychiatric assessment when
taking a history?
, • A. Family psychiatric history only
• B. History of Present Illness (HPI)
• C. Social and developmental history
• D. All of the above
Answer: D
Rationale: A comprehensive psychiatric assessment includes History of Present Illness,
psychiatric history, medical history, family psychiatric history, and social/developmental
history .
4. In the SNAPPS method for clinical reasoning, the first step is to:
• A. Narrow the differential to 2-3 possibilities
• B. Analyze the differential by comparing possibilities
• C. Summarize the history and findings
• D. Probe the preceptor about uncertainties
Answer: C
Rationale: The SNAPPS method begins with summarizing the history and findings, then
narrowing the differential diagnosis to 2-3 possibilities, analyzing the differential by
comparing and contrasting .
5. A 52-year-old client presents after a car accident. She reports persistent sadness,
hopelessness, and thoughts that her husband "would be happier if she wasn't
around." She reports a previous suicide attempt at age 16 but denies current
suicidal intent. Based on her responses, what is the most appropriate action?
• A. No action is necessary as the client is not currently considering suicide
• B. Provide a brief suicide safety assessment
• C. Alert the client's primary care physician
• D. Provide a STAT full mental health evaluation
,Answer: B
Rationale: While the responses do not indicate a need for a STAT full evaluation, the
client requires a brief suicide safety assessment to determine whether a full mental
health evaluation is necessary .
6. Which laboratory test is used to rule out anemia as a cause for depressive
symptoms and fatigue?
• A. Comprehensive Metabolic Panel (CMP)
• B. Complete Blood Count (CBC)
• C. Thyroid Function Tests (TFTs)
• D. Vitamin B12 Level
Answer: B
Rationale: The CBC measures RBCs, hemoglobin, and hematocrit. In mental health, CBC
is used to rule out medical conditions such as anemia that may present with depressive
symptoms and fatigue .
7. The normal range for TSH is:
• A. 0.1-1.0 mIU/L
• B. 0.4-4.5 mIU/L
• C. 5.0-10.0 mIU/L
• D. 10.0-20.0 mIU/L
Answer: B
Rationale: Normal TSH levels range from 0.4-4.5 mIU/L. TSH >4.0 is indicative of
hypothyroidism .
8. A client with fatigue has a TSH of 6.3 mIU/L. The PMHNP should:
• A. Begin treatment for fatigue
, • B. Refer for treatment of hypothyroidism
• C. Order additional psychiatric testing
• D. Prescribe an antidepressant
Answer: B
Rationale: A TSH level >4.0 indicates hypothyroidism, which is associated with fatigue.
The client should be referred for treatment of hypothyroidism .
9. Vitamin D deficiency is associated with all of the following psychiatric
conditions EXCEPT:
• A. Schizophrenia
• B. Depression
• C. Seasonal affective disorder
• D. Personality disorders
Answer: D
Rationale: Vitamin D deficiency is associated with schizophrenia, depression, seasonal
affective disorder, and cognitive impairment. Personality disorders are not typically
associated with vitamin D deficiency .
10. The normal range for vitamin D level (25-hydroxy) is:
• A. 5-10 ng/mL
• B. 10-15 ng/mL
• C. 20-50 ng/mL
• D. 50-100 ng/mL
Answer: C
Rationale: Normal vitamin D level is 20-50 ng/mL. A level less than 12 ng/mL indicates
deficiency .
