NR 547 CEA Final Exam Prep – Differential Diagnosis
Across the Lifespan Practicum – (2026) – Original
Practice Questions
300 QUESTIONS
TABLE OF CONTENTS
# TOPIC
NR 547 CEA Final Exam Prep – Differential Diagnosis Across the Lifespan Practicum – (2026) – Original
1
Practice Questions
,Q1
Which statement best defines a differential diagnosis?
A) The final diagnosis after all testing is complete
B) The provider's initial hypothesis—a working list of potential problems CORRECT
associated with the chief complaint
C) A treatment plan based on presenting symptoms
D) A medication prescription guideline for psychiatric disorders
Rationale
A differential diagnosis is the provider's initial hypothesis and a working list of potential problems that can
be associated with the initial or chief complaint. It is a dynamic, evolving list refined as more information
becomes available through history, physical examination, and diagnostic testing.
Q2
A 45-year-old female presents with persistent sadness, loss of interest in previously enjoyed
activities, fatigue for 3 weeks, and reports sleeping 12 hours per night but still feeling exhausted.
Which of the following is the MOST appropriate next step in the differential diagnosis process?
A) Prescribe an SSRI immediately based on the classic presentation of major depressive disorder
B) Order a comprehensive metabolic panel and thyroid function tests to rule out
CORRECT
medical causes
C) Refer the patient for cognitive behavioral therapy without further workup
D) Diagnose persistent depressive disorder and schedule a follow-up in 4 weeks
Rationale
The differential diagnosis process requires ruling out medical etiologies before attributing symptoms to a
primary psychiatric disorder. Hypothyroidism can present with depressive symptoms including fatigue,
hypersomnia, and anhedonia. A comprehensive metabolic panel and thyroid function tests are essential
to exclude organic causes.
Q3
According to the DSM-5-TR, which factor must be ruled out before assigning most psychiatric
diagnoses?
A) Substance use and other medical conditions CORRECT
2
,B) Childhood trauma history
C) Family history of mental illness
D) Recent stressful life events
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.
Q4
Which statement best defines a differential diagnosis?
A) The provider's final diagnosis after all tests are completed
B) The provider's initial hypothesis; a working list of potential problems
CORRECT
associated with the chief complaint
C) A treatment plan based on the patient's symptoms
D) A medication prescription strategy
Rationale
A differential diagnosis is a systematic method of identifying possible conditions that explain a patient's
presentation. It is refined as more data are gathered and is essential for ruling out medical and
substance-related causes before settling on a psychiatric diagnosis.
Q5
A 45-year-old patient presents with depressive symptoms, fatigue, and weight gain. The PMHNP's
initial differential diagnosis should include which medical condition?
A) Hyperthyroidism
B) Hypothyroidism CORRECT
C) Diabetes insipidus
D) Cushing syndrome
Rationale
Hypothyroidism commonly presents with depressive symptoms, fatigue, weight gain, cold intolerance,
and constipation. Before diagnosing a primary psychiatric disorder, medical causes must be ruled out.
3
, Q6
A 32-year-old patient presents with anxiety, palpitations, and tremors. Which medical condition
should be considered in the differential diagnosis?
A) Hyperthyroidism CORRECT
B) Hypothyroidism
C) Adrenal insufficiency
D) Diabetes mellitus
Rationale
Hyperthyroidism can present with anxiety, palpitations, tremors, heat intolerance, and weight loss. These
symptoms overlap significantly with anxiety disorders, making thyroid function testing an essential part of
the evaluation.
Q7
A patient with schizophrenia reports having a strong sense of purpose and meaningful goals. The
PMHNP recognizes this as:
A) A risk factor for suicide
B) A protective factor for suicide CORRECT
C) An indication of medication nonadherence
D) A sign of mania
Rationale
Protective factors reduce the likelihood of suicide. A sense of purpose, strong social support, effective
coping skills, and access to care all lower risk, whereas prior attempts and hospitalizations increase it.
Q8
A patient presents with depressive symptoms. Which of the following laboratory tests should be
ordered to rule out medical causes?
A) Complete blood count only
B) Thyroid-stimulating hormone (TSH), vitamin B12, and folate levels CORRECT
4
Across the Lifespan Practicum – (2026) – Original
Practice Questions
300 QUESTIONS
TABLE OF CONTENTS
# TOPIC
NR 547 CEA Final Exam Prep – Differential Diagnosis Across the Lifespan Practicum – (2026) – Original
1
Practice Questions
,Q1
Which statement best defines a differential diagnosis?
A) The final diagnosis after all testing is complete
B) The provider's initial hypothesis—a working list of potential problems CORRECT
associated with the chief complaint
C) A treatment plan based on presenting symptoms
D) A medication prescription guideline for psychiatric disorders
Rationale
A differential diagnosis is the provider's initial hypothesis and a working list of potential problems that can
be associated with the initial or chief complaint. It is a dynamic, evolving list refined as more information
becomes available through history, physical examination, and diagnostic testing.
Q2
A 45-year-old female presents with persistent sadness, loss of interest in previously enjoyed
activities, fatigue for 3 weeks, and reports sleeping 12 hours per night but still feeling exhausted.
Which of the following is the MOST appropriate next step in the differential diagnosis process?
A) Prescribe an SSRI immediately based on the classic presentation of major depressive disorder
B) Order a comprehensive metabolic panel and thyroid function tests to rule out
CORRECT
medical causes
C) Refer the patient for cognitive behavioral therapy without further workup
D) Diagnose persistent depressive disorder and schedule a follow-up in 4 weeks
Rationale
The differential diagnosis process requires ruling out medical etiologies before attributing symptoms to a
primary psychiatric disorder. Hypothyroidism can present with depressive symptoms including fatigue,
hypersomnia, and anhedonia. A comprehensive metabolic panel and thyroid function tests are essential
to exclude organic causes.
Q3
According to the DSM-5-TR, which factor must be ruled out before assigning most psychiatric
diagnoses?
A) Substance use and other medical conditions CORRECT
2
,B) Childhood trauma history
C) Family history of mental illness
D) Recent stressful life events
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.
Q4
Which statement best defines a differential diagnosis?
A) The provider's final diagnosis after all tests are completed
B) The provider's initial hypothesis; a working list of potential problems
CORRECT
associated with the chief complaint
C) A treatment plan based on the patient's symptoms
D) A medication prescription strategy
Rationale
A differential diagnosis is a systematic method of identifying possible conditions that explain a patient's
presentation. It is refined as more data are gathered and is essential for ruling out medical and
substance-related causes before settling on a psychiatric diagnosis.
Q5
A 45-year-old patient presents with depressive symptoms, fatigue, and weight gain. The PMHNP's
initial differential diagnosis should include which medical condition?
A) Hyperthyroidism
B) Hypothyroidism CORRECT
C) Diabetes insipidus
D) Cushing syndrome
Rationale
Hypothyroidism commonly presents with depressive symptoms, fatigue, weight gain, cold intolerance,
and constipation. Before diagnosing a primary psychiatric disorder, medical causes must be ruled out.
3
, Q6
A 32-year-old patient presents with anxiety, palpitations, and tremors. Which medical condition
should be considered in the differential diagnosis?
A) Hyperthyroidism CORRECT
B) Hypothyroidism
C) Adrenal insufficiency
D) Diabetes mellitus
Rationale
Hyperthyroidism can present with anxiety, palpitations, tremors, heat intolerance, and weight loss. These
symptoms overlap significantly with anxiety disorders, making thyroid function testing an essential part of
the evaluation.
Q7
A patient with schizophrenia reports having a strong sense of purpose and meaningful goals. The
PMHNP recognizes this as:
A) A risk factor for suicide
B) A protective factor for suicide CORRECT
C) An indication of medication nonadherence
D) A sign of mania
Rationale
Protective factors reduce the likelihood of suicide. A sense of purpose, strong social support, effective
coping skills, and access to care all lower risk, whereas prior attempts and hospitalizations increase it.
Q8
A patient presents with depressive symptoms. Which of the following laboratory tests should be
ordered to rule out medical causes?
A) Complete blood count only
B) Thyroid-stimulating hormone (TSH), vitamin B12, and folate levels CORRECT
4
