NR 547 MIDTERM STUDY GUIDE
The NR547 exam questions are taken from the Course Activities, lectures, linked resources and required readings. Mid-Term Exam: The Mid-Term has 75 questions worth two points each. You will have one attempt to complete the exam with a time limit of 75 minutes. Week 1: Foundations in Differential Diagnosis Formulation
1.The differential diagnosis : working list of potential problems that can be associated with the initial or chief complaint.
1.Importance of the differential diagnosis
2.Analysis of:
a)presenting symptoms
b)clinical data such as physical exam
c)laboratory analysis.
d)Medical history including medications
3.Evidence-based screening tools and psychiatric rating scales
a)Scoring
b)Advantages and disadvantages
c)Components
d)When to use (i.e., when is a brief screening tool inappropriate)
4.The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) (American Psychiatric Association [APA], 2022) criteria.
a)Know diagnostic criteria for various problems, such as Schizophrenia, sleep disorder, sexual disorders and anxiety disorders
5.Rule out physical and substance-related causes for psychological symptoms.
6.Understand differences between the workup and treatment for new onset symptoms versus pre- existing symptoms
a)New patients or new onset symptoms require full workup
b)Pre-existing conditions and diagnosis should be taken into account when formulating your differentials
c)Pre-existing conditions may exclude some differentials
2.Social determinants of health and the psychiatric mental health nurse practitioners (PMHNPs) role in addressing SDOH at the individual and population levels. SDOH have a significant impact on health, quality of
life, and life expectancy in relation to mental health. Social and environmental factors can influence genetic determinants of health and illness and affect the risk for mental illness and substance use disorders.
Discrimination, racism, social exclusion, Adverse early life experiences, Poor education, Unemployment, underemployment, job insecurity, Poverty, Neighborhood deprivation, Food insecurity, Poor housing quality and housing instability
3.Review basics of laboratory analysis including:
1.CBC- Hgb 12-18 grams/100 mL /hct: 38%-48%/ Plt: 150,000-300,000/mL /WBC 5k-10k
2.CMP-NA 135-145/ K 3.5-5/ CL95-105/BICARB 22-28/ CREAT 0.6-1.2 BUN 7-18
3.Thyroid function tests TSH: 0.4-4.5 mIU/L T3: 100-200 ng/dL T4: 5-11 ug/dL
4.Vitamin B12 levels- psychiatric symptoms associated with B12 deficiency include depression, mania, psychotic symptoms, and cognitive impairment B12 190-950 ok if 2-300 borderline and additional testing possibly needed
5.Vitamin D levels- 20-50 ng/mL. A level less than 12 ng/mL indicates a deficiency.
4.Know terms
1.Alogia- short answers, using few words to communicate.
2.Avolition- lack of initiative, withdrawal from work/school
3.Anosognosia- functional inability to recognize illness.
The NR547 exam questions are taken from the Course Activities, lectures, linked resources and required readings. Mid-Term Exam: The Mid-Term has 75 questions worth two points each. You will have one attempt to complete the exam with a time limit of 75 minutes. Week 1: Foundations in Differential Diagnosis Formulation
1.The differential diagnosis : working list of potential problems that can be associated with the initial or chief complaint.
1.Importance of the differential diagnosis
2.Analysis of:
a)presenting symptoms
b)clinical data such as physical exam
c)laboratory analysis.
d)Medical history including medications
3.Evidence-based screening tools and psychiatric rating scales
a)Scoring
b)Advantages and disadvantages
c)Components
d)When to use (i.e., when is a brief screening tool inappropriate)
4.The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) (American Psychiatric Association [APA], 2022) criteria.
a)Know diagnostic criteria for various problems, such as Schizophrenia, sleep disorder, sexual disorders and anxiety disorders
5.Rule out physical and substance-related causes for psychological symptoms.
6.Understand differences between the workup and treatment for new onset symptoms versus pre- existing symptoms
a)New patients or new onset symptoms require full workup
b)Pre-existing conditions and diagnosis should be taken into account when formulating your differentials
c)Pre-existing conditions may exclude some differentials
2.Social determinants of health and the psychiatric mental health nurse practitioners (PMHNPs) role in addressing SDOH at the individual and population levels. SDOH have a significant impact on health, quality of
life, and life expectancy in relation to mental health. Social and environmental factors can influence genetic determinants of health and illness and affect the risk for mental illness and substance use disorders.
Discrimination, racism, social exclusion, Adverse early life experiences, Poor education, Unemployment, underemployment, job insecurity, Poverty, Neighborhood deprivation, Food insecurity, Poor housing quality and housing instability
3.Review basics of laboratory analysis including:
1.CBC- Hgb 12-18 grams/100 mL /hct: 38%-48%/ Plt: 150,000-300,000/mL /WBC 5k-10k
2.CMP-NA 135-145/ K 3.5-5/ CL95-105/BICARB 22-28/ CREAT 0.6-1.2 BUN 7-18
3.Thyroid function tests TSH: 0.4-4.5 mIU/L T3: 100-200 ng/dL T4: 5-11 ug/dL
4.Vitamin B12 levels- psychiatric symptoms associated with B12 deficiency include depression, mania, psychotic symptoms, and cognitive impairment B12 190-950 ok if 2-300 borderline and additional testing possibly needed
5.Vitamin D levels- 20-50 ng/mL. A level less than 12 ng/mL indicates a deficiency.
4.Know terms
1.Alogia- short answers, using few words to communicate.
2.Avolition- lack of initiative, withdrawal from work/school
3.Anosognosia- functional inability to recognize illness.
