FINAL EXAM: NR 547 DIFFERENTIAL
DIAGNOSIS IN PSYCHIATRIC-MENTAL
HEALTH ACROSS THE LIFESPAN
PRACTICUM, (100 QUESTIONS) WITH
CORRECT/ACCURATE ANSWERS
QUESTIONS 1–58
1. Which characteristic is most indicative of narcissistic personality disorder?
A. Fear of abandonment
B. Social inhibition
,C. Ongoing need for admiration (Correct)
D. Unstable relationships
Rationale:
Narcissistic personality disorder is characterized by grandiosity, need for admiration, and lack of empathy.
2. A 25-year-old client reports week-long irritability, insomnia, excessive energy, and
alternating “ups and downs” over years. Most consistent diagnosis?
A. Bipolar II
B. Cyclothymia (Correct)
C. ADHD
D. Borderline personality disorder
Rationale:
Cyclothymia includes 2+ years of fluctuating hypomanic and depressive symptoms not meeting full episode
criteria.
3. Appropriate initial antidepressant for a 75-year-old with new MDD?
A. Amitriptyline
B. Venlafaxine
C. Escitalopram 10 mg daily (Correct)
D. MAOI
Rationale:
Escitalopram is safe and well tolerated in elderly compared to TCAs or MAOIs.
4. CIWA-AR score of 12. What should the NP do?
A. Discharge the patient
B. No meds needed
C. Prescribe STAT oral lorazepam + reassess hourly (Correct)
D. Start antipsychotic
Rationale:
CIWA 10–18 = moderate withdrawal → benzodiazepines indicated.
5. Fear of being alone, difficulty deciding, quickly seeking new relationships → diagnosis?
, A. Histrionic
B. Avoidant
C. Dependent personality disorder (Correct)
D. Borderline
Rationale:
Need for reassurance, difficulty making decisions, clingy behavior = dependent personality.
6. Characteristics of borderline personality disorder?
A. Obsessions and compulsions
B. Tumultuous relationships & brief psychotic episodes (Correct)
C. Grandiosity
D. Detachment
Rationale:
BPD often involves unstable relationships and transient stress-related psychosis.
7. “What did you have for dinner last night?” assesses…
A. Remote memory
B. Immediate memory
C. Recent memory (Correct)
D. Concentration
8. Client used marijuana 3 days ago – worried about drug test. Best response?
A. Up to 24 hours
B. Up to 48 hours
C. Up to 7 days (Correct)
D. 1 month
Rationale:
Occasional users test positive for 3–7 days.
9. DSM anxious distress specifier includes:
A. Low energy
B. Feeling restless, excessive worry (Correct)
DIAGNOSIS IN PSYCHIATRIC-MENTAL
HEALTH ACROSS THE LIFESPAN
PRACTICUM, (100 QUESTIONS) WITH
CORRECT/ACCURATE ANSWERS
QUESTIONS 1–58
1. Which characteristic is most indicative of narcissistic personality disorder?
A. Fear of abandonment
B. Social inhibition
,C. Ongoing need for admiration (Correct)
D. Unstable relationships
Rationale:
Narcissistic personality disorder is characterized by grandiosity, need for admiration, and lack of empathy.
2. A 25-year-old client reports week-long irritability, insomnia, excessive energy, and
alternating “ups and downs” over years. Most consistent diagnosis?
A. Bipolar II
B. Cyclothymia (Correct)
C. ADHD
D. Borderline personality disorder
Rationale:
Cyclothymia includes 2+ years of fluctuating hypomanic and depressive symptoms not meeting full episode
criteria.
3. Appropriate initial antidepressant for a 75-year-old with new MDD?
A. Amitriptyline
B. Venlafaxine
C. Escitalopram 10 mg daily (Correct)
D. MAOI
Rationale:
Escitalopram is safe and well tolerated in elderly compared to TCAs or MAOIs.
4. CIWA-AR score of 12. What should the NP do?
A. Discharge the patient
B. No meds needed
C. Prescribe STAT oral lorazepam + reassess hourly (Correct)
D. Start antipsychotic
Rationale:
CIWA 10–18 = moderate withdrawal → benzodiazepines indicated.
5. Fear of being alone, difficulty deciding, quickly seeking new relationships → diagnosis?
, A. Histrionic
B. Avoidant
C. Dependent personality disorder (Correct)
D. Borderline
Rationale:
Need for reassurance, difficulty making decisions, clingy behavior = dependent personality.
6. Characteristics of borderline personality disorder?
A. Obsessions and compulsions
B. Tumultuous relationships & brief psychotic episodes (Correct)
C. Grandiosity
D. Detachment
Rationale:
BPD often involves unstable relationships and transient stress-related psychosis.
7. “What did you have for dinner last night?” assesses…
A. Remote memory
B. Immediate memory
C. Recent memory (Correct)
D. Concentration
8. Client used marijuana 3 days ago – worried about drug test. Best response?
A. Up to 24 hours
B. Up to 48 hours
C. Up to 7 days (Correct)
D. 1 month
Rationale:
Occasional users test positive for 3–7 days.
9. DSM anxious distress specifier includes:
A. Low energy
B. Feeling restless, excessive worry (Correct)
