NR 547 Differential Dx Midterm Exam Most Recent Exam
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Differential Dx
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
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
Have you ever been hospitalized for any mental health
issues? Have you ever had counseling or psychotherapy?
Have you ever taken medications for your mental health in
the past? Are you currently on any medications for mental
health or sleep?
Toxicology Screen
When diagnosing psychiatric conditions, providers may use toxicology
screenings to rule out substance use as a cause for symptoms. Toxicology
screenings are also used before starting therapy involving controlled
substances, to monitor medication adherence, and in the diagnosis of
substance use disorder.
,Urinalysis (UA)
Urinary tract infections are associated with a variety of neuropsychiatric
symptoms (Lee et al., 2019). When clients present with acute mental status
changes, a urinalysis may be used to rule out a urinary tract infection as the
cause.
Toni is a 58-year-old who presents with fatigue. Her TSH is 6.3 mIU/L.
A) Begin Treatment
B) Refer
B) Refer
Rationale: A TSH level >4.0 is indicative of hypothyroidism, which is associated
with fatigue. A referral for treatment of hypothyroidism is required. Client can
be reevaluated for fatigue if symptoms persist after hypothyroid treatment has
been initiated, TSH levels are within normal limits.
Leo is a 49-year-old who presents with fatigue. His hemoglobin is 15 g/dL
and hematocrit is 42%.
A) Begin Treatment
B) Refer
A) Begin treatment.
Rationale: The hemoglobin and hematocrit are within normal limits. This client's
complaint of fatigue is not due to anemia. Begin treatment based on a
complete evaluation.
, Terri is a 79-year old who presents with confusion. She has positive urine
leukocyte esterase.
A) Begin treatment
B) Refer
B)Refer
Rationale: A positive Urine Leukocyte Esterase indicates the presence of a urinary
tract infection (UTI) , which may cause confusion. Refer this client for treatment
of the UTI.
Julio is a 66-year-old who presents with depression. His vitamin D level 11 ng/mL.
A) Begin Treatment
B) Refer
B) Refer
Rationale: Vitamin D deficiency is associated with depressive symptoms. The
PMHNP may refer or treat vitamin D deficiency depending on the level of
comfort of the provider.
Beth is a 24-year-old who presents with anxiety. Her T3 is 260 ng/dL.
A) Begin Treatment
B) Refer
B) Refer
Rationale: Clients with hyperthyroidism have elevated T3 levels.
Hyperthyroidism is associated with anxiety symptoms. Client can be
reevaluated for anxiety once hyperthyroid treatment has been initiated
and T3 levels are within normal limits.
Actual Complete Real Exam Questions And Correct Answers
(Verified Answers) Already Graded A+ || Guaranteed
Success!! Newest Exam | Just Released!!
Differential Dx
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
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
Have you ever been hospitalized for any mental health
issues? Have you ever had counseling or psychotherapy?
Have you ever taken medications for your mental health in
the past? Are you currently on any medications for mental
health or sleep?
Toxicology Screen
When diagnosing psychiatric conditions, providers may use toxicology
screenings to rule out substance use as a cause for symptoms. Toxicology
screenings are also used before starting therapy involving controlled
substances, to monitor medication adherence, and in the diagnosis of
substance use disorder.
,Urinalysis (UA)
Urinary tract infections are associated with a variety of neuropsychiatric
symptoms (Lee et al., 2019). When clients present with acute mental status
changes, a urinalysis may be used to rule out a urinary tract infection as the
cause.
Toni is a 58-year-old who presents with fatigue. Her TSH is 6.3 mIU/L.
A) Begin Treatment
B) Refer
B) Refer
Rationale: A TSH level >4.0 is indicative of hypothyroidism, which is associated
with fatigue. A referral for treatment of hypothyroidism is required. Client can
be reevaluated for fatigue if symptoms persist after hypothyroid treatment has
been initiated, TSH levels are within normal limits.
Leo is a 49-year-old who presents with fatigue. His hemoglobin is 15 g/dL
and hematocrit is 42%.
A) Begin Treatment
B) Refer
A) Begin treatment.
Rationale: The hemoglobin and hematocrit are within normal limits. This client's
complaint of fatigue is not due to anemia. Begin treatment based on a
complete evaluation.
, Terri is a 79-year old who presents with confusion. She has positive urine
leukocyte esterase.
A) Begin treatment
B) Refer
B)Refer
Rationale: A positive Urine Leukocyte Esterase indicates the presence of a urinary
tract infection (UTI) , which may cause confusion. Refer this client for treatment
of the UTI.
Julio is a 66-year-old who presents with depression. His vitamin D level 11 ng/mL.
A) Begin Treatment
B) Refer
B) Refer
Rationale: Vitamin D deficiency is associated with depressive symptoms. The
PMHNP may refer or treat vitamin D deficiency depending on the level of
comfort of the provider.
Beth is a 24-year-old who presents with anxiety. Her T3 is 260 ng/dL.
A) Begin Treatment
B) Refer
B) Refer
Rationale: Clients with hyperthyroidism have elevated T3 levels.
Hyperthyroidism is associated with anxiety symptoms. Client can be
reevaluated for anxiety once hyperthyroid treatment has been initiated
and T3 levels are within normal limits.
