NR569 DIFFERENTIAL DIAGNOSIS IN ACUTE
CARE PRACTICUM MIDTERM REVIEW WEEKS 1
TO 4 2026 TEST PAPER SOLUTIONS
◉ GAD often presents with physical symptoms, including. Answer:
restlessness or edginess
fatigue
difficulty concentrating
irritability
muscle tension
sleep disturbance
◉ Functional neuroimaging studies of GAD show. Answer: increased
activation of the amygdala and reduced activation in the prefrontal
cortex, indicating heightened activation of the fear response with
diminished capacity for reasoning
◉ Harold is a 32-year-old who presents to the clinic with complaints
of fatigue, difficulty concentrating, and difficulty falling asleep at
night. He states he worries about finances, his performance at work,
and his relationship, and his worries have been "almost constant"
for 8 months. He denies substance use and recently had a normal
physical exam. He feels that his relationship is suffering due to his
constant worry.
,Based on the DSM-5-TR, does Harold meet diagnostic criteria for
generalized anxiety disorder?. Answer: Yes
Rationale: Harold meets the following diagnostic criteria for
generalized anxiety disorder: He has three symptoms associated
with worry, including fatigue, difficulty concentrating, and sleep
difficulties. He has experienced anxiety more days than not for over
6 months, and his worries are impacting his relationship.
◉ Social Anxiety Disorder. Answer: AKA social phobia
-condition in which typical, everyday social interactions cause
significant anxiety, self-consciousness, fear of embarrassment, or a
feeling of being judged negatively by others
-may worry about the presence of physical symptoms that others
may notice such as trembling or blushing
-derealization, or a feeling of "spacing out," may occur
-Causes likely include a combination of genetic and environmental
factors
-past year: 7% of adults and 9% of adolescents
-DSM-5-TR defines social anxiety disorder as an individual's fear of
acting in a way that might cause judgment by others
-anxiety is persistent, lasting greater than six months
,◉ Usually, social anxiety disorder causes distress and anxiety in
specific social situations such as:. Answer: -making small talk with
others
-meeting new people
-performing in front of others (called performance anxiety)
◉ Panic attack. Answer: brief episode of acute anxiety during which
an individual develops an intense fear of negative outcomes
accompanied by a feeling of imminent danger
-can be unpredictable
-feelings are often accompanied by physiological symptoms
• symptoms typically peak within ten to twenty minutes, some may
last for hours
◉ Symptoms of Panic Attacks:. Answer: -Palpitations, pounding
heart, or accelerated heart rate
-Trembling or shaking
-Paresthesias (numbness or tingling sensations)
-Sensation of shortness of breath or smothering
-Derealization (feelings of unreality) or depersonalization (feeling
detached from oneself)
-Feeling of choking
-Feeling of chest pain or discomfort
-Nausea or abdominal stress
, -Feeling dizzy, unsteady, light-headed or faint
-Chills or heat sensations
◉ Panic disorder. Answer: occurs when a person experiences
repeated panic attacks
-Anxiety about future attacks may lead to behavioral changes
• avoid situations that might trigger attacks
◉ Fabrizia is a 27-year-old graphic designer who presents to the
clinic two months after an emergency department visit for
complaints of chest pain, palpitations, nausea, and dizziness. Her
electrocardiogram (ECG) and cardiac enzyme panels showed no
abnormalities. She states that the symptoms began while she was
watching a movie with her boyfriend and lasted about 15 minutes.
She has never experienced anything like this in the past, but since
the episode, she has worried occasionally about the symptoms
recurring, as her father died of a heart attack at age 45.
Based on the DSM-5-TR, does Fabrizia meet diagnostic criteria for
panic disorder?. Answer: No
Rationale: Fabrizia meets diagnostic criteria for a panic attack, but
not for panic disorder. During her panic attack, she reported having
four cardinal symptoms associated with a panic attack. She has only
CARE PRACTICUM MIDTERM REVIEW WEEKS 1
TO 4 2026 TEST PAPER SOLUTIONS
◉ GAD often presents with physical symptoms, including. Answer:
restlessness or edginess
fatigue
difficulty concentrating
irritability
muscle tension
sleep disturbance
◉ Functional neuroimaging studies of GAD show. Answer: increased
activation of the amygdala and reduced activation in the prefrontal
cortex, indicating heightened activation of the fear response with
diminished capacity for reasoning
◉ Harold is a 32-year-old who presents to the clinic with complaints
of fatigue, difficulty concentrating, and difficulty falling asleep at
night. He states he worries about finances, his performance at work,
and his relationship, and his worries have been "almost constant"
for 8 months. He denies substance use and recently had a normal
physical exam. He feels that his relationship is suffering due to his
constant worry.
,Based on the DSM-5-TR, does Harold meet diagnostic criteria for
generalized anxiety disorder?. Answer: Yes
Rationale: Harold meets the following diagnostic criteria for
generalized anxiety disorder: He has three symptoms associated
with worry, including fatigue, difficulty concentrating, and sleep
difficulties. He has experienced anxiety more days than not for over
6 months, and his worries are impacting his relationship.
◉ Social Anxiety Disorder. Answer: AKA social phobia
-condition in which typical, everyday social interactions cause
significant anxiety, self-consciousness, fear of embarrassment, or a
feeling of being judged negatively by others
-may worry about the presence of physical symptoms that others
may notice such as trembling or blushing
-derealization, or a feeling of "spacing out," may occur
-Causes likely include a combination of genetic and environmental
factors
-past year: 7% of adults and 9% of adolescents
-DSM-5-TR defines social anxiety disorder as an individual's fear of
acting in a way that might cause judgment by others
-anxiety is persistent, lasting greater than six months
,◉ Usually, social anxiety disorder causes distress and anxiety in
specific social situations such as:. Answer: -making small talk with
others
-meeting new people
-performing in front of others (called performance anxiety)
◉ Panic attack. Answer: brief episode of acute anxiety during which
an individual develops an intense fear of negative outcomes
accompanied by a feeling of imminent danger
-can be unpredictable
-feelings are often accompanied by physiological symptoms
• symptoms typically peak within ten to twenty minutes, some may
last for hours
◉ Symptoms of Panic Attacks:. Answer: -Palpitations, pounding
heart, or accelerated heart rate
-Trembling or shaking
-Paresthesias (numbness or tingling sensations)
-Sensation of shortness of breath or smothering
-Derealization (feelings of unreality) or depersonalization (feeling
detached from oneself)
-Feeling of choking
-Feeling of chest pain or discomfort
-Nausea or abdominal stress
, -Feeling dizzy, unsteady, light-headed or faint
-Chills or heat sensations
◉ Panic disorder. Answer: occurs when a person experiences
repeated panic attacks
-Anxiety about future attacks may lead to behavioral changes
• avoid situations that might trigger attacks
◉ Fabrizia is a 27-year-old graphic designer who presents to the
clinic two months after an emergency department visit for
complaints of chest pain, palpitations, nausea, and dizziness. Her
electrocardiogram (ECG) and cardiac enzyme panels showed no
abnormalities. She states that the symptoms began while she was
watching a movie with her boyfriend and lasted about 15 minutes.
She has never experienced anything like this in the past, but since
the episode, she has worried occasionally about the symptoms
recurring, as her father died of a heart attack at age 45.
Based on the DSM-5-TR, does Fabrizia meet diagnostic criteria for
panic disorder?. Answer: No
Rationale: Fabrizia meets diagnostic criteria for a panic attack, but
not for panic disorder. During her panic attack, she reported having
four cardinal symptoms associated with a panic attack. She has only
