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NR 547 Midterm Examination: Differential Diagnosis in Psychiatric-Mental Health Across the Lifespan Practicum – A Comprehensive Assessment of Diagnostic Reasoning, DSM-5-TR Application, and Lifespan-Specific Clinical Decision-Making for PMHNP Students

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The NR 547 Midterm Examination is a summative assessment developed for the Differential Diagnosis in Psychiatric-Mental Health Across the Lifespan Practicum, a core course in the Psychiatric-Mental Health Nurse Practitioner (PMHNP) curriculum at Chamberlain University (College of Nursing). This high-stakes midterm examination is designed to evaluate the student's mastery of the differential diagnosis formulation process, the application of DSM-5-TR diagnostic criteria, and the integration of lifespan-specific considerations within psychiatric-mental health assessment. It serves as a critical indicator of readiness to advance in the PMHNP practicum sequence and to enter supervised clinical training.

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NR 547 Midterm Examination: Differential Diagnosis in Psychiatric-Mental Health

Across the Lifespan Practicum – A Comprehensive Assessment of Diagnostic

Reasoning, DSM-5-TR Application, and Lifespan-Specific Clinical Decision-Making

for PMHNP Students



What part of the brain is involved with OCD? Basal Ganglia

Occipital-Frontal



What happens to the brain during adolescence? Dendritic pruning

Emotions are controlled by amygdala

By adulthood, PFC involved as well



When do males typically present with schizophrenia? 10-25 you



When do females typically present with schizophrenia? 25-35 you



What does Erythromycin to Trileptal? You will need to decreases the level because

Trileptal(inducer) and erythromycin is a inhibitor

ACE Inhibitors are the drug of choice for what? Heart Failure

HTN

,What are some psychiatric side effects seen with some asthma drugs Leukotriene

receptor agonists - singulair, accolade, zyflo = agitation, aggression, anxiety,

hallucinations, depression, insomnia, SI, tremor



What should you watch for with Tegretol? Agranulocytosis and Hyponatremia



What are the 3 CK muscle enzyme tests? CKBB, CKMM, CKMB



Which one of the 3 muscle enzymes are related to cardiac muscle damage? CKMB



What is the risk of a seriously elevated CKMB? Polymyositis

Rhabdo

What is a normal CKMB? 0.3 mcg/L



What psychoactive does Detrol interact with? Topamax

KCL

Zonegran



What CN are you assessing when you have the patient shrug their shoulders? CN XI -

Spinal Accessory



What do you see in labs with HIV & Dementia? CD4 <200

Viral Load is high

<20% get it with antiretroviral treatment

,What is the scoring with the Beck Depression Inventory? Self-Report - 0-63

0-13 - minimal

14-19 - mild

20-28 - moderate

29-63 – severe



What is sensitivity? Helps rule-out disease = True Positive = Snout



What is specificity? Helps rule-in disease = True Negative = Spin



What does a sed rate measure? Inflammation (ESR - Erythrocyte Sedimentation Rate)

= distance in mm RBC's have descended in 1 hour.



What is dissemination? Getting the research information out to those who need to

know it!

Publication - highest level

Presenting at National Conference

Presenting at Local Conference

Journal Club where one person reviews an article



What does a 17 on MMSE mean? Moderate cognitive impairment



What is Tegretol in the CYP450 system? Inducer -->will lower dose of Lamictal and BCP's

, What do BCP's do to Lamictal? Inducer - will lower dose of Lamictal



What is a Type I research error? There IS a difference but you say there isn't a

difference.



What is a Type II research error? There is NO difference but you say there is a

difference.

What is pseudo-dementia? Cognitive impairment secondary to depression that clears

when treated in the elderly. Dementia won't improve.



Is it normal for a 1-month-old to have a palmar grasp? Yes.



What is a drug 1/2 life? The time it takes for 50% of a drug to be eliminated from the

body.

What 3 atypical can be used with teens? Zyprexa, Abilify, Seroquel - low doses



What is a risk of using Tramadol? Serotonin Syndrome as it is very serotonergic.



What is the allele seen in Asians that increase the risk of SJS? HLAB-1502



When might you see toxic epidermal necrolysis? With worsening of SJS

How many generations do you include for a genogram? 1st degree - mother, father,

siblings

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