NR 547 Final Exam: (Latest 2026/2027 Update) Mood Disorders, Bipolar
Spectrum, Dementia & Personality Disorders | Q&A | Grade A | 100% Correct
(Verified Answers) – Champion Nursing Program
Subject: Psychiatric-Mental Health Nurse Practitioner (PMHNP) – Mood Disorders, Bipolar Spectrum,
Personality Disorders, Dementia, Substance Withdrawal
Source: NR 547 Final Exam Bank / DSM-5-TR / Clinical Guidelines (2026/2027 Update)
Format: Q&A Guide with Clinical Rationales | Grade A Guaranteed
1: A 68-year-old male presents to your clinic with his daughter, who expresses concern about his
recent lack of interest in hobbies, decreased energy, and complaints of feeling "down." He denies
any history of manic or hypomanic episodes. Which of the following depression screening tools
would be most appropriate for initial assessment in this patient?
A. HAM-D
B. Mood Disorder Questionnaire (MDQ)
C. Geriatric Depression Scale (GDS)
D. PHQ-9
Correct Answer: C. Geriatric Depression Scale (GDS)
1. The Geriatric Depression Scale (GDS) is specifically designed for older adults, using a simple
yes/no format that avoids somatic symptoms often related to aging rather than depression. It is the
most appropriate initial screening tool for this 68-year-old patient.
2. Clinical evidence supports the GDS as having high sensitivity and specificity in detecting
depression in geriatric populations, and it can be self-administered or used with family input,
which aligns with the daughter's concerns.
3. The HAM-D is clinician-rated and more time-consuming; the MDQ screens for bipolar
disorder (not indicated here, as patient denies mania/hypomania); the PHQ-9 is valid but less age-
specific than the GDS for an initial geriatric assessment.
, 2: A 35-year-old female is diagnosed with Major Depressive Disorder (MDD) with atypical features.
Which of the following symptoms is characteristic of MDD with atypical features?
A. Profound despondency and anhedonia
B. Significant weight loss and early morning awakening
C. Mood reactivity and hypersomnia
D. Psychomotor retardation and excessive guilt
Correct Answer: C. Mood reactivity and hypersomnia
1. Atypical features in MDD are defined by mood reactivity (mood brightens in response to
positive events) and at least two of the following: increased appetite/weight gain, hypersomnia
(sleeping >10 hours/day), leaden paralysis, and long-standing rejection sensitivity. Hypersomnia
is a hallmark.
2. This contrasts with melancholic features, which include anhedonia, early morning awakening,
and psychomotor disturbance. Correctly identifying atypical features guides treatment selection
(MAOIs or SSRIs may be preferred).
3. Weight loss and early awakening (option B) are typical of melancholic depression, not atypical;
psychomotor retardation and guilt (option D) are also melancholic or severe depressive features.
3: A patient presents with a history of recurrent mood swings that do not meet the full criteria for
either a hypomanic or major depressive episode, but have persisted for more than two years. These
mood fluctuations cause significant distress. Which diagnosis is most consistent with this
presentation?
A. Bipolar I Disorder
B. Bipolar II Disorder
C. Cyclothymic Disorder
D. Persistent Depressive Disorder
Correct Answer: C. Cyclothymic Disorder
1. Cyclothymic Disorder requires at least 2 years (1 year in youth) of numerous periods with
hypomanic symptoms that do not meet full criteria for a hypomanic episode and depressive
symptoms that do not meet full criteria for a major depressive episode, with no symptom-free
period >2 months.
2. The presentation explicitly states the mood swings do not meet full criteria for hypomanic or
major depressive episodes, ruling out Bipolar I (manic episode required) and Bipolar II
(hypomanic + major depressive episode required). Persistent Depressive Disorder involves
chronic depression without hypomanic symptoms.
3. Cyclothymia is often misdiagnosed as borderline personality disorder, but the chronic, low-
grade mood instability with periods of subsyndromal hypomania is distinct and requires careful
longitudinal assessment.
Spectrum, Dementia & Personality Disorders | Q&A | Grade A | 100% Correct
(Verified Answers) – Champion Nursing Program
Subject: Psychiatric-Mental Health Nurse Practitioner (PMHNP) – Mood Disorders, Bipolar Spectrum,
Personality Disorders, Dementia, Substance Withdrawal
Source: NR 547 Final Exam Bank / DSM-5-TR / Clinical Guidelines (2026/2027 Update)
Format: Q&A Guide with Clinical Rationales | Grade A Guaranteed
1: A 68-year-old male presents to your clinic with his daughter, who expresses concern about his
recent lack of interest in hobbies, decreased energy, and complaints of feeling "down." He denies
any history of manic or hypomanic episodes. Which of the following depression screening tools
would be most appropriate for initial assessment in this patient?
A. HAM-D
B. Mood Disorder Questionnaire (MDQ)
C. Geriatric Depression Scale (GDS)
D. PHQ-9
Correct Answer: C. Geriatric Depression Scale (GDS)
1. The Geriatric Depression Scale (GDS) is specifically designed for older adults, using a simple
yes/no format that avoids somatic symptoms often related to aging rather than depression. It is the
most appropriate initial screening tool for this 68-year-old patient.
2. Clinical evidence supports the GDS as having high sensitivity and specificity in detecting
depression in geriatric populations, and it can be self-administered or used with family input,
which aligns with the daughter's concerns.
3. The HAM-D is clinician-rated and more time-consuming; the MDQ screens for bipolar
disorder (not indicated here, as patient denies mania/hypomania); the PHQ-9 is valid but less age-
specific than the GDS for an initial geriatric assessment.
, 2: A 35-year-old female is diagnosed with Major Depressive Disorder (MDD) with atypical features.
Which of the following symptoms is characteristic of MDD with atypical features?
A. Profound despondency and anhedonia
B. Significant weight loss and early morning awakening
C. Mood reactivity and hypersomnia
D. Psychomotor retardation and excessive guilt
Correct Answer: C. Mood reactivity and hypersomnia
1. Atypical features in MDD are defined by mood reactivity (mood brightens in response to
positive events) and at least two of the following: increased appetite/weight gain, hypersomnia
(sleeping >10 hours/day), leaden paralysis, and long-standing rejection sensitivity. Hypersomnia
is a hallmark.
2. This contrasts with melancholic features, which include anhedonia, early morning awakening,
and psychomotor disturbance. Correctly identifying atypical features guides treatment selection
(MAOIs or SSRIs may be preferred).
3. Weight loss and early awakening (option B) are typical of melancholic depression, not atypical;
psychomotor retardation and guilt (option D) are also melancholic or severe depressive features.
3: A patient presents with a history of recurrent mood swings that do not meet the full criteria for
either a hypomanic or major depressive episode, but have persisted for more than two years. These
mood fluctuations cause significant distress. Which diagnosis is most consistent with this
presentation?
A. Bipolar I Disorder
B. Bipolar II Disorder
C. Cyclothymic Disorder
D. Persistent Depressive Disorder
Correct Answer: C. Cyclothymic Disorder
1. Cyclothymic Disorder requires at least 2 years (1 year in youth) of numerous periods with
hypomanic symptoms that do not meet full criteria for a hypomanic episode and depressive
symptoms that do not meet full criteria for a major depressive episode, with no symptom-free
period >2 months.
2. The presentation explicitly states the mood swings do not meet full criteria for hypomanic or
major depressive episodes, ruling out Bipolar I (manic episode required) and Bipolar II
(hypomanic + major depressive episode required). Persistent Depressive Disorder involves
chronic depression without hypomanic symptoms.
3. Cyclothymia is often misdiagnosed as borderline personality disorder, but the chronic, low-
grade mood instability with periods of subsyndromal hypomania is distinct and requires careful
longitudinal assessment.
