NR547/ NR 547 Midterm Study Guide (Latest 2026/2027 Update) | Differential Diagnosis, Psychiatric Assessment, DSM-5-TR Criteria, Screening Tools, Lab Interpretation, Anxiety Disorders, Panic Disorder | A+ Graded | Chamberlain University

INSTANT PDF DOWNLOAD — This comprehensive exam resource for the NR 547 Midterm Exam covers Differential Diagnosis in Psychiatric-Mental Health across the Lifespan Practicum at Chamberlain University for the 2026/2027 academic year . It features exam-style questions with verified answers and detailed rationales based on official PMHNP curriculum content . Midterm Exam Topics Covered: Differential Diagnosis Process (6 Steps): Step 1: Rule out malingering or factitious disorder . Step 2: Rule out substance/medication etiology (symptoms stop within one month of stopping substance) . Step 3: Rule out disorder due to a medical condition (symptoms begin after medical condition onset, vary with severity, disappear when condition resolves) . Step 4: Determine the specific primary disorder using DSM-5-TR . Step 5: Differentiate adjustment disorders from "other specified/unspecified" categories . Step 6: Establish boundary with no mental disorder (not everyone qualifies for a diagnosis) . Psychiatric Assessment & History Taking: History of Present Illness questions, psychiatric history (hospitalizations, counseling, medications), medical history screening, family psychiatric history, social/developmental history, review of systems . Screening & Psychiatric Rating Scales: ASQ (suicide risk screening), GAD-7 (0-4 minimal, 5-9 mild, 10-14 moderate, 15+ severe anxiety), HAM-A (Hamilton Anxiety Rating Scale - assesses somatic/cognitive anxiety but not worry component for GAD) . PANSS (Positive and Negative Syndrome Scale) for schizophrenia research, BPRS (Brief Psychiatric Rating Scale) for moderate-severe psychosis evaluation over time . Basic Laboratory Interpretation: CBC (rule out anemia as cause of fatigue, infection as cause of mental status changes), CMP (monitor medication effects on liver and glucose), Thyroid Function Tests (TSH 0.4-4.5 mIU/L, elevations suggest hypothyroidism), Vitamin B12 (190-950 pg/mL, deficiency causes depression, mania, psychosis, cognitive impairment), Vitamin D (20-50 ng/mL, deficiency associated with depressive symptoms), Toxicology Screen, Urinalysis (UTI can cause acute mental status changes in elderly) . Treat or Refer Decision Making: Refer for TSH 4.0 (hypothyroidism), elevated T3 (hyperthyroidism), vitamin D deficiency, positive urine leukocyte esterase (UTI), elevated BUN/creatinine (kidney dysfunction). Begin treatment when labs are within normal limits . Social Determinants of Health (SDOH): Conditions in which individuals are "born, grow, live, work, and age" that impact mental health outcomes . Holistic Care Principles: A holistic approach addresses psychiatric, medical, social, spiritual, lifestyle, and behavioral elements impacting mental health . SNAPPS Clinical Reasoning: Structured presentation model for case discussions in clinical education . ICD-10-CM Coding: Standardized coding system for diagnosing and documenting both physical and mental health disorders, essential for treatment, billing, and statistical analysis . Anxiety Disorders: Generalized Anxiety Disorder (GAD-7 15+ severe, first-line SSRIs, buspirone adjunct, GAD involves increased amygdala activation and decreased prefrontal cortex activation) . Panic Disorder (marked persistent recurrent panic attacks, unprovoked, occur in familiar places, peak 10-20 minutes). Social Anxiety Disorder (fear of being judged in social situations 6 months, avoidant behavior). Agoraphobia (fear of places where escape might be difficult, fear of 2+ of 5 places for 6+ months) . Medication Management: Antidepressants continued 6-12 months after remission for anxiety disorders . First-line: SSRIs for GAD, panic disorder, PTSD. Venlafaxine (SNRI) for panic disorder, GAD, SAD. Propranolol for performance anxiety (SAD). Buspirone as adjunct for GAD (2-4 weeks to work) . Psychotic Disorders & Schizophrenia: Schizophrenia is one of the 15 leading causes of disability worldwide, onset before age 25, positive symptoms come and go, negative symptoms more stable, prodromal phase develops before first psychotic episode (days to months), may show interest in abstract ideas, philosophy, occult or religious questions. Genetics have strongest evidence as cause . Child & Adolescent Psychiatry: Enuresis (involuntary discharge of urine/bed wetting). Modafinil for narcolepsy . Clozapine Monitoring Schedule: Weekly for first 6 months, every 2 weeks for months 6-12, monthly after 12 months . 4. VERTICAL KEYWORDS / TAGS NR547/ NR 547 Midterm Study Guide 2026/2027, Chamberlain University PMHNP Exam, Differential Diagnosis in Psychiatric-Mental Health, 6-Step Differential Diagnosis R/O Malingering Factitious Disorder Substance Etiology Medical Condition, ICD-10-CM Coding Psychiatric Disorders, ASQ Suicide Risk Assessment Brief Safety Assessment, GAD-7 Screening Tool Anxiety Severity Minimal Mild Moderate Severe, HAM-A Hamilton Anxiety Rating Scale Limitations No Worry Component, PANSS BPRS Schizophrenia Psychosis Rating Scales, CBC Lab Interpretation Rule Out Anemia Infection, CMP Comprehensive Metabolic Panel Medication Monitoring, Thyroid Function Tests TSH Hypothyroidism Hyperthyroidism, Vitamin B12 Deficiency Depression Mania Psychosis Cognitive Impairment, Vitamin D Deficiency Depressive Symptoms, Treat or Refer Decision Making Elevated TSH Elevated Creatinine Elevated BUN Positive Urine Leukocyte Esterase, Social Determinants of Health SDOH Environmental Factors, Holistic Care Biopsychosocial Spiritual Behavioral Elements, SNAPPS Clinical Reasoning Case Presentation Model, Psychiatric Assessment History Taking HPI Psychiatric History Medical History Family History Social History, Generalized Anxiety Disorder GAD DSM-5 Criteria 6 Months Excessive Worry, GAD Pathophysiology Increased Amygdala Decreased PFC Activation, First-Line GAD Treatment SSRIs Buspirone Adjunct, Panic Disorder DSM-5 Criteria Marked Persistent Recurrent Panic Attacks, Social Anxiety Disorder DSM-5 Criteria Fear of Being Judged Avoidance, Agoraphobia Fear of Escape 2 of 5 Places 6 Months Duration, Performance Anxiety Propranolol 30-60 Minutes Before Event, Schizophrenia Prodromal Phase Negative Symptoms Abstract Ideas Genetics Strongest Evidence, Clozapine Monitoring Schedule Weekly Biweekly Monthly, Alogia Short One-Two Word Phrases, Enuresis Bed Wetting Involuntary Urine Discharge, Get HighScore NR 547 Midterm, Downloadable PDF Chamberlain PMHNP 2026/2027 Study Guide