NR547/ NR 547 Week 1 Exam CEA Pre-Clinical Diagnostic (2026/2027 Update) | Differential Diagnosis & Clinical Management | Psychiatric-Mental Health, Bipolar Disorder, MDD, OCD, Schizophrenia, Physical Assessment | A+ Graded | Chamberlain University

INSTANT PDF DOWNLOAD — This comprehensive EXAM resource for the NR 547 CEA (Clinical Evaluation Assessment) Pre-Clinical Diagnostic Exam at Chamberlain University covers the complete 2026/2027 examination blueprint . It features over 150 exam-style questions with verified answers and detailed rationales covering differential diagnosis, clinical management, physical assessment, and laboratory interpretation across all major body systems. Exam Topics Covered: Section 1: Psychiatric Differential Diagnosis (Questions 1-25) Bipolar I Disorder with Anxious Distress (F31.89): Racing thoughts, inability to pay attention, restless, tense, constant talking for 2+ weeks; toxicology negative Bipolar I with Mood-Congruent Psychotic Features (F31.2): Grandiosity, decreased need for sleep, excessive spending, delusional thinking (e.g., celebrity invited patient backstage) Bipolar I Manic Episode with Mixed Features (F31.12): Racing thoughts centered on worthlessness, fatigue, irritability, increased sexual behavior, suicidal ideation Bipolar II Disorder: Requires at least one hypomanic episode and one major depressive episode, but NO full manic episode Cyclothymic Disorder: Involves highs and lows milder than bipolar disorder; symptoms for ≥2 years without meeting full episode criteria Major Depressive Disorder (MDD): ≥2 weeks of depressed mood or anhedonia plus additional symptoms (SIGECAPS: Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor, Suicidal ideation) Obsessive-Compulsive Disorder (OCD): Intrusive unwanted thoughts (obsessions) with repetitive behaviors (compulsions) to reduce anxiety; obsessions differ from generalized worry Generalized Anxiety Disorder (GAD): Must first rule out hyperthyroidism (TSH, free T4) before making psychiatric diagnosis due to symptom overlap (tachycardia, tremors, nervousness) Panic Disorder: Recurrent unexpected panic attacks peaking within 10 minutes; somatic symptoms including racing heart, sweating, shortness of breath, sense of doom Social Anxiety Disorder: Fear of being judged in social situations for ≥6 months; avoidant behavior Agoraphobia: Fear of places where escape might be difficult; fear of 2+ of 5 places for 6+ months Schizophrenia: Onset before age 25; positive symptoms (hallucinations, delusions) come and go; negative symptoms (avolition, flat affect, alogia) more stable; genetics strongest evidence as cause Schizoaffective Disorder: Uninterrupted period of illness including major mood episode concurrent with schizophrenia criteria, PLUS ≥2 weeks of delusions/hallucinations without mood symptoms Schizophreniform Disorder: Same symptoms as schizophrenia but shorter duration (1-6 months) Delusional Disorder: One or more non-bizarre delusions lasting ≥1 month without other prominent psychotic symptoms or significant functional impairment Catatonia: Psychomotor syndrome characterized by stupor, rigidity, posturing, negativism, purposeless excitement; can occur in schizophrenia, bipolar disorder, or medical conditions Post-Traumatic Stress Disorder (PTSD): Re-experiencing, avoidance, negative alterations in cognition/mood, and hyperarousal for 1 month after trauma Acute Stress Disorder (ASD): Same symptoms as PTSD but duration 3 days to 1 month Adjustment Disorder: Emotional/behavioral symptoms within 3 months of identifiable stressor, resolves within 6 months Alcohol Withdrawal: Can be life-threatening; causes seizures and delirium tremens (DTs); mortality 5-15% without treatment; benzodiazepines first-line Hyperthyroidism: Mimics anxiety and mania; MUST be ruled out before diagnosing primary psychiatric disorder; TSH low, T3/T4 elevated Vitamin B12 Deficiency: Causes depression, mania, psychosis, cognitive impairment; normal 190-950 pg/mL; borderline 200-300 pg/mL may need additional testing Vitamin D Deficiency: Associated with depressive symptoms, schizophrenia, seasonal affective disorder, cognitive impairment; normal 20-50 ng/mL Section 2: Physical Assessment & Diagnostics (Questions 26-50) Point of Maximum Impulse (PMI) Location: Left 5th intercostal space, midclavicular line Heart Sounds: S1 occurs at beginning of systole; S2 occurs at beginning of diastole (end of T wave on ECG) S3 and S4 Heart Sounds: Occur during diastole; S3 (ventricular gallop) in early diastole; S4 (atrial gallop) in late diastole Blood Pressure Cuff Size: Cuff too large → falsely low reading; cuff too small → falsely high reading Varicocele: Enlarged scrotal veins described as feeling like a "bag of worms"; exacerbated by heavy lifting or prolonged standing Exophthalmos: Hallmark sign of hyperthyroidism (Graves' disease) due to retro-orbital inflammation Forced Vital Capacity (FVC): Maximum volume of air exhaled after maximal inhalation; measured during spirometry for COPD diagnosis Addison's Disease Findings: Hypothermia (low body temperature) due to reduced cortisol and aldosterone affecting metabolism and thermoregulation Type 2 Diabetes End-Organ Dysfunction Evaluation: Renal function panel, urinalysis with microalbumin, and dilated eye exam ALL appropriate Angioedema: Commonly affects face, lips, tongue, and throat; causes swelling due to allergic or hereditary causes Actinic Keratosis: Precancerous dermatologic lesion caused by chronic UV-B exposure; may progress to squamous cell carcinoma if untreated ABCDE Criteria for Melanoma: Suspicious finding includes irregular borders (B); other criteria: Asymmetry, Color variation, Diameter 6mm, Evolution/changes Atelectasis: Crackles that clear after coughing suggest atelectasis; dull percussion noted post-operatively; collapsed alveoli reopen with coughing Murphy Sign: Right upper quadrant pain worsening with deep inspiration; positive finding indicates cholecystitis Glomerulonephritis: Hematuria following strep infection; 18-year-old patient Magnesium Toxicity: Symptoms include decreased reflexes, confusion, sleepiness, bladder paralysis, flushing, and headache Lithium Monitoring: Narrow therapeutic index (0.6-1.2 mEq/L); regular monitoring of levels, BUN, creatinine, and TSH required Medical Conditions That Mimic Psychiatric Disorders For Mania: Hyperthyroidism, hypercortisolemia, hyperaldosteronism, brain tumor, neurocognitive disorder, acromegaly, delirium, lupus, HIV, or syphilis For Anxiety: Hyperthyroidism (TSH, free T4) For Depression: Hypothyroidism (TSH elevated), vitamin D deficiency (Vitamin D low), anemia, chronic fatigue syndrome, Cushing's syndrome, Addison's disease, diabetes mellitus For Psychosis: HIV, neurocognitive disorders, delirium, brain