NR547 CEA PMNHP Pre-Clinical Diagnostic Exam
Complete Actual Exam Questions 1- 150 Screenshots
Online Exam Requires Respondus Lockdown Browser
+ Webcam NR547 CEA Differential Diagnosis in
Psychiatric-Mental Health (MSN) PMNHP Exam
Section I: Differential Diagnosis & Clinical Assessment (Questions 1-40)
Question 1: A mother is unable to acknowledge that her teenage son's mental
illness is perpetuated by his polysubstance use disorder and insists that his father's
genes are to blame. Which defense mechanism is being employed?
A. Regression
B. Dissociation
C. Reaction formation
D. Denial
,,answer,,,,: D. Denial
Rationale: Denial is the refusal to accept reality or facts, blocking external events
from awareness. The mother cannot acknowledge the role of substance use despite
clear evidence . This is a primitive defense mechanism commonly observed in
families struggling to accept mental illness diagnoses.
Question 2: A 78-year-old man leans in with the right side of his head, frequently
asks for things to be repeated, and has become increasingly isolated and irritable
because he believes people are yelling at him. His daughter is worried about
dementia or depression. What should the PMHNP do FIRST?
A. Order a CT scan of the head
B. Separate the patient from the daughter and interview him alone
C. Examine the patient's ear canals
D. Provide anticipatory guidance regarding aging parents
,,,answer,,,,: C. Examine the patient's ear canals
Rationale: The presentation is classic for hearing loss. Irritability and social
isolation are common consequences of untreated hearing impairment. Ruling out
hearing loss is the least invasive first step before pursuing neuroimaging or
assuming a primary psychiatric disorder .
Question 3: A 35-year-old man with bipolar disorder mentions that he felt a lump
on his left testicle and is concerned that he has not had a physical exam in 10 years.
What is the best action by the PMHNP?
A. Refer him to his primary care provider
B. Explore the possibility that the lump is a somatic delusion
C. Perform a testicular examination
D. Reassure him that testicular lumps are rarely cancerous
,,answer,,,,: A. Refer him to his primary care provider
Rationale: A new physical complaint in a patient with a psychiatric disorder
requires appropriate medical evaluation by a primary care provider. The PMHNP
should not dismiss the complaint as a somatic delusion without proper medical
assessment nor perform an exam outside their scope of practice .
Question 4: A 35-year-old patient presents with persistent sadness, loss of interest,
and fatigue for 3 weeks. They deny any history of mania or hypomania. What is the
most likely primary diagnosis?
A. Bipolar I Disorder
B. Major Depressive Disorder
C. Persistent Depressive Disorder
D. Cyclothymic Disorder
,,answer,,,,: B. Major Depressive Disorder
*Rationale: MDD requires at least 2 weeks of depressed mood or anhedonia plus
additional symptoms, with no history of mania/hypomania. Persistent Depressive
,Disorder requires symptoms for at least 2 years. Bipolar disorders require
manic/hypomanic episodes .*
Question 5: Which medical condition must be ruled out before diagnosing
Generalized Anxiety Disorder due to significant symptom overlap including
tachycardia, tremors, and nervousness?
A. Hyperthyroidism
B. Hypothyroidism
C. Type 1 Diabetes Mellitus
D. Hypertension
,,answer,,,,: A. Hyperthyroidism
Rationale: Hyperthyroidism mimics anxiety symptoms through sympathetic
nervous system overactivity; thyroid function tests are standard in the initial
workup for new-onset anxiety before making a psychiatric diagnosis .
Question 6: A patient reports intrusive, unwanted thoughts about contamination
with germs and performs repetitive hand washing for hours each day to reduce
anxiety. Which diagnosis is most consistent with this clinical presentation?
A. Generalized Anxiety Disorder
B. Obsessive-Compulsive Disorder
C. Post-Traumatic Stress Disorder
D. Illness Anxiety Disorder
,,answer,,,,: B. Obsessive-Compulsive Disorder
Rationale: OCD is characterized by obsessions (intrusive, unwanted thoughts) and
compulsions (repetitive behaviors or mental acts) performed to neutralize anxiety.
GAD involves worry about multiple events, not specific rituals .
Question 7: Which symptom distinguishes Bipolar I Disorder from Bipolar II
Disorder?
, A. Presence of depressive episodes
B. Presence of at least one manic episode
C. Presence of hypomanic episodes
D. Duration of mood symptoms
,,answer,,,,: B. Presence of at least one manic episode
Rationale: Bipolar I requires at least one full manic episode (lasting at least 7 days
or requiring hospitalization). Bipolar II requires at least one hypomanic episode
and one major depressive episode, but no full mania .
Question 8: A patient experiences sudden episodes of intense fear, palpitations,
and fear of dying, peaking within 10 minutes. What is this phenomenon?
A. Generalized Anxiety
B. Panic Attack
C. Flashback
D. Manic Episode
,,answer,,,,: B. Panic Attack
Rationale: Panic attacks are abrupt surges of intense fear peaking within minutes,
accompanied by at least four characteristic physical and cognitive symptoms. They
can occur in Panic Disorder or in the context of other disorders .
Question 9: A patient reports flashbacks and avoidance behaviors 6 months after a
traumatic event. What is the diagnosis?
A. Acute Stress Disorder
B. Post-Traumatic Stress Disorder (PTSD)
C. Adjustment Disorder
D. Generalized Anxiety Disorder
,,answer,,,,: B. Post-Traumatic Stress Disorder (PTSD)
Complete Actual Exam Questions 1- 150 Screenshots
Online Exam Requires Respondus Lockdown Browser
+ Webcam NR547 CEA Differential Diagnosis in
Psychiatric-Mental Health (MSN) PMNHP Exam
Section I: Differential Diagnosis & Clinical Assessment (Questions 1-40)
Question 1: A mother is unable to acknowledge that her teenage son's mental
illness is perpetuated by his polysubstance use disorder and insists that his father's
genes are to blame. Which defense mechanism is being employed?
A. Regression
B. Dissociation
C. Reaction formation
D. Denial
,,answer,,,,: D. Denial
Rationale: Denial is the refusal to accept reality or facts, blocking external events
from awareness. The mother cannot acknowledge the role of substance use despite
clear evidence . This is a primitive defense mechanism commonly observed in
families struggling to accept mental illness diagnoses.
Question 2: A 78-year-old man leans in with the right side of his head, frequently
asks for things to be repeated, and has become increasingly isolated and irritable
because he believes people are yelling at him. His daughter is worried about
dementia or depression. What should the PMHNP do FIRST?
A. Order a CT scan of the head
B. Separate the patient from the daughter and interview him alone
C. Examine the patient's ear canals
D. Provide anticipatory guidance regarding aging parents
,,,answer,,,,: C. Examine the patient's ear canals
Rationale: The presentation is classic for hearing loss. Irritability and social
isolation are common consequences of untreated hearing impairment. Ruling out
hearing loss is the least invasive first step before pursuing neuroimaging or
assuming a primary psychiatric disorder .
Question 3: A 35-year-old man with bipolar disorder mentions that he felt a lump
on his left testicle and is concerned that he has not had a physical exam in 10 years.
What is the best action by the PMHNP?
A. Refer him to his primary care provider
B. Explore the possibility that the lump is a somatic delusion
C. Perform a testicular examination
D. Reassure him that testicular lumps are rarely cancerous
,,answer,,,,: A. Refer him to his primary care provider
Rationale: A new physical complaint in a patient with a psychiatric disorder
requires appropriate medical evaluation by a primary care provider. The PMHNP
should not dismiss the complaint as a somatic delusion without proper medical
assessment nor perform an exam outside their scope of practice .
Question 4: A 35-year-old patient presents with persistent sadness, loss of interest,
and fatigue for 3 weeks. They deny any history of mania or hypomania. What is the
most likely primary diagnosis?
A. Bipolar I Disorder
B. Major Depressive Disorder
C. Persistent Depressive Disorder
D. Cyclothymic Disorder
,,answer,,,,: B. Major Depressive Disorder
*Rationale: MDD requires at least 2 weeks of depressed mood or anhedonia plus
additional symptoms, with no history of mania/hypomania. Persistent Depressive
,Disorder requires symptoms for at least 2 years. Bipolar disorders require
manic/hypomanic episodes .*
Question 5: Which medical condition must be ruled out before diagnosing
Generalized Anxiety Disorder due to significant symptom overlap including
tachycardia, tremors, and nervousness?
A. Hyperthyroidism
B. Hypothyroidism
C. Type 1 Diabetes Mellitus
D. Hypertension
,,answer,,,,: A. Hyperthyroidism
Rationale: Hyperthyroidism mimics anxiety symptoms through sympathetic
nervous system overactivity; thyroid function tests are standard in the initial
workup for new-onset anxiety before making a psychiatric diagnosis .
Question 6: A patient reports intrusive, unwanted thoughts about contamination
with germs and performs repetitive hand washing for hours each day to reduce
anxiety. Which diagnosis is most consistent with this clinical presentation?
A. Generalized Anxiety Disorder
B. Obsessive-Compulsive Disorder
C. Post-Traumatic Stress Disorder
D. Illness Anxiety Disorder
,,answer,,,,: B. Obsessive-Compulsive Disorder
Rationale: OCD is characterized by obsessions (intrusive, unwanted thoughts) and
compulsions (repetitive behaviors or mental acts) performed to neutralize anxiety.
GAD involves worry about multiple events, not specific rituals .
Question 7: Which symptom distinguishes Bipolar I Disorder from Bipolar II
Disorder?
, A. Presence of depressive episodes
B. Presence of at least one manic episode
C. Presence of hypomanic episodes
D. Duration of mood symptoms
,,answer,,,,: B. Presence of at least one manic episode
Rationale: Bipolar I requires at least one full manic episode (lasting at least 7 days
or requiring hospitalization). Bipolar II requires at least one hypomanic episode
and one major depressive episode, but no full mania .
Question 8: A patient experiences sudden episodes of intense fear, palpitations,
and fear of dying, peaking within 10 minutes. What is this phenomenon?
A. Generalized Anxiety
B. Panic Attack
C. Flashback
D. Manic Episode
,,answer,,,,: B. Panic Attack
Rationale: Panic attacks are abrupt surges of intense fear peaking within minutes,
accompanied by at least four characteristic physical and cognitive symptoms. They
can occur in Panic Disorder or in the context of other disorders .
Question 9: A patient reports flashbacks and avoidance behaviors 6 months after a
traumatic event. What is the diagnosis?
A. Acute Stress Disorder
B. Post-Traumatic Stress Disorder (PTSD)
C. Adjustment Disorder
D. Generalized Anxiety Disorder
,,answer,,,,: B. Post-Traumatic Stress Disorder (PTSD)
