NR 547 Differential Diagnosis in
Psychiatric-Mental Health
Across the Lifespan Practicum
NR 547 Week 8 Final Exam:
1. A 25-year-old client presents with irritability, insomnia, and excessive energy. She states
that she felt this way for about a week. Last month she reported that she felt"really down"
and slept most of the time. She endorses a pattern of ups and downs in her mood at least
half the time over the past few years. Which diagnosis is most consistent with the client's
symptoms?
Cyclothymia
dysthymia
Answer
Based on the symptoms described, the most consistent diagnosis for the client
would be Cyclothymia.
Cyclothymia
Cyclothymia, also known as cyclothymic disorder, is a type of chronic mood
disorder widely considered to be a milder form of bipolar disorder. Cyclothymia is
characterized by numerous mood swings, with periods of hypomanic symptoms
that do not meet full criteria for a hypomanic episode, alternating with periods of
mild or moderate depressive symptoms that do not meet full criteria for a major
depressive episode.
The client's symptoms of irritability, insomnia, and excessive energy, followed by
periods of feeling "really down" and sleeping most of the time, are indicative of the
mood swings typically seen in cyclothymia. The fact that she has experienced these
ups and downs in her mood at least half the time over the past few years also aligns
with the chronic nature of cyclothymia.
Dysthymia
, On the other hand, dysthymia, now known as persistent depressive disorder (PDD),
is a chronic form of depression. Symptoms of dysthymia are the same as those of
major depression but are less severe. However, people with dysthymia can also
experience periods of major depression. The key difference between dysthymia and
cyclothymia is the presence of hypomanic or manic episodes in the latter, which
are not a feature of dysthymia.
In conclusion, while both cyclothymia and dysthymia are chronic mood disorders,
the presence of periods of excessive energy and insomnia, in addition to periods of
depression, suggest a diagnosis of cyclothymia for this client. However, a definitive
diagnosis should be made by a mental health professional following a thorough
evaluation.
2. Which characteristic is most indicative of narcissistic personality disorder?
A. Substance use behavior
B. Inability to monitor reality
C. Ongoing need for admiration
D. Unusual ideas of reference
Answer
The most indicative characteristic of narcissistic personality disorder is:
C. Ongoing need for admiration
Explanation
Narcissistic Personality Disorder (NPD) is a mental condition in which people have
an inflated sense of their own importance, a deep need for excessive attention and
admiration, troubled relationships, and a lack of empathy for others.
Here's a brief explanation of why the other options are not as indicative:
• A. Substance use behavior: While individuals with NPD may engage in
substance use, it is not a defining characteristic of the disorder. Substance
use can be associated with a variety of mental health conditions, not just
NPD.
• B. Inability to monitor reality: This is more indicative of psychotic disorders,
such as schizophrenia, rather than NPD. Individuals with NPD typically do not
lose touch with reality.
• D. Unusual ideas of reference: This refers to the belief that insignificant
events or comments by others have a particular and unusual meaning
Psychiatric-Mental Health
Across the Lifespan Practicum
NR 547 Week 8 Final Exam:
1. A 25-year-old client presents with irritability, insomnia, and excessive energy. She states
that she felt this way for about a week. Last month she reported that she felt"really down"
and slept most of the time. She endorses a pattern of ups and downs in her mood at least
half the time over the past few years. Which diagnosis is most consistent with the client's
symptoms?
Cyclothymia
dysthymia
Answer
Based on the symptoms described, the most consistent diagnosis for the client
would be Cyclothymia.
Cyclothymia
Cyclothymia, also known as cyclothymic disorder, is a type of chronic mood
disorder widely considered to be a milder form of bipolar disorder. Cyclothymia is
characterized by numerous mood swings, with periods of hypomanic symptoms
that do not meet full criteria for a hypomanic episode, alternating with periods of
mild or moderate depressive symptoms that do not meet full criteria for a major
depressive episode.
The client's symptoms of irritability, insomnia, and excessive energy, followed by
periods of feeling "really down" and sleeping most of the time, are indicative of the
mood swings typically seen in cyclothymia. The fact that she has experienced these
ups and downs in her mood at least half the time over the past few years also aligns
with the chronic nature of cyclothymia.
Dysthymia
, On the other hand, dysthymia, now known as persistent depressive disorder (PDD),
is a chronic form of depression. Symptoms of dysthymia are the same as those of
major depression but are less severe. However, people with dysthymia can also
experience periods of major depression. The key difference between dysthymia and
cyclothymia is the presence of hypomanic or manic episodes in the latter, which
are not a feature of dysthymia.
In conclusion, while both cyclothymia and dysthymia are chronic mood disorders,
the presence of periods of excessive energy and insomnia, in addition to periods of
depression, suggest a diagnosis of cyclothymia for this client. However, a definitive
diagnosis should be made by a mental health professional following a thorough
evaluation.
2. Which characteristic is most indicative of narcissistic personality disorder?
A. Substance use behavior
B. Inability to monitor reality
C. Ongoing need for admiration
D. Unusual ideas of reference
Answer
The most indicative characteristic of narcissistic personality disorder is:
C. Ongoing need for admiration
Explanation
Narcissistic Personality Disorder (NPD) is a mental condition in which people have
an inflated sense of their own importance, a deep need for excessive attention and
admiration, troubled relationships, and a lack of empathy for others.
Here's a brief explanation of why the other options are not as indicative:
• A. Substance use behavior: While individuals with NPD may engage in
substance use, it is not a defining characteristic of the disorder. Substance
use can be associated with a variety of mental health conditions, not just
NPD.
• B. Inability to monitor reality: This is more indicative of psychotic disorders,
such as schizophrenia, rather than NPD. Individuals with NPD typically do not
lose touch with reality.
• D. Unusual ideas of reference: This refers to the belief that insignificant
events or comments by others have a particular and unusual meaning
