NR547 DIFFERENTIAL DIAGNOSIS PMH LIFESPAN MIDTERM
PRACTICUM EXAM 2026/2027 | Latest Review Questions |
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[Section 1: Neurodevelopmental Disorders (ADHD, ASD, Intellectual Disability) (Q1-15)]
Q1. A 28-year-old graduate student reports difficulty sustaining attention during
lectures, frequent misplacement of belongings, and trouble meeting deadlines since
childhood. According to DSM-5-TR, what is the minimum number of inattention
symptoms required to establish an ADHD diagnosis in an adult?
A. 3 symptoms
B. 4 symptoms
C. 5 symptoms [CORRECT]
D. 6 symptoms
Rationale: DSM-5-TR requires 5+ symptoms of inattention and/or 5+ symptoms of
hyperactivity-impulsivity for adults aged 17 and older, compared to 6+ symptoms
required for children; symptoms must have onset before age 12 and be present in two
or more settings.
Correct Answer: C
Q2. A 9-year-old boy demonstrates six symptoms of inattention and four symptoms of
hyperactivity-impulsivity at school. His mother reports similar behaviors at home since
age 7. However, his pediatrician notes he sleeps poorly and snores loudly. What is the
essential next step in differential diagnosis?
A. Confirm ADHD-combined presentation immediately and initiate stimulant therapy
B. Rule out obstructive sleep apnea and other medical causes before confirming ADHD
C. Diagnose ADHD-predominantly inattentive presentation because hyperactivity
symptoms are insufficient
D. Delay diagnosis until the child reaches age 12
,Rationale: DSM-5-TR requires that ADHD symptoms are not better explained by another
mental or medical condition; sleep disorders can mimic inattention and hyperactivity, so
medical causes must be ruled out before confirming ADHD.
Correct Answer: B
Q3. A 10-year-old struggles exclusively with mathematics calculations and number
sense but maintains average attention during non-academic tasks and social
interactions. What is the most accurate differential diagnosis?
A. ADHD, predominantly inattentive presentation
B. Specific learning disorder with impairment in mathematics [CORRECT]
C. Autism spectrum disorder
D. Intellectual disability
Rationale: Specific learning disorder involves deficits in academic skills (reading,
writing, mathematics) without the generalized inattention, impulsivity, or social
communication deficits seen in ADHD or ASD; the isolated math deficit supports this
diagnosis per DSM-5-TR.
Correct Answer: B
Q4. An 11-year-old girl reports constant worry about grades, family health, and future
events, resulting in muscle tension, fatigue, and difficulty concentrating. Her teacher
notes she is fidgety and distracted. What is the key differentiating feature between
generalized anxiety disorder and ADHD in this presentation?
A. The presence of any worry automatically excludes ADHD
B. Motor restlessness from muscle tension and worry-based distractibility versus the
chronic disinhibited impulsivity and executive dysfunction of ADHD [CORRECT]
C. Children cannot have both anxiety and ADHD
D. The age of onset is irrelevant in distinguishing these disorders
Rationale: In GAD, distractibility and restlessness stem from worry and somatic tension,
whereas ADHD involves chronic executive dysfunction, disinhibition, and impulsivity
present across multiple contexts since early childhood; DSM-5-TR emphasizes that
symptoms must not be better explained by another disorder.
,Correct Answer: B
Q5. A 32-year-old man reports periods of elevated mood, decreased need for sleep, and
increased goal-directed activity lasting 5 days, interspersed with months of baseline
functioning. His partner notes that between episodes he has chronic difficulty
organizing tasks and maintaining attention. What is the key feature distinguishing
bipolar disorder from ADHD in this adult?
A. Both disorders cause identical sleep disturbances
B. Bipolar disorder presents with distinct episodic mood changes and decreased need
for sleep, whereas ADHD symptoms are chronic and persistent since childhood
[CORRECT]
C. ADHD never co-occurs with bipolar disorder
D. Goal-directed activity is exclusive to bipolar disorder and never occurs in ADHD
Rationale: Bipolar disorder is characterized by distinct manic or hypomanic episodes
with mood elevation and decreased sleep need, while ADHD presents with chronic,
developmentally inappropriate inattention and hyperactivity since childhood; DSM-5-TR
requires episodicity for mania versus chronicity for ADHD.
Correct Answer: B
Q6. A 4-year-old child rarely initiates social interaction, does not share enjoyment during
play, and shows minimal response to parental praise or comfort. Which DSM-5-TR
criterion for autism spectrum disorder is best represented?
A. Restricted repetitive behaviors
B. Deficits in social-emotional reciprocity [CORRECT]
C. Hyperactivity and impulsivity
D. Grandiose self-importance
Rationale: Deficits in social-emotional reciprocity—such as abnormal social approach,
reduced sharing of interests or emotions, and failure to initiate or respond to social
interactions—are a core diagnostic criterion for ASD under DSM-5-TR social
communication and interaction domain.
Correct Answer: B
, Q7. A 6-year-old with ASD makes poor eye contact, uses exaggerated gestures that do
not match his speech content, and fails to understand simple facial expressions from
peers. Which ASD diagnostic domain is primarily impaired?
A. Restricted repetitive behaviors
B. Deficits in nonverbal communicative behaviors used for social interaction [CORRECT]
C. Intellectual functioning
D. Motor coordination
Rationale: DSM-5-TR requires deficits in nonverbal communication, including poorly
integrated verbal and nonverbal communication, abnormal eye contact and body
language, and deficits in understanding and use of gestures and facial expressions, as
part of the social communication criteria for ASD.
Correct Answer: B
Q8. A 5-year-old child with ASD insists on eating the same three foods daily, becomes
distressed if his morning routine changes, and lines up toys in precise patterns. Which
DSM-5-TR criterion is demonstrated?
A. Social anxiety disorder
B. Restricted, repetitive patterns of behavior, interests, or activities [CORRECT]
C. Obsessive-compulsive disorder
D. Oppositional defiant disorder
Rationale: Insistence on sameness, highly restricted fixated interests, and stereotyped
patterns of behavior are core features of the restricted repetitive behavior domain in
ASD; these behaviors differ from OCD compulsions in that they are not performed to
neutralize obsessions per DSM-5-TR.
Correct Answer: B
Q9. A 3-year-old with ASD requires substantial support to communicate functional
needs and exhibits severe distress with minor environmental changes. What DSM-5-TR
severity level is most appropriate?
A. Level 1 (requiring support)
B. Level 2 (requiring substantial support) [CORRECT]
PRACTICUM EXAM 2026/2027 | Latest Review Questions |
Chamberlain | Pass Guaranteed - A+ Graded
[Section 1: Neurodevelopmental Disorders (ADHD, ASD, Intellectual Disability) (Q1-15)]
Q1. A 28-year-old graduate student reports difficulty sustaining attention during
lectures, frequent misplacement of belongings, and trouble meeting deadlines since
childhood. According to DSM-5-TR, what is the minimum number of inattention
symptoms required to establish an ADHD diagnosis in an adult?
A. 3 symptoms
B. 4 symptoms
C. 5 symptoms [CORRECT]
D. 6 symptoms
Rationale: DSM-5-TR requires 5+ symptoms of inattention and/or 5+ symptoms of
hyperactivity-impulsivity for adults aged 17 and older, compared to 6+ symptoms
required for children; symptoms must have onset before age 12 and be present in two
or more settings.
Correct Answer: C
Q2. A 9-year-old boy demonstrates six symptoms of inattention and four symptoms of
hyperactivity-impulsivity at school. His mother reports similar behaviors at home since
age 7. However, his pediatrician notes he sleeps poorly and snores loudly. What is the
essential next step in differential diagnosis?
A. Confirm ADHD-combined presentation immediately and initiate stimulant therapy
B. Rule out obstructive sleep apnea and other medical causes before confirming ADHD
C. Diagnose ADHD-predominantly inattentive presentation because hyperactivity
symptoms are insufficient
D. Delay diagnosis until the child reaches age 12
,Rationale: DSM-5-TR requires that ADHD symptoms are not better explained by another
mental or medical condition; sleep disorders can mimic inattention and hyperactivity, so
medical causes must be ruled out before confirming ADHD.
Correct Answer: B
Q3. A 10-year-old struggles exclusively with mathematics calculations and number
sense but maintains average attention during non-academic tasks and social
interactions. What is the most accurate differential diagnosis?
A. ADHD, predominantly inattentive presentation
B. Specific learning disorder with impairment in mathematics [CORRECT]
C. Autism spectrum disorder
D. Intellectual disability
Rationale: Specific learning disorder involves deficits in academic skills (reading,
writing, mathematics) without the generalized inattention, impulsivity, or social
communication deficits seen in ADHD or ASD; the isolated math deficit supports this
diagnosis per DSM-5-TR.
Correct Answer: B
Q4. An 11-year-old girl reports constant worry about grades, family health, and future
events, resulting in muscle tension, fatigue, and difficulty concentrating. Her teacher
notes she is fidgety and distracted. What is the key differentiating feature between
generalized anxiety disorder and ADHD in this presentation?
A. The presence of any worry automatically excludes ADHD
B. Motor restlessness from muscle tension and worry-based distractibility versus the
chronic disinhibited impulsivity and executive dysfunction of ADHD [CORRECT]
C. Children cannot have both anxiety and ADHD
D. The age of onset is irrelevant in distinguishing these disorders
Rationale: In GAD, distractibility and restlessness stem from worry and somatic tension,
whereas ADHD involves chronic executive dysfunction, disinhibition, and impulsivity
present across multiple contexts since early childhood; DSM-5-TR emphasizes that
symptoms must not be better explained by another disorder.
,Correct Answer: B
Q5. A 32-year-old man reports periods of elevated mood, decreased need for sleep, and
increased goal-directed activity lasting 5 days, interspersed with months of baseline
functioning. His partner notes that between episodes he has chronic difficulty
organizing tasks and maintaining attention. What is the key feature distinguishing
bipolar disorder from ADHD in this adult?
A. Both disorders cause identical sleep disturbances
B. Bipolar disorder presents with distinct episodic mood changes and decreased need
for sleep, whereas ADHD symptoms are chronic and persistent since childhood
[CORRECT]
C. ADHD never co-occurs with bipolar disorder
D. Goal-directed activity is exclusive to bipolar disorder and never occurs in ADHD
Rationale: Bipolar disorder is characterized by distinct manic or hypomanic episodes
with mood elevation and decreased sleep need, while ADHD presents with chronic,
developmentally inappropriate inattention and hyperactivity since childhood; DSM-5-TR
requires episodicity for mania versus chronicity for ADHD.
Correct Answer: B
Q6. A 4-year-old child rarely initiates social interaction, does not share enjoyment during
play, and shows minimal response to parental praise or comfort. Which DSM-5-TR
criterion for autism spectrum disorder is best represented?
A. Restricted repetitive behaviors
B. Deficits in social-emotional reciprocity [CORRECT]
C. Hyperactivity and impulsivity
D. Grandiose self-importance
Rationale: Deficits in social-emotional reciprocity—such as abnormal social approach,
reduced sharing of interests or emotions, and failure to initiate or respond to social
interactions—are a core diagnostic criterion for ASD under DSM-5-TR social
communication and interaction domain.
Correct Answer: B
, Q7. A 6-year-old with ASD makes poor eye contact, uses exaggerated gestures that do
not match his speech content, and fails to understand simple facial expressions from
peers. Which ASD diagnostic domain is primarily impaired?
A. Restricted repetitive behaviors
B. Deficits in nonverbal communicative behaviors used for social interaction [CORRECT]
C. Intellectual functioning
D. Motor coordination
Rationale: DSM-5-TR requires deficits in nonverbal communication, including poorly
integrated verbal and nonverbal communication, abnormal eye contact and body
language, and deficits in understanding and use of gestures and facial expressions, as
part of the social communication criteria for ASD.
Correct Answer: B
Q8. A 5-year-old child with ASD insists on eating the same three foods daily, becomes
distressed if his morning routine changes, and lines up toys in precise patterns. Which
DSM-5-TR criterion is demonstrated?
A. Social anxiety disorder
B. Restricted, repetitive patterns of behavior, interests, or activities [CORRECT]
C. Obsessive-compulsive disorder
D. Oppositional defiant disorder
Rationale: Insistence on sameness, highly restricted fixated interests, and stereotyped
patterns of behavior are core features of the restricted repetitive behavior domain in
ASD; these behaviors differ from OCD compulsions in that they are not performed to
neutralize obsessions per DSM-5-TR.
Correct Answer: B
Q9. A 3-year-old with ASD requires substantial support to communicate functional
needs and exhibits severe distress with minor environmental changes. What DSM-5-TR
severity level is most appropriate?
A. Level 1 (requiring support)
B. Level 2 (requiring substantial support) [CORRECT]
