NR 547 Final Exam 2026 | Differential
Diagnosis in Psychiatric-Mental Health
Across the Lifespan Practicum
(Chamberlain) | Verified Questions &
Answers Study Guide PDF
NR 547 FINAL EXAM 2026 | DIFFERENTIAL DIAGNOSIS IN PSYCHIATRIC-MENTAL
HEALTH ACROSS THE LIFESPAN PRACTICUM
Verified Questions & Answers Study Guide
DOCUMENT OVERVIEW:
• This comprehensive study guide contains 200 verified multiple-choice questions
covering differential diagnosis assessment and clinical decision-making across all
developmental stages (childhood, adolescence, adulthood, older adults)
• Designed to prepare students for advanced psychiatric-mental health nursing
practice with emphasis on accurate diagnostic formulation, DSM-5 criteria
application, and evidence-based differential diagnosis techniques across the
lifespan
QUESTION 1:
A 28-year-old patient presents with persistent sadness, lack of motivation,
and hopelessness for 3 weeks following job loss. Which of the following is the
MOST critical differential diagnosis to consider?
A) Persistent Depressive Disorder (Dysthymia)
B) Major Depressive Disorder
C) Adjustment Disorder with Depressed Mood
D) Bipolar II Disorder
E) Substance-Induced Mood Disorder
,CORRECT ANSWER: C) Adjustment Disorder with Depressed Mood
EXPERT RATIONALE: The 3-week duration and clear identifiable stressor (job loss)
with depressed mood make Adjustment Disorder most likely. Major Depressive
Disorder requires 2 weeks minimum but symptoms typically develop without such
clear precipitants. Persistent Depressive Disorder requires a 2-year duration.
Bipolar II and Substance-Induced require additional diagnostic criteria not
mentioned.
QUESTION 2:
Which DSM-5 criterion is ESSENTIAL for differentiating Major Depressive
Disorder from grief following bereavement?
A) Presence of suicidal ideation
B) Marked functional impairment
C) Guilt related to things other than actions taken at time of death
D) Duration of symptoms exceeding 6 months
E) Complete loss of interest in all activities
CORRECT ANSWER: C) Guilt related to things other than actions taken at time
of death
EXPERT RATIONALE: The DSM-5 specifies that guilt predominantly about things
other than the circumstances of death helps distinguish MDD from normal grief.
While depression with bereavement can occur, specific guilt content and pervasive
guilt are diagnostic markers. The other options can occur in both conditions.
QUESTION 3:
A 45-year-old male reports racing thoughts, decreased need for sleep (3 hours
nightly), and increased goal-directed activity lasting 4 days. He denies mood
elevation. What is the PRIMARY diagnostic consideration?
A) Manic Episode
,B) Hypomanic Episode
C) Cyclothymic Disorder
D) Substance-Induced Manic-Like Episode
E) Generalized Anxiety Disorder
CORRECT ANSWER: D) Substance-Induced Manic-Like Episode
EXPERT RATIONALE: The absence of elevated/expansive mood rules out true
manic/hypomanic episodes. Racing thoughts and decreased sleep with goal-
directed activity lasting only 4 days without mood elevation suggests substance use
(stimulants, steroids, decongestants) or medical condition. A comprehensive
substance and medical history is essential.
QUESTION 4:
Which characteristic BEST differentiates Generalized Anxiety Disorder from
adjustment-related anxiety?
A) Severity of physical symptoms
B) Pervasive worry across multiple life domains lasting 6+ months without
identifiable stressor
C) Presence of panic attacks
D) Heightened startle response
E) Sleep disturbance
CORRECT ANSWER: B) Pervasive worry across multiple life domains lasting 6+
months without identifiable stressor
EXPERT RATIONALE: GAD requires chronic worry (6+ months) across multiple
domains without a clear precipitant. Adjustment-related anxiety occurs in response
to specific identified stressors and typically resolves with stressor removal or
adaptation. Physical symptoms, panic, and sleep issues can occur in both
conditions.
, QUESTION 5:
A 22-year-old female presents with recurrent intrusive thoughts about
contamination, leading to compulsive hand-washing for 2 hours daily. This
pattern has persisted for 8 months and significantly impairs functioning.
Which diagnostic category is MOST appropriate?
A) Specific Phobia
B) Illness Anxiety Disorder
C) Obsessive-Compulsive Disorder
D) Somatic Symptom Disorder
E) Trichotillomania
CORRECT ANSWER: C) Obsessive-Compulsive Disorder
EXPERT RATIONALE: The presence of recognized obsessions (contamination
thoughts) and compulsions (hand-washing) with significant time investment (2
hours), functional impairment, and duration (8 months) meets OCD criteria. The
individual recognizes the irrationality, which is a key OCD feature. Other diagnoses
lack the obsession-compulsion relationship.
SECTION 2: CHILDHOOD & ADOLESCENT DISORDERS
QUESTION 6:
A 7-year-old boy displays persistent difficulty maintaining attention in
classroom and home settings, talks excessively, frequently interrupts others,
and shows difficulty waiting turns. Teachers note symptoms have been
present since kindergarten. Which assessment is MOST critical before
diagnosis?
Diagnosis in Psychiatric-Mental Health
Across the Lifespan Practicum
(Chamberlain) | Verified Questions &
Answers Study Guide PDF
NR 547 FINAL EXAM 2026 | DIFFERENTIAL DIAGNOSIS IN PSYCHIATRIC-MENTAL
HEALTH ACROSS THE LIFESPAN PRACTICUM
Verified Questions & Answers Study Guide
DOCUMENT OVERVIEW:
• This comprehensive study guide contains 200 verified multiple-choice questions
covering differential diagnosis assessment and clinical decision-making across all
developmental stages (childhood, adolescence, adulthood, older adults)
• Designed to prepare students for advanced psychiatric-mental health nursing
practice with emphasis on accurate diagnostic formulation, DSM-5 criteria
application, and evidence-based differential diagnosis techniques across the
lifespan
QUESTION 1:
A 28-year-old patient presents with persistent sadness, lack of motivation,
and hopelessness for 3 weeks following job loss. Which of the following is the
MOST critical differential diagnosis to consider?
A) Persistent Depressive Disorder (Dysthymia)
B) Major Depressive Disorder
C) Adjustment Disorder with Depressed Mood
D) Bipolar II Disorder
E) Substance-Induced Mood Disorder
,CORRECT ANSWER: C) Adjustment Disorder with Depressed Mood
EXPERT RATIONALE: The 3-week duration and clear identifiable stressor (job loss)
with depressed mood make Adjustment Disorder most likely. Major Depressive
Disorder requires 2 weeks minimum but symptoms typically develop without such
clear precipitants. Persistent Depressive Disorder requires a 2-year duration.
Bipolar II and Substance-Induced require additional diagnostic criteria not
mentioned.
QUESTION 2:
Which DSM-5 criterion is ESSENTIAL for differentiating Major Depressive
Disorder from grief following bereavement?
A) Presence of suicidal ideation
B) Marked functional impairment
C) Guilt related to things other than actions taken at time of death
D) Duration of symptoms exceeding 6 months
E) Complete loss of interest in all activities
CORRECT ANSWER: C) Guilt related to things other than actions taken at time
of death
EXPERT RATIONALE: The DSM-5 specifies that guilt predominantly about things
other than the circumstances of death helps distinguish MDD from normal grief.
While depression with bereavement can occur, specific guilt content and pervasive
guilt are diagnostic markers. The other options can occur in both conditions.
QUESTION 3:
A 45-year-old male reports racing thoughts, decreased need for sleep (3 hours
nightly), and increased goal-directed activity lasting 4 days. He denies mood
elevation. What is the PRIMARY diagnostic consideration?
A) Manic Episode
,B) Hypomanic Episode
C) Cyclothymic Disorder
D) Substance-Induced Manic-Like Episode
E) Generalized Anxiety Disorder
CORRECT ANSWER: D) Substance-Induced Manic-Like Episode
EXPERT RATIONALE: The absence of elevated/expansive mood rules out true
manic/hypomanic episodes. Racing thoughts and decreased sleep with goal-
directed activity lasting only 4 days without mood elevation suggests substance use
(stimulants, steroids, decongestants) or medical condition. A comprehensive
substance and medical history is essential.
QUESTION 4:
Which characteristic BEST differentiates Generalized Anxiety Disorder from
adjustment-related anxiety?
A) Severity of physical symptoms
B) Pervasive worry across multiple life domains lasting 6+ months without
identifiable stressor
C) Presence of panic attacks
D) Heightened startle response
E) Sleep disturbance
CORRECT ANSWER: B) Pervasive worry across multiple life domains lasting 6+
months without identifiable stressor
EXPERT RATIONALE: GAD requires chronic worry (6+ months) across multiple
domains without a clear precipitant. Adjustment-related anxiety occurs in response
to specific identified stressors and typically resolves with stressor removal or
adaptation. Physical symptoms, panic, and sleep issues can occur in both
conditions.
, QUESTION 5:
A 22-year-old female presents with recurrent intrusive thoughts about
contamination, leading to compulsive hand-washing for 2 hours daily. This
pattern has persisted for 8 months and significantly impairs functioning.
Which diagnostic category is MOST appropriate?
A) Specific Phobia
B) Illness Anxiety Disorder
C) Obsessive-Compulsive Disorder
D) Somatic Symptom Disorder
E) Trichotillomania
CORRECT ANSWER: C) Obsessive-Compulsive Disorder
EXPERT RATIONALE: The presence of recognized obsessions (contamination
thoughts) and compulsions (hand-washing) with significant time investment (2
hours), functional impairment, and duration (8 months) meets OCD criteria. The
individual recognizes the irrationality, which is a key OCD feature. Other diagnoses
lack the obsession-compulsion relationship.
SECTION 2: CHILDHOOD & ADOLESCENT DISORDERS
QUESTION 6:
A 7-year-old boy displays persistent difficulty maintaining attention in
classroom and home settings, talks excessively, frequently interrupts others,
and shows difficulty waiting turns. Teachers note symptoms have been
present since kindergarten. Which assessment is MOST critical before
diagnosis?
