NR547 / NR 547 Midterm Exam 2025
Differential Diagnosis in Psychiatric-
Mental Health Across the Lifespan –
Chamberlain College of Nursing 100%
Correct & Graded A | Verified Questions &
Detailed Rationales
This guide provides actual exam questions from the Chamberlain
College of Nursing NR547 Midterm Exam for 2025. Each question
includes the correct answer and a detailed rationale to support
your understanding of differential diagnosis in psychiatric-mental
health .
SECTION 1: FOUNDATIONAL CONCEPTS &
NEUROBIOLOGY (Questions 1-8)
Q1. Which factor has the strongest evidence as the cause of
schizophrenia?
• A) Environmental stressors
• B) Genetics
• C) Neurotransmitter imbalances
• D) Traumatic brain injury
,✅ Correct Answer: B (Genetics)
Rationale: Genetics has the strongest evidence as a cause of
schizophrenia. Studies show that individuals with a first-degree
relative with schizophrenia have a significantly higher risk (about
10%) compared to the general population (1%). Twin studies
indicate heritability rates of 70-80%, highlighting a strong genetic
component, though environmental factors also play a role .
Q2. A 45-year-old patient presents with anhedonia,
psychomotor retardation, and significant weight loss. Which
neuroanatomical structure is primarily implicated in the
regulation of appetite and psychomotor activity in this
presentation?
• A) Amygdala
• B) Hippocampus
• C) Basal Ganglia
• D) Hypothalamus
✅ Correct Answer: D (Hypothalamus)
Rationale: The hypothalamus regulates homeostasis, including
appetite, sleep, and psychomotor activity. The basal ganglia are
more involved in movement disorders, while the
amygdala/hippocampus are involved in emotion and memory .
,Q3. A PMHNP is reviewing the role of the hypothalamic-
pituitary-adrenal (HPA) axis in mood disorders. Which finding
is most consistent with chronic major depressive disorder?
• A) Decreased cortisol secretion
• B) Increased dexamethasone suppression test (DST)
nonsuppression
• C) Enlarged hippocampal volume
• D) Hypercortisolemia with feedback resistance
✅ Correct Answer: B (Increased DST nonsuppression)
Rationale: Chronic MDD often leads to HPA axis dysregulation,
resulting in elevated cortisol levels and failure to suppress cortisol
after dexamethasone administration (nonsuppression) .
Q4. Which of the following best describes the
pathophysiology of the "kindling" phenomenon in bipolar
disorder?
• A) The process by which antipsychotics induce
dopamine supersensitivity.
• B) The gradual increase in serotonin transporter density
leading to mania.
• C) The neurotoxic effect of lithium on the prefrontal
cortex.
• D) Increased neuronal sensitivity where subthreshold
stimuli eventually trigger spontaneous mood
episodes.
, ✅ Correct Answer: D (Increased neuronal sensitivity
triggering spontaneous episodes)
Rationale: Kindling suggests that repeated affective episodes
lower the threshold for future episodes, making prophylactic
treatment essential .
Q5. A 16-year-old male is brought in by his parents after a
concussion during a football game 3 weeks ago. He is now
irritable, sleeping 14 hours a day, and failing classes. What is
the most critical initial step in differential diagnosis?
• A) Start a stimulant for suspected ADHD.
• B) Refer for cognitive behavioral therapy (CBT) for
depression.
• C) Obtain a comprehensive neurological evaluation
and neuroimaging.
• D) Diagnose Adjustment Disorder and monitor.
✅ Correct Answer: C (Comprehensive neurological
evaluation and neuroimaging)
Rationale: Post-concussive syndrome must be ruled out before
attributing symptoms to a primary psychiatric disorder, especially
given the recent TBI .
Differential Diagnosis in Psychiatric-
Mental Health Across the Lifespan –
Chamberlain College of Nursing 100%
Correct & Graded A | Verified Questions &
Detailed Rationales
This guide provides actual exam questions from the Chamberlain
College of Nursing NR547 Midterm Exam for 2025. Each question
includes the correct answer and a detailed rationale to support
your understanding of differential diagnosis in psychiatric-mental
health .
SECTION 1: FOUNDATIONAL CONCEPTS &
NEUROBIOLOGY (Questions 1-8)
Q1. Which factor has the strongest evidence as the cause of
schizophrenia?
• A) Environmental stressors
• B) Genetics
• C) Neurotransmitter imbalances
• D) Traumatic brain injury
,✅ Correct Answer: B (Genetics)
Rationale: Genetics has the strongest evidence as a cause of
schizophrenia. Studies show that individuals with a first-degree
relative with schizophrenia have a significantly higher risk (about
10%) compared to the general population (1%). Twin studies
indicate heritability rates of 70-80%, highlighting a strong genetic
component, though environmental factors also play a role .
Q2. A 45-year-old patient presents with anhedonia,
psychomotor retardation, and significant weight loss. Which
neuroanatomical structure is primarily implicated in the
regulation of appetite and psychomotor activity in this
presentation?
• A) Amygdala
• B) Hippocampus
• C) Basal Ganglia
• D) Hypothalamus
✅ Correct Answer: D (Hypothalamus)
Rationale: The hypothalamus regulates homeostasis, including
appetite, sleep, and psychomotor activity. The basal ganglia are
more involved in movement disorders, while the
amygdala/hippocampus are involved in emotion and memory .
,Q3. A PMHNP is reviewing the role of the hypothalamic-
pituitary-adrenal (HPA) axis in mood disorders. Which finding
is most consistent with chronic major depressive disorder?
• A) Decreased cortisol secretion
• B) Increased dexamethasone suppression test (DST)
nonsuppression
• C) Enlarged hippocampal volume
• D) Hypercortisolemia with feedback resistance
✅ Correct Answer: B (Increased DST nonsuppression)
Rationale: Chronic MDD often leads to HPA axis dysregulation,
resulting in elevated cortisol levels and failure to suppress cortisol
after dexamethasone administration (nonsuppression) .
Q4. Which of the following best describes the
pathophysiology of the "kindling" phenomenon in bipolar
disorder?
• A) The process by which antipsychotics induce
dopamine supersensitivity.
• B) The gradual increase in serotonin transporter density
leading to mania.
• C) The neurotoxic effect of lithium on the prefrontal
cortex.
• D) Increased neuronal sensitivity where subthreshold
stimuli eventually trigger spontaneous mood
episodes.
, ✅ Correct Answer: D (Increased neuronal sensitivity
triggering spontaneous episodes)
Rationale: Kindling suggests that repeated affective episodes
lower the threshold for future episodes, making prophylactic
treatment essential .
Q5. A 16-year-old male is brought in by his parents after a
concussion during a football game 3 weeks ago. He is now
irritable, sleeping 14 hours a day, and failing classes. What is
the most critical initial step in differential diagnosis?
• A) Start a stimulant for suspected ADHD.
• B) Refer for cognitive behavioral therapy (CBT) for
depression.
• C) Obtain a comprehensive neurological evaluation
and neuroimaging.
• D) Diagnose Adjustment Disorder and monitor.
✅ Correct Answer: C (Comprehensive neurological
evaluation and neuroimaging)
Rationale: Post-concussive syndrome must be ruled out before
attributing symptoms to a primary psychiatric disorder, especially
given the recent TBI .
