NR547 / NR 547 Differential Diagnosis in Psychiatric-Mental Health
Across Lifespan Midterm Exam Actual Exam 2026/2027 – Complete
Exam-Style Questions | Detailed Rationales – Pass Guaranteed – A+
Graded
,Foundational & Diagnostic Process
Q1. A 52-year-old client presents to the emergency department
following a car accident. The client describes persistent feelings of
sadness and hopelessness and states she sometimes thinks about
taking a handful of sleeping pills. She reports a previous suicide
attempt at age 16 but denies current suicidal ideation. Based on the
client's ASQ score, what is the most appropriate response?
• A) No action is necessary as the client is not currently considering
suicide.
• B) Provide a brief suicide safety assessment.
• C) Alert the client's primary care physician.
• D) Provide a stat full safety and mental health evaluation.
Correct ,,,answer,,,,: B) Provide a brief suicide safety assessment.
• Rationale: The client has a history of a suicide attempt and passive
suicidal thoughts, which indicate risk and require further evaluation.
A brief suicide safety assessment is the appropriate next step to
determine if a full mental health evaluation is necessary .
Q2. What is the primary purpose of diagnostic testing (e.g., lab work)
when evaluating a client for a potential mental health disorder?
• A) To definitively diagnose the specific psychiatric disorder.
• B) To rule out physical conditions that may cause psychiatric
symptoms.
• C) To predict the client's response to specific psychiatric
medications.
• D) To fulfill insurance billing requirements for a psychiatric
evaluation.
, Correct ,,,answer,,,,: B) To rule out physical conditions that may cause
psychiatric symptoms.
• Rationale: Diagnostic tests and labs are most useful for identifying
medical conditions (e.g., thyroid dysfunction, vitamin deficiency,
infection) that can mimic or exacerbate psychiatric symptoms .
Differential Diagnosis & Lab Interpretation
Q3. A 58-year-old client presents with fatigue. Her TSH level is 6.3
mIU/L. Should the PMHNP treat or refer?
• A) Begin treatment for depression.
• B) Refer for evaluation of hypothyroidism.
• C) Order a sleep study.
• D) Increase the dose of her current antidepressants.
Correct ,,,answer,,,,: B) Refer for evaluation of hypothyroidism.
• Rationale: A TSH level >4.0 mIU/L is indicative of hypothyroidism, a
common cause of fatigue. The client should be referred for
treatment of the underlying medical condition before attributing the
fatigue to a primary psychiatric disorder .
Q4. A 49-year-old client presents with fatigue. His hemoglobin is 15
g/dL and hematocrit is 42%. What is the most appropriate next step?
• A) Begin treatment based on a complete psychiatric evaluation.
• B) Refer to a hematologist for anemia.
• C) Order a repeat CBC in 6 months.
• D) Prescribe iron supplements.
Correct ,,,answer,,,,: A) Begin treatment based on a complete
psychiatric evaluation.
Across Lifespan Midterm Exam Actual Exam 2026/2027 – Complete
Exam-Style Questions | Detailed Rationales – Pass Guaranteed – A+
Graded
,Foundational & Diagnostic Process
Q1. A 52-year-old client presents to the emergency department
following a car accident. The client describes persistent feelings of
sadness and hopelessness and states she sometimes thinks about
taking a handful of sleeping pills. She reports a previous suicide
attempt at age 16 but denies current suicidal ideation. Based on the
client's ASQ score, what is the most appropriate response?
• A) No action is necessary as the client is not currently considering
suicide.
• B) Provide a brief suicide safety assessment.
• C) Alert the client's primary care physician.
• D) Provide a stat full safety and mental health evaluation.
Correct ,,,answer,,,,: B) Provide a brief suicide safety assessment.
• Rationale: The client has a history of a suicide attempt and passive
suicidal thoughts, which indicate risk and require further evaluation.
A brief suicide safety assessment is the appropriate next step to
determine if a full mental health evaluation is necessary .
Q2. What is the primary purpose of diagnostic testing (e.g., lab work)
when evaluating a client for a potential mental health disorder?
• A) To definitively diagnose the specific psychiatric disorder.
• B) To rule out physical conditions that may cause psychiatric
symptoms.
• C) To predict the client's response to specific psychiatric
medications.
• D) To fulfill insurance billing requirements for a psychiatric
evaluation.
, Correct ,,,answer,,,,: B) To rule out physical conditions that may cause
psychiatric symptoms.
• Rationale: Diagnostic tests and labs are most useful for identifying
medical conditions (e.g., thyroid dysfunction, vitamin deficiency,
infection) that can mimic or exacerbate psychiatric symptoms .
Differential Diagnosis & Lab Interpretation
Q3. A 58-year-old client presents with fatigue. Her TSH level is 6.3
mIU/L. Should the PMHNP treat or refer?
• A) Begin treatment for depression.
• B) Refer for evaluation of hypothyroidism.
• C) Order a sleep study.
• D) Increase the dose of her current antidepressants.
Correct ,,,answer,,,,: B) Refer for evaluation of hypothyroidism.
• Rationale: A TSH level >4.0 mIU/L is indicative of hypothyroidism, a
common cause of fatigue. The client should be referred for
treatment of the underlying medical condition before attributing the
fatigue to a primary psychiatric disorder .
Q4. A 49-year-old client presents with fatigue. His hemoglobin is 15
g/dL and hematocrit is 42%. What is the most appropriate next step?
• A) Begin treatment based on a complete psychiatric evaluation.
• B) Refer to a hematologist for anemia.
• C) Order a repeat CBC in 6 months.
• D) Prescribe iron supplements.
Correct ,,,answer,,,,: A) Begin treatment based on a complete
psychiatric evaluation.
