NR 547 DIFFERENTIAL
DX MIDTERM WITH ALL
ANSWERS
Differential vDx v- vcorrect vanswer-Diagnostic vreasoning vis vthe vprocess vof
vquestioning vone's vthinking vto vdetermine vif vall vpossible vavenues vhave vbeen
vexplored vand vif vthe vconclusions vthat vare vdrawn vare vbased von vevidence. vThis
vis va vcritical vstep vfor vproviders vwho vare vtrying vto vuncover va vcause, vor
vdiagnosis, vfor vtheir vclients' vsigns vand vsymptoms. vThe vprovider's vinitial
vhypothesis vis vknown vas vthe vdifferential vdiagnosis. vThe vdifferential vdiagnosis, vor
vdifferential, vis va vworking vlist vof vpotential vproblems vthat vcan vbe vassociated vwith
vthe vinitial vor vchief vcomplaint. vEstablishing va vdifferential vdiagnosis vis va vcritical
vstep vin vproviding vsafe, vquality vcare. vThis vevolving vprocess vof vclinical vreasoning
vand vdecision vmaking vinvolves vexamining vthe vclient's vpresentation, vclinical vdata,
vand vwhen vappropriate, vscreening vand vdiagnostic vtest vresults vto vdistinguish vone
vdisease vfrom vanother vand varrive vat vthe vcorrect vdiagnosis. vThe vDiagnostic vand
vStatistical vManual vof vMental vDisorders v(DSM-5-TR)provides vguidance vfor
videntifying vpsychiatric vdiagnosest
History vof vPresent vIllness v- vcorrect vanswer-How vlong vhave vyou vbeen vfeeling
vthis vway?
Did vsomething vhappen vin vyour vlife vthat vmay vhave vtriggered vthese vemotions?
How vis vthis vcurrent vsituation vimpacting vyour vlife?
,The vPsychiatric vHistory v- vcorrect vanswer-Have vyou vever vbeen vhospitalized vfor
vany vmental vhealth vissues?
Have vyou vever vhad vcounseling vor vpsychotherapy?
Have vyou vever vtaken vmedications vfor vyour vmental vhealth vin vthe vpast?
Are vyou vcurrently von vany vmedications vfor vmental vhealth vor vsleep?
Medical vHistory/Screening vfor vGeneral vMedical vConditions v- vcorrect vanswer-Do
vyou vhave va vprimary vcare vprovider?
Do vyou vhave vany vmedical villnesses?
Are vyou vcurrently vtaking vany vmedications vor vherbal vsupplements?
Do vyou vhave vany vallergies vto vmedications?
Have vyou vever vbeen vhospitalized vfor vany vreason?
Have vyou vever vhad vsurgery?
Family vPsychiatric vHistory v- vcorrect vanswer-Has vany vrelative vof vyours vever
vbeen vhospitalized vfor va vmental vhealth vissue?
Has vany vblood vrelative vof vyours vever vbeen vdiagnosed vwith va vmental vhealth
vissue?
Has vany vblood vrelative vof vyours vhad va vhistory vof vseizures vor
vdementia/Alzheimer's?
Social vand vDevelopmental vHistory v- vcorrect vanswer-Tell vme va vlittle vbit vabout
vyour vchildhood vand vhow vyou vgrew vup.
How vwas vyour vexperience vin vschool vwhen vyou vwere vyounger? vDid vyou venjoy
vschool?
How vdo vyou vsupport vyourself vwith vyour vfinances?
Do vyou vhave va vgood vsupport vsystem? vAre vyou vcurrently vin va vrelationship?
vWhere vdo vyou vlive? vWho vdo vyou vlive vwith?
What vdo vyou vdo vin vyour vfree vtime? vWhat vactivities vdo vyou venjoy?
Which vof vthe vfollowing vshould vbe vincluded vwhen vproviding vclient veducation
vabout vmedication vregimens? vSelect vall vthat vapply. v- vcorrect vanswer-A)Explain
vhow vthe vmedication vtargets vthe vsymptoms, vspecific vbenefits, vand vexpected
vtime vcourse. v(Correct vanswer)
B)Identify vpotential vside veffects, vduration vof vside veffects, vand vadverse veffects.
v(Correct vanswer)
C)Explain vthe vinstructions, vdosing, vand vspecial vrequirements. v(Correct vanswer)
D)Use vteach-back vmethods vto vensure vclient vunderstanding. v(Correct vanswer)
Apply vthe vAsk vSuicide-Screening vQuestions v(ASQ) vSuicide vRisk vScreening vTool
v(Links vto van vexternal vsite.) vto vthe vscenario vbelow.
A v52-year-old vclient vpresents vto vthe vemergency vdepartment vfollowing va vcar
vaccident. vThe vemergency vdepartment v(ED) vphysician vis vconcerned vthat vthe
vclient vmay vhave vintentionally vcrashed vher vcar vand vrequests va vstat vPMHNP
vconsult. vIn vspeaking vwith vthe vPMHNP, vthe vclient vdescribes vpersistent vfeelings
vof vsadness vand vhopelessness. vShe vstates vthat vshe voften vwonders vif vher
vhusband vwould vbe vhappier vif vshe vwasn't varound vanymore vsince vshe's vnever
vhappy vand vsometimes vthinks vabout vwhat vit vwould vbe vlike vto vjust vtake va
vhandful vof vsleeping vpills vand vgo vto vsleep vforever. vThe vclient vreports va vprevious
, vsuicide vattempt vwhen vshe vwas v16 vbut vdenies vthat vshe vis vconsidering vkilling
vherself vright vnow.
Based von vthe vclient's vASQ vscore, vwhat vis vthe vmost vappropriate vresponse?
A) vNo vaction vis vnecessary vas vthe vclient vis vnot v- vcorrect vanswer-B)Provide va
vbrief vsuicide vsafety vassessment. v
Rationale: vWhile vthe vclient's vresponses vdo vnot vindicate va vneed vfor va vstat vfull
vsafety vand vmental vhealth vevaluation, vthe vclient vrequires va vbrief vsuicide vsafety
vassessment vto vdetermine vwhether va vfull vmental vhealth vevaluation vin vnecessary.
vIt vis valso vimportant vto vnotify vthe vclient's vphysician vor vthe vclinician vresponsible
vfor vthe vclient's vcare.
Complete vBlood vCount v- vcorrect vanswer-The vCBC vis va vserum vdiagnostic vtest
vthat vmeasures vred vblood vcells, vwhite vblood vcells, vhemoglobin, vhematocrit, vand
vplatelets. vThe vCBC vincludes va vdifferential vof vthe vwhite vblood vcells. vA vCBC vis
voften vincluded vas vpart vof vroutine vhealth vscreening vor vto vobtain vinformation
vrelated vto vspecific vconditions. vIn vmental vhealth, vthe vCBC vis vused vto vrule vout
vmedical vconditions vthat vmay vpresent vwith vsymptoms vthat vcan vbe vattributed vto
vboth vmedical vand vpsychiatric vdiagnoses. vFor vexample, vthe vCBC vcan vhelp vrule
vout vanemia vas va vcause vfor vdepressive vsymptoms vand vfatigue vor vrule vout
vinfection vas va vcause vof vacute vmental vstatus vchanges. vThe vCBC vis valso vused
vto vmonitor vcertain vtreatment vregimens. vFor vexample, vsome vmedications, vsuch
vas vclozapine, vrequire vroutine vanalysis vof vabsolute vneutrophil vcount vand vplatelet
vlevels.
Normal vRange vof: v
Red vblood vcells
Hemoglobin
Hematocrit
Reticulocytes v- vcorrect vanswer-Red vblood vcells: v4.5-6.0 vmillion/microliter
Hemoglobin: v12-18 vgrams/100 vmL
Hematocrit: v38%-48%
Reticulocytes: v0%-1.5%
Normal vRange vof? v
White vblood vcells v(total): v
Neutrophils: v
Eosinophils: v
Basophils: v
Lymphocytes: v
Monocytes: v
Platelets: v- vcorrect vanswer-White vblood vcells v(total): v5000-10,000/microliter
Neutrophils: v55%-70%
Eosinophils: v1%-3%
Basophils: v0.5%-1%
Lymphocytes: v20%-35%
Monocytes: v3%-8%
Platelets: v150,000-300,000/microliter
DX MIDTERM WITH ALL
ANSWERS
Differential vDx v- vcorrect vanswer-Diagnostic vreasoning vis vthe vprocess vof
vquestioning vone's vthinking vto vdetermine vif vall vpossible vavenues vhave vbeen
vexplored vand vif vthe vconclusions vthat vare vdrawn vare vbased von vevidence. vThis
vis va vcritical vstep vfor vproviders vwho vare vtrying vto vuncover va vcause, vor
vdiagnosis, vfor vtheir vclients' vsigns vand vsymptoms. vThe vprovider's vinitial
vhypothesis vis vknown vas vthe vdifferential vdiagnosis. vThe vdifferential vdiagnosis, vor
vdifferential, vis va vworking vlist vof vpotential vproblems vthat vcan vbe vassociated vwith
vthe vinitial vor vchief vcomplaint. vEstablishing va vdifferential vdiagnosis vis va vcritical
vstep vin vproviding vsafe, vquality vcare. vThis vevolving vprocess vof vclinical vreasoning
vand vdecision vmaking vinvolves vexamining vthe vclient's vpresentation, vclinical vdata,
vand vwhen vappropriate, vscreening vand vdiagnostic vtest vresults vto vdistinguish vone
vdisease vfrom vanother vand varrive vat vthe vcorrect vdiagnosis. vThe vDiagnostic vand
vStatistical vManual vof vMental vDisorders v(DSM-5-TR)provides vguidance vfor
videntifying vpsychiatric vdiagnosest
History vof vPresent vIllness v- vcorrect vanswer-How vlong vhave vyou vbeen vfeeling
vthis vway?
Did vsomething vhappen vin vyour vlife vthat vmay vhave vtriggered vthese vemotions?
How vis vthis vcurrent vsituation vimpacting vyour vlife?
,The vPsychiatric vHistory v- vcorrect vanswer-Have vyou vever vbeen vhospitalized vfor
vany vmental vhealth vissues?
Have vyou vever vhad vcounseling vor vpsychotherapy?
Have vyou vever vtaken vmedications vfor vyour vmental vhealth vin vthe vpast?
Are vyou vcurrently von vany vmedications vfor vmental vhealth vor vsleep?
Medical vHistory/Screening vfor vGeneral vMedical vConditions v- vcorrect vanswer-Do
vyou vhave va vprimary vcare vprovider?
Do vyou vhave vany vmedical villnesses?
Are vyou vcurrently vtaking vany vmedications vor vherbal vsupplements?
Do vyou vhave vany vallergies vto vmedications?
Have vyou vever vbeen vhospitalized vfor vany vreason?
Have vyou vever vhad vsurgery?
Family vPsychiatric vHistory v- vcorrect vanswer-Has vany vrelative vof vyours vever
vbeen vhospitalized vfor va vmental vhealth vissue?
Has vany vblood vrelative vof vyours vever vbeen vdiagnosed vwith va vmental vhealth
vissue?
Has vany vblood vrelative vof vyours vhad va vhistory vof vseizures vor
vdementia/Alzheimer's?
Social vand vDevelopmental vHistory v- vcorrect vanswer-Tell vme va vlittle vbit vabout
vyour vchildhood vand vhow vyou vgrew vup.
How vwas vyour vexperience vin vschool vwhen vyou vwere vyounger? vDid vyou venjoy
vschool?
How vdo vyou vsupport vyourself vwith vyour vfinances?
Do vyou vhave va vgood vsupport vsystem? vAre vyou vcurrently vin va vrelationship?
vWhere vdo vyou vlive? vWho vdo vyou vlive vwith?
What vdo vyou vdo vin vyour vfree vtime? vWhat vactivities vdo vyou venjoy?
Which vof vthe vfollowing vshould vbe vincluded vwhen vproviding vclient veducation
vabout vmedication vregimens? vSelect vall vthat vapply. v- vcorrect vanswer-A)Explain
vhow vthe vmedication vtargets vthe vsymptoms, vspecific vbenefits, vand vexpected
vtime vcourse. v(Correct vanswer)
B)Identify vpotential vside veffects, vduration vof vside veffects, vand vadverse veffects.
v(Correct vanswer)
C)Explain vthe vinstructions, vdosing, vand vspecial vrequirements. v(Correct vanswer)
D)Use vteach-back vmethods vto vensure vclient vunderstanding. v(Correct vanswer)
Apply vthe vAsk vSuicide-Screening vQuestions v(ASQ) vSuicide vRisk vScreening vTool
v(Links vto van vexternal vsite.) vto vthe vscenario vbelow.
A v52-year-old vclient vpresents vto vthe vemergency vdepartment vfollowing va vcar
vaccident. vThe vemergency vdepartment v(ED) vphysician vis vconcerned vthat vthe
vclient vmay vhave vintentionally vcrashed vher vcar vand vrequests va vstat vPMHNP
vconsult. vIn vspeaking vwith vthe vPMHNP, vthe vclient vdescribes vpersistent vfeelings
vof vsadness vand vhopelessness. vShe vstates vthat vshe voften vwonders vif vher
vhusband vwould vbe vhappier vif vshe vwasn't varound vanymore vsince vshe's vnever
vhappy vand vsometimes vthinks vabout vwhat vit vwould vbe vlike vto vjust vtake va
vhandful vof vsleeping vpills vand vgo vto vsleep vforever. vThe vclient vreports va vprevious
, vsuicide vattempt vwhen vshe vwas v16 vbut vdenies vthat vshe vis vconsidering vkilling
vherself vright vnow.
Based von vthe vclient's vASQ vscore, vwhat vis vthe vmost vappropriate vresponse?
A) vNo vaction vis vnecessary vas vthe vclient vis vnot v- vcorrect vanswer-B)Provide va
vbrief vsuicide vsafety vassessment. v
Rationale: vWhile vthe vclient's vresponses vdo vnot vindicate va vneed vfor va vstat vfull
vsafety vand vmental vhealth vevaluation, vthe vclient vrequires va vbrief vsuicide vsafety
vassessment vto vdetermine vwhether va vfull vmental vhealth vevaluation vin vnecessary.
vIt vis valso vimportant vto vnotify vthe vclient's vphysician vor vthe vclinician vresponsible
vfor vthe vclient's vcare.
Complete vBlood vCount v- vcorrect vanswer-The vCBC vis va vserum vdiagnostic vtest
vthat vmeasures vred vblood vcells, vwhite vblood vcells, vhemoglobin, vhematocrit, vand
vplatelets. vThe vCBC vincludes va vdifferential vof vthe vwhite vblood vcells. vA vCBC vis
voften vincluded vas vpart vof vroutine vhealth vscreening vor vto vobtain vinformation
vrelated vto vspecific vconditions. vIn vmental vhealth, vthe vCBC vis vused vto vrule vout
vmedical vconditions vthat vmay vpresent vwith vsymptoms vthat vcan vbe vattributed vto
vboth vmedical vand vpsychiatric vdiagnoses. vFor vexample, vthe vCBC vcan vhelp vrule
vout vanemia vas va vcause vfor vdepressive vsymptoms vand vfatigue vor vrule vout
vinfection vas va vcause vof vacute vmental vstatus vchanges. vThe vCBC vis valso vused
vto vmonitor vcertain vtreatment vregimens. vFor vexample, vsome vmedications, vsuch
vas vclozapine, vrequire vroutine vanalysis vof vabsolute vneutrophil vcount vand vplatelet
vlevels.
Normal vRange vof: v
Red vblood vcells
Hemoglobin
Hematocrit
Reticulocytes v- vcorrect vanswer-Red vblood vcells: v4.5-6.0 vmillion/microliter
Hemoglobin: v12-18 vgrams/100 vmL
Hematocrit: v38%-48%
Reticulocytes: v0%-1.5%
Normal vRange vof? v
White vblood vcells v(total): v
Neutrophils: v
Eosinophils: v
Basophils: v
Lymphocytes: v
Monocytes: v
Platelets: v- vcorrect vanswer-White vblood vcells v(total): v5000-10,000/microliter
Neutrophils: v55%-70%
Eosinophils: v1%-3%
Basophils: v0.5%-1%
Lymphocytes: v20%-35%
Monocytes: v3%-8%
Platelets: v150,000-300,000/microliter
