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NR 547 Differential Dx EXAM QUESTIONS WITH 100% CORRECT ANSWERS.

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Complete Blood Count - correct answer️️The CBC is a serum diagnostic test that measures red blood cells, white blood cells, hemoglobin, hematocrit, and platelets. The CBC includes a differential of the white blood cells. A CBC is often included as part of routine health screening or to obtain information related to specific conditions. In mental health, the CBC is used to rule out medical conditions that may present with symptoms that can be attributed to both medical and psychiatric diagnoses. For example, the CBC can help rule out anemia as a cause for depressive symptoms and fatigue or rule out infection as a cause of acute mental status changes. The CBC is also used to monitor certain treatment regimens. For example, some medications, such as clozapine, require routine analysis of absolute neutrophil count and platelet levels. Normal Range of: Red blood cells Hemoglobin Hematocrit Reticulocytes - correct answer️️Red blood cells: 4.5-6.0 million/microliter Hemoglobin: 12-18 grams/100 mL Hematocrit: 38%-48% Reticulocytes: 0%-1.5% Normal Range of? White blood cells (total): Neutrophils: Eosinophils: Basophils: Lymphocytes: Monocytes: Platelets: - correct answer️️White blood cells (total): 5000-10,000/microliter Neutrophils: 55%-70% Eosinophils: 1%-3% Basophils: 0.5%-1% Lymphocytes: 20%-35% Monocytes: 3%-8% Platelets: 150,000-300,000/microliter Comprehensive Metabolic Panel (CMP) - correct answer️️The CMP is another common blood test used to determine general health status. The CMP includes several tests that provide information about fluid and electrolyte balance as well as the status of the body's metabolism, liver function, and kidney function. In psychiatric care, the CMP may be used to rule out medical conditions that could cause symptoms such as changes in mood or cognition. The CMP is also used to monitor the effects of medications, such as antipsychotics, on liver function and glucose levels. Normal CMP Levels Electrolytes Sodium (Na+): Postassium (K+): Chloride (Cl-): Bicarbonate (HCO3-): - correct answer️️Normal CMP Levels Electrolytes Sodium (Na+): 136-145 mEq/L Postassium (K+): 3.5-5.0 mEq/L Chloride (Cl-): 95-105 mEq/L Bicarbonate (HCO3-): 22-28 mEq/L Normal CMP levels Misc. Calcium, serum (Ca 2+) Glucose, serum Fasting: 2-h postprandial: Cholesterol, serum: Total Protein Albumin - correct answer️️Calcium, serum (Ca 2+) 8.4-10.2 mg/dl Glucose, serum Fasting: 70-110 mg/dl; 2-h postprandial: 120mg/dl Cholesterol, serum: REC200 mg/dl Total Protein 6.0-7.8 g/dl Albumin 3.5-5.5 g/dl Kidney Tests Creatinine, serum Urea nitrogen, serum (BUN) - correct answer️️Creatinine, serum 0.6-1.2mg/dl Urea nitrogen, serum (BUN) 7-18mg/dl Liver Tests Alanine aminotransferase (ALT), serum: Aspartate aminotransferase (AST), Bilirubin, serum (adult) Total//Direct: Phosphatase (alkaline), serum: - correct answer️️Liver Tests Alanine aminotransferase (ALT), serum: 8-20 U/L Aspartate aminotransferase (AST), serum: 8-20 U/L Bilirubin, serum (adult) Total//Direct: 0.1-1.0 mg/dl // 0.0-0.3 mg/dl Phosphatase (alkaline), serum: 20-70 U/L Normal TFT levels TSH: T3: T4: - correct answer️️Normal TFT levels TSH: 0.4-4.5 mIU/L T3: 100-200 ng/dL T4: 5-11 ug/dL Vitamin B12 Level - correct answer️️Providers may choose to check vitamin B12 levels. Deficiency of vitamin B12 can affect mood and other brain functions. Common psychiatric symptoms associated with B12 deficiency include depression, mania, psychotic symptoms, and cognitive impairment ( A normal vitamin B12 level is between 190-950 picograms/mL. Between 200-300/mL indicates a borderline level with a possible need for additional testing. Vitamin D Level - correct answer️️Vitamin D affects functions such as neurotransmission, neuroprotection, and neuroimmunomodulation. Studies have indicated a high prevalence of vitamin D deficiency in clients with psychiatric disorders such as schizophrenia, depression, seasonal affective disorder, and cognitive impairment (Cuomo et al., 2019). Symptoms of vitamin D deficiency include depression, irritability, anxiety, psychosis, and poor brain development. A vitamin D level can be measured via the 25-hydroxy vitamin D blood test. A normal level is between 20-50 ng/mL. A level less than 12 ng/mL indicates a deficiency. Toxicology Screen - correct answer️️When diagnosing psychiatric conditions, providers may use toxicology screenings to rule out substance use as a cause for symptoms. Toxicology screenings are also used before starting therapy involving controlled substances, to monitor medication adherence, and in the diagnosis of substance use disorder. Urinalysis (UA) - correct answer️️Urinary tract infections are associated with a variety of neuropsychiatric symptoms (Lee et al., 2019). When clients present with acute mental status changes, a urinalysis may be used to rule out a urinary tract infection as the cause. Toni is a 58-year-old who presents with fatigue. Her TSH is 6.3 mIU/L. A) Begin Treatment B) Refer - correct answer️️B) Refer Rationale: A TSH level 4.0 is indicative of hypothyroidism, which is associated with fatigue. A referral for treatment of hypothyroidism is required. Client can be reevaluated for fatigue if symptoms persist after hypothyroid treatment has been initiated, TSH levels are within normal limits. Leo is a 49-year-old who presents with fatigue. His hemoglobin is 15 g/dL and hematocrit is 42%. A) Begin Treatment B) Refer - correct answer️️A) Begin treatment. Rationale: The hemoglobin and hematocrit are within normal limits. This client's complaint of fatigue is not due to anemia. Begin treatment based on a complete evaluation.

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NR 547 Differential Dx
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NR 547 Differential Dx EXAM
QUESTIONS WITH 100%
CORRECT ANSWERS.
Differential Dx - correct answer✔️✔️Diagnostic reasoning is the process of
questioning one's thinking to determine if all possible avenues have been
explored and if the conclusions that are drawn are based on evidence. This is a
critical step for providers who are trying to uncover a cause, or diagnosis, for their
clients' signs and symptoms. The provider's initial hypothesis is known as the
differential diagnosis. The differential diagnosis, or differential, is a working list of
potential problems that can be associated with the initial or chief complaint.
Establishing a differential diagnosis is a critical step in providing safe, quality care.
This evolving process of clinical reasoning and decision making involves examining
the client's presentation, clinical data, and when appropriate, screening and
diagnostic test results to distinguish one disease from another and arrive at the
correct diagnosis. The Diagnostic and Statistical Manual of Mental Disorders
(DSM-5-TR)provides guidance for identifying psychiatric diagnoses


History of Present Illness - correct answer✔️✔️How long have you been feeling
this way?
Did something happen in your life that may have triggered these emotions?
How is this current situation impacting your life?


The Psychiatric History - correct answer✔️✔️Have you ever been hospitalized for
any mental health issues?
Have you ever had counseling or psychotherapy?
Have you ever taken medications for your mental health in the past?
Are you currently on any medications for mental health or sleep?


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Medical History/Screening for General Medical Conditions - correct
answer✔️✔️Do you have a primary care provider?
Do you have any medical illnesses?
Are you currently taking any medications or herbal supplements?
Do you have any allergies to medications?
Have you ever been hospitalized for any reason?
Have you ever had surgery?


Family Psychiatric History - correct answer✔️✔️Has any relative of yours ever
been hospitalized for a mental health issue?
Has any blood relative of yours ever been diagnosed with a mental health issue?
Has any blood relative of yours had a history of seizures or dementia/Alzheimer's?


Social and Developmental History - correct answer✔️✔️Tell me a little bit about
your childhood and how you grew up.
How was your experience in school when you were younger? Did you enjoy
school?
How do you support yourself with your finances?
Do you have a good support system? Are you currently in a relationship? Where
do you live? Who do you live with?
What do you do in your free time? What activities do you enjoy?


Which of the following should be included when providing client education about
medication regimens? Select all that apply. - correct answer✔️✔️A)Explain how
the medication targets the symptoms, specific benefits, and expected time
course. (Correct answer)

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B)Identify potential side effects, duration of side effects, and adverse effects.
(Correct answer)
C)Explain the instructions, dosing, and special requirements. (Correct answer)
D)Use teach-back methods to ensure client understanding. (Correct answer)


Apply the Ask Suicide-Screening Questions (ASQ) Suicide Risk Screening Tool
(Links to an external site.) to the scenario below.
A 52-year-old client presents to the emergency department following a car
accident. The emergency department (ED) physician is concerned that the client
may have intentionally crashed her car and requests a stat PMHNP consult. In
speaking with the PMHNP, the client describes persistent feelings of sadness and
hopelessness. She states that she often wonders if her husband would be happier
if she wasn't around anymore since she's never happy and sometimes thinks
about what it would be like to just take a handful of sleeping pills and go to sleep
forever. The client reports a previous suicide attempt when she was 16 but denies
that she is considering killing herself right now.
Based on the client's ASQ score, what is the most appropriate response?
A) No action is necessary as the client is not - correct answer✔️✔️B)Provide a
brief suicide safety assessment.


Rationale: While the client's responses do not indicate a need for a stat full safety
and mental health evaluation, the client requires a brief suicide safety assessment
to determine whether a full mental health evaluation in necessary. It is also
important to notify the client's physician or the clinician responsible for the
client's care.


Complete Blood Count - correct answer✔️✔️The CBC is a serum diagnostic test
that measures red blood cells, white blood cells, hemoglobin, hematocrit, and
platelets. The CBC includes a differential of the white blood cells. A CBC is often
included as part of routine health screening or to obtain information related to

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specific conditions. In mental health, the CBC is used to rule out medical
conditions that may present with symptoms that can be attributed to both
medical and psychiatric diagnoses. For example, the CBC can help rule out anemia
as a cause for depressive symptoms and fatigue or rule out infection as a cause of
acute mental status changes. The CBC is also used to monitor certain treatment
regimens. For example, some medications, such as clozapine, require routine
analysis of absolute neutrophil count and platelet levels.


Normal Range of:
Red blood cells
Hemoglobin
Hematocrit
Reticulocytes - correct answer✔️✔️Red blood cells: 4.5-6.0 million/microliter
Hemoglobin: 12-18 grams/100 mL
Hematocrit: 38%-48%
Reticulocytes: 0%-1.5%


Normal Range of?
White blood cells (total):
Neutrophils:
Eosinophils:
Basophils:
Lymphocytes:
Monocytes:
Platelets: - correct answer✔️✔W
️ hite blood cells (total): 5000-10,000/microliter
Neutrophils: 55%-70%

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