FINAL EXAM: NR 547/ NR547 (NEW 2025/ 2026
UPDATE) DIFFERENTIAL DIAGNOSIS IN
PSYCHIATRIC-MENTAL HEALTH REVIEW|
QUESTIONS & ANSWERS| GRADE A| 100%
CORRECT
Differential diagnosis – ANSWER-The provider's
initial hypothesis
-a working list of potential problems that can be
associated with the initial or chief complaint
-Diagnostic and Statistical Manual of Mental Disorders
(DSM-5-TR)
• provides guidance for identifying psychiatric
diagnoses
Psychiatric assessment: History taking - ANSWER-
History of Present Illness
-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
-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?
Medical History/Screening for General Medical
Conditions
-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
-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
-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?
Screening and Psychiatric Rating Scales – ANSWER-
Evidence-based screening tools and psychiatric rating
scales
-can help the provider identify symptoms and assess
their severity and can assist with the evaluation of
response to treatment
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?
No action is necessary as the client is not currently
considering suicide.
Provide a brief suicide safety assessment.
Alert the client's primary care physician.
, Provide a ST – ANSWER-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.
Diagnostic Testing when diagnosing mental health
disorders - ANSWER-Diagnostic tests and labs are
most used to rule out physical conditions that may
cause psychiatric symptoms and to evaluate the effects
of treatment
Basic Laboratory Interpretation – ANSWER-Complete
Blood Count
Comprehensive Metabolic Panel (CMP)
Thyroid Function Tests
Vitamin B12 Level
Vitamin D Level
Toxicology Screen
Urinalysis (UA)
Basic Laboratory Interpretation: Complete Blood Count
- ANSWER-measures RBCs, WBCs, haemoglobin,
haematocrit, and platelets
-includes a differential of the WBCs
UPDATE) DIFFERENTIAL DIAGNOSIS IN
PSYCHIATRIC-MENTAL HEALTH REVIEW|
QUESTIONS & ANSWERS| GRADE A| 100%
CORRECT
Differential diagnosis – ANSWER-The provider's
initial hypothesis
-a working list of potential problems that can be
associated with the initial or chief complaint
-Diagnostic and Statistical Manual of Mental Disorders
(DSM-5-TR)
• provides guidance for identifying psychiatric
diagnoses
Psychiatric assessment: History taking - ANSWER-
History of Present Illness
-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
-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?
Medical History/Screening for General Medical
Conditions
-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
-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
-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?
Screening and Psychiatric Rating Scales – ANSWER-
Evidence-based screening tools and psychiatric rating
scales
-can help the provider identify symptoms and assess
their severity and can assist with the evaluation of
response to treatment
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?
No action is necessary as the client is not currently
considering suicide.
Provide a brief suicide safety assessment.
Alert the client's primary care physician.
, Provide a ST – ANSWER-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.
Diagnostic Testing when diagnosing mental health
disorders - ANSWER-Diagnostic tests and labs are
most used to rule out physical conditions that may
cause psychiatric symptoms and to evaluate the effects
of treatment
Basic Laboratory Interpretation – ANSWER-Complete
Blood Count
Comprehensive Metabolic Panel (CMP)
Thyroid Function Tests
Vitamin B12 Level
Vitamin D Level
Toxicology Screen
Urinalysis (UA)
Basic Laboratory Interpretation: Complete Blood Count
- ANSWER-measures RBCs, WBCs, haemoglobin,
haematocrit, and platelets
-includes a differential of the WBCs
