NR 547 Differential Dx Midterm Exam
NR 547 DIFFERENTIAL DX MIDTERM EXAM NEWEST 2025/2026
COMPLETE ALL QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED A+||BRAND NEW
VERSION!
Toni is a 58-year-old who presents with fatigue. Her TSH is 6.3 mIU/L.
A) Begin Treatment
B) Refer - ANSWER-B) 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 - ANSWER-A) 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.
Terri is a 79-year old who presents with confusion. She has positive urine
leukocyte esterase.
A) Begin treatment
B) Refer - ANSWER-B)Refer
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, NR 547 Differential Dx Midterm Exam
Rationale: A positive Urine Leukocyte Esterase indicates the presence of a urinary
tract infection (UTI) , which may cause confusion. Refer this client for treatment of
the UTI.
Julio is a 66-year-old who presents with depression. His vitamin D level 11 ng/mL.
A) Begin Treatment
B) Refer - ANSWER-B) Refer
Rationale: Vitamin D deficiency is associated with depressive symptoms. The
PMHNP may refer or treat vitamin D deficiency depending on the level of comfort
of the provider.
Beth is a 24-year-old who presents with anxiety. Her T3 is 260 ng/dL.
A) Begin Treatment
B) Refer - ANSWER-B) Refer
Rationale: Clients with hyperthyroidism have elevated T3 levels. Hyperthyroidism
is associated with anxiety symptoms. Client can be reevaluated for anxiety once
hyperthyroid treatment has been initiated and T3 levels are within normal limits.
Fred is a 19-year-old who presents with psychosis. His vitamin B12 level is 900
picograms/mL.
A) Begin Treatment
B) Refer - ANSWER-A) Begin treatment
Rationale: The B12 level is within normal limits. Treatment for symptoms of
psychosis should be initiated.
2|Page
, NR 547 Differential Dx Midterm Exam
Ted is a 64-year-old who presents with confusion. His serum creatinine is 7.0
mg/dL and BUN is 32
A) Begin Treatment
B) Refer - ANSWER-B) Refer
Rationale: Elevated serum creatinine and BUN indicate a problem with kidney
function, which could contribute to confusion.
Differential Dx - 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 diagnosest
History of Present Illness - 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 - ANSWER-Have you ever been hospitalized for any mental
health issues?
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, NR 547 Differential Dx Midterm Exam
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 - 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 - 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 - 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?
4|Page
NR 547 DIFFERENTIAL DX MIDTERM EXAM NEWEST 2025/2026
COMPLETE ALL QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED A+||BRAND NEW
VERSION!
Toni is a 58-year-old who presents with fatigue. Her TSH is 6.3 mIU/L.
A) Begin Treatment
B) Refer - ANSWER-B) 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 - ANSWER-A) 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.
Terri is a 79-year old who presents with confusion. She has positive urine
leukocyte esterase.
A) Begin treatment
B) Refer - ANSWER-B)Refer
1|Page
, NR 547 Differential Dx Midterm Exam
Rationale: A positive Urine Leukocyte Esterase indicates the presence of a urinary
tract infection (UTI) , which may cause confusion. Refer this client for treatment of
the UTI.
Julio is a 66-year-old who presents with depression. His vitamin D level 11 ng/mL.
A) Begin Treatment
B) Refer - ANSWER-B) Refer
Rationale: Vitamin D deficiency is associated with depressive symptoms. The
PMHNP may refer or treat vitamin D deficiency depending on the level of comfort
of the provider.
Beth is a 24-year-old who presents with anxiety. Her T3 is 260 ng/dL.
A) Begin Treatment
B) Refer - ANSWER-B) Refer
Rationale: Clients with hyperthyroidism have elevated T3 levels. Hyperthyroidism
is associated with anxiety symptoms. Client can be reevaluated for anxiety once
hyperthyroid treatment has been initiated and T3 levels are within normal limits.
Fred is a 19-year-old who presents with psychosis. His vitamin B12 level is 900
picograms/mL.
A) Begin Treatment
B) Refer - ANSWER-A) Begin treatment
Rationale: The B12 level is within normal limits. Treatment for symptoms of
psychosis should be initiated.
2|Page
, NR 547 Differential Dx Midterm Exam
Ted is a 64-year-old who presents with confusion. His serum creatinine is 7.0
mg/dL and BUN is 32
A) Begin Treatment
B) Refer - ANSWER-B) Refer
Rationale: Elevated serum creatinine and BUN indicate a problem with kidney
function, which could contribute to confusion.
Differential Dx - 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 diagnosest
History of Present Illness - 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 - ANSWER-Have you ever been hospitalized for any mental
health issues?
3|Page
, NR 547 Differential Dx Midterm Exam
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 - 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 - 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 - 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?
4|Page
