NR 547 DIFFERENTIAL DX MIDTERM EXAM
NR 547 DIFFERENTIAL DX MIDTERM EXAM NEWEST 2025/2026
COMPLETE 250 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) WITH DETAILED RATIONALES |ALREADY GRADED
A+||BRAND NEW VERSION!!
Which antidepressant class should be avoided unless the client has not
responded to other treatments, due to dietary restrictions and drug
interactions?
A. SSRIs
B. SNRIs
C. MAOIs
D. NDRIs
MAOIs-> MAOIs require strict dietary restrictions (e.g., tyramine-containing foods)
and have significant interaction risks, so they’re used only when other options fail.
Which of the following is true about prescribing for clients with comorbid
anxiety?
A. Choose an activating medication
B. Avoid medications that target norepinephrine
C. Fluoxetine is preferred for anxiety
D. SNRIs are always better tolerated
Avoid medications that target norepinephrine-> Norepinephrine can worsen
anxiety symptoms in sensitive individuals, so medications that elevate NE should
be used with caution in anxious clients.
1|Page
, NR 547 DIFFERENTIAL DX MIDTERM EXAM
Which SSRI is known to potentially activate clients and may cause panic in
clients with comorbid anxiety?
A. Paroxetine
B. Sertraline
C. Fluoxetine
D. Escitalopram
Fluoxetine-> Fluoxetine is activating and may lead to increased agitation or panic
in individuals with high baseline anxiety.
What is a valid next step when partial improvement is seen but not full
remission with the current antidepressant?
A. Add a second medication to augment the response
B. Discontinue treatment
C. Continue current dose indefinitely
D. Switch to a benzodiazepine
Add a second medication to augment the response-> Augmentation (e.g., adding
bupropion, an atypical antipsychotic, or lithium) is a common next step when
there’s a partial but insufficient response.
What is a key indication for lithium in the treatment of bipolar disorder?
A. Acute bipolar depression
B. Comorbid anxiety
C. Euphoric mania and suicide prevention
D. Severe psychosis
2|Page
, NR 547 DIFFERENTIAL DX MIDTERM EXAM
Euphoric mania and suicide prevention-> Lithium is the gold standard for treating
euphoric mania and is one of the only mood stabilizers shown to reduce suicide
risk.
Which factor would most influence the decision to choose an antidepressant
with a longer half-life?
A. Severe depression
B. History of psychosis
C. Medication non-adherence
D. Advanced age
Medication non-adherence-> Long half-life medications like fluoxetine help
prevent withdrawal symptoms and maintain blood levels when doses are
occasionally missed.
Why must CYP450 interactions be considered when prescribing antidepressants?
A. They decrease medication cost
B. They affect liver enzyme production
C. They impact medication metabolism
D. They reduce sedation
They impact medication metabolism-> The CYP450 system is involved in breaking
down many medications. Interactions here can lead to toxicity or reduced
effectiveness.
What is a key factor in determining whether a prescribed antidepressant will
truly help the client?
A. Brand name status
3|Page
, NR 547 DIFFERENTIAL DX MIDTERM EXAM
B. Number of side effects
C. Client affordability and access
D. Speed of onset
Client affordability and access-> Even the most effective antidepressant won’t
work if the client can’t afford it or access it consistently.
What is the first step when an antidepressant is not providing adequate
symptom relief?
A. Stop the medication immediately
B. Add a second medication
C. Increase the dose gradually
D. Switch to a different medication class
Increase the dose gradually-> Before switching or augmenting, it’s important to
maximize the dose within the therapeutic range—many clients simply need a
higher dose for effectiveness.
If increasing the dose of an antidepressant does not lead to improvement, what
is a logical next step?
A. Switch to a different drug within the same class
B. Immediately prescribe an antipsychotic
C. Increase the dose again
D. Try a mood stabilizer
Switch to a different drug within the same class-> Sometimes one SSRI might not
be effective for a client, but another SSRI could be. This is a reasonable next step
before switching classes.
4|Page
NR 547 DIFFERENTIAL DX MIDTERM EXAM NEWEST 2025/2026
COMPLETE 250 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) WITH DETAILED RATIONALES |ALREADY GRADED
A+||BRAND NEW VERSION!!
Which antidepressant class should be avoided unless the client has not
responded to other treatments, due to dietary restrictions and drug
interactions?
A. SSRIs
B. SNRIs
C. MAOIs
D. NDRIs
MAOIs-> MAOIs require strict dietary restrictions (e.g., tyramine-containing foods)
and have significant interaction risks, so they’re used only when other options fail.
Which of the following is true about prescribing for clients with comorbid
anxiety?
A. Choose an activating medication
B. Avoid medications that target norepinephrine
C. Fluoxetine is preferred for anxiety
D. SNRIs are always better tolerated
Avoid medications that target norepinephrine-> Norepinephrine can worsen
anxiety symptoms in sensitive individuals, so medications that elevate NE should
be used with caution in anxious clients.
1|Page
, NR 547 DIFFERENTIAL DX MIDTERM EXAM
Which SSRI is known to potentially activate clients and may cause panic in
clients with comorbid anxiety?
A. Paroxetine
B. Sertraline
C. Fluoxetine
D. Escitalopram
Fluoxetine-> Fluoxetine is activating and may lead to increased agitation or panic
in individuals with high baseline anxiety.
What is a valid next step when partial improvement is seen but not full
remission with the current antidepressant?
A. Add a second medication to augment the response
B. Discontinue treatment
C. Continue current dose indefinitely
D. Switch to a benzodiazepine
Add a second medication to augment the response-> Augmentation (e.g., adding
bupropion, an atypical antipsychotic, or lithium) is a common next step when
there’s a partial but insufficient response.
What is a key indication for lithium in the treatment of bipolar disorder?
A. Acute bipolar depression
B. Comorbid anxiety
C. Euphoric mania and suicide prevention
D. Severe psychosis
2|Page
, NR 547 DIFFERENTIAL DX MIDTERM EXAM
Euphoric mania and suicide prevention-> Lithium is the gold standard for treating
euphoric mania and is one of the only mood stabilizers shown to reduce suicide
risk.
Which factor would most influence the decision to choose an antidepressant
with a longer half-life?
A. Severe depression
B. History of psychosis
C. Medication non-adherence
D. Advanced age
Medication non-adherence-> Long half-life medications like fluoxetine help
prevent withdrawal symptoms and maintain blood levels when doses are
occasionally missed.
Why must CYP450 interactions be considered when prescribing antidepressants?
A. They decrease medication cost
B. They affect liver enzyme production
C. They impact medication metabolism
D. They reduce sedation
They impact medication metabolism-> The CYP450 system is involved in breaking
down many medications. Interactions here can lead to toxicity or reduced
effectiveness.
What is a key factor in determining whether a prescribed antidepressant will
truly help the client?
A. Brand name status
3|Page
, NR 547 DIFFERENTIAL DX MIDTERM EXAM
B. Number of side effects
C. Client affordability and access
D. Speed of onset
Client affordability and access-> Even the most effective antidepressant won’t
work if the client can’t afford it or access it consistently.
What is the first step when an antidepressant is not providing adequate
symptom relief?
A. Stop the medication immediately
B. Add a second medication
C. Increase the dose gradually
D. Switch to a different medication class
Increase the dose gradually-> Before switching or augmenting, it’s important to
maximize the dose within the therapeutic range—many clients simply need a
higher dose for effectiveness.
If increasing the dose of an antidepressant does not lead to improvement, what
is a logical next step?
A. Switch to a different drug within the same class
B. Immediately prescribe an antipsychotic
C. Increase the dose again
D. Try a mood stabilizer
Switch to a different drug within the same class-> Sometimes one SSRI might not
be effective for a client, but another SSRI could be. This is a reasonable next step
before switching classes.
4|Page
