Registered Practical Nurse (RPN) Practice Test

In a nonpsychiatric setting, which undiagnosed psychiatric illness is a nurse more likely to encounter?

1. Schizophrenia

2. Delusional disorder

3. Bipolar disorder

4. Major depressive disorder

The correct answer is: Delusional disorder

The most likely undiagnosed psychiatric illness encountered by a nurse in a nonpsychiatric setting is major depressive disorder. This condition is frequently identified in patients presenting with physical complaints, as symptoms of depression can manifest as physical ailments such as fatigue, changes in appetite, or unexplained pain. Major depressive disorder might not be initially recognized as a psychiatric issue because individuals may present with somatic symptoms rather than emotional distress. Moreover, depression can coexist with medical conditions, leading to an oversight of mood symptoms during medical assessments. In contrast, schizophrenia and bipolar disorder often have more pronounced psychiatric symptoms that are more noticeable and may prompt referrals to mental health services. Delusional disorder, while also presenting with significant psychiatric symptoms, typically has a specific focus that might not be evident in general medical assessments. As such, nurses are more likely to encounter undiagnosed major depressive disorder due to its common presentation with non-specific medical complaints.