NRNP6665 MIDTERM ACTUAL ASSESSMENT
2026 COMPLETE SOLVED QUESTIONS
◉ Question 2:
Benjamin is a 4-year-old male who is being evaluated because his
mom is afraid that he may be schizophrenic. There is a history of
schizophrenia in the mother's family; her maternal aunt, one sister,
and one of her brother's children were all diagnosed with
schizophrenia. Today she reports that Benjamin has episodes during
which he appears to be hallucinating. Sometimes he seems to see
things that are not there, and other times he actually talks with and
plays with imaginary people. The PMHNP continues to gather
information from the mother and Benjamin and plans to do some
observation of Benjamin during play. When considering a diagnosis
of early-onset schizophrenia, the PMHNP considers all of the
following except: Answer: A.
B. Hallucinations are significantly more predictive of schizophrenia
than delusions in young children
C. Benjamin's symptoms are more likely a consequence of
developmental immaturity
D. Benjamin's family history should always be considered, but at this
point the diagnosis is very unlikely
◉ Question 26:
,While counseling the parents of Joshua, a 9-year-old patient with
developmental coordination disorder, the PMHNP advised that the
treatment will include: Answer: A. Modified physical education
B. Cognitive behavioral interventions
C. Group sports participation
D. Computer-generated developmental exercises
◉ Question 27:
Maria is an 11-year-old girl who has been diagnosed with early-
onset schizophrenia. In writing up her case report for publication,
the PMHNP makes it a point to highlight which of the following
historical features that are often seen in schizophrenia of middle
childhood? Answer: A. Onset of hallucinations and delusions before
age 6
B. Symptoms easily confused with attention deficit hyperactivity
disorder
C. Delayed motor milestones and language acquisition D. High
expressed emotion characterized by overly critical family response
◉ Question 28:
Ramon is a 12-year-old male who was started on fluoxetine, 40 mg
daily, for major depressive disorder 6 weeks ago. At his 2-week
follow-up, he was feeling well with no adverse drug effects, and his
dose was elevated from 20 to 40 mg. Today he presents for a routine
follow-up visit. He reports that he has been "all wound up" and is
,frequently agitated. He cannot sleep well and has trouble focusing at
school. His friends say that he gets upset quickly, and they are
starting to avoid him. The most appropriate approach is to: Answer:
A. Taper the fluoxetine off and see if these symptoms improve
B. Add a mood stabilizer to the fluoxetine
C. Increase his dose of fluoxetine to 60 mg daily
D. Continue the current dose and reassess in 2 weeks
◉ Question 29:
Taryn is a 14-year-old female who is being evaluated as a condition
to return to the private school in which she has been enrolled since
fifth grade. She has an ongoing inability to focus in school, and her
mood reportedly ranges from "one extreme to the other." Per her
mother, she is either overly excited about something and almost
exaggerated in her approach, or she is disinterested and irritable
and doesn't want to leave her bedroom. She was evaluated several
different times in childhood for ADHD, and even took medication
once, but it did not help. In considering a diagnosis of cyclothymic
disorder, the PMHNP considers that: Answer: A. Symptoms need to
be present for at least 1 year
B. Symptoms need to be present for at least 2 years
C. Symptoms are not characterized by conduct disorders
D. Symptoms are not characterized by suicidal ideation
◉ Question 30:
, Which of the following statements best characterized the treatment
course and progression of bulimia nervosa? Answer: A. Cognitive
behavioral therapy is considered the benchmark, first-line
treatment.
B. Antidepressant medications have not been demonstrated to be
effective.
C. The majority of patients will require hospitalization as an initial
intervention.
D. Psychodynamic therapy is extremely successful when patients are
not lost to follow-up.
◉ Question 31:
The etiology of childhood depression is multifactorial and may
include biological factors. Which of the following is a true statement
with respect to hormonal studies in depressed children? Answer: A.
Prepubertal children having a depressive episode secrete
significantly more growth hormone during sleep than nondepressed
children.
B. Polysomnography demonstrates significantly reduced rapid eye
movement (REM) during depressive episodes. C. Thyroid
stimulating hormone (TSH) levels are elevated > 50% above the
upper limits of normal in the majority of children with depression.
D. Magnetic resonance imaging (MRI) studies in depressed
adolescents reveals low ventricular volume and increased frontal
lobe volume.
2026 COMPLETE SOLVED QUESTIONS
◉ Question 2:
Benjamin is a 4-year-old male who is being evaluated because his
mom is afraid that he may be schizophrenic. There is a history of
schizophrenia in the mother's family; her maternal aunt, one sister,
and one of her brother's children were all diagnosed with
schizophrenia. Today she reports that Benjamin has episodes during
which he appears to be hallucinating. Sometimes he seems to see
things that are not there, and other times he actually talks with and
plays with imaginary people. The PMHNP continues to gather
information from the mother and Benjamin and plans to do some
observation of Benjamin during play. When considering a diagnosis
of early-onset schizophrenia, the PMHNP considers all of the
following except: Answer: A.
B. Hallucinations are significantly more predictive of schizophrenia
than delusions in young children
C. Benjamin's symptoms are more likely a consequence of
developmental immaturity
D. Benjamin's family history should always be considered, but at this
point the diagnosis is very unlikely
◉ Question 26:
,While counseling the parents of Joshua, a 9-year-old patient with
developmental coordination disorder, the PMHNP advised that the
treatment will include: Answer: A. Modified physical education
B. Cognitive behavioral interventions
C. Group sports participation
D. Computer-generated developmental exercises
◉ Question 27:
Maria is an 11-year-old girl who has been diagnosed with early-
onset schizophrenia. In writing up her case report for publication,
the PMHNP makes it a point to highlight which of the following
historical features that are often seen in schizophrenia of middle
childhood? Answer: A. Onset of hallucinations and delusions before
age 6
B. Symptoms easily confused with attention deficit hyperactivity
disorder
C. Delayed motor milestones and language acquisition D. High
expressed emotion characterized by overly critical family response
◉ Question 28:
Ramon is a 12-year-old male who was started on fluoxetine, 40 mg
daily, for major depressive disorder 6 weeks ago. At his 2-week
follow-up, he was feeling well with no adverse drug effects, and his
dose was elevated from 20 to 40 mg. Today he presents for a routine
follow-up visit. He reports that he has been "all wound up" and is
,frequently agitated. He cannot sleep well and has trouble focusing at
school. His friends say that he gets upset quickly, and they are
starting to avoid him. The most appropriate approach is to: Answer:
A. Taper the fluoxetine off and see if these symptoms improve
B. Add a mood stabilizer to the fluoxetine
C. Increase his dose of fluoxetine to 60 mg daily
D. Continue the current dose and reassess in 2 weeks
◉ Question 29:
Taryn is a 14-year-old female who is being evaluated as a condition
to return to the private school in which she has been enrolled since
fifth grade. She has an ongoing inability to focus in school, and her
mood reportedly ranges from "one extreme to the other." Per her
mother, she is either overly excited about something and almost
exaggerated in her approach, or she is disinterested and irritable
and doesn't want to leave her bedroom. She was evaluated several
different times in childhood for ADHD, and even took medication
once, but it did not help. In considering a diagnosis of cyclothymic
disorder, the PMHNP considers that: Answer: A. Symptoms need to
be present for at least 1 year
B. Symptoms need to be present for at least 2 years
C. Symptoms are not characterized by conduct disorders
D. Symptoms are not characterized by suicidal ideation
◉ Question 30:
, Which of the following statements best characterized the treatment
course and progression of bulimia nervosa? Answer: A. Cognitive
behavioral therapy is considered the benchmark, first-line
treatment.
B. Antidepressant medications have not been demonstrated to be
effective.
C. The majority of patients will require hospitalization as an initial
intervention.
D. Psychodynamic therapy is extremely successful when patients are
not lost to follow-up.
◉ Question 31:
The etiology of childhood depression is multifactorial and may
include biological factors. Which of the following is a true statement
with respect to hormonal studies in depressed children? Answer: A.
Prepubertal children having a depressive episode secrete
significantly more growth hormone during sleep than nondepressed
children.
B. Polysomnography demonstrates significantly reduced rapid eye
movement (REM) during depressive episodes. C. Thyroid
stimulating hormone (TSH) levels are elevated > 50% above the
upper limits of normal in the majority of children with depression.
D. Magnetic resonance imaging (MRI) studies in depressed
adolescents reveals low ventricular volume and increased frontal
lobe volume.
