NURS 6630 WEEK 4 ASSIGNMENT 2026/2027 |
Assessing & Treating Pediatric Mood Disorders | 8-
Year-Old African American Male | Verified Solutions |
Pass Guaranteed - A+ Graded
Part One: Assessment, Developmental Considerations &
Differential Diagnosis (8-Year-Old African American Male) (9
Questions)
Q1: An 8-year-old African American male is brought to the psychiatric clinic by his
mother, who reports that for the past year her son has been "angry all the time." He
has severe temper outbursts 4-5 times per week at home and school, often triggered
by minor frustrations like losing a game or being asked to complete homework.
Between outbursts, he is irritable and easily annoyed. His mother describes him as
"never happy." He was evaluated for ADHD last year and did not meet criteria. What
is your first step in the assessment?
A. Prescribe a stimulant for presumed ADHD that was missed in the previous
evaluation
B. Order comprehensive blood work including thyroid function, CBC, and metabolic
panel to rule out medical causes
C. Conduct a thorough clinical interview with the child and parent, obtain school
reports, and use standardized rating scales to characterize the mood and behavior
pattern [CORRECT]
D. Diagnose disruptive mood dysregulation disorder immediately based on the
mother's report
Correct Answer: C
,Rationale: A comprehensive assessment including multiple informants (parent, child,
teacher) and standardized measures is essential before diagnosing any pediatric
mood or behavioral disorder. Option A assumes a missed ADHD diagnosis without
evidence. Option B is premature without red flags for medical causes. Option D
jumps to diagnosis without adequate assessment.
Q2: During the clinical interview, the child's mother reports that his temper outbursts
began around age 7, have occurred 4-5 times weekly for the past year, and involve
verbal aggression (screaming, threats) and physical aggression (hitting, throwing
objects). Between outbursts, he is persistently irritable and angry. He has difficulty
maintaining friendships and has been suspended from school twice. His mood is
consistently negative with no periods of elevated mood or grandiosity. What is the
most likely diagnosis?
A. Bipolar I disorder, because he has severe mood dysregulation and aggression
B. Oppositional defiant disorder, because he is defiant and argumentative
C. Disruptive mood dysregulation disorder (DMDD), because he has severe recurrent
temper outbursts with persistent irritable mood between outbursts, onset before age
10, and no distinct manic episodes [CORRECT]
D. Attention-deficit/hyperactivity disorder, because he has difficulty with impulse
control
Correct Answer: C
Rationale: DMDD is characterized by severe recurrent temper outbursts (3+
times/week) with persistent irritable/angry mood between outbursts, onset before
age 10, and no distinct manic/hypomanic episodes. Option A is incorrect without
mania symptoms (grandiosity, decreased sleep, hypersexuality). Option B doesn't
capture the persistent irritable mood between outbursts. Option D was already ruled
out and doesn't explain the mood pattern.
, Q3: The child's teacher completes the Vanderbilt ADHD Diagnostic Rating Scale,
which shows elevated scores on the oppositional defiant/conduct problems subscale
but normal scores on inattention and hyperactivity subscales. The Children's
Depression Rating Scale-Revised (CDRS-R) total score is 42 (moderate depression).
The Columbia-Suicide Severity Rating Scale (C-SSRS) is negative for suicidal ideation.
How do these results influence your diagnostic formulation?
A. Confirm ADHD as the primary diagnosis and recommend stimulant medication
B. Suggest the child has conduct disorder and requires intensive behavioral
intervention only
C. Support DMDD with comorbid depressive symptoms, as irritability and
oppositionality are prominent with moderate depression but no ADHD or suicidality
[CORRECT]
D. Indicate the rating scales are invalid for African American children and should be
disregarded
Correct Answer: C
Rationale: The pattern of oppositional/conduct elevation without ADHD symptoms,
combined with moderate depression scores, supports DMDD with depressive
features. Option A contradicts the normal ADHD scores. Option B ignores the mood
component. Option D is incorrect—rating scales are valid across races when used
appropriately, though cultural context matters in interpretation.
Q4: The child's mother mentions that his father has a history of depression and
alcohol use disorder, and his maternal grandmother was hospitalized for "nerves" in
her 20s. The mother herself has been treated for depression and anxiety. What is the
clinical significance of this family history?
A. It confirms the child has inherited bipolar disorder and will require mood
stabilizers
B. It increases the child's risk for mood disorders and suggests careful monitoring for
depression, anxiety, and substance use as he develops [CORRECT]
Assessing & Treating Pediatric Mood Disorders | 8-
Year-Old African American Male | Verified Solutions |
Pass Guaranteed - A+ Graded
Part One: Assessment, Developmental Considerations &
Differential Diagnosis (8-Year-Old African American Male) (9
Questions)
Q1: An 8-year-old African American male is brought to the psychiatric clinic by his
mother, who reports that for the past year her son has been "angry all the time." He
has severe temper outbursts 4-5 times per week at home and school, often triggered
by minor frustrations like losing a game or being asked to complete homework.
Between outbursts, he is irritable and easily annoyed. His mother describes him as
"never happy." He was evaluated for ADHD last year and did not meet criteria. What
is your first step in the assessment?
A. Prescribe a stimulant for presumed ADHD that was missed in the previous
evaluation
B. Order comprehensive blood work including thyroid function, CBC, and metabolic
panel to rule out medical causes
C. Conduct a thorough clinical interview with the child and parent, obtain school
reports, and use standardized rating scales to characterize the mood and behavior
pattern [CORRECT]
D. Diagnose disruptive mood dysregulation disorder immediately based on the
mother's report
Correct Answer: C
,Rationale: A comprehensive assessment including multiple informants (parent, child,
teacher) and standardized measures is essential before diagnosing any pediatric
mood or behavioral disorder. Option A assumes a missed ADHD diagnosis without
evidence. Option B is premature without red flags for medical causes. Option D
jumps to diagnosis without adequate assessment.
Q2: During the clinical interview, the child's mother reports that his temper outbursts
began around age 7, have occurred 4-5 times weekly for the past year, and involve
verbal aggression (screaming, threats) and physical aggression (hitting, throwing
objects). Between outbursts, he is persistently irritable and angry. He has difficulty
maintaining friendships and has been suspended from school twice. His mood is
consistently negative with no periods of elevated mood or grandiosity. What is the
most likely diagnosis?
A. Bipolar I disorder, because he has severe mood dysregulation and aggression
B. Oppositional defiant disorder, because he is defiant and argumentative
C. Disruptive mood dysregulation disorder (DMDD), because he has severe recurrent
temper outbursts with persistent irritable mood between outbursts, onset before age
10, and no distinct manic episodes [CORRECT]
D. Attention-deficit/hyperactivity disorder, because he has difficulty with impulse
control
Correct Answer: C
Rationale: DMDD is characterized by severe recurrent temper outbursts (3+
times/week) with persistent irritable/angry mood between outbursts, onset before
age 10, and no distinct manic/hypomanic episodes. Option A is incorrect without
mania symptoms (grandiosity, decreased sleep, hypersexuality). Option B doesn't
capture the persistent irritable mood between outbursts. Option D was already ruled
out and doesn't explain the mood pattern.
, Q3: The child's teacher completes the Vanderbilt ADHD Diagnostic Rating Scale,
which shows elevated scores on the oppositional defiant/conduct problems subscale
but normal scores on inattention and hyperactivity subscales. The Children's
Depression Rating Scale-Revised (CDRS-R) total score is 42 (moderate depression).
The Columbia-Suicide Severity Rating Scale (C-SSRS) is negative for suicidal ideation.
How do these results influence your diagnostic formulation?
A. Confirm ADHD as the primary diagnosis and recommend stimulant medication
B. Suggest the child has conduct disorder and requires intensive behavioral
intervention only
C. Support DMDD with comorbid depressive symptoms, as irritability and
oppositionality are prominent with moderate depression but no ADHD or suicidality
[CORRECT]
D. Indicate the rating scales are invalid for African American children and should be
disregarded
Correct Answer: C
Rationale: The pattern of oppositional/conduct elevation without ADHD symptoms,
combined with moderate depression scores, supports DMDD with depressive
features. Option A contradicts the normal ADHD scores. Option B ignores the mood
component. Option D is incorrect—rating scales are valid across races when used
appropriately, though cultural context matters in interpretation.
Q4: The child's mother mentions that his father has a history of depression and
alcohol use disorder, and his maternal grandmother was hospitalized for "nerves" in
her 20s. The mother herself has been treated for depression and anxiety. What is the
clinical significance of this family history?
A. It confirms the child has inherited bipolar disorder and will require mood
stabilizers
B. It increases the child's risk for mood disorders and suggests careful monitoring for
depression, anxiety, and substance use as he develops [CORRECT]
