NR606 Week 3 Exam V1 | NR606 Diagnosis
& Management in Psychiatric-Mental
Health II Practicum | Q&A with Rationale
(NR606 Week 3 Exam) | Chamberlain
University
1. When initiating a stimulant for an 8-year-old patient diagnosed with ADHD, which
assessment is considered the highest priority before starting the medication?
A. A comprehensive IQ test to determine educational placement.
B. A baseline cardiac history and physical examination including blood pressure and heart
rate.
C. A formal thyroid panel to rule out hyperthyroidism.
D. A complete blood count to check for anemia.
Answer: B
Rationale: Before starting stimulants, a thorough cardiovascular screening is essential to
identify any underlying structural or functional heart issues. Stimulants can increase heart
rate and blood pressure, potentially leading to adverse events in vulnerable patients. This
standard of care ensures patient safety according to the American Academy of Pediatrics
guidelines.
,2. A 10-year-old child presents with chronic, severe persistent irritability and frequent temper
outbursts that are out of proportion to the situation. Which diagnosis is most likely?
A. Bipolar I Disorder
B. Oppositional Defiant Disorder (ODD)
C. Generalized Anxiety Disorder
D. Disruptive Mood Dysregulation Disorder (DMDD)
Answer: D
Rationale: DMDD is characterized by chronic, severe persistent irritability and frequent
temper outbursts in children between 6 and 18 years old. It was introduced to differentiate
these symptoms from pediatric bipolar disorder, which usually involves episodic mood
changes. The symptoms must be present in at least two settings and persist for 12 or more
months.
3. Which screening tool is most appropriate for a PMHNP to use when evaluating a 14-year-
old for substance use during a routine visit?
A. CRAFFT
B. PHQ-9
C. Vanderbilt Scale
D. GADS-7
Answer: A
,Rationale: The CRAFFT screening tool is a validated behavioral health screening tool
specifically designed for adolescents to detect substance-related risks and disorders. It
consists of six questions regarding usage while driving, using to relax, or using alone. Early
detection in adolescents is critical for effective intervention and prevention of long-term
dependency.
4. A child with Autism Spectrum Disorder (ASD) is exhibiting significant irritability and
aggression. Which medication is FDA-approved for the treatment of irritability associated
with ASD in children and adolescents?
A. Fluoxetine
B. Methylphenidate
C. Lithium
D. Risperidone
Answer: D
Rationale: Risperidone is one of the few medications FDA-approved for treating irritability
and aggression in children and adolescents with Autism Spectrum Disorder. Aripiprazole is
also approved for this indication in the pediatric population. The PMHNP must monitor for
side effects like weight gain and metabolic changes when using atypical antipsychotics.
, 5. When prescribing a Selective Serotonin Reuptake Inhibitor (SSRI) to an adolescent with
depression, what is the most critical information to provide to the parents?
A. There is a Black Box warning regarding increased suicidal ideation in children and young
adults.
B. The medication will start working within 24 hours.
C. The child may experience immediate weight loss.
D. SSRIs are only effective if taken with a high-fat meal.
Answer: A
Rationale: The FDA requires a Black Box warning on all antidepressants for pediatric use
due to the risk of increased suicidal thoughts and behaviors. Parents must be educated on
how to monitor for changes in mood, behavior, or signs of self-harm. Close follow-up and
clinical monitoring are essential during the first few months of treatment.
6. What is the primary difference between Oppositional Defiant Disorder (ODD) and Conduct
Disorder (CD)?
A. CD involves the violation of the basic rights of others or major age-appropriate societal
norms, whereas ODD involves defiance and irritability.
B. ODD involves legal violations, while CD does not.
C. ODD is only diagnosed in adults, while CD is for children.
D. CD symptoms must include hallucinations, whereas ODD does not.
& Management in Psychiatric-Mental
Health II Practicum | Q&A with Rationale
(NR606 Week 3 Exam) | Chamberlain
University
1. When initiating a stimulant for an 8-year-old patient diagnosed with ADHD, which
assessment is considered the highest priority before starting the medication?
A. A comprehensive IQ test to determine educational placement.
B. A baseline cardiac history and physical examination including blood pressure and heart
rate.
C. A formal thyroid panel to rule out hyperthyroidism.
D. A complete blood count to check for anemia.
Answer: B
Rationale: Before starting stimulants, a thorough cardiovascular screening is essential to
identify any underlying structural or functional heart issues. Stimulants can increase heart
rate and blood pressure, potentially leading to adverse events in vulnerable patients. This
standard of care ensures patient safety according to the American Academy of Pediatrics
guidelines.
,2. A 10-year-old child presents with chronic, severe persistent irritability and frequent temper
outbursts that are out of proportion to the situation. Which diagnosis is most likely?
A. Bipolar I Disorder
B. Oppositional Defiant Disorder (ODD)
C. Generalized Anxiety Disorder
D. Disruptive Mood Dysregulation Disorder (DMDD)
Answer: D
Rationale: DMDD is characterized by chronic, severe persistent irritability and frequent
temper outbursts in children between 6 and 18 years old. It was introduced to differentiate
these symptoms from pediatric bipolar disorder, which usually involves episodic mood
changes. The symptoms must be present in at least two settings and persist for 12 or more
months.
3. Which screening tool is most appropriate for a PMHNP to use when evaluating a 14-year-
old for substance use during a routine visit?
A. CRAFFT
B. PHQ-9
C. Vanderbilt Scale
D. GADS-7
Answer: A
,Rationale: The CRAFFT screening tool is a validated behavioral health screening tool
specifically designed for adolescents to detect substance-related risks and disorders. It
consists of six questions regarding usage while driving, using to relax, or using alone. Early
detection in adolescents is critical for effective intervention and prevention of long-term
dependency.
4. A child with Autism Spectrum Disorder (ASD) is exhibiting significant irritability and
aggression. Which medication is FDA-approved for the treatment of irritability associated
with ASD in children and adolescents?
A. Fluoxetine
B. Methylphenidate
C. Lithium
D. Risperidone
Answer: D
Rationale: Risperidone is one of the few medications FDA-approved for treating irritability
and aggression in children and adolescents with Autism Spectrum Disorder. Aripiprazole is
also approved for this indication in the pediatric population. The PMHNP must monitor for
side effects like weight gain and metabolic changes when using atypical antipsychotics.
, 5. When prescribing a Selective Serotonin Reuptake Inhibitor (SSRI) to an adolescent with
depression, what is the most critical information to provide to the parents?
A. There is a Black Box warning regarding increased suicidal ideation in children and young
adults.
B. The medication will start working within 24 hours.
C. The child may experience immediate weight loss.
D. SSRIs are only effective if taken with a high-fat meal.
Answer: A
Rationale: The FDA requires a Black Box warning on all antidepressants for pediatric use
due to the risk of increased suicidal thoughts and behaviors. Parents must be educated on
how to monitor for changes in mood, behavior, or signs of self-harm. Close follow-up and
clinical monitoring are essential during the first few months of treatment.
6. What is the primary difference between Oppositional Defiant Disorder (ODD) and Conduct
Disorder (CD)?
A. CD involves the violation of the basic rights of others or major age-appropriate societal
norms, whereas ODD involves defiance and irritability.
B. ODD involves legal violations, while CD does not.
C. ODD is only diagnosed in adults, while CD is for children.
D. CD symptoms must include hallucinations, whereas ODD does not.
