NR 606 Midterm Exam – Chamberlain PMHNP: Comprehensive 2026/2027
Questions, Correct Answers & Detailed Rationale
1. A PMHNP is obtaining informed consent from the parent of a child who needs
psychiatric treatment. What is the most important component of informed consent?
A. The provider makes the decision for the family
B. The parent signs the form without receiving information
C. The parent understands the proposed treatment, risks, benefits, alternatives, and
voluntary nature of the decision
D. The child is excluded from all treatment discussions
Answer: C. The parent understands the proposed treatment, risks, benefits, alternatives,
and voluntary nature of the decision
Rationale: Valid informed consent requires adequate information, understanding, decision-
making capacity, and a voluntary choice. Children should also be included in developmentally
appropriate discussions whenever possible.
2. A PMHNP is treating a minor who reports suspected abuse. What is the PMHNP's
priority responsibility?
A. Maintain absolute confidentiality
B. Ask the child to confront the suspected perpetrator
C. Follow applicable mandatory-reporting requirements
D. Wait until physical evidence is obtained
Answer: C. Follow applicable mandatory-reporting requirements
Rationale: PMHNPs are generally mandated reporters and must follow applicable state and
federal requirements when abuse or neglect is suspected. The clinician does not need to
independently prove abuse before making a required report.
3. A parent requests unrestricted access to an adolescent's psychiatric records. What
should the PMHNP do?
A. Automatically provide the complete record
B. Automatically deny the request
C. Determine the applicable federal and state laws, consent arrangements, and
circumstances affecting parental access
D. Destroy confidential portions of the record
,Answer: C. Determine the applicable federal and state laws, consent arrangements, and
circumstances affecting parental access
Rationale: Parental access to a minor's behavioral-health information can depend on HIPAA,
state law, custody status, and circumstances such as suspected abuse. The PMHNP should not
assume that access is always automatic or always prohibited.
4. A 4-year-old uses words and pictures to represent objects and events. Which Piaget
developmental stage best describes this child?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
Answer: B. Preoperational
Rationale: The preoperational stage generally occurs from about ages 2 to 7 and is
characterized by symbolic thinking, including the use of words and images to represent objects.
5. A school-age child demonstrates increasingly logical thinking about concrete events but
has difficulty reasoning about abstract concepts. Which Piaget stage is expected?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
Answer: C. Concrete operational
Rationale: Concrete operational thinking generally develops around ages 7 to 11 and involves
increasingly logical reasoning about concrete events and situations.
6. An adolescent can reason about hypothetical situations and abstract concepts such as
morality and ethics. Which developmental stage is this?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
,Answer: D. Formal operational
Rationale: Formal operational thinking develops during adolescence and allows increasingly
sophisticated abstract, hypothetical, moral, and logical reasoning.
7. A PMHNP is evaluating a child with anxiety. Which treatment is commonly appropriate
as a first-line psychotherapeutic intervention for many pediatric anxiety disorders?
A. Long-term benzodiazepine monotherapy
B. Electroconvulsive therapy
C. Cognitive behavioral therapy
D. Antipsychotic monotherapy
Answer: C. Cognitive behavioral therapy
Rationale: CBT is an evidence-based treatment for many childhood and adolescent anxiety
disorders and teaches children to identify maladaptive thoughts and develop healthier coping
and behavioral responses.
8. A child refuses to attend school because of intense fear of being separated from a parent
and repeatedly worries that harm will come to the parent. What disorder should the
PMHNP consider?
A. Social anxiety disorder
B. Separation anxiety disorder
C. Conduct disorder
D. Specific learning disorder
Answer: B. Separation anxiety disorder
Rationale: Excessive developmentally inappropriate fear of separation from attachment figures,
including persistent worry about harm to them, is characteristic of separation anxiety disorder.
9. A child has persistent deficits in social communication and social interaction along with
restricted, repetitive behaviors and interests. What diagnosis should be considered?
A. ADHD
B. Autism spectrum disorder
C. Panic disorder
D. Adjustment disorder
, Answer: B. Autism spectrum disorder
Rationale: Autism spectrum disorder is characterized by persistent social-communication
difficulties together with restricted or repetitive behaviors, interests, or activities.
10. A parent asks whether autism spectrum disorder is caused by poor parenting. What is
the best response?
A. "Yes, inconsistent parenting is the primary cause."
B. "Only maternal behavior causes autism."
C. "Autism is a neurodevelopmental condition with complex biological and genetic
contributions; it is not caused by poor parenting."
D. "Autism develops because parents do not provide enough discipline."
Answer: C. "Autism is a neurodevelopmental condition with complex biological and
genetic contributions; it is not caused by poor parenting."
Rationale: Autism spectrum disorder is a neurodevelopmental condition with complex genetic
and environmental contributions. Blaming parents is inaccurate and can increase stigma.
11. A child with ADHD has difficulty sustaining attention, is frequently distracted, and fails
to complete tasks. Which symptom domain is most prominent?
A. Psychosis
B. Inattention
C. Mania
D. Compulsion
Answer: B. Inattention
Rationale: Difficulty sustaining attention, distractibility, poor organization, and failure to
complete tasks are characteristic symptoms of the inattentive domain of ADHD.
12. A child with ADHD is constantly fidgeting, leaves their seat, talks excessively, and has
difficulty waiting their turn. Which symptom domain is represented?
A. Obsession
B. Hyperactivity/impulsivity
C. Psychosis
D. Dissociation
Questions, Correct Answers & Detailed Rationale
1. A PMHNP is obtaining informed consent from the parent of a child who needs
psychiatric treatment. What is the most important component of informed consent?
A. The provider makes the decision for the family
B. The parent signs the form without receiving information
C. The parent understands the proposed treatment, risks, benefits, alternatives, and
voluntary nature of the decision
D. The child is excluded from all treatment discussions
Answer: C. The parent understands the proposed treatment, risks, benefits, alternatives,
and voluntary nature of the decision
Rationale: Valid informed consent requires adequate information, understanding, decision-
making capacity, and a voluntary choice. Children should also be included in developmentally
appropriate discussions whenever possible.
2. A PMHNP is treating a minor who reports suspected abuse. What is the PMHNP's
priority responsibility?
A. Maintain absolute confidentiality
B. Ask the child to confront the suspected perpetrator
C. Follow applicable mandatory-reporting requirements
D. Wait until physical evidence is obtained
Answer: C. Follow applicable mandatory-reporting requirements
Rationale: PMHNPs are generally mandated reporters and must follow applicable state and
federal requirements when abuse or neglect is suspected. The clinician does not need to
independently prove abuse before making a required report.
3. A parent requests unrestricted access to an adolescent's psychiatric records. What
should the PMHNP do?
A. Automatically provide the complete record
B. Automatically deny the request
C. Determine the applicable federal and state laws, consent arrangements, and
circumstances affecting parental access
D. Destroy confidential portions of the record
,Answer: C. Determine the applicable federal and state laws, consent arrangements, and
circumstances affecting parental access
Rationale: Parental access to a minor's behavioral-health information can depend on HIPAA,
state law, custody status, and circumstances such as suspected abuse. The PMHNP should not
assume that access is always automatic or always prohibited.
4. A 4-year-old uses words and pictures to represent objects and events. Which Piaget
developmental stage best describes this child?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
Answer: B. Preoperational
Rationale: The preoperational stage generally occurs from about ages 2 to 7 and is
characterized by symbolic thinking, including the use of words and images to represent objects.
5. A school-age child demonstrates increasingly logical thinking about concrete events but
has difficulty reasoning about abstract concepts. Which Piaget stage is expected?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
Answer: C. Concrete operational
Rationale: Concrete operational thinking generally develops around ages 7 to 11 and involves
increasingly logical reasoning about concrete events and situations.
6. An adolescent can reason about hypothetical situations and abstract concepts such as
morality and ethics. Which developmental stage is this?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
,Answer: D. Formal operational
Rationale: Formal operational thinking develops during adolescence and allows increasingly
sophisticated abstract, hypothetical, moral, and logical reasoning.
7. A PMHNP is evaluating a child with anxiety. Which treatment is commonly appropriate
as a first-line psychotherapeutic intervention for many pediatric anxiety disorders?
A. Long-term benzodiazepine monotherapy
B. Electroconvulsive therapy
C. Cognitive behavioral therapy
D. Antipsychotic monotherapy
Answer: C. Cognitive behavioral therapy
Rationale: CBT is an evidence-based treatment for many childhood and adolescent anxiety
disorders and teaches children to identify maladaptive thoughts and develop healthier coping
and behavioral responses.
8. A child refuses to attend school because of intense fear of being separated from a parent
and repeatedly worries that harm will come to the parent. What disorder should the
PMHNP consider?
A. Social anxiety disorder
B. Separation anxiety disorder
C. Conduct disorder
D. Specific learning disorder
Answer: B. Separation anxiety disorder
Rationale: Excessive developmentally inappropriate fear of separation from attachment figures,
including persistent worry about harm to them, is characteristic of separation anxiety disorder.
9. A child has persistent deficits in social communication and social interaction along with
restricted, repetitive behaviors and interests. What diagnosis should be considered?
A. ADHD
B. Autism spectrum disorder
C. Panic disorder
D. Adjustment disorder
, Answer: B. Autism spectrum disorder
Rationale: Autism spectrum disorder is characterized by persistent social-communication
difficulties together with restricted or repetitive behaviors, interests, or activities.
10. A parent asks whether autism spectrum disorder is caused by poor parenting. What is
the best response?
A. "Yes, inconsistent parenting is the primary cause."
B. "Only maternal behavior causes autism."
C. "Autism is a neurodevelopmental condition with complex biological and genetic
contributions; it is not caused by poor parenting."
D. "Autism develops because parents do not provide enough discipline."
Answer: C. "Autism is a neurodevelopmental condition with complex biological and
genetic contributions; it is not caused by poor parenting."
Rationale: Autism spectrum disorder is a neurodevelopmental condition with complex genetic
and environmental contributions. Blaming parents is inaccurate and can increase stigma.
11. A child with ADHD has difficulty sustaining attention, is frequently distracted, and fails
to complete tasks. Which symptom domain is most prominent?
A. Psychosis
B. Inattention
C. Mania
D. Compulsion
Answer: B. Inattention
Rationale: Difficulty sustaining attention, distractibility, poor organization, and failure to
complete tasks are characteristic symptoms of the inattentive domain of ADHD.
12. A child with ADHD is constantly fidgeting, leaves their seat, talks excessively, and has
difficulty waiting their turn. Which symptom domain is represented?
A. Obsession
B. Hyperactivity/impulsivity
C. Psychosis
D. Dissociation
