NR606 FINAL EXAM QUESTIONS AND ANSWERS ALREADY GRADED
A+ SCORE REVIEW
Logan is a 6-year-old kindergartener who has a newborn sister. His
parents are concerned that Logan seems to be unable to occupy
himself quietly when his sister is napping. Logan interrupts both his
parents and other adults in the home who come to visit his sister. He
gets impatient when his questions are ignored by adults. His parents
endorse that the behaviors began about the same time as his mom's
pregnancy was announced. Logan's teacher does not endorse the
same behaviors at school; his teacher states he is quiet, reserved,
and plays well with others.
What is the most likely diagnosis for Logan?
ADHD predominantly inattentive presentation
ADHD predominantly hyperactive-impulsive presentation
ADHD combined presentation
Unlikely ADHD diagnosis
Unlikely ADHD diagnosis
Rationale: Although Logan has some symptoms that are consistent
with a diagnosis of ADHD, the symptom onset coincides with his
mother's pregnancy. There are no concerns of symptoms at school;
more information is needed to assign a diagnosis of ADHD.
Xander is an 8-year-old second-grader who is the youngest of two
children. His mother notes that he acts as if he has "non-stop
,energy." He pesters and interrupts his older sister to play when she is
reading or doing homework, and he has little patience for completing
his homework. Xander's mom endorses that his behavior has been
consistent for the past few years. Xander's teacher notes that he
fidgets during seat time, speaks out of turn in class, and runs or skips
in the halls.
What is the most likely diagnosis for Xander?
ADHD predominantly inattentive presentation
ADHD predominantly hyperactive-impulsive presentation
ADHD combined presentation
Unlikely ADHD diagnosis
ADHD predominantly hyperactive-impulsive presentation
Rationale: Xander meets diagnostic criteria for ADHD with a
hyperactive-impulsive presentation, including fidgeting, "non-stop"
energy, difficulty in engaging in quiet activities, speaking out of turn,
excessive running, and interrupting others. The behaviors occur in
school and at home and have been present consistently for several
years.
Belle is a 10-year-old fourth-grader who is the oldest of two children.
During parent-teacher conferences, her teachers expressed concerns
that she has difficulty listening and paying attention in class. She
plays with her pencil and eraser constantly during lessons and, when
she does pay attention, she blurts out answers to questions without
waiting to be called upon. She talks to her peers during class and
often interrupts the teacher to share with the class. Belle often
,forgets to bring her backpack or lunch to school and often leaves
school without her jacket. Belle's mother notes that her daughter has
always been talkative and energetic; she has difficulty keeping her
things organized and must be reminded of daily chores, such as
feeding her hamster.
What is the most likely diagnosis for Belle?
ADHD predominantly inattentive presentation
ADHD predominantly hyperactive-impulsive presentation
ADHD combined pres
ADHD combined presentation
Rationale: Belle meets diagnostic criteria for ADHD combined
presentation. She has several symptoms of hyperactive-impulsive
presentation, including fidgeting, speaking out of turn, excessive
talking, and interrupting. She also has symptoms of inattentive
presentation, including difficulty listening, paying attention,
forgetfulness, and difficulty with organization. Although her
symptoms at school differ from those seen at home, she has
symptoms in both environments.
Rating scales for ADHD
-ADHD Rating Scales (ADHD-RS-IV and 5)
-Swanson, Nolan and Pelham (SNAP) scale
-Adult ADHD Self Report Scale (ASRS)
-Vanderbilt scales
-Conners' scales
, ADHD Comorbidities
>2/3 of children dx'd with ADHD have at least one coexisting
psychiatric condition
-learning disabilities
-conduct disorders
-tics
-anxiety
-depression
-language disorders
-SUD's
• adolescents at increased risk
*often tx ADHD 1st then comorbidities, may reduce overall stress
levels, provide clearer picture of comorbid symptoms
Tenzing is a 15-year-old who presents with restlessness,
distractability, impulsive behavior, and inattention at school. He
sleeps very little most nights and is often irritable. His parents
describe him as "moody" and state that the smallest changes cause
his mood to shift. He has had these symptoms for a few years, but
recently the symptoms have gotten worse. The PMHNP diagnoses
Tenzing with ADHD. Which of the following is the most likely
comorbid diagnosis for Tenzing?
A+ SCORE REVIEW
Logan is a 6-year-old kindergartener who has a newborn sister. His
parents are concerned that Logan seems to be unable to occupy
himself quietly when his sister is napping. Logan interrupts both his
parents and other adults in the home who come to visit his sister. He
gets impatient when his questions are ignored by adults. His parents
endorse that the behaviors began about the same time as his mom's
pregnancy was announced. Logan's teacher does not endorse the
same behaviors at school; his teacher states he is quiet, reserved,
and plays well with others.
What is the most likely diagnosis for Logan?
ADHD predominantly inattentive presentation
ADHD predominantly hyperactive-impulsive presentation
ADHD combined presentation
Unlikely ADHD diagnosis
Unlikely ADHD diagnosis
Rationale: Although Logan has some symptoms that are consistent
with a diagnosis of ADHD, the symptom onset coincides with his
mother's pregnancy. There are no concerns of symptoms at school;
more information is needed to assign a diagnosis of ADHD.
Xander is an 8-year-old second-grader who is the youngest of two
children. His mother notes that he acts as if he has "non-stop
,energy." He pesters and interrupts his older sister to play when she is
reading or doing homework, and he has little patience for completing
his homework. Xander's mom endorses that his behavior has been
consistent for the past few years. Xander's teacher notes that he
fidgets during seat time, speaks out of turn in class, and runs or skips
in the halls.
What is the most likely diagnosis for Xander?
ADHD predominantly inattentive presentation
ADHD predominantly hyperactive-impulsive presentation
ADHD combined presentation
Unlikely ADHD diagnosis
ADHD predominantly hyperactive-impulsive presentation
Rationale: Xander meets diagnostic criteria for ADHD with a
hyperactive-impulsive presentation, including fidgeting, "non-stop"
energy, difficulty in engaging in quiet activities, speaking out of turn,
excessive running, and interrupting others. The behaviors occur in
school and at home and have been present consistently for several
years.
Belle is a 10-year-old fourth-grader who is the oldest of two children.
During parent-teacher conferences, her teachers expressed concerns
that she has difficulty listening and paying attention in class. She
plays with her pencil and eraser constantly during lessons and, when
she does pay attention, she blurts out answers to questions without
waiting to be called upon. She talks to her peers during class and
often interrupts the teacher to share with the class. Belle often
,forgets to bring her backpack or lunch to school and often leaves
school without her jacket. Belle's mother notes that her daughter has
always been talkative and energetic; she has difficulty keeping her
things organized and must be reminded of daily chores, such as
feeding her hamster.
What is the most likely diagnosis for Belle?
ADHD predominantly inattentive presentation
ADHD predominantly hyperactive-impulsive presentation
ADHD combined pres
ADHD combined presentation
Rationale: Belle meets diagnostic criteria for ADHD combined
presentation. She has several symptoms of hyperactive-impulsive
presentation, including fidgeting, speaking out of turn, excessive
talking, and interrupting. She also has symptoms of inattentive
presentation, including difficulty listening, paying attention,
forgetfulness, and difficulty with organization. Although her
symptoms at school differ from those seen at home, she has
symptoms in both environments.
Rating scales for ADHD
-ADHD Rating Scales (ADHD-RS-IV and 5)
-Swanson, Nolan and Pelham (SNAP) scale
-Adult ADHD Self Report Scale (ASRS)
-Vanderbilt scales
-Conners' scales
, ADHD Comorbidities
>2/3 of children dx'd with ADHD have at least one coexisting
psychiatric condition
-learning disabilities
-conduct disorders
-tics
-anxiety
-depression
-language disorders
-SUD's
• adolescents at increased risk
*often tx ADHD 1st then comorbidities, may reduce overall stress
levels, provide clearer picture of comorbid symptoms
Tenzing is a 15-year-old who presents with restlessness,
distractability, impulsive behavior, and inattention at school. He
sleeps very little most nights and is often irritable. His parents
describe him as "moody" and state that the smallest changes cause
his mood to shift. He has had these symptoms for a few years, but
recently the symptoms have gotten worse. The PMHNP diagnoses
Tenzing with ADHD. Which of the following is the most likely
comorbid diagnosis for Tenzing?
