NRNP 6665 EXAM / ACTUAL NRNP 6665 FINAL EXAM TEST BANK
2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE COMPLETE
ACCURATE EXAM
1. A 9-year-old child is brought to the PMHNP by a foster parent after multiple
disrupted placements following the death of both biological parents and
prolonged periods of inconsistent caregiving. The child is withdrawn with
unfamiliar adults, rarely seeks comfort when distressed, and demonstrates
limited emotional reciprocity with caregivers. Which diagnosis should the
PMHNP consider most strongly when integrating the developmental history
and current relational behaviors?
A. Reactive attachment disorder
B. Oppositional defiant disorder
C. Separation anxiety disorder
D. Disruptive mood dysregulation disorder
Answer: A
2. A 7-year-old child has persistent difficulty sustaining attention, frequently
leaves the classroom without permission, interrupts others, loses school
materials, and demonstrates similar symptoms at home and school. The
symptoms have persisted for more than six months and interfere
substantially with academic and social functioning. Which diagnosis best
explains this presentation?
A. Conduct disorder
B. Attention-deficit/hyperactivity disorder
C. Autism spectrum disorder
D. Specific learning disorder
Answer: B
3. A school-aged child with ADHD has significant impairment from impulsivity
and hyperactivity but no evidence of psychosis, mania, or substance
exposure. The parents ask the PMHNP why behavioral interventions are still
important when medication is being considered. Which response best
reflects evidence-based clinical reasoning?
1
, A. Behavioral interventions are unnecessary once medication is started
B. Behavioral treatment should be used only when medication fails
C. Behavioral strategies can improve functioning and should be integrated
with developmentally appropriate treatment
D. Behavioral treatment is appropriate only for children younger than five
Answer: C
4. An 8-year-old child has difficulty making eye contact, demonstrates
repetitive hand movements, becomes extremely distressed when routines
change, and has persistent deficits in reciprocal social communication. The
symptoms have been present since early childhood. Which diagnosis is
most consistent with this presentation?
A. Social anxiety disorder
B. Reactive attachment disorder
C. Intellectual disability
D. Autism spectrum disorder
Answer: D
5. A child with autism spectrum disorder becomes severely distressed when a
classroom routine changes unexpectedly. The parent reports that
predictable schedules and visual cues substantially reduce behavioral
outbursts. Which intervention should the PMHNP recommend as part of a
comprehensive management plan?
A. Structured routines with predictable transitions and individualized
behavioral supports
B. Eliminating all expectations for adaptive behavior
C. Repeatedly changing routines so the child becomes accustomed to
unpredictability
D. Using punishment whenever repetitive behaviors occur
Answer: A
6. A 10-year-old child has persistent academic difficulties despite adequate
instruction and normal intellectual functioning. Testing demonstrates
significant impairment in reading accuracy and fluency that is substantially
2
, below what would be expected for age. Which diagnosis should the PMHNP
consider?
A. Intellectual disability
B. Specific learning disorder with impairment in reading
C. Autism spectrum disorder
D. Conduct disorder
Answer: B
7. A child repeatedly makes involuntary eye blinking and facial movements
and occasionally produces brief vocalizations. The symptoms wax and wane,
are exacerbated by stress, and have persisted for less than one year. Which
diagnosis best fits this presentation?
A. Tourette disorder
B. Stereotypic movement disorder
C. Provisional tic disorder
D. Obsessive-compulsive disorder
Answer: C
8. A 12-year-old has both multiple motor tics and vocal tics that have persisted
for more than one year, with periods of increased and decreased severity.
The child remains aware of the behaviors and experiences embarrassment
at school. Which diagnosis is most appropriate?
A. Provisional tic disorder
B. Stereotypic movement disorder
C. Functional neurologic symptom disorder
D. Tourette syndrome
Answer: D
9. A child with intellectual disability requires assistance with money
management, transportation, medication organization, and independent
living skills. The PMHNP explains that severity should be determined
primarily by which factor?
A. The level of impairment in adaptive functioning
B. The child's physical appearance
3
, C. The number of psychiatric medications prescribed
D. The child's highest academic grade completed
Answer: A
10. A 6-year-old child repeatedly rocks, hand-flaps, and engages in repetitive
body movements that interfere with daily activities but are not associated
with substance use or another medical condition. Which diagnosis should
be considered?
A. Tourette syndrome
B. Stereotypic movement disorder
C. Conduct disorder
D. Separation anxiety disorder
Answer: B
11. A 5-year-old child who experienced severe neglect rarely seeks comfort
from caregivers and does not respond appropriately to attempts at
soothing. The PMHNP wants to distinguish this presentation from autism
spectrum disorder. Which historical feature is especially important?
A. The child's preference for solitary play
B. The presence of repetitive movements
C. A history of markedly insufficient caregiving and neglect
D. The child's difficulty tolerating loud sounds
Answer: C
12. A 9-year-old child becomes extremely distressed whenever separated from
a parent, repeatedly worries that the parent will die, refuses to attend
school without the parent, and has recurrent nightmares about separation.
Which diagnosis is most likely?
A. Generalized anxiety disorder
B. Social anxiety disorder
C. Panic disorder
D. Separation anxiety disorder
Answer: D
4
2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE COMPLETE
ACCURATE EXAM
1. A 9-year-old child is brought to the PMHNP by a foster parent after multiple
disrupted placements following the death of both biological parents and
prolonged periods of inconsistent caregiving. The child is withdrawn with
unfamiliar adults, rarely seeks comfort when distressed, and demonstrates
limited emotional reciprocity with caregivers. Which diagnosis should the
PMHNP consider most strongly when integrating the developmental history
and current relational behaviors?
A. Reactive attachment disorder
B. Oppositional defiant disorder
C. Separation anxiety disorder
D. Disruptive mood dysregulation disorder
Answer: A
2. A 7-year-old child has persistent difficulty sustaining attention, frequently
leaves the classroom without permission, interrupts others, loses school
materials, and demonstrates similar symptoms at home and school. The
symptoms have persisted for more than six months and interfere
substantially with academic and social functioning. Which diagnosis best
explains this presentation?
A. Conduct disorder
B. Attention-deficit/hyperactivity disorder
C. Autism spectrum disorder
D. Specific learning disorder
Answer: B
3. A school-aged child with ADHD has significant impairment from impulsivity
and hyperactivity but no evidence of psychosis, mania, or substance
exposure. The parents ask the PMHNP why behavioral interventions are still
important when medication is being considered. Which response best
reflects evidence-based clinical reasoning?
1
, A. Behavioral interventions are unnecessary once medication is started
B. Behavioral treatment should be used only when medication fails
C. Behavioral strategies can improve functioning and should be integrated
with developmentally appropriate treatment
D. Behavioral treatment is appropriate only for children younger than five
Answer: C
4. An 8-year-old child has difficulty making eye contact, demonstrates
repetitive hand movements, becomes extremely distressed when routines
change, and has persistent deficits in reciprocal social communication. The
symptoms have been present since early childhood. Which diagnosis is
most consistent with this presentation?
A. Social anxiety disorder
B. Reactive attachment disorder
C. Intellectual disability
D. Autism spectrum disorder
Answer: D
5. A child with autism spectrum disorder becomes severely distressed when a
classroom routine changes unexpectedly. The parent reports that
predictable schedules and visual cues substantially reduce behavioral
outbursts. Which intervention should the PMHNP recommend as part of a
comprehensive management plan?
A. Structured routines with predictable transitions and individualized
behavioral supports
B. Eliminating all expectations for adaptive behavior
C. Repeatedly changing routines so the child becomes accustomed to
unpredictability
D. Using punishment whenever repetitive behaviors occur
Answer: A
6. A 10-year-old child has persistent academic difficulties despite adequate
instruction and normal intellectual functioning. Testing demonstrates
significant impairment in reading accuracy and fluency that is substantially
2
, below what would be expected for age. Which diagnosis should the PMHNP
consider?
A. Intellectual disability
B. Specific learning disorder with impairment in reading
C. Autism spectrum disorder
D. Conduct disorder
Answer: B
7. A child repeatedly makes involuntary eye blinking and facial movements
and occasionally produces brief vocalizations. The symptoms wax and wane,
are exacerbated by stress, and have persisted for less than one year. Which
diagnosis best fits this presentation?
A. Tourette disorder
B. Stereotypic movement disorder
C. Provisional tic disorder
D. Obsessive-compulsive disorder
Answer: C
8. A 12-year-old has both multiple motor tics and vocal tics that have persisted
for more than one year, with periods of increased and decreased severity.
The child remains aware of the behaviors and experiences embarrassment
at school. Which diagnosis is most appropriate?
A. Provisional tic disorder
B. Stereotypic movement disorder
C. Functional neurologic symptom disorder
D. Tourette syndrome
Answer: D
9. A child with intellectual disability requires assistance with money
management, transportation, medication organization, and independent
living skills. The PMHNP explains that severity should be determined
primarily by which factor?
A. The level of impairment in adaptive functioning
B. The child's physical appearance
3
, C. The number of psychiatric medications prescribed
D. The child's highest academic grade completed
Answer: A
10. A 6-year-old child repeatedly rocks, hand-flaps, and engages in repetitive
body movements that interfere with daily activities but are not associated
with substance use or another medical condition. Which diagnosis should
be considered?
A. Tourette syndrome
B. Stereotypic movement disorder
C. Conduct disorder
D. Separation anxiety disorder
Answer: B
11. A 5-year-old child who experienced severe neglect rarely seeks comfort
from caregivers and does not respond appropriately to attempts at
soothing. The PMHNP wants to distinguish this presentation from autism
spectrum disorder. Which historical feature is especially important?
A. The child's preference for solitary play
B. The presence of repetitive movements
C. A history of markedly insufficient caregiving and neglect
D. The child's difficulty tolerating loud sounds
Answer: C
12. A 9-year-old child becomes extremely distressed whenever separated from
a parent, repeatedly worries that the parent will die, refuses to attend
school without the parent, and has recurrent nightmares about separation.
Which diagnosis is most likely?
A. Generalized anxiety disorder
B. Social anxiety disorder
C. Panic disorder
D. Separation anxiety disorder
Answer: D
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