NR606 Final Exam V2 | NR606 Diagnosis & Management in
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Final Exam) | Chamberlain University
1. A 10-year-old child presents with persistent irritability and frequent temper outbursts that
are out of proportion to the situation. These symptoms have occurred at least three times per
week for the past year across multiple settings. Which diagnosis is most appropriate?
A. Bipolar I Disorder
B. Oppositional Defiant Disorder
C. Disruptive Mood Dysregulation Disorder (DMDD)
D. Conduct Disorder
Answer: C
Explanation: Disruptive Mood Dysregulation Disorder is characterized by severe temper
outbursts and a chronic irritable mood between outbursts. This diagnosis was created to
address the overdiagnosis of pediatric bipolar disorder. The symptoms must be present for
at least 12 months and occur in at least two settings.
2. When prescribing stimulants for a child with ADHD, which of the following is a primary
baseline assessment required before starting medication?
A. Cardiac history and vital signs including height and weight
B. Liver function tests
C. Renal function panel
D. Electroencephalogram (EEG)
Answer: A
Explanation: Stimulants can affect blood pressure and heart rate, making a thorough
cardiac history essential. Height and weight must be monitored regularly due to the risk of
appetite suppression and growth deceleration. A baseline EKG is generally only required if
there is a known family history of sudden cardiac death or personal cardiac symptoms.
3. A 15-year-old female reports feeling depressed, having low energy, and experiencing
suicidal ideation. Which SSRI is the only one FDA-approved for the treatment of depression in
children aged 8 and older?
A. Sertraline
B. Fluoxetine
C. Paroxetine
,D. Citalopram
Answer: B
Explanation: Fluoxetine (Prozac) is the first-line SSRI for pediatric depression and is
approved for children as young as 8 years old. Escitalopram is approved for adolescents
aged 12 to 17. The PMHNP must be aware of the Black Box Warning regarding increased
suicidality in this age group when initiating therapy.
4. Which therapeutic approach focuses on the ‘identified patient’ as a symptom-bearer for a
dysfunctional family system?
A. Family Systems Therapy
B. Cognitive Behavioral Therapy
C. Dialectical Behavior Therapy
D. Interpersonal Therapy
Answer: A
Explanation: Family Systems Therapy views the family as an emotional unit where the
individual’s behavior is connected to the system’s dynamics. The ‘identified patient’ is often
the individual whose symptoms bring the family into treatment, though the focus is on
systemic change. This approach helps the PMHNP understand how family roles and
boundaries impact individual mental health.
5. A 7-year-old boy is brought to the clinic for difficulty sitting still in class, frequently
interrupting others, and losing his school supplies. Symptoms occur at school and home.
What is the most likely diagnosis?
A. Attention-Deficit/Hyperactivity Disorder (ADHD)
B. Specific Learning Disorder
C. Autism Spectrum Disorder
D. Adjustment Disorder
Answer: A
Explanation: ADHD involves a persistent pattern of inattention and/or hyperactivity-
impulsivity that interferes with functioning. These symptoms must be present in two or
more settings, such as home and school, and have persisted for at least six months. The
Vanderbilt Assessment Scale is commonly used to gather data from parents and teachers to
support this diagnosis.
6. Which of the following is a key diagnostic criterion for Autism Spectrum Disorder (ASD)
according to the DSM-5?
A. Deficits in social-emotional reciprocity
, B. Aggression toward people and animals
C. Delusions and hallucinations
D. Sudden onset of motor tics
Answer: A
Explanation: ASD is characterized by persistent deficits in social communication and
social interaction across multiple contexts. This includes deficits in social-emotional
reciprocity, nonverbal communicative behaviors, and developing/maintaining
relationships. Additionally, restricted, repetitive patterns of behavior or interests must be
present.
7. An adolescent is prescribed an atypical antipsychotic for the management of aggression
associated with Autism Spectrum Disorder. Which monitoring is most critical for this
medication class?
A. Serial chest X-rays
B. Vision acuity testing
C. Serum electrolytes every week
D. Weight, blood glucose, and lipid profile
Answer: D
Explanation: Second-generation antipsychotics (SGAs) like Risperidone and Aripiprazole
are known to cause metabolic side effects. PMHNPs must monitor for weight gain,
hyperlipidemia, and the development of type 2 diabetes. These assessments should occur
at baseline and at regular intervals throughout treatment.
8. A child presents with both multiple motor tics and at least one vocal tic that have persisted
for more than a year. What is the diagnosis?
A. Provisional Tic Disorder
B. Persistent Motor Tic Disorder
C. Tourette’s Disorder
D. Stereotypic Movement Disorder
Answer: C
Explanation: Tourette’s Disorder requires the presence of both multiple motor tics and at
least one vocal tic. These tics must have occurred for more than one year since the first tic
onset. The onset of tics must occur before the age of 18 years.
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Final Exam) | Chamberlain University
1. A 10-year-old child presents with persistent irritability and frequent temper outbursts that
are out of proportion to the situation. These symptoms have occurred at least three times per
week for the past year across multiple settings. Which diagnosis is most appropriate?
A. Bipolar I Disorder
B. Oppositional Defiant Disorder
C. Disruptive Mood Dysregulation Disorder (DMDD)
D. Conduct Disorder
Answer: C
Explanation: Disruptive Mood Dysregulation Disorder is characterized by severe temper
outbursts and a chronic irritable mood between outbursts. This diagnosis was created to
address the overdiagnosis of pediatric bipolar disorder. The symptoms must be present for
at least 12 months and occur in at least two settings.
2. When prescribing stimulants for a child with ADHD, which of the following is a primary
baseline assessment required before starting medication?
A. Cardiac history and vital signs including height and weight
B. Liver function tests
C. Renal function panel
D. Electroencephalogram (EEG)
Answer: A
Explanation: Stimulants can affect blood pressure and heart rate, making a thorough
cardiac history essential. Height and weight must be monitored regularly due to the risk of
appetite suppression and growth deceleration. A baseline EKG is generally only required if
there is a known family history of sudden cardiac death or personal cardiac symptoms.
3. A 15-year-old female reports feeling depressed, having low energy, and experiencing
suicidal ideation. Which SSRI is the only one FDA-approved for the treatment of depression in
children aged 8 and older?
A. Sertraline
B. Fluoxetine
C. Paroxetine
,D. Citalopram
Answer: B
Explanation: Fluoxetine (Prozac) is the first-line SSRI for pediatric depression and is
approved for children as young as 8 years old. Escitalopram is approved for adolescents
aged 12 to 17. The PMHNP must be aware of the Black Box Warning regarding increased
suicidality in this age group when initiating therapy.
4. Which therapeutic approach focuses on the ‘identified patient’ as a symptom-bearer for a
dysfunctional family system?
A. Family Systems Therapy
B. Cognitive Behavioral Therapy
C. Dialectical Behavior Therapy
D. Interpersonal Therapy
Answer: A
Explanation: Family Systems Therapy views the family as an emotional unit where the
individual’s behavior is connected to the system’s dynamics. The ‘identified patient’ is often
the individual whose symptoms bring the family into treatment, though the focus is on
systemic change. This approach helps the PMHNP understand how family roles and
boundaries impact individual mental health.
5. A 7-year-old boy is brought to the clinic for difficulty sitting still in class, frequently
interrupting others, and losing his school supplies. Symptoms occur at school and home.
What is the most likely diagnosis?
A. Attention-Deficit/Hyperactivity Disorder (ADHD)
B. Specific Learning Disorder
C. Autism Spectrum Disorder
D. Adjustment Disorder
Answer: A
Explanation: ADHD involves a persistent pattern of inattention and/or hyperactivity-
impulsivity that interferes with functioning. These symptoms must be present in two or
more settings, such as home and school, and have persisted for at least six months. The
Vanderbilt Assessment Scale is commonly used to gather data from parents and teachers to
support this diagnosis.
6. Which of the following is a key diagnostic criterion for Autism Spectrum Disorder (ASD)
according to the DSM-5?
A. Deficits in social-emotional reciprocity
, B. Aggression toward people and animals
C. Delusions and hallucinations
D. Sudden onset of motor tics
Answer: A
Explanation: ASD is characterized by persistent deficits in social communication and
social interaction across multiple contexts. This includes deficits in social-emotional
reciprocity, nonverbal communicative behaviors, and developing/maintaining
relationships. Additionally, restricted, repetitive patterns of behavior or interests must be
present.
7. An adolescent is prescribed an atypical antipsychotic for the management of aggression
associated with Autism Spectrum Disorder. Which monitoring is most critical for this
medication class?
A. Serial chest X-rays
B. Vision acuity testing
C. Serum electrolytes every week
D. Weight, blood glucose, and lipid profile
Answer: D
Explanation: Second-generation antipsychotics (SGAs) like Risperidone and Aripiprazole
are known to cause metabolic side effects. PMHNPs must monitor for weight gain,
hyperlipidemia, and the development of type 2 diabetes. These assessments should occur
at baseline and at regular intervals throughout treatment.
8. A child presents with both multiple motor tics and at least one vocal tic that have persisted
for more than a year. What is the diagnosis?
A. Provisional Tic Disorder
B. Persistent Motor Tic Disorder
C. Tourette’s Disorder
D. Stereotypic Movement Disorder
Answer: C
Explanation: Tourette’s Disorder requires the presence of both multiple motor tics and at
least one vocal tic. These tics must have occurred for more than one year since the first tic
onset. The onset of tics must occur before the age of 18 years.
