NR606 Week 1 Exam V1 | NR606 Diagnosis & Management in
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 1 Exam) | Chamberlain University
1. When diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD) in a child, which of the
following criteria is mandatory according to the DSM-5?
A. Symptoms must be present before the age of 7.
B. The child must demonstrate a significant decline in IQ scores.
C. Hyperactivity must be the predominant symptom observed.
D. Symptoms must be present in at least two different settings.
Answer: D
Explanation: The DSM-5 requires that ADHD symptoms be present in at least two settings,
such as home and school, to ensure the behavior is not context-specific. While symptoms
must be present before age 12, the previous age 7 cutoff was updated. This criterion helps
clinicians differentiate ADHD from environmental stressors or specific learning disabilities.
2. A 9-year-old child presents with chronic, severe irritability and frequent temper outbursts
that are developmentally inappropriate. Which diagnosis is most likely?
A. Disruptive Mood Dysregulation Disorder (DMDD)
B. Oppositional Defiant Disorder
C. Pediatric Bipolar Disorder
D. Conduct Disorder
Answer: A
Explanation: DMDD was added to the DSM-5 to address the over-diagnosis of bipolar
disorder in children. It is characterized by severe temper outbursts and a persistent
irritable mood between outbursts. The diagnosis cannot be made before age 6 or after age
18.
3. Which pharmacological intervention is considered first-line for a child diagnosed with
moderate to severe ADHD?
A. Guanfacine (Tenex)
B. Atomoxetine (Strattera)
C. Bupropion (Wellbutrin)
D. Methylphenidate (Ritalin)
,Answer: D
Explanation: Stimulants like Methylphenidate are evidence-based first-line treatments for
ADHD due to their high efficacy rates in improving focus and reducing impulsivity. Non-
stimulants like Atomoxetine are typically reserved for patients who do not tolerate
stimulants or have a history of substance abuse. The PMHNP must monitor for side effects
like appetite suppression and growth deceleration.
4. In the context of pediatric psychiatry, what does the term ‘assent’ refer to?
A. The legal authority of the parent to sign for treatment.
B. The court order required for involuntary commitment of a minor.
C. The child’s agreement to participate in treatment or research.
D. The process of transferring records to a new provider.
Answer: C
Explanation: Assent is the child’s affirmative agreement to participate in clinical care or
research, even though they lack the legal capacity to provide full consent. It reflects ethical
practice by involving the minor in their own healthcare decisions. Legal consent must still
be obtained from the parent or guardian.
5. A 5-year-old child is referred for evaluation due to a lack of social interest, repetitive hand-
flapping, and a delay in language development. These symptoms are hallmarks of:
A. Social Anxiety Disorder
B. Intellectual Disability
C. Stereotypic Movement Disorder
D. Autism Spectrum Disorder (ASD)
Answer: D
Explanation: ASD is defined by deficits in social communication and social interaction
across multiple contexts, alongside restricted, repetitive patterns of behavior. Early
intervention is critical for improving long-term developmental outcomes. The severity is
categorized based on the level of support required.
6. When prescribing an SSRI to a 15-year-old for Major Depressive Disorder, the PMHNP must
educate the family on the FDA Black Box warning regarding:
A. Increased risk of suicidal ideation and behavior.
B. Risk of weight gain and metabolic syndrome.
C. Increased risk of hepatotoxicity.
D. Potential for permanent growth suppression.
, Answer: A
Explanation: The FDA issued a black box warning for all SSRIs in pediatric populations due
to an observed increase in suicidal thoughts and behaviors during early treatment. Close
monitoring, especially during the first few weeks of therapy, is mandatory for patient
safety. Families should be instructed to report any sudden changes in mood or agitation
immediately.
7. Which of the following is a primary characteristic of Oppositional Defiant Disorder (ODD)?
A. Physical aggression toward people or animals.
B. Vandalism and theft.
C. A pattern of angry, irritable mood and argumentative behavior.
D. Repeated violations of the basic rights of others.
Answer: C
Explanation: ODD involves a pattern of angry/irritable mood, argumentative/defiant
behavior, or vindictiveness lasting at least six months. Unlike Conduct Disorder, ODD does
not typically involve serious violations of social norms or the rights of others. Behavioral
therapy is the primary treatment modality for this condition.
8. A child presents with a sudden onset of motor tics and vocal tics that have persisted for
over a year. The most likely diagnosis is:
A. Provisional Tic Disorder
B. Chronic Motor Tic Disorder
C. Tourette’s Disorder
D. Persistent Vocal Tic Disorder
Answer: C
Explanation: Tourette’s Disorder requires the presence of multiple motor tics and at least
one vocal tic, though not necessarily concurrently, for more than one year. The onset must
be before age 18. Treatment may include Alpha-2 agonists or habit reversal therapy.
9. In family therapy, the concept of ‘triangulation’ refers to:
A. A healthy three-way communication channel.
B. The formal structure of a three-generation genogram.
C. A process where two members bring in a third to alleviate tension.
D. A therapeutic technique to balance power in the room.
Answer: C
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 1 Exam) | Chamberlain University
1. When diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD) in a child, which of the
following criteria is mandatory according to the DSM-5?
A. Symptoms must be present before the age of 7.
B. The child must demonstrate a significant decline in IQ scores.
C. Hyperactivity must be the predominant symptom observed.
D. Symptoms must be present in at least two different settings.
Answer: D
Explanation: The DSM-5 requires that ADHD symptoms be present in at least two settings,
such as home and school, to ensure the behavior is not context-specific. While symptoms
must be present before age 12, the previous age 7 cutoff was updated. This criterion helps
clinicians differentiate ADHD from environmental stressors or specific learning disabilities.
2. A 9-year-old child presents with chronic, severe irritability and frequent temper outbursts
that are developmentally inappropriate. Which diagnosis is most likely?
A. Disruptive Mood Dysregulation Disorder (DMDD)
B. Oppositional Defiant Disorder
C. Pediatric Bipolar Disorder
D. Conduct Disorder
Answer: A
Explanation: DMDD was added to the DSM-5 to address the over-diagnosis of bipolar
disorder in children. It is characterized by severe temper outbursts and a persistent
irritable mood between outbursts. The diagnosis cannot be made before age 6 or after age
18.
3. Which pharmacological intervention is considered first-line for a child diagnosed with
moderate to severe ADHD?
A. Guanfacine (Tenex)
B. Atomoxetine (Strattera)
C. Bupropion (Wellbutrin)
D. Methylphenidate (Ritalin)
,Answer: D
Explanation: Stimulants like Methylphenidate are evidence-based first-line treatments for
ADHD due to their high efficacy rates in improving focus and reducing impulsivity. Non-
stimulants like Atomoxetine are typically reserved for patients who do not tolerate
stimulants or have a history of substance abuse. The PMHNP must monitor for side effects
like appetite suppression and growth deceleration.
4. In the context of pediatric psychiatry, what does the term ‘assent’ refer to?
A. The legal authority of the parent to sign for treatment.
B. The court order required for involuntary commitment of a minor.
C. The child’s agreement to participate in treatment or research.
D. The process of transferring records to a new provider.
Answer: C
Explanation: Assent is the child’s affirmative agreement to participate in clinical care or
research, even though they lack the legal capacity to provide full consent. It reflects ethical
practice by involving the minor in their own healthcare decisions. Legal consent must still
be obtained from the parent or guardian.
5. A 5-year-old child is referred for evaluation due to a lack of social interest, repetitive hand-
flapping, and a delay in language development. These symptoms are hallmarks of:
A. Social Anxiety Disorder
B. Intellectual Disability
C. Stereotypic Movement Disorder
D. Autism Spectrum Disorder (ASD)
Answer: D
Explanation: ASD is defined by deficits in social communication and social interaction
across multiple contexts, alongside restricted, repetitive patterns of behavior. Early
intervention is critical for improving long-term developmental outcomes. The severity is
categorized based on the level of support required.
6. When prescribing an SSRI to a 15-year-old for Major Depressive Disorder, the PMHNP must
educate the family on the FDA Black Box warning regarding:
A. Increased risk of suicidal ideation and behavior.
B. Risk of weight gain and metabolic syndrome.
C. Increased risk of hepatotoxicity.
D. Potential for permanent growth suppression.
, Answer: A
Explanation: The FDA issued a black box warning for all SSRIs in pediatric populations due
to an observed increase in suicidal thoughts and behaviors during early treatment. Close
monitoring, especially during the first few weeks of therapy, is mandatory for patient
safety. Families should be instructed to report any sudden changes in mood or agitation
immediately.
7. Which of the following is a primary characteristic of Oppositional Defiant Disorder (ODD)?
A. Physical aggression toward people or animals.
B. Vandalism and theft.
C. A pattern of angry, irritable mood and argumentative behavior.
D. Repeated violations of the basic rights of others.
Answer: C
Explanation: ODD involves a pattern of angry/irritable mood, argumentative/defiant
behavior, or vindictiveness lasting at least six months. Unlike Conduct Disorder, ODD does
not typically involve serious violations of social norms or the rights of others. Behavioral
therapy is the primary treatment modality for this condition.
8. A child presents with a sudden onset of motor tics and vocal tics that have persisted for
over a year. The most likely diagnosis is:
A. Provisional Tic Disorder
B. Chronic Motor Tic Disorder
C. Tourette’s Disorder
D. Persistent Vocal Tic Disorder
Answer: C
Explanation: Tourette’s Disorder requires the presence of multiple motor tics and at least
one vocal tic, though not necessarily concurrently, for more than one year. The onset must
be before age 18. Treatment may include Alpha-2 agonists or habit reversal therapy.
9. In family therapy, the concept of ‘triangulation’ refers to:
A. A healthy three-way communication channel.
B. The formal structure of a three-generation genogram.
C. A process where two members bring in a third to alleviate tension.
D. A therapeutic technique to balance power in the room.
Answer: C
