NR606 Week 4 Exam V1 | NR606 Diagnosis & Management in
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 4 Exam) | Chamberlain University
1. A 9-year-old child presents with frequent temper outbursts and persistent irritability that is
present for at least 12 months in multiple settings. Which diagnosis is most appropriate?
A. Bipolar I Disorder
B. Disruptive Mood Dysregulation Disorder (DMDD)
C. Oppositional Defiant Disorder (ODD)
D. Attention-Deficit/Hyperactivity Disorder (ADHD)
Answer: B
Explanation: DMDD is characterized by chronic, severe persistent irritability and frequent
temper outbursts in children. It was introduced in the DSM-5 to reduce the overdiagnosis
of Bipolar Disorder in pediatric populations. The symptoms must be present for at least 12
months across two or more settings to meet criteria.
2. When screening a 24-month-old for Autism Spectrum Disorder (ASD), which tool is
considered the gold standard for clinical use?
A. PHQ-A
B. M-CHAT-R/F
C. Vanderbilt Assessment Scale
D. GADS
Answer: B
Explanation: The Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-
CHAT-R/F) is the validated screening tool for children aged 16 to 30 months. It helps
identify children who may benefit from a more thorough developmental evaluation. Early
detection via this tool is crucial for implementing early intervention services which
improve long-term outcomes.
3. Which of the following SSRIs is FDA-approved for the treatment of Major Depressive
Disorder (MDD) in children aged 8 and older?
A. Sertraline
B. Fluoxetine
C. Paroxetine
,D. Escitalopram
Answer: B
Explanation: Fluoxetine is the only SSRI with FDA approval for treating MDD in children
starting at age 8. Escitalopram is approved for MDD in adolescents aged 12 and older. The
PMHNP must always assess for the black box warning regarding increased suicidal ideation
when initiating these medications in pediatric patients.
4. A 10-year-old male exhibits a repetitive pattern of violating the basic rights of others and
major societal norms, including physical aggression toward peers. What is the most likely
diagnosis?
A. Intermittent Explosive Disorder
B. Conduct Disorder
C. Oppositional Defiant Disorder
D. Social Anxiety Disorder
Answer: B
Explanation: Conduct Disorder involves a persistent pattern of behavior that violates the
rights of others, such as aggression, destruction of property, or theft. It is more severe than
Oppositional Defiant Disorder, which focuses more on mood and defiance rather than
physical harm or law-breaking. Treatment often requires multi-systemic therapy and
addressing underlying family dynamics.
5. Which medication is a non-stimulant approved for the treatment of ADHD and is
particularly useful when there is a concern for substance abuse?
A. Methylphenidate
B. Atomoxetine
C. Lisdexamfetamine
D. Alprazolam
Answer: B
Explanation: Atomoxetine is a selective norepinephrine reuptake inhibitor (SNRI) and is
not a controlled substance. It is a preferred option for patients with a personal or family
history of substance use disorders. Unlike stimulants, it may take several weeks to reach
full therapeutic effectiveness.
6. A 7-year-old child presents with motor tics and at least one vocal tic that have persisted for
more than a year. Which diagnosis applies?
A. Provisional Tic Disorder
B. Tourette’s Disorder
, C. Persistent Motor Tic Disorder
D. Stereotypic Movement Disorder
Answer: B
Explanation: Tourette’s Disorder requires both multiple motor tics and at least one vocal
tic to be present for more than one year. The onset must be before age 18 and not due to
physiological effects of a substance. Alpha-2 agonists like Guanfacine are often used as a
first-line pharmacological treatment for tics in children.
7. What is the primary neurodevelopmental focus when managing a child with Fetal Alcohol
Syndrome (FAS)?
A. Wait-and-see approach for cognitive delays
B. Early intervention and structured environments
C. Focusing solely on physical dysmorphology
D. High-dose stimulant therapy for all cases
Answer: B
Explanation: Children with FAS benefit significantly from early intervention services and
highly structured, predictable environments. These interventions help manage executive
functioning deficits and behavioral challenges associated with prenatal alcohol exposure.
The PMHNP plays a key role in coordinating multi-disciplinary care for these patients.
8. According to Erikson’s stages of psychosocial development, a 4-year-old child is in which
stage?
A. Autonomy vs. Shame and Doubt
B. Initiative vs. Guilt
C. Industry vs. Inferiority
D. Trust vs. Mistrust
Answer: B
Explanation: The stage of Initiative vs. Guilt occurs during the preschool years (ages 3 to
5). Children begin to assert power and control over the world through directing play and
other social interactions. Success in this stage leads to a sense of purpose, while failure
results in a sense of guilt.
9. Which side effect of stimulant medication for ADHD requires immediate cessation and
evaluation?
A. Decreased appetite
B. New onset of hallucinations or mania
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 4 Exam) | Chamberlain University
1. A 9-year-old child presents with frequent temper outbursts and persistent irritability that is
present for at least 12 months in multiple settings. Which diagnosis is most appropriate?
A. Bipolar I Disorder
B. Disruptive Mood Dysregulation Disorder (DMDD)
C. Oppositional Defiant Disorder (ODD)
D. Attention-Deficit/Hyperactivity Disorder (ADHD)
Answer: B
Explanation: DMDD is characterized by chronic, severe persistent irritability and frequent
temper outbursts in children. It was introduced in the DSM-5 to reduce the overdiagnosis
of Bipolar Disorder in pediatric populations. The symptoms must be present for at least 12
months across two or more settings to meet criteria.
2. When screening a 24-month-old for Autism Spectrum Disorder (ASD), which tool is
considered the gold standard for clinical use?
A. PHQ-A
B. M-CHAT-R/F
C. Vanderbilt Assessment Scale
D. GADS
Answer: B
Explanation: The Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-
CHAT-R/F) is the validated screening tool for children aged 16 to 30 months. It helps
identify children who may benefit from a more thorough developmental evaluation. Early
detection via this tool is crucial for implementing early intervention services which
improve long-term outcomes.
3. Which of the following SSRIs is FDA-approved for the treatment of Major Depressive
Disorder (MDD) in children aged 8 and older?
A. Sertraline
B. Fluoxetine
C. Paroxetine
,D. Escitalopram
Answer: B
Explanation: Fluoxetine is the only SSRI with FDA approval for treating MDD in children
starting at age 8. Escitalopram is approved for MDD in adolescents aged 12 and older. The
PMHNP must always assess for the black box warning regarding increased suicidal ideation
when initiating these medications in pediatric patients.
4. A 10-year-old male exhibits a repetitive pattern of violating the basic rights of others and
major societal norms, including physical aggression toward peers. What is the most likely
diagnosis?
A. Intermittent Explosive Disorder
B. Conduct Disorder
C. Oppositional Defiant Disorder
D. Social Anxiety Disorder
Answer: B
Explanation: Conduct Disorder involves a persistent pattern of behavior that violates the
rights of others, such as aggression, destruction of property, or theft. It is more severe than
Oppositional Defiant Disorder, which focuses more on mood and defiance rather than
physical harm or law-breaking. Treatment often requires multi-systemic therapy and
addressing underlying family dynamics.
5. Which medication is a non-stimulant approved for the treatment of ADHD and is
particularly useful when there is a concern for substance abuse?
A. Methylphenidate
B. Atomoxetine
C. Lisdexamfetamine
D. Alprazolam
Answer: B
Explanation: Atomoxetine is a selective norepinephrine reuptake inhibitor (SNRI) and is
not a controlled substance. It is a preferred option for patients with a personal or family
history of substance use disorders. Unlike stimulants, it may take several weeks to reach
full therapeutic effectiveness.
6. A 7-year-old child presents with motor tics and at least one vocal tic that have persisted for
more than a year. Which diagnosis applies?
A. Provisional Tic Disorder
B. Tourette’s Disorder
, C. Persistent Motor Tic Disorder
D. Stereotypic Movement Disorder
Answer: B
Explanation: Tourette’s Disorder requires both multiple motor tics and at least one vocal
tic to be present for more than one year. The onset must be before age 18 and not due to
physiological effects of a substance. Alpha-2 agonists like Guanfacine are often used as a
first-line pharmacological treatment for tics in children.
7. What is the primary neurodevelopmental focus when managing a child with Fetal Alcohol
Syndrome (FAS)?
A. Wait-and-see approach for cognitive delays
B. Early intervention and structured environments
C. Focusing solely on physical dysmorphology
D. High-dose stimulant therapy for all cases
Answer: B
Explanation: Children with FAS benefit significantly from early intervention services and
highly structured, predictable environments. These interventions help manage executive
functioning deficits and behavioral challenges associated with prenatal alcohol exposure.
The PMHNP plays a key role in coordinating multi-disciplinary care for these patients.
8. According to Erikson’s stages of psychosocial development, a 4-year-old child is in which
stage?
A. Autonomy vs. Shame and Doubt
B. Initiative vs. Guilt
C. Industry vs. Inferiority
D. Trust vs. Mistrust
Answer: B
Explanation: The stage of Initiative vs. Guilt occurs during the preschool years (ages 3 to
5). Children begin to assert power and control over the world through directing play and
other social interactions. Success in this stage leads to a sense of purpose, while failure
results in a sense of guilt.
9. Which side effect of stimulant medication for ADHD requires immediate cessation and
evaluation?
A. Decreased appetite
B. New onset of hallucinations or mania
