NR606 Week 4 Exam V3 | NR606 Diagnosis & Management in
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 4 Exam) | Chamberlain University
1. A 9-year-old male is brought to the clinic for an evaluation due to persistent difficulty
staying in his seat, interrupting others, and losing his school supplies. According to the DSM-
5-TR, which criterion is necessary for a diagnosis of Attention-Deficit/Hyperactivity Disorder
(ADHD)?
A. Symptoms must be present in at least one setting, such as school or home.
B. Several symptoms must be present prior to the age of 12 years.
C. Symptoms must be present for a minimum duration of 12 consecutive months.
D. The patient must exhibit at least eight symptoms of inattention or hyperactivity.
Answer: B
Explanation: The DSM-5-TR specifies that for a diagnosis of ADHD, several inattentive or
hyperactive-impulsive symptoms must have been present prior to age 12. Additionally, the
symptoms must be present in two or more settings, such as home, school, or work. For
children under 17, at least six symptoms are required in either the inattention or
hyperactivity/impulsivity categories.
2. When prescribing Methylphenidate for a pediatric patient with ADHD, the PMHNP should
monitor which physical parameters at every follow-up visit?
A. Height, weight, blood pressure, and heart rate
B. Serum creatinine and liver enzymes
C. Blood glucose and cholesterol levels
D. Visual acuity and intraocular pressure
Answer: A
Explanation: Stimulant medications like Methylphenidate are associated with potential
side effects including appetite suppression and cardiovascular changes. It is essential to
track height and weight on a growth chart to monitor for growth suppression over time.
Monitoring blood pressure and heart rate is also required due to the sympathomimetic
effects of stimulants.
3. A 7-year-old girl demonstrates significant impairment in social communication, fails to
maintain eye contact, and engages in repetitive hand-flapping. Which condition is most likely
indicated by these symptoms?
A. Social Anxiety Disorder
,B. Autism Spectrum Disorder (ASD)
C. Stereotypic Movement Disorder
D. Reactive Attachment Disorder
Answer: B
Explanation: Autism Spectrum Disorder is characterized by persistent deficits in social
communication and social interaction across multiple contexts. It also requires the
presence of restricted, repetitive patterns of behavior, interests, or activities, such as hand-
flapping or lining up toys. These symptoms must be present in the early developmental
period for a proper diagnosis.
4. Which non-stimulant medication is FDA-approved for the treatment of ADHD in children
and functions as a selective norepinephrine reuptake inhibitor (SNRI)?
A. Guanfacine
B. Clonidine
C. Bupropion
D. Atomoxetine
Answer: D
Explanation: Atomoxetine (Strattera) is a non-stimulant selective norepinephrine
reuptake inhibitor approved for ADHD in pediatric and adult populations. Unlike
stimulants, it has a lower potential for abuse and is often used when there is a concern for
substance use or tics. It typically takes several weeks to achieve full therapeutic effect
compared to the immediate response of stimulants.
5. A 14-year-old male is referred to the clinic for aggressive behavior toward animals,
frequent skipping of school, and theft. These behaviors reflect a violation of the basic rights
of others. What is the most likely diagnosis?
A. Oppositional Defiant Disorder (ODD)
B. Intermittent Explosive Disorder
C. Conduct Disorder (CD)
D. Antisocial Personality Disorder
Answer: C
Explanation: Conduct Disorder involves a repetitive and persistent pattern of behavior in
which the basic rights of others or major age-appropriate societal norms are violated. The
four main groupings of behaviors include aggression to people and animals, destruction of
property, deceitfulness or theft, and serious violations of rules. ODD is different as it
, focuses on defiance and irritability rather than the violation of others’ rights or physical
aggression.
6. What is the primary difference between Oppositional Defiant Disorder (ODD) and Conduct
Disorder (CD)?
A. CD includes behaviors that violate the rights of others, whereas ODD involves defiance
and irritability.
B. ODD involves physical aggression toward others, while CD does not.
C. ODD is only diagnosed in adults, while CD is only diagnosed in children.
D. There is no significant clinical difference between the two disorders.
Answer: A
Explanation: ODD is characterized by a pattern of angry/irritable mood,
argumentative/defiant behavior, or vindictiveness. CD represents a more severe
progression where the individual violates social norms and the rights of others, including
physical violence or law-breaking. While ODD can precede CD, they are distinct clinical
entities within the DSM-5-TR.
7. A 10-year-old patient presents with chronic, severe irritability and frequent temper
outbursts (3 or more times per week) that are developmentally inappropriate. Which
diagnosis should the PMHNP consider first?
A. Disruptive Mood Dysregulation Disorder (DMDD)
B. Bipolar I Disorder
C. Major Depressive Disorder
D. Generalized Anxiety Disorder
Answer: A
Explanation: DMDD was created to address the over-diagnosis of Bipolar Disorder in
children who exhibit chronic irritability and frequent temper tantrums. The symptoms
must be present for at least 12 months in multiple settings, and the onset must be before
age 10. The irritability must be persistent throughout the day and observed by others, such
as parents and teachers.
8. Which medication is the only FDA-approved SSRI for the treatment of Major Depressive
Disorder in children aged 8 and older?
A. Sertraline
B. Fluoxetine
C. Paroxetine
D. Escitalopram
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 4 Exam) | Chamberlain University
1. A 9-year-old male is brought to the clinic for an evaluation due to persistent difficulty
staying in his seat, interrupting others, and losing his school supplies. According to the DSM-
5-TR, which criterion is necessary for a diagnosis of Attention-Deficit/Hyperactivity Disorder
(ADHD)?
A. Symptoms must be present in at least one setting, such as school or home.
B. Several symptoms must be present prior to the age of 12 years.
C. Symptoms must be present for a minimum duration of 12 consecutive months.
D. The patient must exhibit at least eight symptoms of inattention or hyperactivity.
Answer: B
Explanation: The DSM-5-TR specifies that for a diagnosis of ADHD, several inattentive or
hyperactive-impulsive symptoms must have been present prior to age 12. Additionally, the
symptoms must be present in two or more settings, such as home, school, or work. For
children under 17, at least six symptoms are required in either the inattention or
hyperactivity/impulsivity categories.
2. When prescribing Methylphenidate for a pediatric patient with ADHD, the PMHNP should
monitor which physical parameters at every follow-up visit?
A. Height, weight, blood pressure, and heart rate
B. Serum creatinine and liver enzymes
C. Blood glucose and cholesterol levels
D. Visual acuity and intraocular pressure
Answer: A
Explanation: Stimulant medications like Methylphenidate are associated with potential
side effects including appetite suppression and cardiovascular changes. It is essential to
track height and weight on a growth chart to monitor for growth suppression over time.
Monitoring blood pressure and heart rate is also required due to the sympathomimetic
effects of stimulants.
3. A 7-year-old girl demonstrates significant impairment in social communication, fails to
maintain eye contact, and engages in repetitive hand-flapping. Which condition is most likely
indicated by these symptoms?
A. Social Anxiety Disorder
,B. Autism Spectrum Disorder (ASD)
C. Stereotypic Movement Disorder
D. Reactive Attachment Disorder
Answer: B
Explanation: Autism Spectrum Disorder is characterized by persistent deficits in social
communication and social interaction across multiple contexts. It also requires the
presence of restricted, repetitive patterns of behavior, interests, or activities, such as hand-
flapping or lining up toys. These symptoms must be present in the early developmental
period for a proper diagnosis.
4. Which non-stimulant medication is FDA-approved for the treatment of ADHD in children
and functions as a selective norepinephrine reuptake inhibitor (SNRI)?
A. Guanfacine
B. Clonidine
C. Bupropion
D. Atomoxetine
Answer: D
Explanation: Atomoxetine (Strattera) is a non-stimulant selective norepinephrine
reuptake inhibitor approved for ADHD in pediatric and adult populations. Unlike
stimulants, it has a lower potential for abuse and is often used when there is a concern for
substance use or tics. It typically takes several weeks to achieve full therapeutic effect
compared to the immediate response of stimulants.
5. A 14-year-old male is referred to the clinic for aggressive behavior toward animals,
frequent skipping of school, and theft. These behaviors reflect a violation of the basic rights
of others. What is the most likely diagnosis?
A. Oppositional Defiant Disorder (ODD)
B. Intermittent Explosive Disorder
C. Conduct Disorder (CD)
D. Antisocial Personality Disorder
Answer: C
Explanation: Conduct Disorder involves a repetitive and persistent pattern of behavior in
which the basic rights of others or major age-appropriate societal norms are violated. The
four main groupings of behaviors include aggression to people and animals, destruction of
property, deceitfulness or theft, and serious violations of rules. ODD is different as it
, focuses on defiance and irritability rather than the violation of others’ rights or physical
aggression.
6. What is the primary difference between Oppositional Defiant Disorder (ODD) and Conduct
Disorder (CD)?
A. CD includes behaviors that violate the rights of others, whereas ODD involves defiance
and irritability.
B. ODD involves physical aggression toward others, while CD does not.
C. ODD is only diagnosed in adults, while CD is only diagnosed in children.
D. There is no significant clinical difference between the two disorders.
Answer: A
Explanation: ODD is characterized by a pattern of angry/irritable mood,
argumentative/defiant behavior, or vindictiveness. CD represents a more severe
progression where the individual violates social norms and the rights of others, including
physical violence or law-breaking. While ODD can precede CD, they are distinct clinical
entities within the DSM-5-TR.
7. A 10-year-old patient presents with chronic, severe irritability and frequent temper
outbursts (3 or more times per week) that are developmentally inappropriate. Which
diagnosis should the PMHNP consider first?
A. Disruptive Mood Dysregulation Disorder (DMDD)
B. Bipolar I Disorder
C. Major Depressive Disorder
D. Generalized Anxiety Disorder
Answer: A
Explanation: DMDD was created to address the over-diagnosis of Bipolar Disorder in
children who exhibit chronic irritability and frequent temper tantrums. The symptoms
must be present for at least 12 months in multiple settings, and the onset must be before
age 10. The irritability must be persistent throughout the day and observed by others, such
as parents and teachers.
8. Which medication is the only FDA-approved SSRI for the treatment of Major Depressive
Disorder in children aged 8 and older?
A. Sertraline
B. Fluoxetine
C. Paroxetine
D. Escitalopram
