NR606 Week 5 Exam V1 | NR606 Diagnosis & Management in
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 5 Exam) | Chamberlain University
1. A 9-year-old male is brought to the clinic for an evaluation due to persistent irritability and
frequent temper outbursts that occur approximately four times per week. The mother
reports these symptoms have been present for over a year across multiple settings. Which
diagnosis is most consistent with these clinical findings?
A. Oppositional Defiant Disorder (ODD)
B. Intermittent Explosive Disorder
C. Pediatric Bipolar Disorder
D. Disruptive Mood Dysregulation Disorder (DMDD)
Answer: D
Explanation: Disruptive Mood Dysregulation Disorder (DMDD) is characterized by severe
temper outbursts and a chronic, persistently irritable or angry mood between outbursts.
According to the DSM-5, the onset must be before age 10, and symptoms must be present
for at least 12 months in at least two settings. This diagnosis was created to reduce the
overdiagnosis of pediatric bipolar disorder in children with chronic rather than episodic
irritability.
2. Which of the following screening tools is most appropriate for assessing symptoms of
Autism Spectrum Disorder (ASD) in a 24-month-old child?
A. Vanderbilt Assessment Scale
B. M-CHAT-R/F
C. SCARED Tool
D. PHQ-A
Answer: B
Explanation: The Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-
CHAT-R/F) is a validated tool for children aged 16 to 30 months. It consists of a parent-
report questionnaire to identify toddlers who may be at risk for ASD. Early identification
through this tool allows for timely referral to developmental specialists and early
intervention services.
3. When prescribing Methylphenidate for a child with ADHD, which physical monitoring
parameter is essential at every follow-up visit?
A. Complete blood count (CBC)
,B. Height, weight, and blood pressure
C. Liver function tests (LFTs)
D. Serum glucose levels
Answer: B
Explanation: Stimulant medications like Methylphenidate require consistent monitoring of
growth parameters and cardiovascular vitals. Clinicians must track height and weight to
screen for growth suppression, which is a known potential side effect of long-term
stimulant use. Additionally, monitoring blood pressure and heart rate is necessary to
ensure cardiovascular safety during treatment.
4. A 15-year-old female presents with restrictive eating, intense fear of gaining weight, and a
body mass index (BMI) significantly below the 5th percentile for her age. She admits to
excessive exercising but denies purging. What is the most likely diagnosis?
A. Bulimia Nervosa
B. Avoidant/Restrictive Food Intake Disorder (ARFID)
C. Binge-Eating Disorder
D. Anorexia Nervosa, restricting type
Answer: D
Explanation: Anorexia Nervosa, restricting type, is characterized by weight loss achieved
through dieting, fasting, and/or excessive exercise without regular binge-eating or purging.
The DSM-5 criteria include a restricted energy intake leading to significantly low body
weight and an intense fear of weight gain. Unlike ARFID, Anorexia involves a disturbance in
the way one’s body weight or shape is experienced.
5. Which FDA-approved medication is indicated for the treatment of irritability associated
with Autism Spectrum Disorder in children and adolescents?
A. Fluoxetine
B. Risperidone
C. Guanfacine
D. Lithium
Answer: B
Explanation: Risperidone and Aripiprazole are the only two atypical antipsychotics
currently FDA-approved for treating irritability in children with ASD. These medications
target symptoms such as aggression, deliberate self-injury, and severe temper tantrums.
Use of these medications requires careful monitoring for metabolic side effects, including
weight gain and hyperprolactinemia.
, 6. According to the DSM-5, which symptom is required for a diagnosis of Major Depressive
Disorder in children and adolescents that differs from the adult presentation?
A. Hypersomnia
B. Irritable mood instead of depressed mood
C. Psychomotor agitation
D. Increased appetite
Answer: B
Explanation: In children and adolescents, the DSM-5 specifies that an irritable mood can
satisfy the requirement for a depressed mood. This developmental variation is crucial for
PMHNPs to recognize, as pediatric depression often manifests as grumpiness or hostility
rather than overt sadness. Failure to recognize irritability as a depressive equivalent can
lead to underdiagnosis or misdiagnosis.
7. Which of the following is considered a ‘first-line’ evidence-based psychotherapeutic
intervention for childhood Post-Traumatic Stress Disorder (PTSD)?
A. Dialectical Behavior Therapy (DBT)
B. Play Therapy
C. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
D. Interpersonal Therapy (IPT)
Answer: C
Explanation: TF-CBT is the gold standard for treating PTSD in the pediatric population. It
involves both the child and the caregiver, focusing on trauma processing, coping skills, and
cognitive restructuring. This intervention has the strongest evidence base for reducing
trauma-related symptoms and improving functioning in children.
8. A 7-year-old child displays a consistent pattern of inhibited, emotionally withdrawn
behavior toward adult caregivers, rarely seeking comfort when distressed. This behavior
followed a history of severe social neglect. What is the most likely diagnosis?
A. Reactive Attachment Disorder (RAD)
B. Disinhibited Social Engagement Disorder
C. Separation Anxiety Disorder
D. Social Anxiety Disorder
Answer: A
Explanation: Reactive Attachment Disorder (RAD) is characterized by a pattern of
withdrawn behavior toward caregivers and limited positive affect. It typically arises from a
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 5 Exam) | Chamberlain University
1. A 9-year-old male is brought to the clinic for an evaluation due to persistent irritability and
frequent temper outbursts that occur approximately four times per week. The mother
reports these symptoms have been present for over a year across multiple settings. Which
diagnosis is most consistent with these clinical findings?
A. Oppositional Defiant Disorder (ODD)
B. Intermittent Explosive Disorder
C. Pediatric Bipolar Disorder
D. Disruptive Mood Dysregulation Disorder (DMDD)
Answer: D
Explanation: Disruptive Mood Dysregulation Disorder (DMDD) is characterized by severe
temper outbursts and a chronic, persistently irritable or angry mood between outbursts.
According to the DSM-5, the onset must be before age 10, and symptoms must be present
for at least 12 months in at least two settings. This diagnosis was created to reduce the
overdiagnosis of pediatric bipolar disorder in children with chronic rather than episodic
irritability.
2. Which of the following screening tools is most appropriate for assessing symptoms of
Autism Spectrum Disorder (ASD) in a 24-month-old child?
A. Vanderbilt Assessment Scale
B. M-CHAT-R/F
C. SCARED Tool
D. PHQ-A
Answer: B
Explanation: The Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-
CHAT-R/F) is a validated tool for children aged 16 to 30 months. It consists of a parent-
report questionnaire to identify toddlers who may be at risk for ASD. Early identification
through this tool allows for timely referral to developmental specialists and early
intervention services.
3. When prescribing Methylphenidate for a child with ADHD, which physical monitoring
parameter is essential at every follow-up visit?
A. Complete blood count (CBC)
,B. Height, weight, and blood pressure
C. Liver function tests (LFTs)
D. Serum glucose levels
Answer: B
Explanation: Stimulant medications like Methylphenidate require consistent monitoring of
growth parameters and cardiovascular vitals. Clinicians must track height and weight to
screen for growth suppression, which is a known potential side effect of long-term
stimulant use. Additionally, monitoring blood pressure and heart rate is necessary to
ensure cardiovascular safety during treatment.
4. A 15-year-old female presents with restrictive eating, intense fear of gaining weight, and a
body mass index (BMI) significantly below the 5th percentile for her age. She admits to
excessive exercising but denies purging. What is the most likely diagnosis?
A. Bulimia Nervosa
B. Avoidant/Restrictive Food Intake Disorder (ARFID)
C. Binge-Eating Disorder
D. Anorexia Nervosa, restricting type
Answer: D
Explanation: Anorexia Nervosa, restricting type, is characterized by weight loss achieved
through dieting, fasting, and/or excessive exercise without regular binge-eating or purging.
The DSM-5 criteria include a restricted energy intake leading to significantly low body
weight and an intense fear of weight gain. Unlike ARFID, Anorexia involves a disturbance in
the way one’s body weight or shape is experienced.
5. Which FDA-approved medication is indicated for the treatment of irritability associated
with Autism Spectrum Disorder in children and adolescents?
A. Fluoxetine
B. Risperidone
C. Guanfacine
D. Lithium
Answer: B
Explanation: Risperidone and Aripiprazole are the only two atypical antipsychotics
currently FDA-approved for treating irritability in children with ASD. These medications
target symptoms such as aggression, deliberate self-injury, and severe temper tantrums.
Use of these medications requires careful monitoring for metabolic side effects, including
weight gain and hyperprolactinemia.
, 6. According to the DSM-5, which symptom is required for a diagnosis of Major Depressive
Disorder in children and adolescents that differs from the adult presentation?
A. Hypersomnia
B. Irritable mood instead of depressed mood
C. Psychomotor agitation
D. Increased appetite
Answer: B
Explanation: In children and adolescents, the DSM-5 specifies that an irritable mood can
satisfy the requirement for a depressed mood. This developmental variation is crucial for
PMHNPs to recognize, as pediatric depression often manifests as grumpiness or hostility
rather than overt sadness. Failure to recognize irritability as a depressive equivalent can
lead to underdiagnosis or misdiagnosis.
7. Which of the following is considered a ‘first-line’ evidence-based psychotherapeutic
intervention for childhood Post-Traumatic Stress Disorder (PTSD)?
A. Dialectical Behavior Therapy (DBT)
B. Play Therapy
C. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
D. Interpersonal Therapy (IPT)
Answer: C
Explanation: TF-CBT is the gold standard for treating PTSD in the pediatric population. It
involves both the child and the caregiver, focusing on trauma processing, coping skills, and
cognitive restructuring. This intervention has the strongest evidence base for reducing
trauma-related symptoms and improving functioning in children.
8. A 7-year-old child displays a consistent pattern of inhibited, emotionally withdrawn
behavior toward adult caregivers, rarely seeking comfort when distressed. This behavior
followed a history of severe social neglect. What is the most likely diagnosis?
A. Reactive Attachment Disorder (RAD)
B. Disinhibited Social Engagement Disorder
C. Separation Anxiety Disorder
D. Social Anxiety Disorder
Answer: A
Explanation: Reactive Attachment Disorder (RAD) is characterized by a pattern of
withdrawn behavior toward caregivers and limited positive affect. It typically arises from a
