NR606 Week 9 Exam V1 | NR606 Diagnosis & Management in
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 9 Exam) | Chamberlain University
1. A 10-year-old child presents with persistent patterns of inattention and hyperactivity
across both school and home environments. According to DSM-5 criteria, what is the
minimum number of symptoms required in either category for a diagnosis of ADHD in a child?
A. 6 symptoms
B. 5 symptoms
C. 4 symptoms
D. 7 symptoms
Answer: A
Explanation: For children up to age 16, the DSM-5 requires at least six symptoms of
inattention or six symptoms of hyperactivity-impulsivity to be present. These symptoms
must have persisted for at least six months to a degree that is inconsistent with
developmental level. For adolescents 17 and older, only five symptoms are required for the
diagnosis.
2. When prescribing a Selective Serotonin Reuptake Inhibitor (SSRI) to an adolescent patient
with Major Depressive Disorder, the PMHNP must discuss the FDA Black Box Warning. What
is the primary risk identified in this warning?
A. Increased risk of cardiac arrhythmias
B. Risk of metabolic syndrome and weight gain
C. Higher incidence of hepatotoxicity
D. Increased risk of suicidal ideation and behaviors
Answer: D
Explanation: The FDA Black Box Warning for SSRIs in children and young adults highlights
an increased risk of suicidal thoughts and behaviors. This warning requires providers to
monitor patients closely, especially during the first few weeks of treatment or after dosage
changes. Frequent follow-up appointments are necessary to ensure patient safety and
assess for behavioral changes.
3. An 8-year-old child is being evaluated for Autism Spectrum Disorder (ASD). Which of the
following is considered a core diagnostic feature of ASD according to the DSM-5?
A. Recurrent episodes of physical aggression toward peers
B. Below average intellectual functioning as measured by IQ testing
,C. Specific learning disabilities in reading and mathematics
D. Persistent deficits in social communication and social interaction
Answer: D
Explanation: The core features of Autism Spectrum Disorder include persistent deficits in
social communication and social interaction across multiple contexts. Additionally, the
patient must demonstrate restricted, repetitive patterns of behavior, interests, or activities.
These symptoms must be present in the early developmental period and cause significant
clinical impairment.
4. The PMHNP is screening a 24-month-old child for developmental delays. Which validated
tool is most appropriate for assessing the risk of Autism Spectrum Disorder at this age?
A. PHQ-9A
B. M-CHAT-R/F
C. CRAFFT
D. GSRD
Answer: B
Explanation: The Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-
CHAT-R/F) is the gold standard screening tool for children aged 16 to 30 months. It
consists of a parent-report questionnaire that assesses social communication and play
behaviors. A positive screen indicates the need for further diagnostic evaluation but is not a
definitive diagnosis of ASD.
5. Which medication is classified as a non-stimulant and is FDA-approved for the treatment of
ADHD in children and adolescents?
A. Lisdexamfetamine
B. Methylphenidate
C. Modafinil
D. Atomoxetine
Answer: D
Explanation: Atomoxetine (Strattera) is a selective norepinephrine reuptake inhibitor that
is FDA-approved for ADHD as a non-stimulant option. It is particularly useful for patients
who do not tolerate stimulants or have a high risk of substance misuse. Unlike stimulants,
atomoxetine may take several weeks to reach its full therapeutic effect.
, 6. A 14-year-old female presents with evidence of calluses on the dorsal surface of her hand
(Russell’s Sign) and dental enamel erosion. These physical findings are most suggestive of
which disorder?
A. Bulimia Nervosa
B. Anorexia Nervosa, Restricting Type
C. Avoidant/Restrictive Food Intake Disorder
D. Binge Eating Disorder
Answer: A
Explanation: Russell’s Sign, characterized by calluses on the knuckles, results from
repeated self-induced vomiting associated with Bulimia Nervosa. The gastric acid from
vomit also causes the erosion of dental enamel over time. These physical markers are
critical for PMHNPs to identify during a physical assessment of adolescent patients with
suspected eating disorders.
7. In the treatment of pediatric Bipolar Disorder, which of the following is a primary concern
when prescribing Valproic Acid to adolescent females?
A. Aplastic Anemia
B. Polycycstic Ovary Syndrome (PCOS)
C. Stevens-Johnson Syndrome
D. Growth hormone suppression
Answer: B
Explanation: Valproic acid use in adolescent females is associated with an increased risk of
developing Polycystic Ovary Syndrome (PCOS). PMHNPs must monitor for symptoms such
as irregular menses, hirsutism, and weight gain. Alternative mood stabilizers may be
considered if these metabolic or hormonal side effects occur.
8. Which disorder is characterized by a persistent pattern of angry/irritable mood,
argumentative/defiant behavior, or vindictiveness lasting at least 6 months?
A. Conduct Disorder
B. Intermittent Explosive Disorder
C. Disruptive Mood Dysregulation Disorder (DMDD)
D. Oppositional Defiant Disorder (ODD)
Answer: D
Explanation: Oppositional Defiant Disorder (ODD) is defined by a pattern of angry or
irritable mood and defiant behavior toward authority figures. Unlike Conduct Disorder,
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 9 Exam) | Chamberlain University
1. A 10-year-old child presents with persistent patterns of inattention and hyperactivity
across both school and home environments. According to DSM-5 criteria, what is the
minimum number of symptoms required in either category for a diagnosis of ADHD in a child?
A. 6 symptoms
B. 5 symptoms
C. 4 symptoms
D. 7 symptoms
Answer: A
Explanation: For children up to age 16, the DSM-5 requires at least six symptoms of
inattention or six symptoms of hyperactivity-impulsivity to be present. These symptoms
must have persisted for at least six months to a degree that is inconsistent with
developmental level. For adolescents 17 and older, only five symptoms are required for the
diagnosis.
2. When prescribing a Selective Serotonin Reuptake Inhibitor (SSRI) to an adolescent patient
with Major Depressive Disorder, the PMHNP must discuss the FDA Black Box Warning. What
is the primary risk identified in this warning?
A. Increased risk of cardiac arrhythmias
B. Risk of metabolic syndrome and weight gain
C. Higher incidence of hepatotoxicity
D. Increased risk of suicidal ideation and behaviors
Answer: D
Explanation: The FDA Black Box Warning for SSRIs in children and young adults highlights
an increased risk of suicidal thoughts and behaviors. This warning requires providers to
monitor patients closely, especially during the first few weeks of treatment or after dosage
changes. Frequent follow-up appointments are necessary to ensure patient safety and
assess for behavioral changes.
3. An 8-year-old child is being evaluated for Autism Spectrum Disorder (ASD). Which of the
following is considered a core diagnostic feature of ASD according to the DSM-5?
A. Recurrent episodes of physical aggression toward peers
B. Below average intellectual functioning as measured by IQ testing
,C. Specific learning disabilities in reading and mathematics
D. Persistent deficits in social communication and social interaction
Answer: D
Explanation: The core features of Autism Spectrum Disorder include persistent deficits in
social communication and social interaction across multiple contexts. Additionally, the
patient must demonstrate restricted, repetitive patterns of behavior, interests, or activities.
These symptoms must be present in the early developmental period and cause significant
clinical impairment.
4. The PMHNP is screening a 24-month-old child for developmental delays. Which validated
tool is most appropriate for assessing the risk of Autism Spectrum Disorder at this age?
A. PHQ-9A
B. M-CHAT-R/F
C. CRAFFT
D. GSRD
Answer: B
Explanation: The Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-
CHAT-R/F) is the gold standard screening tool for children aged 16 to 30 months. It
consists of a parent-report questionnaire that assesses social communication and play
behaviors. A positive screen indicates the need for further diagnostic evaluation but is not a
definitive diagnosis of ASD.
5. Which medication is classified as a non-stimulant and is FDA-approved for the treatment of
ADHD in children and adolescents?
A. Lisdexamfetamine
B. Methylphenidate
C. Modafinil
D. Atomoxetine
Answer: D
Explanation: Atomoxetine (Strattera) is a selective norepinephrine reuptake inhibitor that
is FDA-approved for ADHD as a non-stimulant option. It is particularly useful for patients
who do not tolerate stimulants or have a high risk of substance misuse. Unlike stimulants,
atomoxetine may take several weeks to reach its full therapeutic effect.
, 6. A 14-year-old female presents with evidence of calluses on the dorsal surface of her hand
(Russell’s Sign) and dental enamel erosion. These physical findings are most suggestive of
which disorder?
A. Bulimia Nervosa
B. Anorexia Nervosa, Restricting Type
C. Avoidant/Restrictive Food Intake Disorder
D. Binge Eating Disorder
Answer: A
Explanation: Russell’s Sign, characterized by calluses on the knuckles, results from
repeated self-induced vomiting associated with Bulimia Nervosa. The gastric acid from
vomit also causes the erosion of dental enamel over time. These physical markers are
critical for PMHNPs to identify during a physical assessment of adolescent patients with
suspected eating disorders.
7. In the treatment of pediatric Bipolar Disorder, which of the following is a primary concern
when prescribing Valproic Acid to adolescent females?
A. Aplastic Anemia
B. Polycycstic Ovary Syndrome (PCOS)
C. Stevens-Johnson Syndrome
D. Growth hormone suppression
Answer: B
Explanation: Valproic acid use in adolescent females is associated with an increased risk of
developing Polycystic Ovary Syndrome (PCOS). PMHNPs must monitor for symptoms such
as irregular menses, hirsutism, and weight gain. Alternative mood stabilizers may be
considered if these metabolic or hormonal side effects occur.
8. Which disorder is characterized by a persistent pattern of angry/irritable mood,
argumentative/defiant behavior, or vindictiveness lasting at least 6 months?
A. Conduct Disorder
B. Intermittent Explosive Disorder
C. Disruptive Mood Dysregulation Disorder (DMDD)
D. Oppositional Defiant Disorder (ODD)
Answer: D
Explanation: Oppositional Defiant Disorder (ODD) is defined by a pattern of angry or
irritable mood and defiant behavior toward authority figures. Unlike Conduct Disorder,
