NURS 6660 Midterm Exam/ NURS6660 Midterm Exam

Question.1 Jack is a 3-year-old boy who is being evaluated for developmental delay. The mental status examination is significant for an inability to stack two blocks or draw a circle. The PMHNP also appreciates the inability to attend to any task for more than a few seconds. These findings indicate an abnormality in: A. Social relatedness B. Thought process and content C. Motor behavior D. Judgment and insight Question.2 During the mental status exam of Oliver, a 4-year-old child, the PMHNP appreciates that he appears to be having transient visual and auditory hallucinations. The PMHNP knows that the best approach to this finding is to consider that: A. This is most consistent with early-onset schizophrenia B. An organic brain disorder should be ruled out C. These are normal findings in very young children D. Comprehensive psychiatric assessment is indicated Question.3 Jason is a 17-month-old male who is referred for evaluation of an unusually high level of irritability. His mother says he cries “all the time,” and sometimes he just cannot be comforted; Jason’s pediatrician felt that the complaint warranted an evaluation by child psychiatry. Comprehensive assessment of Jason’s irritability should include all the following except: A. A comprehensive medical assessment B. Standardized developmental measures C. Assessment without the parents present D. Observation of Jason during play Question.4 When evaluating treatment strategies for a 14-year-old patient with obsessive-compulsive disorder (OCD), the PMHNP considers that evidence-based data from the Pediatric OCD Treatment Study (POTS) suggests that best outcomes are achieved with cognitive behavioral therapy (CBT) and: A. Clomipramine (Anafranil) B. Sertraline (Zoloft) C. Aripiprazole (Abilify) D. Lithium (Eskalith) Question.5 Which of the following behaviors is least suspicious for an adolescent who is being bullied at school? A. A significant change in study habits in which the patient is demonstrating higher academic achievement to the exclusion of a social life B. A persistent, sustained increase in the number and variety of physical complaints that have no obvious organic cause C. Evidence that the patient has started smoking cigarettes and seems to spend more time alone than usual D. Migration to a completely different peer group and a change in appearance and behavior to aggressively mimic the new group Question.6 Michael is a 13-year-old boy who was involved in a traumatic automobile accident in which his mother, the driver, was killed. After suffering multiple injuries and weeks in the hospital, Michael was discharged to home with physical therapy. He ultimately made a complete physical recovery but is unable to get into a car. Just the thought of riding in a car produces profound physiologic symptoms. He has been diagnosed with post-traumatic stress disorder (PTSD). His avoidance of riding in a car is conceptualized as: A. Panic attacks B. Operant conditioning C. Hyper arousal D. Flashbacks Question.7 Which of the following is a true statement with respect to developmental testing in infants? A. None of the available validated developmental tools are reliable in infants under 6 months of age. B. An infant’s score on developmental assessment is a reliable predictor of future intelligence quotient. C. Infant assessments are helpful in detecting mental retardation and developmental disorders. D. Assessment in older infants focuses on sensorimotor and social responses. Question.8 Wendy is a 6-year-old female being evaluated by the PMHNP following a suicide attempt. The police were called when a neighbor saw Wendy jump out of the open window of her first-floor apartment. She was unhurt, but when the neighbor asked why she jumped out she said she wanted to kill herself. Which coincident finding would warrant an inpatient psychiatric admission for Wendy? A. This was not the first episode. B. The caretaker is incapable of arranging follow-up. C. One or both of the biological parents has a history of suicide attempts. D. Wendy was left with a babysitter when the incident occurred. Question.9 Caleb is a 10-year-old boy who is referred for assessment because he is not following any of the rules of discipline at home. His parents report that they have had three separate nannies resign in the last 4 months because Caleb is unmanageable. This is a long-standing problem, going back to daycare even before kindergarten. The PMHNP knows that when conducting her initial interview of Caleb she should: A. Anticipate that he can tolerate up to a 45-minute session B. Consider that symbolic play with dolls will be informative C. Interview him alone before involving the parents D. Be clear that he is there because of problem behavior Question.10 Treatment of abused children is multimodal and long term. The single most important aspect of treatment is: A. Establishing a safe place for the child B. Exposure related to the feared experience C. Psychoeducation D. Cognitive-behavioral interventions