NURS 6660 MIDTERM EXAM

NURS 6660 MIDTERM EXAMJack 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 C 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 B 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 NURS 6660 mid term WALDEN D Which of the following is the most common anxiety disorder of childhood? A . Generalized anxiety disorder B . Separation anxiety disorder C . Social anxiety disorder D . Obsessive-compulsive disorder A 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) B 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 A 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 C 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. C 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 firstfloor 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. B 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 D 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 A Psychiatric assessment of the adolescent patient is different in several ways from assessment of younger children. While trying to establish a therapeutic environment with an adolescent who is openly hostile, one of the most important things the PMHNP can do is to: A . Be more liberal in terms of limit setting and tolerating hostility in order to facilitate honest communication B . Ensure the patient that under no circumstances will anything said be repeated to the parents C . Allow silences to last as long as necessary until the patient is inclined to offer any verbal input D . Communicate to the patient that his or her perspective is valued and will not be judged or critiqued A A variety of questionnaires, scales, guided-interview tools, and other standardized instruments are available to aid with various aspects of assessment. The majority are intended only to be used as an aid to information gathering and not to make a diagnosis. Which of the following tools requires training to administer and can be used to determine diagnoses? A . Child and Adolescent Psychiatric Assessment (CAPA) B . Brief Impairment Scale C . Pictorial Instrument for Children and Adolescents (PICA-III-R) D . Achenbach Child Behavior Checklist C The PMHNP is drafting a proposal for research funding for a project to offer primary prevention strategies designed to reduce the incidence of bullying. In support of this project, the PMHNP provides data supporting the fact that both perpetrators and victims of bullying suffer all of the following except: A . Higher incidence of emotional problems B . Greater difficulty making friends C . Poorer academic achievement D . Increased percentage of smoking D Which of the following manifestations of childhood anxiety disorders is considered a psychiatric emergency? A . School refusal B . Bedtime refusal C . Eating refusal D . Speech refusal A The PMHNP is performing an assessment on Julie, a 4-year-old girl who has been brought to care by her mother. The mother was referred by the pediatrician because Julie has been demonstrating an appreciable change in her behavior. She is developmentally on target and has always been a happy and curious child, but for the last few months she seems to be much more fearful and anxious. Which of the following recently acquired behaviors described by the mother is most suspicious for sexual abuse? A . Prolonged periods of daydreaming B . Masturbating with a toy C . Touching the genitals of her 3-year-old cousin D . Showing her genitals to other children at daycare B What is the primary diagnostic difference between obsessive-compulsive disorders in children as compared to adults? A . Age of onset B . Response to treatment C . Recognition that the thoughts or behaviors are irrational D . The thoughts or behaviors occupy 1 hour daily A With respect to treatment of conduct disorder, the PMHNP knows that: A . The reduction of violence and aggression in school is critical B . Parental psychiatric intervention has not demonstrated improved outcomes C . Atypical antipsychotics are avoided due to the adverse effect profile D . Treatment with psychostimulants exacerbates a