NR606 Midterm Exam
Steps for Obtaining Informed Consent - (correct Answer) - -Assess pt ability to understand medical info,
tx options, to make a voluntary decision.
-Present relevant info with accuracy and sensitivity:
• diagnosis
• nature & purpose of tx options
• benefits, risks, burdens of all tx options, including forgoing tx
-Document informed consent conversation in the medical record, including all consent forms.
Underlying assumptions for child and adolescent psychotherapy - (correct Answer) - Developmental
considerations
Family involvement
Systems involvement
Resiliency
Underlying assumptions for child and adolescent psychotherapy: Developmental considerations -
(correct Answer) - -developmental level will impact how they:
• reason
• approach relationships
• regulate emotion and behavior
• communicate
-Developmental considerations
• inform the diagnostic process
• guide tx planning
Underlying assumptions for child and adolescent psychotherapy: Family involvement - (correct Answer) -
-Family involvement in tx & decision-making
• a norm in child and adolescent psychotherapy
,-invite parents to share the hx of the child or adolescent's chief complaint & prior tx, medical &
developmental hx, & behavioral info privately with the therapist ahead of the session
• avoid feelings of criticism or discouragement
-collaborate with parent or caregiver as a tx partner
Underlying assumptions for child and adolescent psychotherapy: Systems involvement - (correct
Answer) - -Therapists must consider the systems that surround children & adolescents & promote their
development
• family
• school
• peers
• the community
-Therapy can help promote the child/adolescent's socioemotional competence
-help develop a community support system
Underlying assumptions for child and adolescent psychotherapy: Resiliency - (correct Answer) - -
therapist work to promote resiliency in children & adolescents
• using strength-based orientation
-supports:
• functioning
• self-regulation
• deal with challenges they faces
Piaget's Stages of Cognitive Development - (correct Answer) - -Sensorimotor stage: Birth-2 yrs
• cognitive abilities based on reflexes
• object permanence & causality
-Preoperational stage: 2-7yrs
• can use mental representations, symbolic thought, & language
• thinking is egocentric
,-Concrete operational stage: 7-11yrs
• logical operations when thinking/solving problems
• thinking is concrete
-Formal operational stage: 12yrs+
• Adolescent can use abstract reasoning in addition to logical operations
• Child can understand theories, hypothesize, comprehend abstract ideas (love & justice)
Screening, Brief Intervention, Referral to Treatment (SBIRT) - (correct Answer) - -Screening
• Quickly assesses severity of substance use & ID the appropriate level of tx
-Brief intervention
• Focuses on increasing insight & awareness regarding substance use & motivation toward behavioral
change
-Referral
• Guidance to tx provides those identified as needing more extensive tx with access to specialty care
Medication-Assisted Treatment (MAT) - (correct Answer) - Treatment for opioid use disorder combining
the use of medications (methadone, buprenorphine, or naltrexone) with counseling and behavioral
therapies.
Mental health and youth - (correct Answer) - -13% of children ages 8-15 experience a mental health
condition
-50% of children ages 8-15 experiencing a mental health condition do not receive tx
-13-20% of children living in the U.S. (1 out of 5 children) experience a mental health condition in a given
year
-17% of high school students seriously consider suicide
-1/2 of all lifetime cases of mental illness begin by age 14
, Barriers to Mental Health Treatment in Children and Adolescents - (correct Answer) - -lack of sufficient
information or access to services
-stigmas or negative perceptions towards mental health services
-many drop out before receiving effective treatment, often due to:
• poverty
• language barriers
• living in communities with scarce resources
• stressors such as
➣problems in the family
➣violence in the community
➣unstable housing
➣unemployment
➣food insecurity
-Cost
-scheduling conflicts
-long waitlists for services
-high staff turnover
Prescribing Considerations for Children and Adolescents - (correct Answer) - -physiologic factors impact
pediatric med selection & dosing
-Children, more rapid metabolism than adults, may require larger dose of med per unit of body weight
-Around puberty, pharmacokinetic properties reach adult parameters
• dosing after puberty may need to be decreased
-Developmental considerations
• attuned to signs of adverse effects, younger children may not be able to communicate complaints
Kassia, a 5-year-old, is prescribed a stimulant medication for ADHD (Attention Deficit Hyperactivity
Disorders) for the first time.
Steps for Obtaining Informed Consent - (correct Answer) - -Assess pt ability to understand medical info,
tx options, to make a voluntary decision.
-Present relevant info with accuracy and sensitivity:
• diagnosis
• nature & purpose of tx options
• benefits, risks, burdens of all tx options, including forgoing tx
-Document informed consent conversation in the medical record, including all consent forms.
Underlying assumptions for child and adolescent psychotherapy - (correct Answer) - Developmental
considerations
Family involvement
Systems involvement
Resiliency
Underlying assumptions for child and adolescent psychotherapy: Developmental considerations -
(correct Answer) - -developmental level will impact how they:
• reason
• approach relationships
• regulate emotion and behavior
• communicate
-Developmental considerations
• inform the diagnostic process
• guide tx planning
Underlying assumptions for child and adolescent psychotherapy: Family involvement - (correct Answer) -
-Family involvement in tx & decision-making
• a norm in child and adolescent psychotherapy
,-invite parents to share the hx of the child or adolescent's chief complaint & prior tx, medical &
developmental hx, & behavioral info privately with the therapist ahead of the session
• avoid feelings of criticism or discouragement
-collaborate with parent or caregiver as a tx partner
Underlying assumptions for child and adolescent psychotherapy: Systems involvement - (correct
Answer) - -Therapists must consider the systems that surround children & adolescents & promote their
development
• family
• school
• peers
• the community
-Therapy can help promote the child/adolescent's socioemotional competence
-help develop a community support system
Underlying assumptions for child and adolescent psychotherapy: Resiliency - (correct Answer) - -
therapist work to promote resiliency in children & adolescents
• using strength-based orientation
-supports:
• functioning
• self-regulation
• deal with challenges they faces
Piaget's Stages of Cognitive Development - (correct Answer) - -Sensorimotor stage: Birth-2 yrs
• cognitive abilities based on reflexes
• object permanence & causality
-Preoperational stage: 2-7yrs
• can use mental representations, symbolic thought, & language
• thinking is egocentric
,-Concrete operational stage: 7-11yrs
• logical operations when thinking/solving problems
• thinking is concrete
-Formal operational stage: 12yrs+
• Adolescent can use abstract reasoning in addition to logical operations
• Child can understand theories, hypothesize, comprehend abstract ideas (love & justice)
Screening, Brief Intervention, Referral to Treatment (SBIRT) - (correct Answer) - -Screening
• Quickly assesses severity of substance use & ID the appropriate level of tx
-Brief intervention
• Focuses on increasing insight & awareness regarding substance use & motivation toward behavioral
change
-Referral
• Guidance to tx provides those identified as needing more extensive tx with access to specialty care
Medication-Assisted Treatment (MAT) - (correct Answer) - Treatment for opioid use disorder combining
the use of medications (methadone, buprenorphine, or naltrexone) with counseling and behavioral
therapies.
Mental health and youth - (correct Answer) - -13% of children ages 8-15 experience a mental health
condition
-50% of children ages 8-15 experiencing a mental health condition do not receive tx
-13-20% of children living in the U.S. (1 out of 5 children) experience a mental health condition in a given
year
-17% of high school students seriously consider suicide
-1/2 of all lifetime cases of mental illness begin by age 14
, Barriers to Mental Health Treatment in Children and Adolescents - (correct Answer) - -lack of sufficient
information or access to services
-stigmas or negative perceptions towards mental health services
-many drop out before receiving effective treatment, often due to:
• poverty
• language barriers
• living in communities with scarce resources
• stressors such as
➣problems in the family
➣violence in the community
➣unstable housing
➣unemployment
➣food insecurity
-Cost
-scheduling conflicts
-long waitlists for services
-high staff turnover
Prescribing Considerations for Children and Adolescents - (correct Answer) - -physiologic factors impact
pediatric med selection & dosing
-Children, more rapid metabolism than adults, may require larger dose of med per unit of body weight
-Around puberty, pharmacokinetic properties reach adult parameters
• dosing after puberty may need to be decreased
-Developmental considerations
• attuned to signs of adverse effects, younger children may not be able to communicate complaints
Kassia, a 5-year-old, is prescribed a stimulant medication for ADHD (Attention Deficit Hyperactivity
Disorders) for the first time.
