Final Exam|NRNP 6665 Final Exam| Test Questions & Answers| Latest Updated A+ Guide Solution

Which of the following is not a true statement with respect to confidentiality of the child or adolescent client? (Ans- A. The PMHNP should not be concerned with consent for disclosure when child abuse or maltreatment has occurred. B. In 1979, the American Psychiatric Association (APA) stated that children 12 years of age or older can give consent for disclosure. C. The American Academy of Child and Adolescent Psychiatry (AACAP) Code of Ethics states that consent is not required for disclosure. D. Regardless of code or position statement by any organization, the best approach is when the child and PMHNP agree on disclosure. Andrew is a 14-year-old male who is being managed for bipolar I disorder. He was started on lithium 6 weeks ago and has achieved a serum level of 1.1 mEq/L according to his most recent blood work. Andrew says he doesn't feel any different, but both his parents and teachers report improvement in his mood. He has been more stable, is getting along better with friends and siblings, and is even more interested in his schoolwork. The PMHNP plans to maintain Andrew on this medication and knows that he will need which of the following ongoing laboratory assessments? (Ans- A. Complete blood count, thyroid function tests, and serum calcium B. Liver function tests, complete blood count, and 12-lead electrocardiogram C. White blood cell differential, fasting glucose, and fasting lipid profile D. Comprehensive metabolic panel, complete blood count, and thyroid function tests The therapeutic outcomes for children with disorders of written expression are most favorable when they are characterized by: (Ans- A. Concomitant pharmacotherapy with a psychostimulant to promote attention and focus B. Multimodal therapy to include group interaction with peer-to-peer feedback on writing samples C. variety of tutors who will offer a variety of writing techniques, composition strategies, and critiques D. Intensive, continuous administration of individually tailored, one-on-one expressive and creative writing therapy Aripiprazole (Ans- ability/ antipsychotic (atypical) S/sx: drowsiness Risperidone (Ans- Atypical antipsychotic causing high prolactin levels with lots of extrapyramidal SE Amphetamine IR (Ans- Adderall CNS Stimulant Amphetamine XR (Ans- Adderall (XR) CNS Stimulant Dextroamphetamine (Ans- CNS stimulant *Mech*: Inc catecholamines at the synaptic cleft, especially NE and dopamine. *Use*: ADHD, narcolepsy, apetite control Atomoxetine (Strattera) (Ans- - BBW Risk of suicidal ideation; monitor for suicidal thinking or behavior, worsening, or unusual behavior - Contraindications Glaucoma, pheochromocytoma, MAO I use within past 14 days - Warning Rare, but severe hepatotoxicity (most within 120 days of start of treatment) SE Headache, insomnia, *somnolence*, dry mouth, nausea, abdominal pain, decrease in appetite, nausea, etc. Priapism NOTE * do not open capsule * - irritant CYPD 2D6 substrate watch out for *LIVER PROBLEMS * Clonidine (Ans- alpha 2 agonist -treatment for hypertension and opioid withdrawal -side effects of bradycardia and hypotension Dexmethylphenidate (Ans- ADHD stimulant Guanfacine Hydrochloride (Ans- *Antihypertensive/Antipsychotic *Tenex, Intuniv Lisdexamfetamine (Ans- Vyvanse ADHD C-II Methylphenidate (Ans- Concerta, Ritalin, Metadate, Methylin CNS Agent for ADHD Methylphenidate ER (Ans- Concerta, Metadate CD, Ritalin LA, Quillichew (chewable tablets), Quillivant (suspension), Cotempla (ODT) When considering a diagnosis of developmental coordination disorder, the PMHNP knows that the diagnosis may be associated with: (Ans- A. Above-average scores on performance subtests of standardized intelligence testing B. Below-average scores on verbal subtests of standardized intelligence testing C. Soft neurologic signs on physical examination such as slight reflex abnormalities D. Physical findings consistent with neuromuscular disease such as muscular dystrophy Children with gender dysphoria typically have higher rates of all the following except: (Ans- A. Depression B. Impulse control disorders C. Anxiety disorders D. Eating disorder Eileen is a 23-month-old girl who is being evaluated for autism spectrum disorder because her pediatrician is concerned about the presence of developmental red flags. She has just a few words of speech and has not put together any meaningful two-word phrases. While taking a history from Eileen's mother the PMHNP learns that for approximately the last 2 months Eileen has been seen eating paint chips that are peeling off the baseboard and window sills in the family home; when she sees one she puts it in her mouth. This is a concern because they live in an old farmhouse and there may be lead-based paint in some of the paint layers. The PMHNP considers that which of the following is not consistent with a diagnosis of pica? (Ans- A. A diagnosis of autism spectrum disorder B. Symptoms 6 months duration C. The pattern of eating D. Lack of potential consequences Which of the following symptom clusters is most likely in a 16-year-old male with major depressive disorder? (Ans- A. Disturbance of mood, loss of interest, and mood-congruent hallucinations B. Irritability, persistent abdominal complaints, and insomnia C. Decreased concentration, social withdrawal, and substance abuse D. Pervasive anhedonia, hopelessness, and severe psychomotor retardation The current scholarly consensus is that the etiology of bulimia nervosa is multifactorial to include biological, sociocultural, family, cognitive-behavioral, and psychodynamic factors. When considering the etiology of bulimia nervosa, the PMHNP understands that: (Ans- A. Family factors contributing to bulimia nervosa include emotional restraint, tight parental control of behavior, and avoidance of conflict. B. Lowered serotonin activity is seen in the brains of patients with bulimia nervosa. C. There is a disproportionate incidence in childhood sexual abuse in patients with bulimia nervosa. D. Cultural influences are much less implicit in the development of bulimia nervosa as compared to anorexia nervosa.