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Final Exam V2: NR606 / NR 606 (
Edition) Diagnosis and Management in
Psychiatric-Mental Health II Practicum |
Questions and verified Answers | 100% Correct |
Grade A - Chamberlain
What is the DSM-5 definition of ADHD?
A persistent pattern of selective attention and/or hyperactivity and or impulsivity that interferes
with functioning or development. The patient should usually have 6 or more symptoms of
selective attention, hyperactivity and impulsivity for 6 months or longer.
Symptoms interfere with social, academic, or occupational functioning
symptoms are present in two or more setting
What are some s/s of selective attention (refers to the ability to focus on specific information or
stimuli while actively filtering out irrelevant distractions, essentially choosing what to pay
attention to) within children with ADHD?
lack of attention to detail, carelesnessness, not listening, losing things, diverting attention,
forgetfulness.
What are some s/s of impulsivity?
Not waiting your turn, blurting things out, interrupting, excessive talking
What are some s/s of hyperactivity?
trouble playing quietly, leaving ones set, running/climbing, fidgeting
What are some s/s of lack of sustained attention?
poor problem solving, difficulty completing tasks, disorganization, difficulty sustaining mental
effort
When is ADHD usually diagnosed and what gender does it mainly affect?
It is diagnosed within early childhood to adolescents.
ADHD has a 2:1 male to female ratio.
What is the importance of early ADHD diagnosis and treatment?
ADHD symptoms may be mild or so severe and persistent that they interfere with virtually all
aspects of a person's life.
Without early identification and proper treatment, ADHD can cause disruptions in academic
performance, family stress, difficulties in social relationships, and accidental injuries.
,What are the lasting consequences of non-treatment of ADHD in children?
Children with ADHD may experience delays in speech, motor, and social development. They
often demonstrate reduced behavioral inhibition, emotional dys-regulation or impulsivity, and
negative emotionality. Some children with ADHD have challenges with working memory.
ADHD typically presents with_________ IN EARLY CHILDHOOD.
HYPERACTIVITY
What is the difficult about diagnosing ADHD in children under the age of 4?
It can be hard to distinguish actually ADHD symptoms from normal neurotypical children.
_______ FEATURES become more prominent in PRESCHOOL and ELEMENTARY school,
which is when ADHD is most often diagnosed.
Inattentive.
Young children can experience developmental delays and may engage in behaviors that are less
mature than their peers.
In adolescence, signs of hyperactivity become less common, but some adolescents experience a
worsening of the condition with development of _______ behaviors.
Anti-social
Teens with ADHD are at risk for poor academic performance, problems with driving, difficulties
with social situations, risky sexual behavior, and substance abuse.- Particularly untreated
As clients reach adolescence, hyperactive symptoms may decline and become less apparent to
others, but adolescents and adults with ADHD may still struggle with executive function,
attention, and working memory, which can create problems with day-to-day functioning,
performance at work, and relationships.
How would you as a PMHNP screen or diagnose ADHD?
To make an informed diagnosis, it is essential to gather data from multiple sources, including the
client, parents, and teachers of children and adolescents. Several instruments are available, either
free or for a fee, to assist in diagnosis, as well as to monitor changes in symptoms during
treatment.
You can use the Vanderbilt scale- FREE
Connor Scale- not free
What are some co-morbidities of ADHD?
Substance use disorder, depression, anxiety, OCD, Bipolar
Common co-occurring conditions include learning disabilities, conduct disorders, tics, anxiety,
depression, and language disorders; adolescents are at increased risk of substance use disorders.
Consideration must be given to whether the presenting symptoms are attributed to ADHD,
another disorder, or to both disorders to make an accurate diagnosis and treatment plan.
, How is treatment typically handled when a child has ADHD AND a co-existing mental health
ailment?
Children with co-occurring conditions are often treated first for ADHD and then for
comorbidities, as treating ADHD symptoms first may help reduce overall stress levels and
provide a clearer picture of the comorbid symptoms
What is the first-line treatment for ADHD?
A stimulant medication.
A non-stimulant is used if a stimulant is contraindicated or if a stimulant is not effective.
However remember that treatment of ADHD is multi-modal, often requiring medical,
educational, behavioral, and psychological intervention.
________ can help lower distractibility and improve attention, working memory, and
impulsivity.
Non-stimulants
How would you treat a patient who is having argumentative or oppositional symptoms?
A combination of stimulants and non-stimulants can be used
What cardiac considerations should be considered before starting any patients on a stimulant?
A cardiac workup should be completed.
An electrocardiogram (EKG) is required if cardiac history is present in a first-degree relative. (it
can help identify potential underlying heart conditions that could be adversely affected by the
medication, even if the patient appears healthy, as stimulants can slightly increase heart rate and
blood pressure, potentially causing complications in individuals with undiagnosed heart issues;
this practice is recommended by the American Heart Association (AHA) to prioritize patient
safety. ) and ensure to document this.
What bio-metric considerations should be considered before starting any patients on a stimulant?
Monitor BP, height and weight during every appointment. (ensure the child is not experiencing
abnormal BP, ensure stimulant is not affecting the child's growth and development. Ensure the
medication is not cause anorexia within the patient. Stimulants decrease appetite.
What mental health considerations should be considered before starting any patients on a
stimulant?
- Assess all clients for bipolar disorder before treatment.
Central nervous system (CNS) stimulants may cause psychotic or manic symptoms in clients
with no prior history or may exacerbate behavior disturbance symptoms and thought disorders in
clients with pre-existing psychosis.
- CNS stimulants may exacerbate comorbid anxiety and substance use disorders.
What are two teaching points for patients if they begin to complain of insomnia while on a
stimulant?
Final Exam V2: NR606 / NR 606 (
Edition) Diagnosis and Management in
Psychiatric-Mental Health II Practicum |
Questions and verified Answers | 100% Correct |
Grade A - Chamberlain
What is the DSM-5 definition of ADHD?
A persistent pattern of selective attention and/or hyperactivity and or impulsivity that interferes
with functioning or development. The patient should usually have 6 or more symptoms of
selective attention, hyperactivity and impulsivity for 6 months or longer.
Symptoms interfere with social, academic, or occupational functioning
symptoms are present in two or more setting
What are some s/s of selective attention (refers to the ability to focus on specific information or
stimuli while actively filtering out irrelevant distractions, essentially choosing what to pay
attention to) within children with ADHD?
lack of attention to detail, carelesnessness, not listening, losing things, diverting attention,
forgetfulness.
What are some s/s of impulsivity?
Not waiting your turn, blurting things out, interrupting, excessive talking
What are some s/s of hyperactivity?
trouble playing quietly, leaving ones set, running/climbing, fidgeting
What are some s/s of lack of sustained attention?
poor problem solving, difficulty completing tasks, disorganization, difficulty sustaining mental
effort
When is ADHD usually diagnosed and what gender does it mainly affect?
It is diagnosed within early childhood to adolescents.
ADHD has a 2:1 male to female ratio.
What is the importance of early ADHD diagnosis and treatment?
ADHD symptoms may be mild or so severe and persistent that they interfere with virtually all
aspects of a person's life.
Without early identification and proper treatment, ADHD can cause disruptions in academic
performance, family stress, difficulties in social relationships, and accidental injuries.
,What are the lasting consequences of non-treatment of ADHD in children?
Children with ADHD may experience delays in speech, motor, and social development. They
often demonstrate reduced behavioral inhibition, emotional dys-regulation or impulsivity, and
negative emotionality. Some children with ADHD have challenges with working memory.
ADHD typically presents with_________ IN EARLY CHILDHOOD.
HYPERACTIVITY
What is the difficult about diagnosing ADHD in children under the age of 4?
It can be hard to distinguish actually ADHD symptoms from normal neurotypical children.
_______ FEATURES become more prominent in PRESCHOOL and ELEMENTARY school,
which is when ADHD is most often diagnosed.
Inattentive.
Young children can experience developmental delays and may engage in behaviors that are less
mature than their peers.
In adolescence, signs of hyperactivity become less common, but some adolescents experience a
worsening of the condition with development of _______ behaviors.
Anti-social
Teens with ADHD are at risk for poor academic performance, problems with driving, difficulties
with social situations, risky sexual behavior, and substance abuse.- Particularly untreated
As clients reach adolescence, hyperactive symptoms may decline and become less apparent to
others, but adolescents and adults with ADHD may still struggle with executive function,
attention, and working memory, which can create problems with day-to-day functioning,
performance at work, and relationships.
How would you as a PMHNP screen or diagnose ADHD?
To make an informed diagnosis, it is essential to gather data from multiple sources, including the
client, parents, and teachers of children and adolescents. Several instruments are available, either
free or for a fee, to assist in diagnosis, as well as to monitor changes in symptoms during
treatment.
You can use the Vanderbilt scale- FREE
Connor Scale- not free
What are some co-morbidities of ADHD?
Substance use disorder, depression, anxiety, OCD, Bipolar
Common co-occurring conditions include learning disabilities, conduct disorders, tics, anxiety,
depression, and language disorders; adolescents are at increased risk of substance use disorders.
Consideration must be given to whether the presenting symptoms are attributed to ADHD,
another disorder, or to both disorders to make an accurate diagnosis and treatment plan.
, How is treatment typically handled when a child has ADHD AND a co-existing mental health
ailment?
Children with co-occurring conditions are often treated first for ADHD and then for
comorbidities, as treating ADHD symptoms first may help reduce overall stress levels and
provide a clearer picture of the comorbid symptoms
What is the first-line treatment for ADHD?
A stimulant medication.
A non-stimulant is used if a stimulant is contraindicated or if a stimulant is not effective.
However remember that treatment of ADHD is multi-modal, often requiring medical,
educational, behavioral, and psychological intervention.
________ can help lower distractibility and improve attention, working memory, and
impulsivity.
Non-stimulants
How would you treat a patient who is having argumentative or oppositional symptoms?
A combination of stimulants and non-stimulants can be used
What cardiac considerations should be considered before starting any patients on a stimulant?
A cardiac workup should be completed.
An electrocardiogram (EKG) is required if cardiac history is present in a first-degree relative. (it
can help identify potential underlying heart conditions that could be adversely affected by the
medication, even if the patient appears healthy, as stimulants can slightly increase heart rate and
blood pressure, potentially causing complications in individuals with undiagnosed heart issues;
this practice is recommended by the American Heart Association (AHA) to prioritize patient
safety. ) and ensure to document this.
What bio-metric considerations should be considered before starting any patients on a stimulant?
Monitor BP, height and weight during every appointment. (ensure the child is not experiencing
abnormal BP, ensure stimulant is not affecting the child's growth and development. Ensure the
medication is not cause anorexia within the patient. Stimulants decrease appetite.
What mental health considerations should be considered before starting any patients on a
stimulant?
- Assess all clients for bipolar disorder before treatment.
Central nervous system (CNS) stimulants may cause psychotic or manic symptoms in clients
with no prior history or may exacerbate behavior disturbance symptoms and thought disorders in
clients with pre-existing psychosis.
- CNS stimulants may exacerbate comorbid anxiety and substance use disorders.
What are two teaching points for patients if they begin to complain of insomnia while on a
stimulant?
