D347 NURS 6440
Advanced Psychiatric Mental Health Care
of Children & Adolescents
Proctored Final Assessment Review
(With Solutions)
2026
1
,Multiple Choice
A 14-year-old diagnosed with severe major depressive disorder has
failed two trials of SSRIs. Which of the following is the next best step
in pharmacological management? a) Add a benzodiazepine b) Switch
to a tricyclic antidepressant c) Augment with atypical antipsychotic
such as aripiprazole d) Increase SSRI dose beyond recommended
maximum
Answer: c) Augment with atypical antipsychotic such as aripiprazole
Rationale: For SSRI-resistant depression in adolescents,
augmentation with atypical antipsychotics is evidence-based. TCAs
have higher toxicity risk, and benzodiazepines are not first-line in
depressive disorders.
2. Which neurodevelopmental disorder is most commonly comorbid
with pediatric anxiety disorders?
a) Autism Spectrum Disorder
b) Attention Deficit Hyperactivity Disorder
c) Oppositional Defiant Disorder
d) Tourette’s Syndrome
Answer: b) Attention Deficit Hyperactivity Disorder
Rationale: ADHD frequently co-occurs with anxiety disorders in
children and adolescents, complicating management plans.
3. In the assessment of pediatric bipolar disorder, which symptom
differentiates it from ADHD?
a) Hyperactivity
b) Distractibility
c) Grandiosity
d) Impulsivity
Answer: c) Grandiosity
Rationale: Grandiosity is more specific to mania in bipolar disorder,
2
, less typical in ADHD.
4. What is the preferred first-line medication for treating pediatric
generalized anxiety disorder?
a) Fluoxetine
b) Haloperidol
c) Lithium
d) Methylphenidate
Answer: a) Fluoxetine
Rationale: SSRIs such as fluoxetine are FDA-approved and evidence-
based for pediatric anxiety disorders.
5. Which of these statements regarding CBT in children and
adolescents is TRUE?
a) It is ineffective in youths younger than 12 years
b) It remains the first-line psychotherapeutic intervention in anxiety
and depression
c) It requires pharmacotherapy to achieve positive outcomes
d) It has significant risks of adverse effects
Answer: b) It remains the first-line psychotherapeutic intervention in
anxiety and depression
Rationale: CBT is effective and recommended first-line for many
disorders without inherent pharmacological adverse effects.
True / False
True or False: Electroconvulsive therapy (ECT) is contraindicated in
adolescents.
Answer: False
Rationale: ECT may be used in severe, treatment-resistant mood
disorders in adolescents under strict guidelines.
True or False: Children with conduct disorder frequently display
3
Advanced Psychiatric Mental Health Care
of Children & Adolescents
Proctored Final Assessment Review
(With Solutions)
2026
1
,Multiple Choice
A 14-year-old diagnosed with severe major depressive disorder has
failed two trials of SSRIs. Which of the following is the next best step
in pharmacological management? a) Add a benzodiazepine b) Switch
to a tricyclic antidepressant c) Augment with atypical antipsychotic
such as aripiprazole d) Increase SSRI dose beyond recommended
maximum
Answer: c) Augment with atypical antipsychotic such as aripiprazole
Rationale: For SSRI-resistant depression in adolescents,
augmentation with atypical antipsychotics is evidence-based. TCAs
have higher toxicity risk, and benzodiazepines are not first-line in
depressive disorders.
2. Which neurodevelopmental disorder is most commonly comorbid
with pediatric anxiety disorders?
a) Autism Spectrum Disorder
b) Attention Deficit Hyperactivity Disorder
c) Oppositional Defiant Disorder
d) Tourette’s Syndrome
Answer: b) Attention Deficit Hyperactivity Disorder
Rationale: ADHD frequently co-occurs with anxiety disorders in
children and adolescents, complicating management plans.
3. In the assessment of pediatric bipolar disorder, which symptom
differentiates it from ADHD?
a) Hyperactivity
b) Distractibility
c) Grandiosity
d) Impulsivity
Answer: c) Grandiosity
Rationale: Grandiosity is more specific to mania in bipolar disorder,
2
, less typical in ADHD.
4. What is the preferred first-line medication for treating pediatric
generalized anxiety disorder?
a) Fluoxetine
b) Haloperidol
c) Lithium
d) Methylphenidate
Answer: a) Fluoxetine
Rationale: SSRIs such as fluoxetine are FDA-approved and evidence-
based for pediatric anxiety disorders.
5. Which of these statements regarding CBT in children and
adolescents is TRUE?
a) It is ineffective in youths younger than 12 years
b) It remains the first-line psychotherapeutic intervention in anxiety
and depression
c) It requires pharmacotherapy to achieve positive outcomes
d) It has significant risks of adverse effects
Answer: b) It remains the first-line psychotherapeutic intervention in
anxiety and depression
Rationale: CBT is effective and recommended first-line for many
disorders without inherent pharmacological adverse effects.
True / False
True or False: Electroconvulsive therapy (ECT) is contraindicated in
adolescents.
Answer: False
Rationale: ECT may be used in severe, treatment-resistant mood
disorders in adolescents under strict guidelines.
True or False: Children with conduct disorder frequently display
3
