NR606 Midterm Exam Study Guide
Midterm Exam
Review the weekly Explore section content and required readings as noted within your Student
Lesson Plan for Learning Success.
Study Tips:
Summarize key concepts in your own words or create diagrams to visualize relationships.
Teach the material to someone else to reinforce understanding.
Study in focused sessions of 25–50 minutes, with 5–10-minute breaks in between.
Review material periodically over several days or weeks instead of cramming. Write
notes by hand and use color coding or mind maps to organize information visually.
Read each exam question twice before looking at the answer
Set aside specific times each day for studying.
View challenges as opportunities to improve.
At the end of each study session, jot down key takeaways, lingering questions, or topics
needing more review and use this reflection to plan your next study session effectively
Ethical and Practical Considerations – Week One
● What are barriers to seeking mental health care: parents lack of education or access to
services, parents reluctant to seek help due to the stigma or negative perceptions towards
mental health, Although some children and adolescents receive treatment, many drop out
before receiving effective treatment, often due to poverty, language barriers, living in
communities with scarce resources, and stressors such as problems in the family, violence
in the community, unstable housing, unemployment, and food insecurity. Cost,
scheduling conflicts, long waitlists for services, and high staff turnover also create
impediments for families seeking care.
● Social determinants and access to care in children and adolescents often due to poverty,
language barriers, living in communities with scarce resources, and stressors such as
problems in the family, violence in the community, unstable housing, unemployment, and
food insecurity. Cost, scheduling conflicts, long waitlists for services, and high staff
turnover also create impediments for families seeking care.
● Developmentally appropriate teaching in children and adolescents
● Racial and ethnic barriers to treatment
● Know types of stigma:
,1) Structural: Structural stigma, or institutional stigma, includes policies, regulations, or
laws that intentionally or unintentionally lead to discrimination. Structural stigma can limit
access to resources and other opportunities, thereby impacting the well-being of the
stigmatized group. A program policy that prohibits individuals from using specific forms
of prescribed medication for addiction (MAT) treatment is an example of structural
stigma.
, 2) Self: self-stigma refers to the shame individuals internalize about negative stereotypes. For
individuals affected by SUDs, self-stigma may lead to feelings of being flawed or
unworthy of love or connection. It may also prevent them from seeking help.
3) Public: Public stigma encompasses the attitudes, beliefs, and behaviors of groups or
individuals which form a stereotype that creates an emotional reaction or prejudice and
results in discrimination. A stereotypic belief that individuals choose to use alcohol or
other drugs and blame them for their substance use disorder is an example of public
stigma. Healthcare providers who have a conscious or unconscious bias against clients
who use substances in the perinatal period may not provide appropriate care and
treatment
4) Intervention: Madden (2019) has proposed a new category of stigma:
intervention stigma; “Individuals working in [medication-assisted treatment] MAT
experience discrimination and prejudice from other healthcare professionals,
especially abstinent treatment professionals who disagree with the use of medications
to treat opioid use disorders. This discrimination and prejudice stem at times from
stigma toward addiction diagnoses, and at other times toward unique features of MAT
itself.
● Parental access to child/adolescent’s mental health records – legal aspects: Typically,
parents have the right to request access to a minor child’s mental health record, including
symptoms, diagnosis, and treatment plan; however, certain circumstances may limit that
right. The U.S. Department of Health and Human Services provides guidance regarding how
the Health Insurance Portability and Accountability Act (HIPAA) affects parents’ access to
their child’s information. State regulations may also address access to this information.
PMHNPs are responsible for following all relevant statutes in their state of practice. Can
withhold if
suspect parental neglect?
● Ethical and legal principles of informed consent: Assess client ability to understand medical
information and treatment options and to make a voluntary decision. Present relevant
, information with accuracy and sensitivity. Should include information about diagnosis, nature and
purpose of treatment options, benefits, risks, and burdens of all treatment options, including
forgoing treatment. Document informed consent conversation in the medical record, including
all consent forms. Although children may not be able to give legal consent, they should be
included in discussions about medication and treatment whenever possible. Child input into
treatment decisions may encourage treatment adherence. Positive experiences with providers
and treatment can help instill the perception that treatment is beneficial, which can support
positive mental health behaviors in the future.
● Mandatory reporting: The Federal Child Abuse Prevention and Treatment Act (CAPTA)
requires each State to have provisions or procedures for requiring certain individuals to
report known or suspected instances of child abuse and neglect. Most states consider
PMHNPs to be
mandated reporters who are required to report suspicions about abuse or neglect to the
appropriate authorities. Both federal and state statutes include stipulations related to mandatory
reporting. PMHNPs are responsible for following all relevant statutes in their state of
practice.
● What are principles of dosing children with medications/ physiologic differences in
treatment of children: Children have a more rapid metabolism than adults and may require
a larger dose of medication per unit of body weight. Around puberty, pharmacokinetic
properties reach adult parameters; therefore, dosing after puberty may need to be
decreased
● Piaget proposed four major stages of cognitive development, and called them (1)
sensorimotor intelligence (0-2), (2) preoperational thinking (2-7), (3) concrete
operational thinking (7-11) its like a car and meds will help it run better, and (4)
formal operational thinking (12 and up).
● Roughly 50% of lifetime cases of mental illness begin by age 14
Midterm Exam
Review the weekly Explore section content and required readings as noted within your Student
Lesson Plan for Learning Success.
Study Tips:
Summarize key concepts in your own words or create diagrams to visualize relationships.
Teach the material to someone else to reinforce understanding.
Study in focused sessions of 25–50 minutes, with 5–10-minute breaks in between.
Review material periodically over several days or weeks instead of cramming. Write
notes by hand and use color coding or mind maps to organize information visually.
Read each exam question twice before looking at the answer
Set aside specific times each day for studying.
View challenges as opportunities to improve.
At the end of each study session, jot down key takeaways, lingering questions, or topics
needing more review and use this reflection to plan your next study session effectively
Ethical and Practical Considerations – Week One
● What are barriers to seeking mental health care: parents lack of education or access to
services, parents reluctant to seek help due to the stigma or negative perceptions towards
mental health, Although some children and adolescents receive treatment, many drop out
before receiving effective treatment, often due to poverty, language barriers, living in
communities with scarce resources, and stressors such as problems in the family, violence
in the community, unstable housing, unemployment, and food insecurity. Cost,
scheduling conflicts, long waitlists for services, and high staff turnover also create
impediments for families seeking care.
● Social determinants and access to care in children and adolescents often due to poverty,
language barriers, living in communities with scarce resources, and stressors such as
problems in the family, violence in the community, unstable housing, unemployment, and
food insecurity. Cost, scheduling conflicts, long waitlists for services, and high staff
turnover also create impediments for families seeking care.
● Developmentally appropriate teaching in children and adolescents
● Racial and ethnic barriers to treatment
● Know types of stigma:
,1) Structural: Structural stigma, or institutional stigma, includes policies, regulations, or
laws that intentionally or unintentionally lead to discrimination. Structural stigma can limit
access to resources and other opportunities, thereby impacting the well-being of the
stigmatized group. A program policy that prohibits individuals from using specific forms
of prescribed medication for addiction (MAT) treatment is an example of structural
stigma.
, 2) Self: self-stigma refers to the shame individuals internalize about negative stereotypes. For
individuals affected by SUDs, self-stigma may lead to feelings of being flawed or
unworthy of love or connection. It may also prevent them from seeking help.
3) Public: Public stigma encompasses the attitudes, beliefs, and behaviors of groups or
individuals which form a stereotype that creates an emotional reaction or prejudice and
results in discrimination. A stereotypic belief that individuals choose to use alcohol or
other drugs and blame them for their substance use disorder is an example of public
stigma. Healthcare providers who have a conscious or unconscious bias against clients
who use substances in the perinatal period may not provide appropriate care and
treatment
4) Intervention: Madden (2019) has proposed a new category of stigma:
intervention stigma; “Individuals working in [medication-assisted treatment] MAT
experience discrimination and prejudice from other healthcare professionals,
especially abstinent treatment professionals who disagree with the use of medications
to treat opioid use disorders. This discrimination and prejudice stem at times from
stigma toward addiction diagnoses, and at other times toward unique features of MAT
itself.
● Parental access to child/adolescent’s mental health records – legal aspects: Typically,
parents have the right to request access to a minor child’s mental health record, including
symptoms, diagnosis, and treatment plan; however, certain circumstances may limit that
right. The U.S. Department of Health and Human Services provides guidance regarding how
the Health Insurance Portability and Accountability Act (HIPAA) affects parents’ access to
their child’s information. State regulations may also address access to this information.
PMHNPs are responsible for following all relevant statutes in their state of practice. Can
withhold if
suspect parental neglect?
● Ethical and legal principles of informed consent: Assess client ability to understand medical
information and treatment options and to make a voluntary decision. Present relevant
, information with accuracy and sensitivity. Should include information about diagnosis, nature and
purpose of treatment options, benefits, risks, and burdens of all treatment options, including
forgoing treatment. Document informed consent conversation in the medical record, including
all consent forms. Although children may not be able to give legal consent, they should be
included in discussions about medication and treatment whenever possible. Child input into
treatment decisions may encourage treatment adherence. Positive experiences with providers
and treatment can help instill the perception that treatment is beneficial, which can support
positive mental health behaviors in the future.
● Mandatory reporting: The Federal Child Abuse Prevention and Treatment Act (CAPTA)
requires each State to have provisions or procedures for requiring certain individuals to
report known or suspected instances of child abuse and neglect. Most states consider
PMHNPs to be
mandated reporters who are required to report suspicions about abuse or neglect to the
appropriate authorities. Both federal and state statutes include stipulations related to mandatory
reporting. PMHNPs are responsible for following all relevant statutes in their state of
practice.
● What are principles of dosing children with medications/ physiologic differences in
treatment of children: Children have a more rapid metabolism than adults and may require
a larger dose of medication per unit of body weight. Around puberty, pharmacokinetic
properties reach adult parameters; therefore, dosing after puberty may need to be
decreased
● Piaget proposed four major stages of cognitive development, and called them (1)
sensorimotor intelligence (0-2), (2) preoperational thinking (2-7), (3) concrete
operational thinking (7-11) its like a car and meds will help it run better, and (4)
formal operational thinking (12 and up).
● Roughly 50% of lifetime cases of mental illness begin by age 14
