Final Exam: NR606 / NR 606 (Latest Update
) Diagnosis and Management in
Psychiatric-Mental Health II Practicum | Lessons
5 – 8 COMPREHENSIVE EXAM BANK
Questions with Answers & Detailed Rationales |
Grade A | 100% Correct
Leave your honest rating⭐⭐⭐⭐⭐
Question 1:
A 5-year-old child is prescribed a stimulant medication for ADHD. Using Piaget's
developmental framework, which education statement is most appropriate for this
patient?
a. "This medication can help you ignore distractions so you can complete tasks."
b. "It's like your bike has great wheels but the brakes need fixing. The medicine
fixes the brakes."
c. "Do you know how it's sometimes hard for you to sit still at school? This
medicine will help you."
d. "This medication works at the neurotransmitter level to improve dopamine
availability."
Rationale: A 5-year-old is in Piaget's Preoperational Stage (ages 2-7). Children in
this stage think symbolically but are egocentric and have difficulty seeing things
from others' perspectives. Their thinking is very concrete, so explanations must be
simple and direct. "This medicine will help you sit still" uses concrete language the
child can understand. The bike analogy is more appropriate for the Concrete
Operational stage (ages 7-11). Abstract reasoning about neurotransmitters is
appropriate for adolescents in the Formal Operational stage.
Question 2:
A 10-year-old patient with ADHD is started on a stimulant. According to Piaget's
framework, which education approach is appropriate?
,a. "This medication can help you ignore distractions so you can complete tasks."
b. "It's like your bike has great wheels but the brakes need fixing. The
medicine fixes the brakes."
c. "Do you know how it's sometimes hard for you to sit still at school? This
medicine will help you."
d. "This medication enhances dopamine transmission in the prefrontal cortex."
Rationale: A 10-year-old is in Piaget's Concrete Operational Stage (ages 7-11).
Children in this stage can use logical operations when thinking and solving
problems, but their thinking is still concrete. They understand analogies and
metaphors that relate to concrete objects or experiences. The bike analogy works
well because it connects medication to a concrete, relatable concept.
Question 3:
An adolescent patient with ADHD is prescribed a stimulant. Which statement best
reflects developmentally appropriate education?
a. "This medication can help you ignore distractions so you can complete
tasks. It may also help with self-control."
b. "It's like your bike has great wheels but the brakes need fixing. The medicine
fixes the brakes."
c. "Do you know how it's sometimes hard for you to sit still at school? This
medicine will help you."
d. "This medication enhances dopamine transmission in the prefrontal cortex."
Rationale: Adolescents are in Piaget's Formal Operational Stage (age 12 and up).
They can reason abstractly and consider hypothetical problems. They understand
cause-and-effect relationships. Option A provides a clear, logical explanation of
what the medication does in a way that respects the adolescent's cognitive abilities
and ability to plan for the future.
Question 4:
A 7-year-old child with ADHD is having difficulty with peer relationships.
According to Erikson's psychosocial stages, what is the developmental crisis this
child is facing?
,a. Trust vs. mistrust
b. Autonomy vs. shame
c. Industry vs. inferiority
d. Identity vs. role confusion
Rationale: Erikson's Industry vs. Inferiority stage occurs during ages 6-12.
Children in this stage are learning to master academic and social skills. Difficulty
with peer relationships can lead to feelings of inadequacy and inferiority. The
nurse should support the child's development of social skills and self-esteem.
Question 5:
A 4-year-old child presents with difficulty separating from parents, night terrors,
and stomachaches before school. What is the most likely diagnosis?
a. Attention-deficit/hyperactivity disorder
b. Separation anxiety disorder
c. Social anxiety disorder
d. Generalized anxiety disorder
Rationale: Separation anxiety disorder is characterized by excessive fear or
anxiety concerning separation from attachment figures, lasting at least 4 weeks in
children. Symptoms include difficulty separating, worry about harm to attachment
figures, and physical complaints (stomachaches) before separation. Night terrors
are a common symptom in children with separation anxiety.
Question 6:
A 12-year-old patient with ADHD has been on methylphenidate for 6 months. The
parents report that the child has difficulty sleeping and has decreased appetite.
Which recommendation is appropriate?
a. Discontinue the medication immediately
b. Administer the medication earlier in the day
c. Increase the dose to achieve better symptom control
d. Switch to a non-stimulant medication
Rationale: Sleep disturbance and decreased appetite are common side effects of
stimulant medications. Administering the medication earlier in the day can help
reduce sleep disturbances. The dose should not be increased if side effects are
, problematic. Non-stimulants may be considered if side effects persist, but earlier
administration is the first-line recommendation.
Question 7:
An 8-year-old child with ADHD is prescribed atomoxetine. What is an important
teaching point for the parents?
a. "This medication works immediately after the first dose."
b. "This medication is a stimulant and should be given in the morning."
c. "This medication may take 2-4 weeks to show full effect."
d. "This medication can be stopped abruptly without side effects."
Rationale: Atomoxetine is a non-stimulant (SNRI) that takes 2-4 weeks to reach
therapeutic effect. Unlike stimulants, it does not work immediately. The parents
should be educated about the delayed onset and the importance of consistent daily
dosing.
Question 8:
A 15-year-old girl with anorexia nervosa has a BMI of 16.5. What is the most
important medical concern?
a. Depression
b. Amenorrhea
c. Cardiac dysrhythmias
d. Osteoporosis
Rationale: Cardiac dysrhythmias (including bradycardia, prolonged QT interval,
and arrhythmias) are the most serious medical concern in patients with anorexia
nervosa and are the leading cause of death. While amenorrhea, depression, and
osteoporosis are also concerns, cardiac complications are the most immediately
life-threatening.
Question 9:
A 16-year-old boy with depression is started on fluoxetine. What is an important
side effect to monitor?
) Diagnosis and Management in
Psychiatric-Mental Health II Practicum | Lessons
5 – 8 COMPREHENSIVE EXAM BANK
Questions with Answers & Detailed Rationales |
Grade A | 100% Correct
Leave your honest rating⭐⭐⭐⭐⭐
Question 1:
A 5-year-old child is prescribed a stimulant medication for ADHD. Using Piaget's
developmental framework, which education statement is most appropriate for this
patient?
a. "This medication can help you ignore distractions so you can complete tasks."
b. "It's like your bike has great wheels but the brakes need fixing. The medicine
fixes the brakes."
c. "Do you know how it's sometimes hard for you to sit still at school? This
medicine will help you."
d. "This medication works at the neurotransmitter level to improve dopamine
availability."
Rationale: A 5-year-old is in Piaget's Preoperational Stage (ages 2-7). Children in
this stage think symbolically but are egocentric and have difficulty seeing things
from others' perspectives. Their thinking is very concrete, so explanations must be
simple and direct. "This medicine will help you sit still" uses concrete language the
child can understand. The bike analogy is more appropriate for the Concrete
Operational stage (ages 7-11). Abstract reasoning about neurotransmitters is
appropriate for adolescents in the Formal Operational stage.
Question 2:
A 10-year-old patient with ADHD is started on a stimulant. According to Piaget's
framework, which education approach is appropriate?
,a. "This medication can help you ignore distractions so you can complete tasks."
b. "It's like your bike has great wheels but the brakes need fixing. The
medicine fixes the brakes."
c. "Do you know how it's sometimes hard for you to sit still at school? This
medicine will help you."
d. "This medication enhances dopamine transmission in the prefrontal cortex."
Rationale: A 10-year-old is in Piaget's Concrete Operational Stage (ages 7-11).
Children in this stage can use logical operations when thinking and solving
problems, but their thinking is still concrete. They understand analogies and
metaphors that relate to concrete objects or experiences. The bike analogy works
well because it connects medication to a concrete, relatable concept.
Question 3:
An adolescent patient with ADHD is prescribed a stimulant. Which statement best
reflects developmentally appropriate education?
a. "This medication can help you ignore distractions so you can complete
tasks. It may also help with self-control."
b. "It's like your bike has great wheels but the brakes need fixing. The medicine
fixes the brakes."
c. "Do you know how it's sometimes hard for you to sit still at school? This
medicine will help you."
d. "This medication enhances dopamine transmission in the prefrontal cortex."
Rationale: Adolescents are in Piaget's Formal Operational Stage (age 12 and up).
They can reason abstractly and consider hypothetical problems. They understand
cause-and-effect relationships. Option A provides a clear, logical explanation of
what the medication does in a way that respects the adolescent's cognitive abilities
and ability to plan for the future.
Question 4:
A 7-year-old child with ADHD is having difficulty with peer relationships.
According to Erikson's psychosocial stages, what is the developmental crisis this
child is facing?
,a. Trust vs. mistrust
b. Autonomy vs. shame
c. Industry vs. inferiority
d. Identity vs. role confusion
Rationale: Erikson's Industry vs. Inferiority stage occurs during ages 6-12.
Children in this stage are learning to master academic and social skills. Difficulty
with peer relationships can lead to feelings of inadequacy and inferiority. The
nurse should support the child's development of social skills and self-esteem.
Question 5:
A 4-year-old child presents with difficulty separating from parents, night terrors,
and stomachaches before school. What is the most likely diagnosis?
a. Attention-deficit/hyperactivity disorder
b. Separation anxiety disorder
c. Social anxiety disorder
d. Generalized anxiety disorder
Rationale: Separation anxiety disorder is characterized by excessive fear or
anxiety concerning separation from attachment figures, lasting at least 4 weeks in
children. Symptoms include difficulty separating, worry about harm to attachment
figures, and physical complaints (stomachaches) before separation. Night terrors
are a common symptom in children with separation anxiety.
Question 6:
A 12-year-old patient with ADHD has been on methylphenidate for 6 months. The
parents report that the child has difficulty sleeping and has decreased appetite.
Which recommendation is appropriate?
a. Discontinue the medication immediately
b. Administer the medication earlier in the day
c. Increase the dose to achieve better symptom control
d. Switch to a non-stimulant medication
Rationale: Sleep disturbance and decreased appetite are common side effects of
stimulant medications. Administering the medication earlier in the day can help
reduce sleep disturbances. The dose should not be increased if side effects are
, problematic. Non-stimulants may be considered if side effects persist, but earlier
administration is the first-line recommendation.
Question 7:
An 8-year-old child with ADHD is prescribed atomoxetine. What is an important
teaching point for the parents?
a. "This medication works immediately after the first dose."
b. "This medication is a stimulant and should be given in the morning."
c. "This medication may take 2-4 weeks to show full effect."
d. "This medication can be stopped abruptly without side effects."
Rationale: Atomoxetine is a non-stimulant (SNRI) that takes 2-4 weeks to reach
therapeutic effect. Unlike stimulants, it does not work immediately. The parents
should be educated about the delayed onset and the importance of consistent daily
dosing.
Question 8:
A 15-year-old girl with anorexia nervosa has a BMI of 16.5. What is the most
important medical concern?
a. Depression
b. Amenorrhea
c. Cardiac dysrhythmias
d. Osteoporosis
Rationale: Cardiac dysrhythmias (including bradycardia, prolonged QT interval,
and arrhythmias) are the most serious medical concern in patients with anorexia
nervosa and are the leading cause of death. While amenorrhea, depression, and
osteoporosis are also concerns, cardiac complications are the most immediately
life-threatening.
Question 9:
A 16-year-old boy with depression is started on fluoxetine. What is an important
side effect to monitor?
