NR 668 FINAL EXAM
QUESTIONS AND CORRECT
ANSWERS 2026
LATEST GUIDE BEST FOR
REVISION .
,1. An 8-year-old boy diagnosed with leukemia is referred to child psychiatry because he is consistently
displaying a flat affect, irritability, angry acting out, and occasional physical aggression toward his 6-year-old
brother. What
approach should the PMHNP take when interviewing this child?✔✔ correct answer Providetoysandallow the child to play
2. Which eating disorder is considered ego syntonic?✔✔ correct answer Anorexia Nervosa (Anorexia Nervosa is challenging to treat because i
is ego syntonic. In other words, one's behaviors, feelings and values are in line with the needs of the ego and reliable to one's self image.)
3. A 30-year-old G1P0,1 has become increasingly oddly related, neglecting
self-care, sleeping much of the day, eating minimally, crying easily, and despite reassurance that her pregnancy is
progressing normally, worries that she will lose the pregnancy. Which of the following medications is considered
least harmful in pregnancy?✔✔ correct answer Sertraline
4. A 10-year-old boy who had been prescribed fluoxetine for major depressive disorder presents to the psychiatric
emergency department for running into the street in front of a car on the way home from school. In the emergency
department, he has been selectively mute, but the nurse practitioner student was able to elicit his desire to be dead.
He has been medically cleared pending a psychiatric evaluation. What is the most common sign of major
depressive disorder in children?✔✔ correct answer Psychomotor agitation
5. A 6-year-old boy is referred by the child study team for speech difficulty. On examination the boy is friendly
and cooperative, his speech is clear, and he uses simple sentences with a limited vocabulary. Most notably he
confuses verb tenses consistently. The parents report he met most of his developmental milestones except speech,
which was delayed. His clinical presentation is most consistent with which of the following?✔✔ correct answer Expressive
language disorder
6. The school psychologist refers a 7-year-old girl with difficulty reading, dis- tractibility, and writing avoidance
behaviors. The child has no diagnosed con- ditions, takes no medications, and met all of her developmental
milestones. She loves arts and crafts and physical education. Prior to diagnosing a learning disorder, which of the
following screening tests must be performed?✔✔ correct answer Vision and hearing
,7. Which disorder is associated with higher rates of ADHD, enlarges testes, a long narrow face, hypotonia and short
stature?✔✔ correct answer Fragile X (Fragile X is associated with a higher rate of ADHD, impaired intellectual ability, learning d/o's, autism spectrum d/o.
Physical attributes include hypotonia, flat feet, enlarges testes, long narrow face, flexible fingers and short stature.)
8. A 10-year-old girl is referred for evaluation of behavioral difficulties. Her teachers report that she is easily
distracted and fails to complete any class work, and often stares off into space or tries to chat with her neighbor.
Her mother reports that mornings are the most difficult because of her general dis- organization and forgetfulness.
Otherwise she is socially engaged and enjoys many activities. Which of the following is the most likely diagnosis?✔✔
correct answer Attention deficit disorder
9. A pregnant woman with depression is reluctant to take medication for fear of causing her baby neonatal
abstinence syndrome due to selective serotonin reuptake inhibitor (SSRI) medication. Her husband states they
would like to use a faith healer instead. Which of the following is most accurate regarding the prognosis of depression
during pregnancy?✔✔ correct answer The actual course of depression cannot be predicted
10. Which of the following statements regarding intellectual developmental dis- order is false?✔✔ correct answer IQ test scores
remain the gold standard for determining intellectual disability (IQ test scores are not the gold standard for determining intellectual disability. Furthermore, IQ tests fail to asses
reasoning in real life scenarios and fail to measure mastery of practical tasks despite measuring conceptual capacity.)
11. An 8-year-old boy presents with nocturnal enuresis, which persists despite behavioral interventions including
eliminating fluid intake in the evening, scheduled awakening at night to use the bathroom, and a urine alarm.
Which of the following medications is most appropriate?✔✔ correct answer Imipramine
12. Sam is 11 years old without past psychiatric history. He was born by normal spontaneous vaginal delivery with
normal APGAR scores. He has met all of
his developmental milestones. He began sixth grade this year and has had increased trouble falling asleep. He has
always had bedtime rituals but lately they are extending in complexity and length. Most of his time in the
evening is spent checking that the lights are turned off and that the windows are locked. As a result, he is only
getting 5 hours of sleep at night and now has excessive
, daytime sleepiness with decreased interest in socialization and failing grades. Which of the following infectious
diseases may contribute to this clinical pre- sentation?✔✔ correct answer Streptococcus
13. The PMHNP is providing psychoeducation and anticipatory guidance to the concerned parent regarding night
terrors. At which stage of sleep is this most likely to occur?✔✔ correct answer Stage 3 to 4
14. Early onset Schizophrenia is considered what?✔✔ correct answer All of the statements listed are true. (Early onset schizophrenia is rare. It is
8X more prevalent amongst 1st degree relatives (Sadock, Sadock & Ruiz, 2014).
15. Child protective services is requested for an evaluation of a 9-month-old girl in foster care whose mother
was on a methadone maintenance program and using cocaine while pregnant. The child is HIV negative and during
the assessment you learn of a 3-year-old brother who is HIV positive. You are asked to recommend placement for both
these children. Which of the following is best?✔✔ correct answer A foster home
16. In regards to Insecure Attachment✔✔ correct answer Ambivalent type children are more likely to .✔✔
correct answer Be bullied (Insecure attachment✔✔ correct answer Ambivalent children are uncertain of a caregiver's response regardless of a situation. These children are
more likely to be bullied and do worse with separations. The caregiver sometimes uses threats of abandonment as a form of punishment.)
17. An 8-year-old boy is referred to you for evaluation for disruptive behavior in school. The teachers report that
without warning the boy will make disruptive sounds or shout out in class. Other than these instances the boy is
described as polite and well kempt, but restless. This clinical presentation is most consistent with which of the
following disorders?✔✔ correct answer Tourette's syndrome
18. Ella is trying to help her 3-year-old son sleep through the night but reports recently he has had three
episodes of waking up within 3 hours of falling asleep with inconsolable screaming and crying. He then falls
back asleep on his own and has no memory of what happened. What would be the best intervention?✔✔ correct answer
Create and maintain bedtime routine and reduce stimuli
19. A father brings his 6-year-old son to you because he is worried about him. He states that the son sits up in bed
shortly after falling asleep and screams. He says he is inconsolable and unable to be awakened during these
episodes but eventually he falls back asleep. The father states he is not able to fall back
QUESTIONS AND CORRECT
ANSWERS 2026
LATEST GUIDE BEST FOR
REVISION .
,1. An 8-year-old boy diagnosed with leukemia is referred to child psychiatry because he is consistently
displaying a flat affect, irritability, angry acting out, and occasional physical aggression toward his 6-year-old
brother. What
approach should the PMHNP take when interviewing this child?✔✔ correct answer Providetoysandallow the child to play
2. Which eating disorder is considered ego syntonic?✔✔ correct answer Anorexia Nervosa (Anorexia Nervosa is challenging to treat because i
is ego syntonic. In other words, one's behaviors, feelings and values are in line with the needs of the ego and reliable to one's self image.)
3. A 30-year-old G1P0,1 has become increasingly oddly related, neglecting
self-care, sleeping much of the day, eating minimally, crying easily, and despite reassurance that her pregnancy is
progressing normally, worries that she will lose the pregnancy. Which of the following medications is considered
least harmful in pregnancy?✔✔ correct answer Sertraline
4. A 10-year-old boy who had been prescribed fluoxetine for major depressive disorder presents to the psychiatric
emergency department for running into the street in front of a car on the way home from school. In the emergency
department, he has been selectively mute, but the nurse practitioner student was able to elicit his desire to be dead.
He has been medically cleared pending a psychiatric evaluation. What is the most common sign of major
depressive disorder in children?✔✔ correct answer Psychomotor agitation
5. A 6-year-old boy is referred by the child study team for speech difficulty. On examination the boy is friendly
and cooperative, his speech is clear, and he uses simple sentences with a limited vocabulary. Most notably he
confuses verb tenses consistently. The parents report he met most of his developmental milestones except speech,
which was delayed. His clinical presentation is most consistent with which of the following?✔✔ correct answer Expressive
language disorder
6. The school psychologist refers a 7-year-old girl with difficulty reading, dis- tractibility, and writing avoidance
behaviors. The child has no diagnosed con- ditions, takes no medications, and met all of her developmental
milestones. She loves arts and crafts and physical education. Prior to diagnosing a learning disorder, which of the
following screening tests must be performed?✔✔ correct answer Vision and hearing
,7. Which disorder is associated with higher rates of ADHD, enlarges testes, a long narrow face, hypotonia and short
stature?✔✔ correct answer Fragile X (Fragile X is associated with a higher rate of ADHD, impaired intellectual ability, learning d/o's, autism spectrum d/o.
Physical attributes include hypotonia, flat feet, enlarges testes, long narrow face, flexible fingers and short stature.)
8. A 10-year-old girl is referred for evaluation of behavioral difficulties. Her teachers report that she is easily
distracted and fails to complete any class work, and often stares off into space or tries to chat with her neighbor.
Her mother reports that mornings are the most difficult because of her general dis- organization and forgetfulness.
Otherwise she is socially engaged and enjoys many activities. Which of the following is the most likely diagnosis?✔✔
correct answer Attention deficit disorder
9. A pregnant woman with depression is reluctant to take medication for fear of causing her baby neonatal
abstinence syndrome due to selective serotonin reuptake inhibitor (SSRI) medication. Her husband states they
would like to use a faith healer instead. Which of the following is most accurate regarding the prognosis of depression
during pregnancy?✔✔ correct answer The actual course of depression cannot be predicted
10. Which of the following statements regarding intellectual developmental dis- order is false?✔✔ correct answer IQ test scores
remain the gold standard for determining intellectual disability (IQ test scores are not the gold standard for determining intellectual disability. Furthermore, IQ tests fail to asses
reasoning in real life scenarios and fail to measure mastery of practical tasks despite measuring conceptual capacity.)
11. An 8-year-old boy presents with nocturnal enuresis, which persists despite behavioral interventions including
eliminating fluid intake in the evening, scheduled awakening at night to use the bathroom, and a urine alarm.
Which of the following medications is most appropriate?✔✔ correct answer Imipramine
12. Sam is 11 years old without past psychiatric history. He was born by normal spontaneous vaginal delivery with
normal APGAR scores. He has met all of
his developmental milestones. He began sixth grade this year and has had increased trouble falling asleep. He has
always had bedtime rituals but lately they are extending in complexity and length. Most of his time in the
evening is spent checking that the lights are turned off and that the windows are locked. As a result, he is only
getting 5 hours of sleep at night and now has excessive
, daytime sleepiness with decreased interest in socialization and failing grades. Which of the following infectious
diseases may contribute to this clinical pre- sentation?✔✔ correct answer Streptococcus
13. The PMHNP is providing psychoeducation and anticipatory guidance to the concerned parent regarding night
terrors. At which stage of sleep is this most likely to occur?✔✔ correct answer Stage 3 to 4
14. Early onset Schizophrenia is considered what?✔✔ correct answer All of the statements listed are true. (Early onset schizophrenia is rare. It is
8X more prevalent amongst 1st degree relatives (Sadock, Sadock & Ruiz, 2014).
15. Child protective services is requested for an evaluation of a 9-month-old girl in foster care whose mother
was on a methadone maintenance program and using cocaine while pregnant. The child is HIV negative and during
the assessment you learn of a 3-year-old brother who is HIV positive. You are asked to recommend placement for both
these children. Which of the following is best?✔✔ correct answer A foster home
16. In regards to Insecure Attachment✔✔ correct answer Ambivalent type children are more likely to .✔✔
correct answer Be bullied (Insecure attachment✔✔ correct answer Ambivalent children are uncertain of a caregiver's response regardless of a situation. These children are
more likely to be bullied and do worse with separations. The caregiver sometimes uses threats of abandonment as a form of punishment.)
17. An 8-year-old boy is referred to you for evaluation for disruptive behavior in school. The teachers report that
without warning the boy will make disruptive sounds or shout out in class. Other than these instances the boy is
described as polite and well kempt, but restless. This clinical presentation is most consistent with which of the
following disorders?✔✔ correct answer Tourette's syndrome
18. Ella is trying to help her 3-year-old son sleep through the night but reports recently he has had three
episodes of waking up within 3 hours of falling asleep with inconsolable screaming and crying. He then falls
back asleep on his own and has no memory of what happened. What would be the best intervention?✔✔ correct answer
Create and maintain bedtime routine and reduce stimuli
19. A father brings his 6-year-old son to you because he is worried about him. He states that the son sits up in bed
shortly after falling asleep and screams. He says he is inconsolable and unable to be awakened during these
episodes but eventually he falls back asleep. The father states he is not able to fall back
