NR547 Week 5 Exam V2 | NR547
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 5 Exam) | Chamberlain University
1. A 9-year-old child is brought to the clinic for an evaluation due to concerns about school
performance and behavior. The parent reports that the child frequently loses school
assignments, fails to pay close attention to details, and is easily distracted by extraneous
stimuli. According to the DSM-5-TR, how many symptoms of inattention must be present for
at least 6 months to meet the diagnostic criteria for ADHD in a child?
A. At least 4 symptoms
B. At least 5 symptoms
C. At least 6 symptoms
D. At least 7 symptoms
Answer: C
Rationale: For children up to age 16, the DSM-5-TR requires at least 6 symptoms of
inattention or hyperactivity-impulsivity to be present for at least 6 months. These
symptoms must be inappropriate for the developmental level and negatively impact social
and academic activities. In contrast, individuals aged 17 and older only require 5 symptoms
for a diagnosis.
,2. The PMHNP is evaluating a 24-month-old child for developmental delays. The mother
mentions that the child does not point to objects, lacks eye contact, and does not engage in
pretend play. Which screening tool is most appropriate for assessing the risk of Autism
Spectrum Disorder (ASD) in this toddler?
A. M-CHAT-R/F
B. Vanderbilt Assessment Scale
C. PHQ-9 Modified for Adolescents
D. Conners 3 Rating Scale
Answer: A
Rationale: The Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-
CHAT-R/F) is a validated tool for children between 16 and 30 months. It is specifically
designed to identify toddlers who may benefit from a more thorough developmental and
diagnostic evaluation. Early identification through such tools is critical for initiating
intervention services as early as possible.
3. When prescribing stimulant medication for a child with ADHD, which of the following is a
mandatory physical assessment that must be documented at every follow-up visit?
A. Vision and hearing screenings
B. Blood pressure, heart rate, height, and weight
C. Deep tendon reflexes and gait
D. Abdominal circumference and BMI
,Answer: B
Rationale: Stimulant medications can cause increases in blood pressure and heart rate, as
well as appetite suppression leading to weight loss or slowed growth. The PMHNP must
monitor these parameters closely at every visit to ensure the safety and healthy
development of the child. Significant deviations in growth percentiles may require a
medication holiday or a change in the treatment plan.
4. A 19-year-old college student presents for an initial evaluation for ADHD. To meet the
DSM-5-TR diagnostic criteria for ADHD in an adult, symptoms must have been present prior
to which age?
A. Age 12
B. Age 10
C. Age 7
D. Age 15
Answer: A
Rationale: The DSM-5-TR requires that several inattentive or hyperactive-impulsive
symptoms were present prior to age 12. This criterion emphasizes that ADHD is a
neurodevelopmental disorder that originates in childhood, even if it is not diagnosed until
adulthood. Retrospective history taking is essential when evaluating adult patients to
establish this developmental timeline.
, 5. Which non-stimulant medication is FDA-approved for the treatment of ADHD and acts as a
selective norepinephrine reuptake inhibitor (SNRI)?
A. Guanfacine
B. Atomoxetine
C. Clonidine
D. Bupropion
Answer: B
Rationale: Atomoxetine (Strattera) is a selective norepinephrine reuptake inhibitor and
was the first non-stimulant approved by the FDA for ADHD. Unlike stimulants, it is not a
controlled substance and has a lower potential for abuse. It is particularly useful for
patients who have comorbid anxiety or who do not tolerate stimulants well.
6. The PMHNP is considering a diagnosis of Intellectual Disability (Intellectual Developmental
Disorder) for a pediatric patient. According to the DSM-5-TR, which three domains of
adaptive functioning must be assessed?
A. Social, Emotional, and Physical
B. Academic, Occupational, and Interpersonal
C. Cognitive, Linguistic, and Motor
D. Conceptual, Social, and Practical
Answer: D
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 5 Exam) | Chamberlain University
1. A 9-year-old child is brought to the clinic for an evaluation due to concerns about school
performance and behavior. The parent reports that the child frequently loses school
assignments, fails to pay close attention to details, and is easily distracted by extraneous
stimuli. According to the DSM-5-TR, how many symptoms of inattention must be present for
at least 6 months to meet the diagnostic criteria for ADHD in a child?
A. At least 4 symptoms
B. At least 5 symptoms
C. At least 6 symptoms
D. At least 7 symptoms
Answer: C
Rationale: For children up to age 16, the DSM-5-TR requires at least 6 symptoms of
inattention or hyperactivity-impulsivity to be present for at least 6 months. These
symptoms must be inappropriate for the developmental level and negatively impact social
and academic activities. In contrast, individuals aged 17 and older only require 5 symptoms
for a diagnosis.
,2. The PMHNP is evaluating a 24-month-old child for developmental delays. The mother
mentions that the child does not point to objects, lacks eye contact, and does not engage in
pretend play. Which screening tool is most appropriate for assessing the risk of Autism
Spectrum Disorder (ASD) in this toddler?
A. M-CHAT-R/F
B. Vanderbilt Assessment Scale
C. PHQ-9 Modified for Adolescents
D. Conners 3 Rating Scale
Answer: A
Rationale: The Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-
CHAT-R/F) is a validated tool for children between 16 and 30 months. It is specifically
designed to identify toddlers who may benefit from a more thorough developmental and
diagnostic evaluation. Early identification through such tools is critical for initiating
intervention services as early as possible.
3. When prescribing stimulant medication for a child with ADHD, which of the following is a
mandatory physical assessment that must be documented at every follow-up visit?
A. Vision and hearing screenings
B. Blood pressure, heart rate, height, and weight
C. Deep tendon reflexes and gait
D. Abdominal circumference and BMI
,Answer: B
Rationale: Stimulant medications can cause increases in blood pressure and heart rate, as
well as appetite suppression leading to weight loss or slowed growth. The PMHNP must
monitor these parameters closely at every visit to ensure the safety and healthy
development of the child. Significant deviations in growth percentiles may require a
medication holiday or a change in the treatment plan.
4. A 19-year-old college student presents for an initial evaluation for ADHD. To meet the
DSM-5-TR diagnostic criteria for ADHD in an adult, symptoms must have been present prior
to which age?
A. Age 12
B. Age 10
C. Age 7
D. Age 15
Answer: A
Rationale: The DSM-5-TR requires that several inattentive or hyperactive-impulsive
symptoms were present prior to age 12. This criterion emphasizes that ADHD is a
neurodevelopmental disorder that originates in childhood, even if it is not diagnosed until
adulthood. Retrospective history taking is essential when evaluating adult patients to
establish this developmental timeline.
, 5. Which non-stimulant medication is FDA-approved for the treatment of ADHD and acts as a
selective norepinephrine reuptake inhibitor (SNRI)?
A. Guanfacine
B. Atomoxetine
C. Clonidine
D. Bupropion
Answer: B
Rationale: Atomoxetine (Strattera) is a selective norepinephrine reuptake inhibitor and
was the first non-stimulant approved by the FDA for ADHD. Unlike stimulants, it is not a
controlled substance and has a lower potential for abuse. It is particularly useful for
patients who have comorbid anxiety or who do not tolerate stimulants well.
6. The PMHNP is considering a diagnosis of Intellectual Disability (Intellectual Developmental
Disorder) for a pediatric patient. According to the DSM-5-TR, which three domains of
adaptive functioning must be assessed?
A. Social, Emotional, and Physical
B. Academic, Occupational, and Interpersonal
C. Cognitive, Linguistic, and Motor
D. Conceptual, Social, and Practical
Answer: D
