NR606 Week 9 Exam V2 | NR606 Diagnosis
& Management in Psychiatric-Mental
Health II Practicum | Q&A with Rationale
(NR606 Week 9 Exam) | Chamberlain
University
1. A 7-year-old child presents with persistent irritability and frequent, severe temper
outbursts that are out of proportion to the situation. These symptoms have been present for
14 months in multiple settings. Which diagnosis is most likely?
A. Disruptive Mood Dysregulation Disorder (DMDD)
B. Oppositional Defiant Disorder
C. Bipolar I Disorder
D. Conduct Disorder
Answer: A
Rationale: Disruptive Mood Dysregulation Disorder (DMDD) was specifically added to the
DSM-5 to address the over-diagnosis of bipolar disorder in children. The criteria include
chronic, severe persistent irritability and frequent temper outbursts occurring at least
three times per week for over a year. Unlike ODD, DMDD focuses more on the mood
dysregulation component than just the defiant behavior.
,2. When diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD) in a child, the PMHNP
knows that symptoms must be present in at least how many settings?
A. One setting
B. Two settings
C. Three settings
D. Four settings
Answer: B
Rationale: The DSM-5 criteria for ADHD require that symptoms of inattention or
hyperactivity-impulsivity be present in two or more settings, such as home, school, or
work. This requirement ensures that the impairment is not solely the result of a specific
environmental stressor. Clinicians must gather collateral information from teachers or
other caregivers to verify cross-setting impairment.
3. Which of the following is considered a primary social communication deficit in children
with Autism Spectrum Disorder (ASD)?
A. High intelligence quotient (IQ)
B. Failure to initiate or respond to social interactions
C. Excessive physical aggression
D. Hyperactivity in classroom settings
Answer: B
,Rationale: Social communication and social interaction deficits are core features of Autism
Spectrum Disorder. This includes difficulties with social-emotional reciprocity, such as
failing to respond to social overtures or failing to engage in back-and-forth conversation.
The PMHNP should use standardized tools like the M-CHAT-R to screen for these deficits in
early childhood.
4. The PMHNP is considering starting a child on a stimulant for ADHD. Which baseline
assessment is most critical before beginning therapy?
A. Cardiac history and vital signs
B. Liver function tests
C. Serum electrolytes
D. Renal function panel
Answer: A
Rationale: Stimulants can increase heart rate and blood pressure, making a baseline
cardiac assessment essential. The PMHNP must screen for a family history of sudden
cardiac death or personal history of heart defects. Regular monitoring of height, weight,
and blood pressure is also required throughout treatment to ensure safety.
5. A 15-year-old is diagnosed with Major Depressive Disorder (MDD). The PMHNP explains
the FDA-approved medications for this age group include:
A. Sertraline and Paroxetine
B. Fluoxetine and Escitalopram
, C. Venlafaxine and Duloxetine
D. Bupropion and Amitriptyline
Answer: B
Rationale: Fluoxetine (Prozac) and Escitalopram (Lexapro) are the only two SSRIs
currently FDA-approved for the treatment of depression in adolescents. While other SSRIs
may be used off-label, evidence-based guidelines emphasize these two first due to their
safety and efficacy profiles. The PMHNP must always monitor for the black box warning
regarding increased suicidal ideation in this population.
6. Which screening tool is most appropriate for assessing adolescent substance use during a
practicum rotation?
A. PHQ-9
B. GHT-7
C. CRAFFT
D. Vanderbilt Scale
Answer: C
Rationale: The CRAFFT screening tool is specifically designed for adolescents to identify
high-risk alcohol and drug use. It stands for Car, Relax, Alone, Forget, Friends, and Trouble,
which are the key areas assessed. Utilizing this tool allows the PMHNP to quickly gauge the
severity of substance issues and determine if further intervention is needed.
& Management in Psychiatric-Mental
Health II Practicum | Q&A with Rationale
(NR606 Week 9 Exam) | Chamberlain
University
1. A 7-year-old child presents with persistent irritability and frequent, severe temper
outbursts that are out of proportion to the situation. These symptoms have been present for
14 months in multiple settings. Which diagnosis is most likely?
A. Disruptive Mood Dysregulation Disorder (DMDD)
B. Oppositional Defiant Disorder
C. Bipolar I Disorder
D. Conduct Disorder
Answer: A
Rationale: Disruptive Mood Dysregulation Disorder (DMDD) was specifically added to the
DSM-5 to address the over-diagnosis of bipolar disorder in children. The criteria include
chronic, severe persistent irritability and frequent temper outbursts occurring at least
three times per week for over a year. Unlike ODD, DMDD focuses more on the mood
dysregulation component than just the defiant behavior.
,2. When diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD) in a child, the PMHNP
knows that symptoms must be present in at least how many settings?
A. One setting
B. Two settings
C. Three settings
D. Four settings
Answer: B
Rationale: The DSM-5 criteria for ADHD require that symptoms of inattention or
hyperactivity-impulsivity be present in two or more settings, such as home, school, or
work. This requirement ensures that the impairment is not solely the result of a specific
environmental stressor. Clinicians must gather collateral information from teachers or
other caregivers to verify cross-setting impairment.
3. Which of the following is considered a primary social communication deficit in children
with Autism Spectrum Disorder (ASD)?
A. High intelligence quotient (IQ)
B. Failure to initiate or respond to social interactions
C. Excessive physical aggression
D. Hyperactivity in classroom settings
Answer: B
,Rationale: Social communication and social interaction deficits are core features of Autism
Spectrum Disorder. This includes difficulties with social-emotional reciprocity, such as
failing to respond to social overtures or failing to engage in back-and-forth conversation.
The PMHNP should use standardized tools like the M-CHAT-R to screen for these deficits in
early childhood.
4. The PMHNP is considering starting a child on a stimulant for ADHD. Which baseline
assessment is most critical before beginning therapy?
A. Cardiac history and vital signs
B. Liver function tests
C. Serum electrolytes
D. Renal function panel
Answer: A
Rationale: Stimulants can increase heart rate and blood pressure, making a baseline
cardiac assessment essential. The PMHNP must screen for a family history of sudden
cardiac death or personal history of heart defects. Regular monitoring of height, weight,
and blood pressure is also required throughout treatment to ensure safety.
5. A 15-year-old is diagnosed with Major Depressive Disorder (MDD). The PMHNP explains
the FDA-approved medications for this age group include:
A. Sertraline and Paroxetine
B. Fluoxetine and Escitalopram
, C. Venlafaxine and Duloxetine
D. Bupropion and Amitriptyline
Answer: B
Rationale: Fluoxetine (Prozac) and Escitalopram (Lexapro) are the only two SSRIs
currently FDA-approved for the treatment of depression in adolescents. While other SSRIs
may be used off-label, evidence-based guidelines emphasize these two first due to their
safety and efficacy profiles. The PMHNP must always monitor for the black box warning
regarding increased suicidal ideation in this population.
6. Which screening tool is most appropriate for assessing adolescent substance use during a
practicum rotation?
A. PHQ-9
B. GHT-7
C. CRAFFT
D. Vanderbilt Scale
Answer: C
Rationale: The CRAFFT screening tool is specifically designed for adolescents to identify
high-risk alcohol and drug use. It stands for Car, Relax, Alone, Forget, Friends, and Trouble,
which are the key areas assessed. Utilizing this tool allows the PMHNP to quickly gauge the
severity of substance issues and determine if further intervention is needed.
