NURS 629 Exam 4 V1 | NURS 629 Peds |
Actual Q&A with Rationale (NURS629
Exam 4) | Maryville University
1. A 9-year-old child is being evaluated for Attention-Deficit/Hyperactivity Disorder (ADHD).
Which of the following criteria must be met for a definitive diagnosis according to the DSM-5?
(Select all that apply)
A. Symptoms must be present in two or more settings (e.g., home and school)
B. Several symptoms were present before age 12
C. Symptoms have persisted for at least 3 months
D. Clear evidence that symptoms interfere with social, academic, or occupational
functioning
E. Symptoms are better explained by another mental disorder such as anxiety
F. Six or more symptoms of inattention or hyperactivity-impulsivity for children up to age
16
Correct Answer: A, B, D, F
The clinical diagnosis of ADHD requires a comprehensive history confirming that
symptoms manifest in multiple environments rather than a single isolated setting. The
DSM-5 guidelines specify that these behavioral patterns must have an onset prior to twelve
years of age and persist for at least six months. Furthermore, the clinician must ensure that
,the impairment is significant enough to hinder the child’s daily life and is not a result of a
different psychological condition.
2. During a routine physical for a 12-year-old female, the provider performs the Adams
Forward Bend test. What Cobb angle measurement is generally considered the threshold for
a formal diagnosis of scoliosis?
A. Greater than 5 degrees
B. Greater than 10 degrees
C. Greater than 7 degrees
D. Greater than 20 degrees
Correct Answer: B
Scoliosis is defined as a lateral curvature of the spine that exceeds ten degrees as
measured by the Cobb method on a radiograph. While smaller degrees of trunk rotation
may be noted during physical screening with a scoliometer, the radiological threshold
remains the standard for clinical diagnosis. Early detection during the adolescent growth
spurt is critical for determining if bracing or surgical intervention will be necessary as the
patient matures.
3. A 15-year-old male presents with persistent low mood and loss of interest in activities.
Which of the following screening tools is most appropriate for assessing adolescent
depression in the primary care setting?
A. M-CHAT-R
,B. PHQ-9 Modified for Adolescents (PHQ-A)
C. Vanderbilt Assessment Scale
D. CRAFFT Screening Tool
Correct Answer: B
The Patient Health Questionnaire for Adolescents is a validated instrument specifically
designed to screen for depressive symptoms in the teenage population. It helps providers
quantify the severity of the depression and monitor the response to treatment over time.
Use of such standardized tools is a key component of the adolescent well-visit to ensure
that mental health concerns are addressed promptly.
4. Which of the following physical and behavioral signs are commonly associated with
Generalized Anxiety Disorder in pediatric patients? (Select all that apply)
A. Frequent complaints of stomachaches or headaches
B. Excessive worry about everyday activities or school performance
C. Deliberate defiance of authority figures
D. Difficulty falling or staying asleep
E. Restlessness or feeling ‘on edge’
Correct Answer: A, B, D, E
Anxiety in children often presents with somatic symptoms such as gastrointestinal
distress or muscle tension rather than just verbal expressions of fear. These children may
, struggle with chronic fatigue and sleep disturbances due to the persistent nature of their
worries. Identifying these non-specific physical complaints as manifestations of an
underlying anxiety disorder is crucial for proper management.
5. A 10-year-old presents with joint swelling, morning stiffness, and a persistent limp. The
provider suspects Juvenile Idiopathic Arthritis (JIA). Which specialist referral is most critical
for monitoring potential silent complications of this disease?
A. Ophthalmologist
B. Cardiologist
C. Endocrinologist
D. Dermatologist
Correct Answer: A
Children with JIA, particularly the oligoarticular and polyarticular subtypes, are at
significant risk for developing chronic uveitis. Because this inflammation of the eye is often
asymptomatic in the early stages, regular slit-lamp examinations by an ophthalmologist are
mandatory to prevent permanent vision loss. This screening remains a cornerstone of JIA
management regardless of the joint symptoms’ severity.
6. A newborn female is noted to have lymphedema of the hands and feet, a low posterior
hairline, and a webbed neck. Which genetic condition should the provider investigate?
A. Down Syndrome
B. Klinefelter Syndrome
Actual Q&A with Rationale (NURS629
Exam 4) | Maryville University
1. A 9-year-old child is being evaluated for Attention-Deficit/Hyperactivity Disorder (ADHD).
Which of the following criteria must be met for a definitive diagnosis according to the DSM-5?
(Select all that apply)
A. Symptoms must be present in two or more settings (e.g., home and school)
B. Several symptoms were present before age 12
C. Symptoms have persisted for at least 3 months
D. Clear evidence that symptoms interfere with social, academic, or occupational
functioning
E. Symptoms are better explained by another mental disorder such as anxiety
F. Six or more symptoms of inattention or hyperactivity-impulsivity for children up to age
16
Correct Answer: A, B, D, F
The clinical diagnosis of ADHD requires a comprehensive history confirming that
symptoms manifest in multiple environments rather than a single isolated setting. The
DSM-5 guidelines specify that these behavioral patterns must have an onset prior to twelve
years of age and persist for at least six months. Furthermore, the clinician must ensure that
,the impairment is significant enough to hinder the child’s daily life and is not a result of a
different psychological condition.
2. During a routine physical for a 12-year-old female, the provider performs the Adams
Forward Bend test. What Cobb angle measurement is generally considered the threshold for
a formal diagnosis of scoliosis?
A. Greater than 5 degrees
B. Greater than 10 degrees
C. Greater than 7 degrees
D. Greater than 20 degrees
Correct Answer: B
Scoliosis is defined as a lateral curvature of the spine that exceeds ten degrees as
measured by the Cobb method on a radiograph. While smaller degrees of trunk rotation
may be noted during physical screening with a scoliometer, the radiological threshold
remains the standard for clinical diagnosis. Early detection during the adolescent growth
spurt is critical for determining if bracing or surgical intervention will be necessary as the
patient matures.
3. A 15-year-old male presents with persistent low mood and loss of interest in activities.
Which of the following screening tools is most appropriate for assessing adolescent
depression in the primary care setting?
A. M-CHAT-R
,B. PHQ-9 Modified for Adolescents (PHQ-A)
C. Vanderbilt Assessment Scale
D. CRAFFT Screening Tool
Correct Answer: B
The Patient Health Questionnaire for Adolescents is a validated instrument specifically
designed to screen for depressive symptoms in the teenage population. It helps providers
quantify the severity of the depression and monitor the response to treatment over time.
Use of such standardized tools is a key component of the adolescent well-visit to ensure
that mental health concerns are addressed promptly.
4. Which of the following physical and behavioral signs are commonly associated with
Generalized Anxiety Disorder in pediatric patients? (Select all that apply)
A. Frequent complaints of stomachaches or headaches
B. Excessive worry about everyday activities or school performance
C. Deliberate defiance of authority figures
D. Difficulty falling or staying asleep
E. Restlessness or feeling ‘on edge’
Correct Answer: A, B, D, E
Anxiety in children often presents with somatic symptoms such as gastrointestinal
distress or muscle tension rather than just verbal expressions of fear. These children may
, struggle with chronic fatigue and sleep disturbances due to the persistent nature of their
worries. Identifying these non-specific physical complaints as manifestations of an
underlying anxiety disorder is crucial for proper management.
5. A 10-year-old presents with joint swelling, morning stiffness, and a persistent limp. The
provider suspects Juvenile Idiopathic Arthritis (JIA). Which specialist referral is most critical
for monitoring potential silent complications of this disease?
A. Ophthalmologist
B. Cardiologist
C. Endocrinologist
D. Dermatologist
Correct Answer: A
Children with JIA, particularly the oligoarticular and polyarticular subtypes, are at
significant risk for developing chronic uveitis. Because this inflammation of the eye is often
asymptomatic in the early stages, regular slit-lamp examinations by an ophthalmologist are
mandatory to prevent permanent vision loss. This screening remains a cornerstone of JIA
management regardless of the joint symptoms’ severity.
6. A newborn female is noted to have lymphedema of the hands and feet, a low posterior
hairline, and a webbed neck. Which genetic condition should the provider investigate?
A. Down Syndrome
B. Klinefelter Syndrome
