NRNP 6665: PSYCHIATRIC-MENTAL
HEALTH NURSE PRACTITIONER
(CHILD AND ADOLESCENT)
COMPREHENSIVE EXAM PREP
1. Which clinical feature most accurately distinguishes Disruptive Mood Dysregulation
Disorder (DMDD) from Pediatric Bipolar Disorder?
A. The presence of chronic, persistent irritability between outbursts.
B. The presence of distinct periods of euphoria or grandiosity.
C. The age of onset occurring before 10 years old.
D. The severity of physical aggression during temper tantrums.
Answer: B
Conceptual Explanation: DMDD is characterized by chronic, non-episodic irritability. The
hallmark of Bipolar Disorder is the presence of discrete manic or hypomanic episodes
(euphoria/grandiosity), which are not present in DMDD.
,2. According to the American Academy of Pediatrics, at what ages should formal screening for
Autism Spectrum Disorder (ASD) using a tool like the M-CHAT-R occur?
A. 12 months and 24 months
B. 9 months and 18 months
C. 18 months and 24 months
D. 24 months and 36 months
Answer: C
Conceptual Explanation: Standard developmental screening occurs at 9, 18, and 30
months, but specific ASD screening is recommended at 18 and 24 months.
3. A 9-year-old male is diagnosed with ADHD, combined type. Which neurobiological
mechanism is primarily targeted by stimulant medications like methylphenidate?
A. Inhibition of serotonin reuptake in the raphe nuclei.
B. Blockade of dopamine and norepinephrine transporters in the prefrontal cortex.
C. Antagonism of NMDA receptors in the hippocampus.
D. Agonism of Alpha-2A adrenergic receptors.
Answer: B
Conceptual Explanation: Stimulants increase the availability of dopamine and
norepinephrine in the synapse by blocking their reuptake transporters, particularly in the
prefrontal cortex and basal ganglia.
, 4. The FDA ‘Black Box Warning’ for SSRIs in children and adolescents specifically warns of an
increased risk for which of the following?
A. Completed suicide
B. Serotonin syndrome
C. Suicidal ideation and behaviors
D. Growth retardation
Answer: C
Conceptual Explanation: The warning highlights an increased risk of suicidal thoughts
and behaviors (ideation) in children, adolescents, and young adults, though it does not
demonstrate an increase in completed suicides.
5. In Piaget’s stages of cognitive development, a child who begins to understand conservation
and can perform mental operations on concrete objects is in which stage?
A. Concrete Operational
B. Preoperational
C. Sensorimotor
D. Formal Operational
Answer: A
HEALTH NURSE PRACTITIONER
(CHILD AND ADOLESCENT)
COMPREHENSIVE EXAM PREP
1. Which clinical feature most accurately distinguishes Disruptive Mood Dysregulation
Disorder (DMDD) from Pediatric Bipolar Disorder?
A. The presence of chronic, persistent irritability between outbursts.
B. The presence of distinct periods of euphoria or grandiosity.
C. The age of onset occurring before 10 years old.
D. The severity of physical aggression during temper tantrums.
Answer: B
Conceptual Explanation: DMDD is characterized by chronic, non-episodic irritability. The
hallmark of Bipolar Disorder is the presence of discrete manic or hypomanic episodes
(euphoria/grandiosity), which are not present in DMDD.
,2. According to the American Academy of Pediatrics, at what ages should formal screening for
Autism Spectrum Disorder (ASD) using a tool like the M-CHAT-R occur?
A. 12 months and 24 months
B. 9 months and 18 months
C. 18 months and 24 months
D. 24 months and 36 months
Answer: C
Conceptual Explanation: Standard developmental screening occurs at 9, 18, and 30
months, but specific ASD screening is recommended at 18 and 24 months.
3. A 9-year-old male is diagnosed with ADHD, combined type. Which neurobiological
mechanism is primarily targeted by stimulant medications like methylphenidate?
A. Inhibition of serotonin reuptake in the raphe nuclei.
B. Blockade of dopamine and norepinephrine transporters in the prefrontal cortex.
C. Antagonism of NMDA receptors in the hippocampus.
D. Agonism of Alpha-2A adrenergic receptors.
Answer: B
Conceptual Explanation: Stimulants increase the availability of dopamine and
norepinephrine in the synapse by blocking their reuptake transporters, particularly in the
prefrontal cortex and basal ganglia.
, 4. The FDA ‘Black Box Warning’ for SSRIs in children and adolescents specifically warns of an
increased risk for which of the following?
A. Completed suicide
B. Serotonin syndrome
C. Suicidal ideation and behaviors
D. Growth retardation
Answer: C
Conceptual Explanation: The warning highlights an increased risk of suicidal thoughts
and behaviors (ideation) in children, adolescents, and young adults, though it does not
demonstrate an increase in completed suicides.
5. In Piaget’s stages of cognitive development, a child who begins to understand conservation
and can perform mental operations on concrete objects is in which stage?
A. Concrete Operational
B. Preoperational
C. Sensorimotor
D. Formal Operational
Answer: A
