NRNP 6665 COMPREHENSIVE EXAM
PREP QUESTIONS AND ANSWERS
1. A 9-year-old child presents with persistent irritability and frequent temper outbursts that
are developmentally inappropriate. These symptoms have been present for 14 months across
multiple settings. Which diagnosis is most appropriate?
A. Bipolar I Disorder
B. Oppositional Defiant Disorder
C. Disruptive Mood Dysregulation Disorder
D. Major Depressive Disorder
Answer: C
Conceptual Explanation: DMDD is characterized by severe recurrent temper outbursts
and a persistent irritable or angry mood between outbursts, occurring for at least 12
months in a child aged 6 to 18.
2. Which of the following is a core requirement for a diagnosis of Autism Spectrum Disorder
according to the DSM-5-TR?
A. Persistent deficits in social communication and social interaction
B. Intellectual impairment and language delay
,C. History of developmental regression before age 3
D. Aggressive behavior toward peers
Answer: A
Conceptual Explanation: DSM-5-TR criteria for ASD focus on persistent deficits in social
communication/interaction and restricted, repetitive patterns of behavior.
3. A 15-year-old is prescribed Fluoxetine for depression. What is the most critical monitoring
parameter required by the FDA for this age group?
A. Suicidal ideation and behavior
B. Liver function tests
C. Weight and height
D. Electrocardiogram changes
Answer: A
Conceptual Explanation: The FDA Black Box Warning for SSRIs in children and
adolescents highlights an increased risk of suicidal thinking and behavior.
4. In the treatment of ADHD, what is the primary mechanism of action for methylphenidate?
A. Alpha-2 adrenergic agonist
B. Antagonism of NMDA receptors
C. Stimulation of serotonin release
, D. Inhibition of the reuptake of dopamine and norepinephrine
Answer: D
Conceptual Explanation: Methylphenidate works by blocking the reuptake of dopamine
and norepinephrine into the presynaptic neuron, increasing their availability in the
synaptic cleft.
5. Which symptom distinguishes Conduct Disorder from Oppositional Defiant Disorder?
A. Argumentative behavior with authority figures
B. Vindictiveness and spitefulness
C. Loss of temper and irritability
D. Violation of the basic rights of others or major societal norms
Answer: D
Conceptual Explanation: Conduct Disorder involves more severe behaviors like
aggression toward people/animals, destruction of property, or theft, which violate rights or
norms, unlike ODD.
6. A child presents with a pattern of inhibited, emotionally withdrawn behavior toward adult
caregivers and rarely seeks comfort when distressed. This most likely indicates:
A. Separation Anxiety Disorder
B. Social Anxiety Disorder
C. Disinhibited Social Engagement Disorder
PREP QUESTIONS AND ANSWERS
1. A 9-year-old child presents with persistent irritability and frequent temper outbursts that
are developmentally inappropriate. These symptoms have been present for 14 months across
multiple settings. Which diagnosis is most appropriate?
A. Bipolar I Disorder
B. Oppositional Defiant Disorder
C. Disruptive Mood Dysregulation Disorder
D. Major Depressive Disorder
Answer: C
Conceptual Explanation: DMDD is characterized by severe recurrent temper outbursts
and a persistent irritable or angry mood between outbursts, occurring for at least 12
months in a child aged 6 to 18.
2. Which of the following is a core requirement for a diagnosis of Autism Spectrum Disorder
according to the DSM-5-TR?
A. Persistent deficits in social communication and social interaction
B. Intellectual impairment and language delay
,C. History of developmental regression before age 3
D. Aggressive behavior toward peers
Answer: A
Conceptual Explanation: DSM-5-TR criteria for ASD focus on persistent deficits in social
communication/interaction and restricted, repetitive patterns of behavior.
3. A 15-year-old is prescribed Fluoxetine for depression. What is the most critical monitoring
parameter required by the FDA for this age group?
A. Suicidal ideation and behavior
B. Liver function tests
C. Weight and height
D. Electrocardiogram changes
Answer: A
Conceptual Explanation: The FDA Black Box Warning for SSRIs in children and
adolescents highlights an increased risk of suicidal thinking and behavior.
4. In the treatment of ADHD, what is the primary mechanism of action for methylphenidate?
A. Alpha-2 adrenergic agonist
B. Antagonism of NMDA receptors
C. Stimulation of serotonin release
, D. Inhibition of the reuptake of dopamine and norepinephrine
Answer: D
Conceptual Explanation: Methylphenidate works by blocking the reuptake of dopamine
and norepinephrine into the presynaptic neuron, increasing their availability in the
synaptic cleft.
5. Which symptom distinguishes Conduct Disorder from Oppositional Defiant Disorder?
A. Argumentative behavior with authority figures
B. Vindictiveness and spitefulness
C. Loss of temper and irritability
D. Violation of the basic rights of others or major societal norms
Answer: D
Conceptual Explanation: Conduct Disorder involves more severe behaviors like
aggression toward people/animals, destruction of property, or theft, which violate rights or
norms, unlike ODD.
6. A child presents with a pattern of inhibited, emotionally withdrawn behavior toward adult
caregivers and rarely seeks comfort when distressed. This most likely indicates:
A. Separation Anxiety Disorder
B. Social Anxiety Disorder
C. Disinhibited Social Engagement Disorder
