,1. A 30-year-old woman, G1P0, presents with increasing odd behavior, self-neglect,
hypersomnia, poor appe te, and excessive worry about losing her pregnancy. Which of the
following medica ons is considered least harmful in pregnancy?
• A) Fluoxe ne
• B) Sertraline
• C) Paroxe ne
• D) Bupropion
Correct answer B) Sertraline
Ra onale: Sertraline is o en considered a first-line SSRI during pregnancy due to its rela vely
favorable safety profile and extensive data, making it the least harmful op on among the
choices.
2. A 10-year-old boy prescribed fluoxe ne for Major Depressive Disorder presents to the
emergency department a er a dangerous incident. He is selec vely mute but expresses a
desire to be dead. What is the most common sign of major depressive disorder in children?
• A) Psychomotor retarda on
• B) Psychomotor agita on
• C) Hypersomnia
• D) Soma c complaints
Correct answer B) Psychomotor agita on
Ra onale: In children, major depressive disorder o en presents with irritability and
psychomotor agita on rather than the classic depressed mood seen in adults.
3. A 6-year-old boy is referred for speech difficulty. He is friendly, speaks in simple sentences,
and has a limited vocabulary, but consistently confuses verb tenses. His speech development
was delayed. What is his most likely diagnosis?
• A) Mixed recep ve-expressive language disorder
• B) Expressive language disorder
• C) Phonological disorder
• D) Stu ering
Correct answer B) Expressive language disorder
,Ra onale: The key features are an isolated impairment in expressive language development
(limited vocabulary, tense errors) with otherwise clear speech and normal social interac on,
which is consistent with Expressive Language Disorder.
4. A 7-year-old girl has difficulty reading, is easily distracted, and avoids wri ng. All
developmental milestones were met. Prior to diagnosing a learning disorder, which screening
tests are essen al?
• A) Vision and hearing screening
• B) IQ tes ng
• C) Behavioral assessment scales
• D) Electroencephalogram (EEG)
Correct answer A) Vision and hearing screening
Ra onale: It is essen al to rule out sensory deficits that could impact learning before
diagnosing a specific learning disorder.
5. Which disorder is associated with higher rates of ADHD, enlarged testes, a long narrow
face, hypotonia, and short stature?
• A) Klinefelter syndrome
• B) Turner syndrome
• C) Fragile X syndrome
• D) Down syndrome
Correct answer C) Fragile X syndrome
Ra onale: Fragile X syndrome is a gene c condi on with characteris c physical features (long
narrow face, enlarged testes, hypotonia, short stature) and is associated with a high rate of
ADHD and intellectual disability.
6. A 10-year-old girl is referred for behavioral difficul es. She is easily distracted, disorganized,
forge ul, and fails to complete classwork. She is socially engaged. What is the most likely
diagnosis?
• A) Generalized Anxiety Disorder
• B) A en on-Deficit/Hyperac vity Disorder (ADHD), predominantly ina en ve
presenta on
, • C) Opposi onal Defiant Disorder
• D) Specific Learning Disorder
Correct answer B) A en on-Deficit/Hyperac vity Disorder (ADHD), predominantly ina en ve
presenta on
Ra onale: The descrip on of distrac bility, disorganiza on, forge ulness, and failure to
complete work, without significant hyperac vity, points to the predominantly ina en ve type
of ADHD.
7. An 8-year-old boy presents with nocturnal enuresis that persists despite behavioral
interven ons like fluid restric on and a urine alarm. Which medica on is most appropriate?
• A) Methylphenidate
• B) Imipramine
• C) Fluoxe ne
• D) Desmopressin
Correct answer B) Imipramine
Ra onale: While desmopressin is a common treatment, the provided answers indicate that
Imipramine is the most appropriate among the listed op ons for persistent nocturnal enuresis
a er behavioral interven ons.
8. A PMHNP is working with an insurance organiza on to provide oversight and authoriza on
of services and benefits to pa ents. Which role best describes this ac vity?
• A) Advocacy
• B) Mentoring
• C) Case management
• D) Policy making
Correct answer C) Case management
Ra onale: Overseeing and authorizing services and benefits as part of care coordina on falls
under the func on of case management.
9. A pa ent experiences a sudden onset of hyperreflexia, clonus, severe diaphoresis, and
diarrhea a er adding Tramadol to a stable regimen of Sertraline. What is the likely diagnosis?
• A) Neurolep c Malignant Syndrome
hypersomnia, poor appe te, and excessive worry about losing her pregnancy. Which of the
following medica ons is considered least harmful in pregnancy?
• A) Fluoxe ne
• B) Sertraline
• C) Paroxe ne
• D) Bupropion
Correct answer B) Sertraline
Ra onale: Sertraline is o en considered a first-line SSRI during pregnancy due to its rela vely
favorable safety profile and extensive data, making it the least harmful op on among the
choices.
2. A 10-year-old boy prescribed fluoxe ne for Major Depressive Disorder presents to the
emergency department a er a dangerous incident. He is selec vely mute but expresses a
desire to be dead. What is the most common sign of major depressive disorder in children?
• A) Psychomotor retarda on
• B) Psychomotor agita on
• C) Hypersomnia
• D) Soma c complaints
Correct answer B) Psychomotor agita on
Ra onale: In children, major depressive disorder o en presents with irritability and
psychomotor agita on rather than the classic depressed mood seen in adults.
3. A 6-year-old boy is referred for speech difficulty. He is friendly, speaks in simple sentences,
and has a limited vocabulary, but consistently confuses verb tenses. His speech development
was delayed. What is his most likely diagnosis?
• A) Mixed recep ve-expressive language disorder
• B) Expressive language disorder
• C) Phonological disorder
• D) Stu ering
Correct answer B) Expressive language disorder
,Ra onale: The key features are an isolated impairment in expressive language development
(limited vocabulary, tense errors) with otherwise clear speech and normal social interac on,
which is consistent with Expressive Language Disorder.
4. A 7-year-old girl has difficulty reading, is easily distracted, and avoids wri ng. All
developmental milestones were met. Prior to diagnosing a learning disorder, which screening
tests are essen al?
• A) Vision and hearing screening
• B) IQ tes ng
• C) Behavioral assessment scales
• D) Electroencephalogram (EEG)
Correct answer A) Vision and hearing screening
Ra onale: It is essen al to rule out sensory deficits that could impact learning before
diagnosing a specific learning disorder.
5. Which disorder is associated with higher rates of ADHD, enlarged testes, a long narrow
face, hypotonia, and short stature?
• A) Klinefelter syndrome
• B) Turner syndrome
• C) Fragile X syndrome
• D) Down syndrome
Correct answer C) Fragile X syndrome
Ra onale: Fragile X syndrome is a gene c condi on with characteris c physical features (long
narrow face, enlarged testes, hypotonia, short stature) and is associated with a high rate of
ADHD and intellectual disability.
6. A 10-year-old girl is referred for behavioral difficul es. She is easily distracted, disorganized,
forge ul, and fails to complete classwork. She is socially engaged. What is the most likely
diagnosis?
• A) Generalized Anxiety Disorder
• B) A en on-Deficit/Hyperac vity Disorder (ADHD), predominantly ina en ve
presenta on
, • C) Opposi onal Defiant Disorder
• D) Specific Learning Disorder
Correct answer B) A en on-Deficit/Hyperac vity Disorder (ADHD), predominantly ina en ve
presenta on
Ra onale: The descrip on of distrac bility, disorganiza on, forge ulness, and failure to
complete work, without significant hyperac vity, points to the predominantly ina en ve type
of ADHD.
7. An 8-year-old boy presents with nocturnal enuresis that persists despite behavioral
interven ons like fluid restric on and a urine alarm. Which medica on is most appropriate?
• A) Methylphenidate
• B) Imipramine
• C) Fluoxe ne
• D) Desmopressin
Correct answer B) Imipramine
Ra onale: While desmopressin is a common treatment, the provided answers indicate that
Imipramine is the most appropriate among the listed op ons for persistent nocturnal enuresis
a er behavioral interven ons.
8. A PMHNP is working with an insurance organiza on to provide oversight and authoriza on
of services and benefits to pa ents. Which role best describes this ac vity?
• A) Advocacy
• B) Mentoring
• C) Case management
• D) Policy making
Correct answer C) Case management
Ra onale: Overseeing and authorizing services and benefits as part of care coordina on falls
under the func on of case management.
9. A pa ent experiences a sudden onset of hyperreflexia, clonus, severe diaphoresis, and
diarrhea a er adding Tramadol to a stable regimen of Sertraline. What is the likely diagnosis?
• A) Neurolep c Malignant Syndrome
