NR606 Week 1 Exam V2 | NR606 Diagnosis & Management in
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 1 Exam) | Chamberlain University
1. A 9-year-old male presents with persistent irritability and frequent temper outbursts that
are out of proportion to the situation. These symptoms have occurred at least three times per
week for the past 14 months. Which diagnosis should the PMHNP prioritize?
A. Disruptive Mood Dysregulation Disorder
B. Oppositional Defiant Disorder
C. Bipolar I Disorder
D. Major Depressive Disorder
Answer: A
Explanation: Disruptive Mood Dysregulation Disorder (DMDD) was introduced in the
DSM-5 to address the over-diagnosis of bipolar disorder in children. The criteria include
chronic, severe persistent irritability and frequent temper outbursts for at least 12 months
in at least two settings. The diagnosis cannot be made before age 6 or after age 18, and the
onset must be before age 10.
2. When assessing an adolescent using Erikson’s stages of psychosocial development, which
conflict is most relevant to this age group?
A. Identity vs. Role Confusion
B. Industry vs. Inferiority
C. Intimacy vs. Isolation
D. Initiative vs. Guilt
Answer: A
Explanation: Erik Erikson’s stage for adolescence (ages 12-18) is Identity vs. Role
Confusion, where the individual seeks to develop a sense of self and personal identity.
During this stage, success leads to an ability to stay true to oneself, while failure leads to
role confusion and a weak sense of self. Understanding this stage is critical for PMHNPs
when evaluating adolescent behavioral changes and social integration.
3. A PMHNP is considering starting a 10-year-old child on an SSRI for depression. Which FDA
warning is most critical for the provider to discuss with the parents?
A. Risk of hepatotoxicity
B. Increased risk of suicidal ideation and behavior
,C. Potential for growth retardation
D. Risk of Stevens-Johnson syndrome
Answer: B
Explanation: The FDA issued a ‘Black Box’ warning for all antidepressant medications
regarding the increased risk of suicidal thinking and behavior in children, adolescents, and
young adults. Providers must monitor patients closely for clinical worsening or unusual
changes in behavior, especially during the first few months of therapy or at times of dose
changes. Documenting the discussion of this risk with the family is a vital legal and clinical
requirement for the PMHNP.
4. A 6-year-old child exhibits significant difficulty in social communication, engages in
repetitive motor mannerisms, and shows an intense preoccupation with train schedules.
Which assessment tool is most appropriate for initial screening?
A. PHQ-A
B. M-CHAT-R/F
C. SCARED
D. Vanderbilt Assessment Scale
Answer: B
Explanation: The Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-
CHAT-R/F) is a validated tool for screening for Autism Spectrum Disorder (ASD). While
typically used in younger toddlers, the presentation of social deficits and repetitive
behaviors strongly suggests the need for ASD-specific screening. The PMHNP must utilize
standardized tools to support a clinical diagnosis of neurodevelopmental disorders.
5. According to Piaget, a child who can think logically about concrete events but struggles
with abstract or hypothetical concepts is in which stage of cognitive development?
A. Sensorimotor
B. Preoperational
C. Concrete Operational
D. Formal Operational
Answer: C
Explanation: The Concrete Operational stage typically occurs between ages 7 and 11.
During this time, children gain a better understanding of mental operations and logical
thought about concrete objects. However, they still have difficulty with abstract thinking,
which is not fully developed until the Formal Operational stage.
, 6. Which symptom is a required diagnostic criterion for Attention-Deficit/Hyperactivity
Disorder (ADHD) in a child according to the DSM-5?
A. Low intellectual functioning
B. History of childhood trauma
C. Onset of symptoms after age 12
D. Symptoms present in at least two settings
Answer: D
Explanation: The DSM-5 requires that ADHD symptoms be present in two or more
settings, such as at home, school, or work. Symptoms must be present before age 12 and
interfere with, or reduce the quality of, social, academic, or occupational functioning. This
multi-setting requirement ensures that the behavior is not simply a reaction to a specific
environment or caregiver.
7. A 15-year-old female presents with a refusal to maintain a minimally normal body weight,
an intense fear of gaining weight, and a distorted body image. What is the priority
assessment?
A. Personality testing
B. Educational attainment
C. Family dynamics assessment
D. Electrolyte and cardiovascular status
Answer: D
Explanation: In patients with suspected Anorexia Nervosa, the immediate priority is
physiological stability due to the risk of life-threatening complications. Dehydration,
electrolyte imbalances (like hypokalemia), and bradycardia are common and require
urgent medical evaluation. Once the patient is medically stable, the PMHNP can proceed
with psychological and family assessments.
8. In Bowen Family Systems Theory, the process of a third person being brought into a conflict
between two people to reduce tension is known as:
A. Differentiation
B. Emotional Cutoff
C. Triangulation
D. Multigenerational Transmission
Answer: C
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 1 Exam) | Chamberlain University
1. A 9-year-old male presents with persistent irritability and frequent temper outbursts that
are out of proportion to the situation. These symptoms have occurred at least three times per
week for the past 14 months. Which diagnosis should the PMHNP prioritize?
A. Disruptive Mood Dysregulation Disorder
B. Oppositional Defiant Disorder
C. Bipolar I Disorder
D. Major Depressive Disorder
Answer: A
Explanation: Disruptive Mood Dysregulation Disorder (DMDD) was introduced in the
DSM-5 to address the over-diagnosis of bipolar disorder in children. The criteria include
chronic, severe persistent irritability and frequent temper outbursts for at least 12 months
in at least two settings. The diagnosis cannot be made before age 6 or after age 18, and the
onset must be before age 10.
2. When assessing an adolescent using Erikson’s stages of psychosocial development, which
conflict is most relevant to this age group?
A. Identity vs. Role Confusion
B. Industry vs. Inferiority
C. Intimacy vs. Isolation
D. Initiative vs. Guilt
Answer: A
Explanation: Erik Erikson’s stage for adolescence (ages 12-18) is Identity vs. Role
Confusion, where the individual seeks to develop a sense of self and personal identity.
During this stage, success leads to an ability to stay true to oneself, while failure leads to
role confusion and a weak sense of self. Understanding this stage is critical for PMHNPs
when evaluating adolescent behavioral changes and social integration.
3. A PMHNP is considering starting a 10-year-old child on an SSRI for depression. Which FDA
warning is most critical for the provider to discuss with the parents?
A. Risk of hepatotoxicity
B. Increased risk of suicidal ideation and behavior
,C. Potential for growth retardation
D. Risk of Stevens-Johnson syndrome
Answer: B
Explanation: The FDA issued a ‘Black Box’ warning for all antidepressant medications
regarding the increased risk of suicidal thinking and behavior in children, adolescents, and
young adults. Providers must monitor patients closely for clinical worsening or unusual
changes in behavior, especially during the first few months of therapy or at times of dose
changes. Documenting the discussion of this risk with the family is a vital legal and clinical
requirement for the PMHNP.
4. A 6-year-old child exhibits significant difficulty in social communication, engages in
repetitive motor mannerisms, and shows an intense preoccupation with train schedules.
Which assessment tool is most appropriate for initial screening?
A. PHQ-A
B. M-CHAT-R/F
C. SCARED
D. Vanderbilt Assessment Scale
Answer: B
Explanation: The Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-
CHAT-R/F) is a validated tool for screening for Autism Spectrum Disorder (ASD). While
typically used in younger toddlers, the presentation of social deficits and repetitive
behaviors strongly suggests the need for ASD-specific screening. The PMHNP must utilize
standardized tools to support a clinical diagnosis of neurodevelopmental disorders.
5. According to Piaget, a child who can think logically about concrete events but struggles
with abstract or hypothetical concepts is in which stage of cognitive development?
A. Sensorimotor
B. Preoperational
C. Concrete Operational
D. Formal Operational
Answer: C
Explanation: The Concrete Operational stage typically occurs between ages 7 and 11.
During this time, children gain a better understanding of mental operations and logical
thought about concrete objects. However, they still have difficulty with abstract thinking,
which is not fully developed until the Formal Operational stage.
, 6. Which symptom is a required diagnostic criterion for Attention-Deficit/Hyperactivity
Disorder (ADHD) in a child according to the DSM-5?
A. Low intellectual functioning
B. History of childhood trauma
C. Onset of symptoms after age 12
D. Symptoms present in at least two settings
Answer: D
Explanation: The DSM-5 requires that ADHD symptoms be present in two or more
settings, such as at home, school, or work. Symptoms must be present before age 12 and
interfere with, or reduce the quality of, social, academic, or occupational functioning. This
multi-setting requirement ensures that the behavior is not simply a reaction to a specific
environment or caregiver.
7. A 15-year-old female presents with a refusal to maintain a minimally normal body weight,
an intense fear of gaining weight, and a distorted body image. What is the priority
assessment?
A. Personality testing
B. Educational attainment
C. Family dynamics assessment
D. Electrolyte and cardiovascular status
Answer: D
Explanation: In patients with suspected Anorexia Nervosa, the immediate priority is
physiological stability due to the risk of life-threatening complications. Dehydration,
electrolyte imbalances (like hypokalemia), and bradycardia are common and require
urgent medical evaluation. Once the patient is medically stable, the PMHNP can proceed
with psychological and family assessments.
8. In Bowen Family Systems Theory, the process of a third person being brought into a conflict
between two people to reduce tension is known as:
A. Differentiation
B. Emotional Cutoff
C. Triangulation
D. Multigenerational Transmission
Answer: C
