NR606 Week 4 Exam V2 | NR606 Diagnosis & Management in
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 4 Exam) | Chamberlain University
1. A 9-year-old male is brought to the clinic by his parents due to persistent patterns of
irritability and frequent temper outbursts. The PMHNP considers a diagnosis of Disruptive
Mood Dysregulation Disorder (DMDD). Which criterion is essential for this diagnosis?
A. The symptoms must be present for at least 6 months.
B. The onset of symptoms must be after age 10.
C. The mood between outbursts is typically euphoric.
D. Temper outbursts occur on average three or more times per week.
Answer: D
Explanation: According to the DSM-5, the temper outbursts in DMDD must occur three or
more times per week on average. The diagnosis should not be made for the first time
before age 6 or after age 18. Additionally, the chronic irritability between outbursts must
be present for at least 12 months to meet the full diagnostic criteria.
2. When initiating a stimulant medication for a child with ADHD, which of the following
baseline assessments is considered most critical by the PMHNP?
A. Liver function tests and renal panel.
B. Height, weight, and blood pressure.
C. An electroencephalogram (EEG).
D. Thyroid stimulating hormone (TSH) levels.
Answer: B
Explanation: Stimulants can potentially impact a child’s growth trajectory and
cardiovascular stability. Baseline measurements of height and weight are necessary to
monitor for growth suppression over time. Blood pressure and heart rate must also be
tracked to screen for adverse sympathomimetic effects.
3. A 15-year-old female presents with restrictive eating, intense fear of gaining weight, and a
body mass index (BMI) significantly below the 5th percentile for her age. Which diagnosis is
most likely?
A. Bulimia Nervosa
B. Anorexia Nervosa
C. Avoidant/Restrictive Food Intake Disorder (ARFID)
,D. Binge Eating Disorder
Answer: B
Explanation: Anorexia Nervosa is characterized by a restriction of energy intake leading to
a significantly low body weight. It also involves an intense fear of gaining weight or
persistent behavior that interferes with weight gain. Unlike ARFID, Anorexia involves a
disturbance in the way one’s body weight or shape is experienced.
4. In Family Systems Theory, which concept refers to a three-person emotional configuration
that is considered the smallest stable relationship system?
A. Enmeshment
B. Differentiation of self
C. Nuclear family emotional process
D. Triangulation
Answer: D
Explanation: Triangulation occurs when a two-person system under stress draws in a
third person to stabilize the relationship. This concept was developed by Murray Bowen to
describe how tension is managed within families. Recognizing these patterns is crucial for
PMHNPs conducting family therapy sessions.
5. A 7-year-old child exhibits significant difficulty in social communication, repetitive motor
mannerisms, and a preoccupation with vacuum cleaner parts. These symptoms are hallmarks
of which disorder?
A. Attention-Deficit/Hyperactivity Disorder
B. Social Communication Disorder
C. Stereotypic Movement Disorder
D. Autism Spectrum Disorder
Answer: D
Explanation: Autism Spectrum Disorder (ASD) involves persistent deficits in social
communication and social interaction across multiple contexts. It also requires the
presence of restricted, repetitive patterns of behavior, interests, or activities. A
preoccupation with specific objects like vacuum parts is a common manifestation of
restricted interests.
6. Which of the following is an FDA-approved medication for the treatment of irritability
associated with Autism Spectrum Disorder in children aged 5 to 16?
A. Risperidone
B. Fluoxetine
, C. Methylphenidate
D. Lithium
Answer: A
Explanation: Risperidone was the first medication FDA-approved for the treatment of
irritability in children with ASD. Aripiprazole is the other second-generation antipsychotic
with this specific pediatric indication. These medications help manage aggression, self-
injury, and severe temper tantrums in this population.
7. A PMHNP is evaluating a 10-year-old for Separation Anxiety Disorder. Which symptom
would most likely support this diagnosis?
A. Consistent failure to speak in specific social situations.
B. Persistent and excessive worry about losing major attachment figures.
C. Fear of being in open spaces or using public transportation.
D. Recurring flashbacks of a traumatic separation event.
Answer: B
Explanation: Separation Anxiety Disorder is characterized by developmentally
inappropriate and excessive fear or anxiety concerning separation from those to whom the
individual is attached. This often manifests as worry about harm befalling the attachment
figure or refusal to go out. The anxiety must last at least 4 weeks in children and
adolescents.
8. Which neurotransmitter system is primarily targeted by stimulant medications like
Adderall in the treatment of ADHD?
A. Serotonin and Glutamate
B. Dopamine and Norepinephrine
C. GABA and Acetylcholine
D. Endorphins and Oxytocin
Answer: B
Explanation: Stimulants increase the availability of dopamine and norepinephrine in the
prefrontal cortex. These neurotransmitters are essential for executive functioning,
attention, and impulse control. By blocking reuptake and increasing release, stimulants
alleviate the primary symptoms of ADHD.
9. An adolescent patient is prescribed Atomoxetine (Strattera) for ADHD. The PMHNP must
educate the family about which black box warning associated with this non-stimulant?
A. Risk of severe hepatotoxicity.
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 4 Exam) | Chamberlain University
1. A 9-year-old male is brought to the clinic by his parents due to persistent patterns of
irritability and frequent temper outbursts. The PMHNP considers a diagnosis of Disruptive
Mood Dysregulation Disorder (DMDD). Which criterion is essential for this diagnosis?
A. The symptoms must be present for at least 6 months.
B. The onset of symptoms must be after age 10.
C. The mood between outbursts is typically euphoric.
D. Temper outbursts occur on average three or more times per week.
Answer: D
Explanation: According to the DSM-5, the temper outbursts in DMDD must occur three or
more times per week on average. The diagnosis should not be made for the first time
before age 6 or after age 18. Additionally, the chronic irritability between outbursts must
be present for at least 12 months to meet the full diagnostic criteria.
2. When initiating a stimulant medication for a child with ADHD, which of the following
baseline assessments is considered most critical by the PMHNP?
A. Liver function tests and renal panel.
B. Height, weight, and blood pressure.
C. An electroencephalogram (EEG).
D. Thyroid stimulating hormone (TSH) levels.
Answer: B
Explanation: Stimulants can potentially impact a child’s growth trajectory and
cardiovascular stability. Baseline measurements of height and weight are necessary to
monitor for growth suppression over time. Blood pressure and heart rate must also be
tracked to screen for adverse sympathomimetic effects.
3. A 15-year-old female presents with restrictive eating, intense fear of gaining weight, and a
body mass index (BMI) significantly below the 5th percentile for her age. Which diagnosis is
most likely?
A. Bulimia Nervosa
B. Anorexia Nervosa
C. Avoidant/Restrictive Food Intake Disorder (ARFID)
,D. Binge Eating Disorder
Answer: B
Explanation: Anorexia Nervosa is characterized by a restriction of energy intake leading to
a significantly low body weight. It also involves an intense fear of gaining weight or
persistent behavior that interferes with weight gain. Unlike ARFID, Anorexia involves a
disturbance in the way one’s body weight or shape is experienced.
4. In Family Systems Theory, which concept refers to a three-person emotional configuration
that is considered the smallest stable relationship system?
A. Enmeshment
B. Differentiation of self
C. Nuclear family emotional process
D. Triangulation
Answer: D
Explanation: Triangulation occurs when a two-person system under stress draws in a
third person to stabilize the relationship. This concept was developed by Murray Bowen to
describe how tension is managed within families. Recognizing these patterns is crucial for
PMHNPs conducting family therapy sessions.
5. A 7-year-old child exhibits significant difficulty in social communication, repetitive motor
mannerisms, and a preoccupation with vacuum cleaner parts. These symptoms are hallmarks
of which disorder?
A. Attention-Deficit/Hyperactivity Disorder
B. Social Communication Disorder
C. Stereotypic Movement Disorder
D. Autism Spectrum Disorder
Answer: D
Explanation: Autism Spectrum Disorder (ASD) involves persistent deficits in social
communication and social interaction across multiple contexts. It also requires the
presence of restricted, repetitive patterns of behavior, interests, or activities. A
preoccupation with specific objects like vacuum parts is a common manifestation of
restricted interests.
6. Which of the following is an FDA-approved medication for the treatment of irritability
associated with Autism Spectrum Disorder in children aged 5 to 16?
A. Risperidone
B. Fluoxetine
, C. Methylphenidate
D. Lithium
Answer: A
Explanation: Risperidone was the first medication FDA-approved for the treatment of
irritability in children with ASD. Aripiprazole is the other second-generation antipsychotic
with this specific pediatric indication. These medications help manage aggression, self-
injury, and severe temper tantrums in this population.
7. A PMHNP is evaluating a 10-year-old for Separation Anxiety Disorder. Which symptom
would most likely support this diagnosis?
A. Consistent failure to speak in specific social situations.
B. Persistent and excessive worry about losing major attachment figures.
C. Fear of being in open spaces or using public transportation.
D. Recurring flashbacks of a traumatic separation event.
Answer: B
Explanation: Separation Anxiety Disorder is characterized by developmentally
inappropriate and excessive fear or anxiety concerning separation from those to whom the
individual is attached. This often manifests as worry about harm befalling the attachment
figure or refusal to go out. The anxiety must last at least 4 weeks in children and
adolescents.
8. Which neurotransmitter system is primarily targeted by stimulant medications like
Adderall in the treatment of ADHD?
A. Serotonin and Glutamate
B. Dopamine and Norepinephrine
C. GABA and Acetylcholine
D. Endorphins and Oxytocin
Answer: B
Explanation: Stimulants increase the availability of dopamine and norepinephrine in the
prefrontal cortex. These neurotransmitters are essential for executive functioning,
attention, and impulse control. By blocking reuptake and increasing release, stimulants
alleviate the primary symptoms of ADHD.
9. An adolescent patient is prescribed Atomoxetine (Strattera) for ADHD. The PMHNP must
educate the family about which black box warning associated with this non-stimulant?
A. Risk of severe hepatotoxicity.
