NR606 Week 9 Exam V2 | NR606 Diagnosis & Management in
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 9 Exam) | Chamberlain University
1. A 10-year-old boy is brought to the clinic by his parents who report he is frequently ‘in
trouble’ at school for not following rules and arguing with teachers. The PMHNP notes the
child is often irritable and spiteful but does not show signs of physical aggression toward
others or animals. Which diagnosis is most likely?
A. Conduct Disorder
B. Oppositional Defiant Disorder (ODD)
C. Disruptive Mood Dysregulation Disorder (DMDD)
D. Attention-Deficit/Hyperactivity Disorder
Answer: B
Explanation: Oppositional Defiant Disorder (ODD) is characterized by a pattern of
angry/irritable mood, argumentative/defiant behavior, or vindictiveness. Unlike Conduct
Disorder, ODD does not typically involve serious violations of societal norms or the rights
of others, such as cruelty to animals or theft. The PMHNP must differentiate this from
DMDD, where the primary feature is chronic, severe persistent irritability and frequent
temper outbursts.
2. When prescribing an SSRI for a 15-year-old patient with Major Depressive Disorder, the
PMHNP must prioritize which of the following education points for the family?
A. The FDA Black Box warning regarding increased suicidal ideation.
B. The risk of weight gain and metabolic syndrome.
C. The immediate onset of therapeutic effects within 24 hours.
D. The necessity of a low-tyramine diet while on the medication.
Answer: A
Explanation: The FDA requires a Black Box warning on all antidepressants for children
and young adults under age 24 due to an increased risk of suicidal thoughts and behaviors.
It is crucial for the PMHNP to educate the family to monitor the patient closely during the
initial weeks of treatment. This safety education is a standard of care in pediatric mental
health management.
,3. A 7-year-old girl exhibits significant deficits in social communication, engages in repetitive
hand-flapping, and insists on the same daily routine without deviation. According to the
DSM-5, these symptoms are most indicative of:
A. Social Anxiety Disorder
B. Stereotypic Movement Disorder
C. Selective Mutism
D. Autism Spectrum Disorder (ASD)
Answer: D
Explanation: Autism Spectrum Disorder (ASD) is defined by 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, such as hand-
flapping or insistence on sameness. The PMHNP should evaluate the severity of these
symptoms to determine the level of support required for the child.
4. Which medication is considered a non-stimulant option for the treatment of Attention-
Deficit/Hyperactivity Disorder (ADHD) in a child who has a history of substance abuse in the
home?
A. Atomoxetine
B. Lisdexamfetamine
C. Methylphenidate
D. Mixed Amphetamine Salts
Answer: A
Explanation: Atomoxetine is a selective norepinephrine reuptake inhibitor and is
classified as a non-stimulant for ADHD. It is often preferred in scenarios where there is a
high risk of diversion or substance abuse in the household because it lacks the abuse
potential of stimulants. The PMHNP must monitor for side effects like liver injury and
suicidal ideation, although these are rare.
5. An adolescent presents with intense fear of being scrutinized in social situations, such as
giving a presentation in class, leading to avoidance behavior. What is the first-line
pharmacotherapeutic intervention?
A. Alprazolam as needed
B. Selective Serotonin Reuptake Inhibitor (SSRI)
C. Propranolol
D. Buspirone
Answer: B
, Explanation: SSRIs are considered the first-line pharmacological treatment for Social
Anxiety Disorder in children and adolescents. They provide a broad range of efficacy for
anxiety and are safer for long-term use compared to benzodiazepines. Cognitive Behavioral
Therapy (CBT) is often used concurrently to provide the most effective treatment
outcomes.
6. A 9-year-old child demonstrates persistent irritability and frequent, severe temper
outbursts that are out of proportion to the situation, occurring 3 or more times per week. The
symptoms have been present for 12 months in multiple settings. Which diagnosis should the
PMHNP consider?
A. Bipolar I Disorder
B. Disruptive Mood Dysregulation Disorder (DMDD)
C. Intermittent Explosive Disorder
D. Major Depressive Disorder
Answer: B
Explanation: Disruptive Mood Dysregulation Disorder (DMDD) was introduced in the
DSM-5 to address concerns about the overdiagnosis of Bipolar Disorder in children. The
diagnosis requires chronic, severe irritability and temper outbursts that occur at least
three times a week for at least one year. The PMHNP must verify that symptoms began
before the age of 10 and are present in at least two settings.
7. When evaluating a child for Reactive Attachment Disorder (RAD), which historical factor is
most consistent with the diagnosis?
A. Early childhood exposure to traumatic violence.
B. Excessive familiarity with strangers.
C. A history of social neglect or lack of consistent caregivers.
D. Genetic predisposition to anxiety disorders.
Answer: C
Explanation: Reactive Attachment Disorder (RAD) is rooted in a history of social neglect or
deprivation, often due to frequent changes in primary caregivers or being raised in
institutional settings. The child fails to seek or respond to comfort when distressed. This
differs from Disinhibited Social Engagement Disorder, where the child is overly familiar
with strangers.
8. A 16-year-old female is diagnosed with Bulimia Nervosa. Which medication is FDA-
approved for the treatment of this condition?
A. Fluoxetine
B. Sertraline
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 9 Exam) | Chamberlain University
1. A 10-year-old boy is brought to the clinic by his parents who report he is frequently ‘in
trouble’ at school for not following rules and arguing with teachers. The PMHNP notes the
child is often irritable and spiteful but does not show signs of physical aggression toward
others or animals. Which diagnosis is most likely?
A. Conduct Disorder
B. Oppositional Defiant Disorder (ODD)
C. Disruptive Mood Dysregulation Disorder (DMDD)
D. Attention-Deficit/Hyperactivity Disorder
Answer: B
Explanation: Oppositional Defiant Disorder (ODD) is characterized by a pattern of
angry/irritable mood, argumentative/defiant behavior, or vindictiveness. Unlike Conduct
Disorder, ODD does not typically involve serious violations of societal norms or the rights
of others, such as cruelty to animals or theft. The PMHNP must differentiate this from
DMDD, where the primary feature is chronic, severe persistent irritability and frequent
temper outbursts.
2. When prescribing an SSRI for a 15-year-old patient with Major Depressive Disorder, the
PMHNP must prioritize which of the following education points for the family?
A. The FDA Black Box warning regarding increased suicidal ideation.
B. The risk of weight gain and metabolic syndrome.
C. The immediate onset of therapeutic effects within 24 hours.
D. The necessity of a low-tyramine diet while on the medication.
Answer: A
Explanation: The FDA requires a Black Box warning on all antidepressants for children
and young adults under age 24 due to an increased risk of suicidal thoughts and behaviors.
It is crucial for the PMHNP to educate the family to monitor the patient closely during the
initial weeks of treatment. This safety education is a standard of care in pediatric mental
health management.
,3. A 7-year-old girl exhibits significant deficits in social communication, engages in repetitive
hand-flapping, and insists on the same daily routine without deviation. According to the
DSM-5, these symptoms are most indicative of:
A. Social Anxiety Disorder
B. Stereotypic Movement Disorder
C. Selective Mutism
D. Autism Spectrum Disorder (ASD)
Answer: D
Explanation: Autism Spectrum Disorder (ASD) is defined by 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, such as hand-
flapping or insistence on sameness. The PMHNP should evaluate the severity of these
symptoms to determine the level of support required for the child.
4. Which medication is considered a non-stimulant option for the treatment of Attention-
Deficit/Hyperactivity Disorder (ADHD) in a child who has a history of substance abuse in the
home?
A. Atomoxetine
B. Lisdexamfetamine
C. Methylphenidate
D. Mixed Amphetamine Salts
Answer: A
Explanation: Atomoxetine is a selective norepinephrine reuptake inhibitor and is
classified as a non-stimulant for ADHD. It is often preferred in scenarios where there is a
high risk of diversion or substance abuse in the household because it lacks the abuse
potential of stimulants. The PMHNP must monitor for side effects like liver injury and
suicidal ideation, although these are rare.
5. An adolescent presents with intense fear of being scrutinized in social situations, such as
giving a presentation in class, leading to avoidance behavior. What is the first-line
pharmacotherapeutic intervention?
A. Alprazolam as needed
B. Selective Serotonin Reuptake Inhibitor (SSRI)
C. Propranolol
D. Buspirone
Answer: B
, Explanation: SSRIs are considered the first-line pharmacological treatment for Social
Anxiety Disorder in children and adolescents. They provide a broad range of efficacy for
anxiety and are safer for long-term use compared to benzodiazepines. Cognitive Behavioral
Therapy (CBT) is often used concurrently to provide the most effective treatment
outcomes.
6. A 9-year-old child demonstrates persistent irritability and frequent, severe temper
outbursts that are out of proportion to the situation, occurring 3 or more times per week. The
symptoms have been present for 12 months in multiple settings. Which diagnosis should the
PMHNP consider?
A. Bipolar I Disorder
B. Disruptive Mood Dysregulation Disorder (DMDD)
C. Intermittent Explosive Disorder
D. Major Depressive Disorder
Answer: B
Explanation: Disruptive Mood Dysregulation Disorder (DMDD) was introduced in the
DSM-5 to address concerns about the overdiagnosis of Bipolar Disorder in children. The
diagnosis requires chronic, severe irritability and temper outbursts that occur at least
three times a week for at least one year. The PMHNP must verify that symptoms began
before the age of 10 and are present in at least two settings.
7. When evaluating a child for Reactive Attachment Disorder (RAD), which historical factor is
most consistent with the diagnosis?
A. Early childhood exposure to traumatic violence.
B. Excessive familiarity with strangers.
C. A history of social neglect or lack of consistent caregivers.
D. Genetic predisposition to anxiety disorders.
Answer: C
Explanation: Reactive Attachment Disorder (RAD) is rooted in a history of social neglect or
deprivation, often due to frequent changes in primary caregivers or being raised in
institutional settings. The child fails to seek or respond to comfort when distressed. This
differs from Disinhibited Social Engagement Disorder, where the child is overly familiar
with strangers.
8. A 16-year-old female is diagnosed with Bulimia Nervosa. Which medication is FDA-
approved for the treatment of this condition?
A. Fluoxetine
B. Sertraline
