NR606 Week 10 Exam V1 | NR606 Diagnosis & Management in
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 10 Exam) | Chamberlain University
1. Which of the following medications is currently the only FDA-approved SSRI for the
treatment of Major Depressive Disorder (MDD) in children aged 8 years and older?
A. Sertraline
B. Fluoxetine
C. Escitalopram
D. Paroxetine
Answer: B
Explanation: Fluoxetine is the primary pharmacological treatment approved by the FDA
for children as young as 8 with MDD. While other SSRIs are used off-label, their safety
profile in younger children is not as robustly established. Clinicians must monitor for the
black box warning regarding increased suicidal ideation in this age group.
2. A 10-year-old male is brought to the clinic for disruptive behavior. He often loses his
temper, argues with authority figures, and actively defies requests. However, he does not
show physical aggression or violate the basic rights of others. What is the most likely
diagnosis?
A. Conduct Disorder
B. Attention-Deficit/Hyperactivity Disorder
C. Disruptive Mood Dysregulation Disorder
D. Oppositional Defiant Disorder
Answer: D
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 the violation of basic rights or physical cruelty to
animals or people. The diagnosis requires these behaviors to be present for at least six
months.
3. When screening an 18-month-old child for Autism Spectrum Disorder (ASD), which
standardized tool is most appropriate for the PMHNP to utilize?
A. PHQ-9
B. M-CHAT-R/F
,C. Gilles de la Tourette Syndrome Questionnaire
D. Vanderbilt Assessment Scale
Answer: B
Explanation: The Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-
CHAT-R/F) is specifically designed for children aged 16 to 30 months. It screens for social
communication delays and restricted or repetitive behaviors associated with ASD. Early
detection through this tool allows for prompt referral to specialized intervention services.
4. A 15-year-old female presents with restrictive eating, a BMI of 16.5, and an intense fear of
gaining weight. She acknowledges she is thin but believes her thighs are ‘huge.’ Which
diagnosis fits this clinical picture?
A. Anorexia Nervosa, Restricting Type
B. Avoidant/Restrictive Food Intake Disorder
C. Bulimia Nervosa
D. Binge Eating Disorder
Answer: A
Explanation: Anorexia Nervosa is characterized by significantly low body weight, an
intense fear of weight gain, and body image distortion. In the restricting type, weight loss is
achieved primarily through dieting, fasting, and/or excessive exercise. The patient’s BMI
and specific focus on body parts are hallmark signs of this disorder.
5. According to Erikson’s stages of psychosocial development, a child aged 7 to 11 years is in
which stage?
A. Industry vs. Inferiority
B. Trust vs. Mistrust
C. Autonomy vs. Shame and Doubt
D. Identity vs. Role Confusion
Answer: A
Explanation: The stage of Industry vs. Inferiority occurs during the elementary school
years when children learn to master formal skills. Success leads to a sense of competence,
while failure results in feelings of inadequacy. This stage is critical for developing self-
esteem through academic and social achievements.
6. In the treatment of ADHD, what is the primary mechanism of action for stimulant
medications like Methylphenidate?
A. Selective inhibition of serotonin reuptake
, B. Antagonism of NMDA receptors
C. Blocking the reuptake of dopamine and norepinephrine
D. Agonism of Alpha-2 adrenergic receptors
Answer: C
Explanation: Stimulants function by increasing the levels of dopamine and norepinephrine
in the synaptic cleft by blocking their reuptake. This increase in neurotransmitter
availability enhances executive functioning in the prefrontal cortex. This mechanism helps
improve focus, impulse control, and hyperactivity in patients with ADHD.
7. A 9-year-old child presents with chronic, severe irritability manifested by frequent temper
outbursts (3 or more times per week) and a persistently irritable mood between outbursts.
These symptoms have lasted for over a year. Which diagnosis should be considered?
A. Bipolar I Disorder
B. Intermittent Explosive Disorder
C. Generalized Anxiety Disorder
D. Disruptive Mood Dysregulation Disorder (DMDD)
Answer: D
Explanation: DMDD was introduced in the DSM-5 to address concerns about the
overdiagnosis of bipolar disorder in children. It focuses on chronic non-episodic irritability
and frequent outbursts that are out of proportion to the situation. Diagnosis requires
symptoms to be present before age 10 and persistent for at least 12 months.
8. Which side effect of second-generation antipsychotics is of greatest concern in the
pediatric population regarding long-term health?
A. Acute dystonia
B. Metabolic syndrome and weight gain
C. Agranulocytosis
D. Hypertensive crisis
Answer: B
Explanation: Pediatric patients are particularly susceptible to significant weight gain and
metabolic changes when taking second-generation antipsychotics. This increase in weight,
glucose, and lipids can lead to early-onset type 2 diabetes and cardiovascular issues.
Monitoring BMI and metabolic labs is an essential component of the PMHNP’s management
plan.
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 10 Exam) | Chamberlain University
1. Which of the following medications is currently the only FDA-approved SSRI for the
treatment of Major Depressive Disorder (MDD) in children aged 8 years and older?
A. Sertraline
B. Fluoxetine
C. Escitalopram
D. Paroxetine
Answer: B
Explanation: Fluoxetine is the primary pharmacological treatment approved by the FDA
for children as young as 8 with MDD. While other SSRIs are used off-label, their safety
profile in younger children is not as robustly established. Clinicians must monitor for the
black box warning regarding increased suicidal ideation in this age group.
2. A 10-year-old male is brought to the clinic for disruptive behavior. He often loses his
temper, argues with authority figures, and actively defies requests. However, he does not
show physical aggression or violate the basic rights of others. What is the most likely
diagnosis?
A. Conduct Disorder
B. Attention-Deficit/Hyperactivity Disorder
C. Disruptive Mood Dysregulation Disorder
D. Oppositional Defiant Disorder
Answer: D
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 the violation of basic rights or physical cruelty to
animals or people. The diagnosis requires these behaviors to be present for at least six
months.
3. When screening an 18-month-old child for Autism Spectrum Disorder (ASD), which
standardized tool is most appropriate for the PMHNP to utilize?
A. PHQ-9
B. M-CHAT-R/F
,C. Gilles de la Tourette Syndrome Questionnaire
D. Vanderbilt Assessment Scale
Answer: B
Explanation: The Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-
CHAT-R/F) is specifically designed for children aged 16 to 30 months. It screens for social
communication delays and restricted or repetitive behaviors associated with ASD. Early
detection through this tool allows for prompt referral to specialized intervention services.
4. A 15-year-old female presents with restrictive eating, a BMI of 16.5, and an intense fear of
gaining weight. She acknowledges she is thin but believes her thighs are ‘huge.’ Which
diagnosis fits this clinical picture?
A. Anorexia Nervosa, Restricting Type
B. Avoidant/Restrictive Food Intake Disorder
C. Bulimia Nervosa
D. Binge Eating Disorder
Answer: A
Explanation: Anorexia Nervosa is characterized by significantly low body weight, an
intense fear of weight gain, and body image distortion. In the restricting type, weight loss is
achieved primarily through dieting, fasting, and/or excessive exercise. The patient’s BMI
and specific focus on body parts are hallmark signs of this disorder.
5. According to Erikson’s stages of psychosocial development, a child aged 7 to 11 years is in
which stage?
A. Industry vs. Inferiority
B. Trust vs. Mistrust
C. Autonomy vs. Shame and Doubt
D. Identity vs. Role Confusion
Answer: A
Explanation: The stage of Industry vs. Inferiority occurs during the elementary school
years when children learn to master formal skills. Success leads to a sense of competence,
while failure results in feelings of inadequacy. This stage is critical for developing self-
esteem through academic and social achievements.
6. In the treatment of ADHD, what is the primary mechanism of action for stimulant
medications like Methylphenidate?
A. Selective inhibition of serotonin reuptake
, B. Antagonism of NMDA receptors
C. Blocking the reuptake of dopamine and norepinephrine
D. Agonism of Alpha-2 adrenergic receptors
Answer: C
Explanation: Stimulants function by increasing the levels of dopamine and norepinephrine
in the synaptic cleft by blocking their reuptake. This increase in neurotransmitter
availability enhances executive functioning in the prefrontal cortex. This mechanism helps
improve focus, impulse control, and hyperactivity in patients with ADHD.
7. A 9-year-old child presents with chronic, severe irritability manifested by frequent temper
outbursts (3 or more times per week) and a persistently irritable mood between outbursts.
These symptoms have lasted for over a year. Which diagnosis should be considered?
A. Bipolar I Disorder
B. Intermittent Explosive Disorder
C. Generalized Anxiety Disorder
D. Disruptive Mood Dysregulation Disorder (DMDD)
Answer: D
Explanation: DMDD was introduced in the DSM-5 to address concerns about the
overdiagnosis of bipolar disorder in children. It focuses on chronic non-episodic irritability
and frequent outbursts that are out of proportion to the situation. Diagnosis requires
symptoms to be present before age 10 and persistent for at least 12 months.
8. Which side effect of second-generation antipsychotics is of greatest concern in the
pediatric population regarding long-term health?
A. Acute dystonia
B. Metabolic syndrome and weight gain
C. Agranulocytosis
D. Hypertensive crisis
Answer: B
Explanation: Pediatric patients are particularly susceptible to significant weight gain and
metabolic changes when taking second-generation antipsychotics. This increase in weight,
glucose, and lipids can lead to early-onset type 2 diabetes and cardiovascular issues.
Monitoring BMI and metabolic labs is an essential component of the PMHNP’s management
plan.
