NR606 Week 8 Exam V3 | NR606 Diagnosis & Management in
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 8 Exam) | Chamberlain University
1. A 9-year-old male is brought to the clinic for an evaluation due to persistent irritability and
frequent, severe temper outbursts that occur approximately four times per week. According
to the DSM-5, which diagnosis is most appropriate if these symptoms have been present for
over a year?
A. Oppositional Defiant Disorder
B. Bipolar I Disorder
C. Disruptive Mood Dysregulation Disorder
D. Pediatric Major Depressive Disorder
Answer: C
Explanation: Disruptive Mood Dysregulation Disorder (DMDD) was established to reduce
the overdiagnosis of Bipolar Disorder in children. The core feature is chronic, severe
persistent irritability and temper outbursts that are inconsistent with developmental level.
This diagnosis requires symptoms to be present for at least 12 months in at least two
settings.
2. When evaluating a child for Autism Spectrum Disorder (ASD), the clinician notes significant
deficits in social-emotional reciprocity and nonverbal communicative behaviors. Which
screening tool is most appropriate for a 24-month-old child?
A. M-CHAT-R/F
B. ASQ-SE
C. PHQ-A
D. Vanderbilt Assessment Scale
Answer: A
Explanation: The Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-
CHAT-R/F) is the standard screening tool for toddlers aged 16 to 30 months. It assesses the
risk for Autism Spectrum Disorder through a series of parent-report questions. Early
detection is critical for initiating behavioral interventions that improve long-term
outcomes.
,3. A 10-year-old child diagnosed with ADHD is prescribed Methylphenidate (Ritalin). During a
follow-up visit, which vital sign or measurement is most critical for the PMHNP to monitor
regularly?
A. Temperature
B. Respiratory Rate
C. Height and Weight
D. Oxygen Saturation
Answer: C
Explanation: Stimulants like Methylphenidate are associated with potential growth
suppression in pediatric patients. It is essential to monitor height and weight using
standardized growth charts at every follow-up visit. If significant deceleration occurs, a
‘medication holiday’ or dose adjustment may be necessary.
4. An adolescent patient is experiencing symptoms of Major Depressive Disorder. The PMHNP
considers prescribing an SSRI. Which medication is the only one FDA-approved for the
treatment of depression in children aged 8 and older?
A. Fluoxetine
B. Paroxetine
C. Sertraline
D. Venlafaxine
Answer: A
Explanation: Fluoxetine (Prozac) is the first-line SSRI and the only one FDA-approved for
depression in children as young as 8 years old. Escitalopram is approved for children aged
12 and older for depression. Clinicians must monitor for the black box warning regarding
increased suicidal ideation in this age group.
5. In Structural Family Therapy, developed by Salvador Minuchin, the therapist focuses on
which of the following to improve family functioning?
A. The family genogram and multigenerational patterns
B. Uncovering unconscious drives of family members
C. The ‘miracle question’ to identify solutions
D. Boundaries, subsystems, and hierarchies
Answer: D
Explanation: Structural Family Therapy emphasizes the importance of clear boundaries
between subsystems (e.g., parental vs. sibling). The therapist observes how the family is
, organized and intervenes to strengthen the parental hierarchy. Dysfunctional families often
exhibit enmeshed or disengaged boundaries that contribute to the identified patient’s
symptoms.
6. A 7-year-old child exhibits extreme distress when away from home and experiences
frequent nightmares about being kidnapped. The child refuses to attend school despite
various incentives. What is the most likely diagnosis?
A. Social Anxiety Disorder
B. Agoraphobia
C. Generalized Anxiety Disorder
D. Separation Anxiety Disorder
Answer: D
Explanation: Separation Anxiety Disorder involves developmentally inappropriate and
excessive fear or anxiety concerning separation from those to whom the individual is
attached. Common symptoms include school refusal, physical complaints when separation
is anticipated, and nightmares regarding loss. It is one of the most common anxiety
disorders in children under the age of 12.
7. Which of the following pharmacological agents is classified as a non-stimulant for the
treatment of ADHD and acts as a selective norepinephrine reuptake inhibitor?
A. Guanfacine
B. Atomoxetine
C. Lisdexamfetamine
D. Clonidine
Answer: B
Explanation: Atomoxetine (Strattera) is a non-stimulant medication that inhibits the
presynaptic norepinephrine transporter. Unlike stimulants, it has a lower risk for abuse
and does not carry the same level of insomnia side effects. It is often used as a second-line
treatment when stimulants are ineffective or contraindicated.
8. A PMHNP is conducting a group therapy session for adolescents. One member consistently
takes on the role of ‘the monopolizer,’ preventing others from participating. How should the
therapist best handle this dynamic according to Yalom’s principles?
A. Tell the student to leave the group immediately
B. Ignore the behavior to avoid giving it attention
C. Address the behavior by asking the group how it affects them
D. Lecture the student on the rules of social etiquette
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 8 Exam) | Chamberlain University
1. A 9-year-old male is brought to the clinic for an evaluation due to persistent irritability and
frequent, severe temper outbursts that occur approximately four times per week. According
to the DSM-5, which diagnosis is most appropriate if these symptoms have been present for
over a year?
A. Oppositional Defiant Disorder
B. Bipolar I Disorder
C. Disruptive Mood Dysregulation Disorder
D. Pediatric Major Depressive Disorder
Answer: C
Explanation: Disruptive Mood Dysregulation Disorder (DMDD) was established to reduce
the overdiagnosis of Bipolar Disorder in children. The core feature is chronic, severe
persistent irritability and temper outbursts that are inconsistent with developmental level.
This diagnosis requires symptoms to be present for at least 12 months in at least two
settings.
2. When evaluating a child for Autism Spectrum Disorder (ASD), the clinician notes significant
deficits in social-emotional reciprocity and nonverbal communicative behaviors. Which
screening tool is most appropriate for a 24-month-old child?
A. M-CHAT-R/F
B. ASQ-SE
C. PHQ-A
D. Vanderbilt Assessment Scale
Answer: A
Explanation: The Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-
CHAT-R/F) is the standard screening tool for toddlers aged 16 to 30 months. It assesses the
risk for Autism Spectrum Disorder through a series of parent-report questions. Early
detection is critical for initiating behavioral interventions that improve long-term
outcomes.
,3. A 10-year-old child diagnosed with ADHD is prescribed Methylphenidate (Ritalin). During a
follow-up visit, which vital sign or measurement is most critical for the PMHNP to monitor
regularly?
A. Temperature
B. Respiratory Rate
C. Height and Weight
D. Oxygen Saturation
Answer: C
Explanation: Stimulants like Methylphenidate are associated with potential growth
suppression in pediatric patients. It is essential to monitor height and weight using
standardized growth charts at every follow-up visit. If significant deceleration occurs, a
‘medication holiday’ or dose adjustment may be necessary.
4. An adolescent patient is experiencing symptoms of Major Depressive Disorder. The PMHNP
considers prescribing an SSRI. Which medication is the only one FDA-approved for the
treatment of depression in children aged 8 and older?
A. Fluoxetine
B. Paroxetine
C. Sertraline
D. Venlafaxine
Answer: A
Explanation: Fluoxetine (Prozac) is the first-line SSRI and the only one FDA-approved for
depression in children as young as 8 years old. Escitalopram is approved for children aged
12 and older for depression. Clinicians must monitor for the black box warning regarding
increased suicidal ideation in this age group.
5. In Structural Family Therapy, developed by Salvador Minuchin, the therapist focuses on
which of the following to improve family functioning?
A. The family genogram and multigenerational patterns
B. Uncovering unconscious drives of family members
C. The ‘miracle question’ to identify solutions
D. Boundaries, subsystems, and hierarchies
Answer: D
Explanation: Structural Family Therapy emphasizes the importance of clear boundaries
between subsystems (e.g., parental vs. sibling). The therapist observes how the family is
, organized and intervenes to strengthen the parental hierarchy. Dysfunctional families often
exhibit enmeshed or disengaged boundaries that contribute to the identified patient’s
symptoms.
6. A 7-year-old child exhibits extreme distress when away from home and experiences
frequent nightmares about being kidnapped. The child refuses to attend school despite
various incentives. What is the most likely diagnosis?
A. Social Anxiety Disorder
B. Agoraphobia
C. Generalized Anxiety Disorder
D. Separation Anxiety Disorder
Answer: D
Explanation: Separation Anxiety Disorder involves developmentally inappropriate and
excessive fear or anxiety concerning separation from those to whom the individual is
attached. Common symptoms include school refusal, physical complaints when separation
is anticipated, and nightmares regarding loss. It is one of the most common anxiety
disorders in children under the age of 12.
7. Which of the following pharmacological agents is classified as a non-stimulant for the
treatment of ADHD and acts as a selective norepinephrine reuptake inhibitor?
A. Guanfacine
B. Atomoxetine
C. Lisdexamfetamine
D. Clonidine
Answer: B
Explanation: Atomoxetine (Strattera) is a non-stimulant medication that inhibits the
presynaptic norepinephrine transporter. Unlike stimulants, it has a lower risk for abuse
and does not carry the same level of insomnia side effects. It is often used as a second-line
treatment when stimulants are ineffective or contraindicated.
8. A PMHNP is conducting a group therapy session for adolescents. One member consistently
takes on the role of ‘the monopolizer,’ preventing others from participating. How should the
therapist best handle this dynamic according to Yalom’s principles?
A. Tell the student to leave the group immediately
B. Ignore the behavior to avoid giving it attention
C. Address the behavior by asking the group how it affects them
D. Lecture the student on the rules of social etiquette
