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ABPN CHILD AND ADOLESCENT
PSYCHIATRY PRACTICE EXAM —
QUESTIONS WITH VERIFIED ANSWERS
AND COMPLETE RATIONALES
## SECTION 1: DEVELOPMENT
**1. A 4-year-old child is brought for evaluation because of
parental concern about "not talking like other kids." The child
uses approximately 20 words, does not combine words into
phrases, and has difficulty following simple directions. Hearing
evaluation is normal. Which of the following is the MOST
appropriate next step?**
A. Reassurance that the child will outgrow the delay
B. Referral for comprehensive speech-language evaluation
C. Initiation of an SSRI trial
D. Diagnosis of autism spectrum disorder without further
evaluation
**Correct answer:** B
**Rationale:** A child with significantly delayed expressive
language at age 4 warrants comprehensive speech-language
evaluation. While autism spectrum disorder must be
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considered, a full developmental assessment is required before
making that diagnosis. Reassurance is inappropriate given the
severity of the delay.
**2. Which of the following best describes the developmental
trajectory of separation anxiety disorder?**
A. It typically begins in adolescence and resolves by early
adulthood
B. It typically emerges in childhood, with peak onset around 7–
9 years, and may persist into adulthood
C. It is exclusively a disorder of infancy
D. It is more common in males than females
**Correct answer:** B
**Rationale:** Separation anxiety disorder typically emerges in
childhood with a peak onset around 7–9 years, though it can
occur earlier. It affects both children and adolescents and may
persist into adulthood if untreated.
**3. A 15-year-old adolescent is described by parents as
increasingly distant, spending more time with peers, and
challenging family rules. Which statement about this
presentation is MOST accurate?**
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A. This represents pathological oppositional behavior requiring
immediate intervention
B. This is consistent with normal adolescent development
involving individuation and increased peer orientation
C. This indicates emerging conduct disorder
D. This is a sign of an underlying mood disorder
**Correct answer:** B
**Rationale:** Increased peer orientation, desire for autonomy,
and questioning of family rules are normal developmental tasks
of adolescence. Pathological behavior would be distinguished
by severity, persistence, and functional impairment.
**4. According to attachment theory, which pattern is
characterized by a child who shows little distress upon
separation from the caregiver and avoids or ignores the
caregiver upon return?**
A. Secure attachment
B. Insecure-avoidant attachment
C. Insecure-resistant attachment
D. Disorganized attachment
**Correct answer:** B
ABPN CHILD AND ADOLESCENT
PSYCHIATRY PRACTICE EXAM —
QUESTIONS WITH VERIFIED ANSWERS
AND COMPLETE RATIONALES
## SECTION 1: DEVELOPMENT
**1. A 4-year-old child is brought for evaluation because of
parental concern about "not talking like other kids." The child
uses approximately 20 words, does not combine words into
phrases, and has difficulty following simple directions. Hearing
evaluation is normal. Which of the following is the MOST
appropriate next step?**
A. Reassurance that the child will outgrow the delay
B. Referral for comprehensive speech-language evaluation
C. Initiation of an SSRI trial
D. Diagnosis of autism spectrum disorder without further
evaluation
**Correct answer:** B
**Rationale:** A child with significantly delayed expressive
language at age 4 warrants comprehensive speech-language
evaluation. While autism spectrum disorder must be
,2 | Page
considered, a full developmental assessment is required before
making that diagnosis. Reassurance is inappropriate given the
severity of the delay.
**2. Which of the following best describes the developmental
trajectory of separation anxiety disorder?**
A. It typically begins in adolescence and resolves by early
adulthood
B. It typically emerges in childhood, with peak onset around 7–
9 years, and may persist into adulthood
C. It is exclusively a disorder of infancy
D. It is more common in males than females
**Correct answer:** B
**Rationale:** Separation anxiety disorder typically emerges in
childhood with a peak onset around 7–9 years, though it can
occur earlier. It affects both children and adolescents and may
persist into adulthood if untreated.
**3. A 15-year-old adolescent is described by parents as
increasingly distant, spending more time with peers, and
challenging family rules. Which statement about this
presentation is MOST accurate?**
, 3 | Page
A. This represents pathological oppositional behavior requiring
immediate intervention
B. This is consistent with normal adolescent development
involving individuation and increased peer orientation
C. This indicates emerging conduct disorder
D. This is a sign of an underlying mood disorder
**Correct answer:** B
**Rationale:** Increased peer orientation, desire for autonomy,
and questioning of family rules are normal developmental tasks
of adolescence. Pathological behavior would be distinguished
by severity, persistence, and functional impairment.
**4. According to attachment theory, which pattern is
characterized by a child who shows little distress upon
separation from the caregiver and avoids or ignores the
caregiver upon return?**
A. Secure attachment
B. Insecure-avoidant attachment
C. Insecure-resistant attachment
D. Disorganized attachment
**Correct answer:** B
