Nr668 Final Exam – Psychiatric-Mental Health Capstone Practicum Intensive | Verified Questions & A+ Graded Answers | 2024/2025 Comprehensive Study Guide

1. Which of the following developmental milestones should a 2-year-old child be able to accomplish? a. Copy a square b. Identify age and gender c. Ride a tricycle d. Copy a circle - ANSWER d. Copy a circle 2. A woman in her 20th week of pregnancy has been resumed on lithium for bipolar disorder. The PMHNP knows that the patient may become subtherapeutic despite taking the medication as prescribed due to: a. Increased blood volume b. Reduced blood volume c. Increased fetal metabolism d. Reduced muscle mass - ANSWER a. Increased blood volume 3. An 8-year-old boy diagnosed with leukemia is referred to child psychiatry because he is consistently displaying a flat affect, irritability, angry acting out, and occasional physical aggression toward his 6-year-old brother. What approach should the PMHNP take when interviewing this child? a. Encourage the child to talk about whatever is on his mind b. Sit quietly and allow the child to talk c. Ask the child direct questions about how he feels about his disease d. Provide toys and allow the child to play - ANSWER d. Provide toys and allow the child to play 4. The PMHNP is providing psychoeducation and anticipatory guidance to the concerned parent regarding night terrors. At which stage of sleep is this most likely to occur? a. Any stage of sleep b. Stage 3 to 4 c. Stage 1 d. Stage 2 - ANSWER b. Stage 3 to 4 5. When evaluating a 7-year-old girl diagnosed with expressive language disorder, which of the following assessments would be most helpful in confirming the diagnosis? a. Children's assessment scale b. Diagnostic interview scheduled for children c. IQ test d. Diagnostic interview for children and adolescents - ANSWER c. IQ test 6. A father brings his 6-year-old son to you because he is worried about him. He states that the son sits up in bed shortly after falling asleep and screams. He says he is inconsolable and unable to be awakened during these episodes but eventually he falls back asleep. The father states he is not able to fall back asleep after those episodes and is exhausted and falling asleep at work during the day. The child is energetic and playful during the day and has no memory of the episodes. What is the most appropriate response? a. "I can see this is upsetting for you" b. "Tell me why you can't fall back asleep after your son does?" c. "Are you worried you are doing something wrong?" d. "I can see you're upset, but really you are overreacting" - ANSWER a. "I can see this is upsetting for you" 7. Major Depressive disorder in the pediatric population has some variability in symptomatology compared to MDD in adults. Which of the following best categorizes the pediatric symptoms of major depressive disorder? a. Anxiousness with periods of psychomotor retardation b. Sleep difficulties, appetite changes and hopelessness c. Sullen, lethargic, and increased appetite d. Angry and irritable with somatic complaints - ANSWER d. Angry and irritable with somatic complaints 8. *when looking at MDD in the pediatric population, keep in mind the same criteria for adults, but may substitute irritability for depressed mood; children may describe the depression as feeling angry instead of sad; more somatic complaints may exist and hallucinations are possible 9. Which disorder is associated with higher rates of ADHD, enlarges testes, a long narrow face, hypotonia and short stature? a. Fragile X b. PKU c. Prader-Willis syndrome d. Asperger's syndrome - ANSWER a. Fragile X 10. *Fragile X is associated with a higher rate of ADHD, impaired intellectual ability, learning disorders, autism spectrum disorder; physical attributes include hypotonia, flat feet, enlarged testes, long narrow face, flexible fingers, and short stature 11. A 19-year-old female is being seen at a crisis pregnancy center for an unplanned pregnancy. She feels compelled by her boyfriend to get an abortion, but it goes against her deeply held religious beliefs. Which of the following reduces her risk of being the victim of domestic violence? a. Financial independence b. Fear of isolation c. Poor social support d. Pregnancy - ANSWER a. Financial independence 12. A 24-month-old girl is referred to psychiatry for an expressive language disorder. The mother reports that the child has not yet spoken a clear word, inconsistently follows commands, and does not play with her older brother of 4 years. In addition, the mother reports that the child has started making repetitive motions with her hands and seems to be clumsy with increasing difficulty walking. These clinical findings are suggestive of a pervasive developmental disorder, most likely: a. Cerebral palsy b. Autism spectrum disorder c. Intellectual disability d. Rett syndrome - ANSWER d. Rett syndrome 13. The PMHNP is performing primary prevention in the high school regarding mental illness. The most common psychiatric emergency in children and adolescents is: a. Homicidal behavior b. Psychotic behavior c. Suicidal behavior d. Sexually inappropriate behavior - ANSWER c. Suicidal behavior 14. Luanne is a 19-year-old single mother of a 3-year-old boy. She works during the day and attends classes for her high school equivalency exam several evenings per week. Her son is in daycare and an after-school program from 8 a.m. to 7 p.m. 5 days per week. She reports feeling so tired that she sometimes loses her patience with her son and gives him Benadryl to help calm him down and sleep through the night. Which of the following actions should the PMHNP take? a. Provide dosing instructions to prevent accidental overdose b. Commend the mother on her efforts of handling work and school c. Provide psychoeducation for her son's challenges d. Report the mother to child protective services - ANSWER d. Report the mother to child protective services 15. Sam is 11 years old without past psychiatric history. He was born by normal spontaneous vaginal delivery with normal APGAR scores. He has met all of his developmental milestones. He began sixth grade this year and has had increased trouble falling asleep. He has always had bedtime rituals but lately they are extending in complexity and length. Most of his time in the evening is spent checking that the lights are turned off and that the windows are locked. As a result, he is only getting 5 hours of sleep at night and now has excessive daytime sleepiness with decreased interest in socialization and failing grades. Which of the following infectious diseases may contribute to this clinical presentation? a. Treponema b. Congenital herpes simplex virus c. Human immunodeficiency virus d. Streptococcus - ANSWER d. Streptococcus 16. Which eating disorder is considered ego syntonic? a. Binge eating disorder b. Anorexia nervosa c. The mediterranean diet d. Bulimia nervosa - ANSWER b. Anorexia nervosa *anorexia nervosa is challenging to treat because it is ego syntonic; in other words, one's behaviors, feelings and values are in line with the needs of the ego and reliable to one's self image 17. The school psychologist refers a 7-year-old girl with difficulty reading, distractibility, and writing avoidance behaviors. The child has no diagnosed conditions, takes no medications, and met all of her developmental milestones. She loves arts and crafts and physical education. Prior to diagnosing a learning disorder, which of the following screening tests must be performed? a. Vision and hearing b. Neurological evaluation c. Family history d. Complete history and physical exam - ANSWER a. Vision and hearing 18. A 4-year-old boy is brought to the pediatric emergency department kicking and screaming while trying to run away from the sharks he fears are going to eat him. Which of the following diagnostic tests would be most appropriate? a. Urine toxicology b. Complete blood count c. Comprehensive metabolic profile d. EKG - ANSWER a. Urine toxicology