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4. Pharmacological treatment in autism spectrum disorder is most likely to
have a positive effect on which of the following?
A. Aggressiveness
B. Gaze aversion
C. Prosodic modulation
D. Gestural communication - 🧠ANSWER ✔✔A. Aggressiveness
27. The parents of a toddler are concerned about a recent increase in the
frequency, intensity and duration of the child's temper tantrums. The
parents report that the toddler gets on the floor, kicks and screams when
they set limits. The child's health and developmental history is
unremarkable. Family history is significant for mood and anxiety disorders
,on the mother's side, and attention-deficit hyperactivity disorder (ADHD)
and oppositional defiant disorder (ODD) on the father's side. Which of the
following would be the most appropriate step for the psychiatrist to take
next?
A. Administer a Denver developmental screening test to the child.
B. Explore the parents' concerns about seemingly normal behavior.
C. Inquire about early separations and traumatic events in the child's life.
D. Administer an inventory to assess the parenting style of each parent.
E. Begin parent psychoeducation about ADHD and oppositional d -
🧠ANSWER ✔✔B. Explore the parents' concerns about seemingly normal
behavior.
Questions 39 — 42 pertain to the following vignette.
A 9-year-old girl is brought in by her parents for an outpatient psychiatric
evaluation due to behavior difficulties at home. When frustrated, the girl
screams, yells, curses and threatens to
kill herself. This behavior has been occurring more frequently whenever the
girl does not get her way. The parents usually give in and allow the girl to
do what she wants. Similar episodes have occurred at school. The girl is
,often irritable, argumentative and provocative. Her schoolwork is on grade
level. The girl has friends and interacts well with them, though she is
described as "bossy." Her appetite, energy and sleep patterns have been
normal and stable. There are no other problems. When seen with her
parents and individually, the child is calm, cooperative and interactive. She
denies suicidal or homicidal ideation and says that she "just gets mad." Her
mood is euthymic w - 🧠ANSWER ✔✔A. Send the patient home with the
parents.
40 Which of the following would be the most appropriate initial diagnostic
step by the physician?
A. Neuroimaging
B. Genetic testing
C. Psychological testing
D. Neurological evaluation
E. Obtain a teacher report - 🧠ANSWER ✔✔E. Obtain a teacher report
41. At a follow-up interview, the physician learns that the recent
exacerbation of symptoms appears to be related to increasing parental
disagreement about how the patient's
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, outbursts should be handled. It would be most appropriate for the physician
to next
obtain additional information about parental discipline and:
A. explore reasons for parental differences.
B. reinforce the parent with the best approach.
C. Explain the options for psychiatric interventions.
D. explore the parents' slowness in obtaining care.
E. Elicit the child's opinion about which parent's discipline style works best -
🧠ANSWER ✔✔A. explore reasons for parental differences.
42 The psychiatrist educates the parents about possible reasons for the
perpetuation of the child's temper tantrums. The psychiatrist teaches the
parents how to develop and implement an age-appropriate behavioral
management plan with clear expectations and consequences. Over the
next month, the child's behavior improves. The parents state that whenever
the child has a temper tantrum they ignore the behavior, wait for the child to
calm down and then expect the child to obey the rules. The behavior has
most likely
improved because the child has: