NR606 FINAL EXAM WITH 100% PASS RATE
What ADHD symptoms are lack of attention to detail, careless mistakes, not listening,
losing things diverting attention, forgetfulness - ANSWER-Selective attention
What ADHD symptoms are poor problem solving, trouble completing a task,
disorganization, trouble sustaining mental effort - ANSWER-Lack of sustained attention
What ADHD symptoms are excessive talking, blurting things out, not waiting ones turn,
interrupting - ANSWER-Impulsivity
What ADHD symptoms are fidgeting, leaving ones seat, running, climbing, trouble
playing quietly - ANSWER-Hyperactivity
What ADHD symptom is common in childhood - ANSWER-hyperactivity
Effects of maturation ADHD- young kids may experience - ANSWER-DD, bx less
mature than peers
Effects of maturation ADHD- teens - ANSWER-poor academic performance, trouble
driving, trouble in social situations, risky sexual bx, SUD
Effects of maturation ADHD- Adult - ANSWER-Issues with EF, attention, working
memory, that cause issues with day to day fnx and performance at work and in
relationships
Dx criteria for ADHD
How many s/s
How long
How many settings - ANSWER-Pattern of 6 s/s that interfere with fnx/development,
6 months or longer
Present in 2 or more settings
How to combat anorexia with stimulant use - ANSWER-Take medication with breakfast
to decrease anorexia or associated weight loss
When patients with ADHD have co morbid MH issues, what do you tx first - ANSWER-
ADHD (stimulants first line)
Treating ADHD s/s first will give a clearer picture of the comorbidities
Work up for starting stimulant - ANSWER-ECG- if personal/first relative fmly hx
Check bp/wgt/hgt
, What co morbidity should the PMHNP assess for before starting a stimulant -
ANSWER-BPD, CNS stimulant can cause psychotic or manic s/s in pt's with no prior hx
or may exacerbate bx disturbances and thought d/o in pt's with pre-exisiting psychosis
Stimulants can exacerbate what comorbid dx - ANSWER-anxiety and SUD
Increased irritability or insomnia can be tx with what - ANSWER-low dose non stim
Abrupt withdrawal from stimulants can cause what - ANSWER-irritability and rebound
s/s
What to do with tx for ADHD if the pt is argumentative or oppositional - ANSWER-
Combo therapy with stim and non stim
Recommendations for parent training in behavior management for ADHD as a first-line
Intervention
- What do the parents learn - ANSWER-Recommended for child under 6
- Parents learn positive communication and reinforcement, structure, and discipline
- Teaches kids to better control their own bx = improved fnx at school, home, and
relationships
What setting is ODD most common - ANSWER-Home setting with peers or adults that
the pt knows
What is ODD proceeds - ANSWER-Conduct disorder and ADHD, more common in boys
anxiety and depression. Increased risk of SI
Dx criteria for ODD - ANSWER--4 or more symptoms have occurred during an
interaction with one or more individuals not including siblings within the last 6 months
-Kids under 5 bx occur on most days for at least 6 months
ODD s/s - ANSWER-Angry/irritable mood: Loss of temper, easily annoyed, anger and
resentment
Argumentative/Defiant: Argues with authority figures, actively defiant or refusing to
follow rules or requests from authority figure, deliberately annoys others, blames others
for their mistakes/misbx
Vindictiveness: spiteful or vindictive at least twice within the past 6 months.
Hallmark of ODD - ANSWER-Persistent angry irritable mood and defiant bx with
vindictiveness
Conduct disorder exhibits lack of - ANSWER-empathy, aggression and impulsivity
What ADHD symptoms are lack of attention to detail, careless mistakes, not listening,
losing things diverting attention, forgetfulness - ANSWER-Selective attention
What ADHD symptoms are poor problem solving, trouble completing a task,
disorganization, trouble sustaining mental effort - ANSWER-Lack of sustained attention
What ADHD symptoms are excessive talking, blurting things out, not waiting ones turn,
interrupting - ANSWER-Impulsivity
What ADHD symptoms are fidgeting, leaving ones seat, running, climbing, trouble
playing quietly - ANSWER-Hyperactivity
What ADHD symptom is common in childhood - ANSWER-hyperactivity
Effects of maturation ADHD- young kids may experience - ANSWER-DD, bx less
mature than peers
Effects of maturation ADHD- teens - ANSWER-poor academic performance, trouble
driving, trouble in social situations, risky sexual bx, SUD
Effects of maturation ADHD- Adult - ANSWER-Issues with EF, attention, working
memory, that cause issues with day to day fnx and performance at work and in
relationships
Dx criteria for ADHD
How many s/s
How long
How many settings - ANSWER-Pattern of 6 s/s that interfere with fnx/development,
6 months or longer
Present in 2 or more settings
How to combat anorexia with stimulant use - ANSWER-Take medication with breakfast
to decrease anorexia or associated weight loss
When patients with ADHD have co morbid MH issues, what do you tx first - ANSWER-
ADHD (stimulants first line)
Treating ADHD s/s first will give a clearer picture of the comorbidities
Work up for starting stimulant - ANSWER-ECG- if personal/first relative fmly hx
Check bp/wgt/hgt
, What co morbidity should the PMHNP assess for before starting a stimulant -
ANSWER-BPD, CNS stimulant can cause psychotic or manic s/s in pt's with no prior hx
or may exacerbate bx disturbances and thought d/o in pt's with pre-exisiting psychosis
Stimulants can exacerbate what comorbid dx - ANSWER-anxiety and SUD
Increased irritability or insomnia can be tx with what - ANSWER-low dose non stim
Abrupt withdrawal from stimulants can cause what - ANSWER-irritability and rebound
s/s
What to do with tx for ADHD if the pt is argumentative or oppositional - ANSWER-
Combo therapy with stim and non stim
Recommendations for parent training in behavior management for ADHD as a first-line
Intervention
- What do the parents learn - ANSWER-Recommended for child under 6
- Parents learn positive communication and reinforcement, structure, and discipline
- Teaches kids to better control their own bx = improved fnx at school, home, and
relationships
What setting is ODD most common - ANSWER-Home setting with peers or adults that
the pt knows
What is ODD proceeds - ANSWER-Conduct disorder and ADHD, more common in boys
anxiety and depression. Increased risk of SI
Dx criteria for ODD - ANSWER--4 or more symptoms have occurred during an
interaction with one or more individuals not including siblings within the last 6 months
-Kids under 5 bx occur on most days for at least 6 months
ODD s/s - ANSWER-Angry/irritable mood: Loss of temper, easily annoyed, anger and
resentment
Argumentative/Defiant: Argues with authority figures, actively defiant or refusing to
follow rules or requests from authority figure, deliberately annoys others, blames others
for their mistakes/misbx
Vindictiveness: spiteful or vindictive at least twice within the past 6 months.
Hallmark of ODD - ANSWER-Persistent angry irritable mood and defiant bx with
vindictiveness
Conduct disorder exhibits lack of - ANSWER-empathy, aggression and impulsivity
