NR606 Week 6 Exam V1 | NR606 Diagnosis
& Management in Psychiatric-Mental
Health II Practicum | Q&A with Rationale
(NR606 Week 6 Exam) | Chamberlain
University
1. When assessing a 7-year-old child suspected of having Attention-Deficit/Hyperactivity
Disorder (ADHD), which of the following criteria must be met according to the DSM-5?
A. Symptoms must be present in only one setting, such as home or school.
B. Symptoms must have been present before the age of 12.
C. Symptoms must be present for at least 12 consecutive months.
D. The child must exhibit symptoms of conduct disorder simultaneously.
Answer: B
Rationale: The DSM-5 requires that several inattentive or hyperactive-impulsive
symptoms be present prior to age 12. Furthermore, these symptoms must be manifest in
two or more settings to support the diagnosis. This ensures that the behaviors are not
simply a reaction to a specific environment or teacher.
2. An elderly patient presents with a sudden onset of confusion, altered consciousness, and
visual hallucinations that fluctuate throughout the day. Which diagnosis should the PMHNP
prioritize?
A. Alzheimer’s Disease
,B. Delirium
C. Major Depressive Disorder
D. Vascular Dementia
Answer: B
Rationale: Delirium is characterized by an acute onset of cognitive impairment and
fluctuating levels of consciousness, often triggered by an underlying medical condition or
toxicity. Unlike dementia, which is progressive and stable, delirium represents a medical
emergency that requires immediate intervention. The presence of visual hallucinations and
waxing/waning awareness are hallmark signs of this condition.
3. A patient taking Clozapine (Clozaril) for treatment-resistant schizophrenia reports a sore
throat and fever. What is the most appropriate immediate action for the PMHNP?
A. Prescribe a broad-spectrum antibiotic.
B. Order an immediate Absolute Neutrophil Count (ANC).
C. Discontinue the medication and switch to Risperidone.
D. Advise the patient to increase fluid intake and rest.
Answer: B
Rationale: Clozapine is associated with a risk of severe neutropenia, also known as
agranulocytosis, which can be life-threatening. A sore throat and fever are clinical
indicators of a potential infection due to low white blood cell counts. The PMHNP must
, immediately verify the ANC to determine if the medication should be halted according to
REMS guidelines.
4. Which pharmacological agent is considered first-line treatment for an adolescent
diagnosed with Moderate Depression when psychotherapy alone is insufficient?
A. Fluoxetine
B. Amitriptyline
C. Venlafaxine
D. Phenelzine
Answer: A
Rationale: Fluoxetine is the only SSRI with robust FDA approval for the treatment of
depression in children and adolescents. It has a longer half-life, which may be beneficial in
younger populations who might occasionally miss a dose. While other SSRIs are used off-
label, Fluoxetine remains the primary evidence-based choice for this demographic.
5. A 10-year-old child is being evaluated for disruptive behavior. The child frequently loses
their temper, argues with authority figures, and actively defies rules, but does not physically
hurt others or animals. Which diagnosis is most likely?
A. Oppositional Defiant Disorder
B. Conduct Disorder
C. Intermittent Explosive Disorder
& Management in Psychiatric-Mental
Health II Practicum | Q&A with Rationale
(NR606 Week 6 Exam) | Chamberlain
University
1. When assessing a 7-year-old child suspected of having Attention-Deficit/Hyperactivity
Disorder (ADHD), which of the following criteria must be met according to the DSM-5?
A. Symptoms must be present in only one setting, such as home or school.
B. Symptoms must have been present before the age of 12.
C. Symptoms must be present for at least 12 consecutive months.
D. The child must exhibit symptoms of conduct disorder simultaneously.
Answer: B
Rationale: The DSM-5 requires that several inattentive or hyperactive-impulsive
symptoms be present prior to age 12. Furthermore, these symptoms must be manifest in
two or more settings to support the diagnosis. This ensures that the behaviors are not
simply a reaction to a specific environment or teacher.
2. An elderly patient presents with a sudden onset of confusion, altered consciousness, and
visual hallucinations that fluctuate throughout the day. Which diagnosis should the PMHNP
prioritize?
A. Alzheimer’s Disease
,B. Delirium
C. Major Depressive Disorder
D. Vascular Dementia
Answer: B
Rationale: Delirium is characterized by an acute onset of cognitive impairment and
fluctuating levels of consciousness, often triggered by an underlying medical condition or
toxicity. Unlike dementia, which is progressive and stable, delirium represents a medical
emergency that requires immediate intervention. The presence of visual hallucinations and
waxing/waning awareness are hallmark signs of this condition.
3. A patient taking Clozapine (Clozaril) for treatment-resistant schizophrenia reports a sore
throat and fever. What is the most appropriate immediate action for the PMHNP?
A. Prescribe a broad-spectrum antibiotic.
B. Order an immediate Absolute Neutrophil Count (ANC).
C. Discontinue the medication and switch to Risperidone.
D. Advise the patient to increase fluid intake and rest.
Answer: B
Rationale: Clozapine is associated with a risk of severe neutropenia, also known as
agranulocytosis, which can be life-threatening. A sore throat and fever are clinical
indicators of a potential infection due to low white blood cell counts. The PMHNP must
, immediately verify the ANC to determine if the medication should be halted according to
REMS guidelines.
4. Which pharmacological agent is considered first-line treatment for an adolescent
diagnosed with Moderate Depression when psychotherapy alone is insufficient?
A. Fluoxetine
B. Amitriptyline
C. Venlafaxine
D. Phenelzine
Answer: A
Rationale: Fluoxetine is the only SSRI with robust FDA approval for the treatment of
depression in children and adolescents. It has a longer half-life, which may be beneficial in
younger populations who might occasionally miss a dose. While other SSRIs are used off-
label, Fluoxetine remains the primary evidence-based choice for this demographic.
5. A 10-year-old child is being evaluated for disruptive behavior. The child frequently loses
their temper, argues with authority figures, and actively defies rules, but does not physically
hurt others or animals. Which diagnosis is most likely?
A. Oppositional Defiant Disorder
B. Conduct Disorder
C. Intermittent Explosive Disorder
