Jack is a 3-year-old boy who is being evaluated for developmental delay. The mental status
examination is significant for an inability to stack two
... [Show More] blocks or draw a circle. The PMHNP
also appreciates the inability to attend to any task for more than a few seconds. These
findings indicate an abnormality in:
A
.
Social relatedness
B
.
Thought process and
content
C
.
Motor behavior
D
.
Judgment and insight
C
During the mental status exam of Oliver, a 4-year-old child, the PMHNP appreciates that he
appears to be having transient visual and auditory hallucinations. The PMHNP knows that the
best approach to this finding is to consider that:
A
.
This is most consistent with early-onset
schizophrenia
B
.
An organic brain disorder should be ruled out
C
.
These are normal findings in very young
children
D
.
Comprehensive psychiatric assessment is
indicated
B
Jason is a 17-month-old male who is referred for evaluation of an unusually high level of
irritability. His mother says he cries “all the time,” and sometimes he just cannot be
comforted; Jason’s pediatrician felt that the complaint warranted an evaluation by child
psychiatry. Comprehensive assessment of Jason’s irritability should include all the following
except:
A
.
A comprehensive medical
assessment
B
.
Standardized developmental
measures
C
.
Assessment without the parents
present
D
.
Observation of Jason during play
D
Which of the following is the most common anxiety disorder of childhood?
A
.
Generalized anxiety
disorder
B
.
Separation anxiety
disorder
C
.
Social anxiety disorder
D
.
Obsessive-compulsive
disorder
A
When evaluating treatment strategies for a 14-year-old patient with obsessive-compulsive
disorder (OCD), the PMHNP considers that evidence-based data from the Pediatric OCD
Treatment Study (POTS) suggests that best outcomes are achieved with cognitive behavioral
therapy (CBT) and:
A
.
Clomipramine
(Anafranil)
B
.
Sertraline (Zoloft)
C
.
Aripiprazole (Abilify)
D
.
Lithium (Eskalith)
B
Which of the following behaviors is least suspicious for an adolescent who is being bullied at
school?
A
.
A significant change in study habits in which the patient is demonstrating higher
academic achievement to the exclusion of a social life
B
.
A persistent, sustained increase in the number and variety of physical complaints that
have no obvious organic cause
C
.
Evidence that the patient has started smoking cigarettes and seems to spend more time
alone than usual
D
.
Migration to a completely different peer group and a change in appearance and behavior
to aggressively mimic the new group
A
Michael is a 13-year-old boy who was involved in a traumatic automobile accident in which
his mother, the driver, was killed. After suffering multiple injuries and weeks in the hospital,
Michael was discharged to home with physical therapy. He ultimately made a complete
physical recovery but is unable to get into a car. Just the thought of riding in a car produces
profound physiologic symptoms. He has been diagnosed with post-traumatic stress disorder
(PTSD). His avoidance of riding in a car is conceptualized as:
A
.
Panic attacks
B
.
Operant
conditioning
C
.
Hyper arousal
D
.
Flashbacks
C
Which of the following is a true statement with respect to developmental testing in infants?
A
.
None of the available validated developmental tools are reliable in infants under 6
months of age.
B
.
An infant’s score on developmental assessment is a reliable predictor of future
intelligence quotient.
C
.
Infant assessments are helpful in detecting mental retardation and developmental
disorders.
D
.
Assessment in older infants focuses on sensorimotor and social responses.
C
Wendy is a 6-year-old female being evaluated by the PMHNP following a suicide attempt. The
police were called when a neighbor saw Wendy jump out of the open window of her firstfloor apartment. She was unhurt, but when the neighbor asked why she jumped out she said
she wanted to kill herself. Which coincident finding would warrant an inpatient psychiatric
admission for Wendy?
A
.
This was not the first episode.
B
.
The caretaker is incapable of arranging follow-up.
C
.
One or both of the biological parents has a history of
suicide attempts.
D
.
Wendy was left with a babysitter when the incident
occurred.
B
Caleb is a 10-year-old boy who is referred for assessment because he is not following any of
the rules of discipline at home. His parents report that they have had three separate nannies
resign in the last 4 months because Caleb is unmanageable. This is a long-standing problem,
going back to daycare even before kindergarten. The PMHNP knows that when conducting
her initial interview of Caleb she should:
A
.
Anticipate that he can tolerate up to a 45-
minute session
B
.
Consider that symbolic play with dolls will be
informative
C
.
Interview him alone before involving the parents
D
.
Be clear that he is there because of problem
behavior
D
Treatment of abused children is multimodal and long term. The single most important aspect
of treatment is:
A
.
Establishing a safe place for the
child
B
.
Exposure related to the feared
experience
C
.
Psychoeducation
D
.
Cognitive-behavioral interventions
A
Psychiatric assessment of the adolescent patient is different in several ways from
assessment of younger children. While trying to establish a therapeutic environment with an
adolescent who is openly hostile, one of the most important things the PMHNP can do is to:
A
.
Be more liberal in terms of limit setting and tolerating hostility in order to facilitate honest
communication
B
.
Ensure the patient that under no circumstances will anything said be repeated to the
parents
C
.
Allow silences to last as long as necessary until the patient is inclined to offer any verbal
input
D
.
Communicate to the patient that his or her perspective is valued and will not be judged
or critiqued
A [Show Less]