NURS 6660: Psychiatric Mental Health Nurse Practitioner - Child and Adolescent

Conventional Aantipsychotics AareAnotAfirst-lineAinterventions AinAearly-
onsetAschizophreniaAdueAtoAtheAriskAofAdystonicAreactions.AHowever,AwhenAchildrenAareAnotA
responsiveAtoAfirst-
Aline Atherapy Awith Aatypical Aantipsychotics, Awhich A ofAthe Afollowing Ais Athe A most Aappropriate Ac

onventional Achoice?


Selected D.
AAnswer: ChlorpromaziA
ne



TheAtherapeuticAoutcomes AforAchildrenAwithAdisorders AofAwrittenAexpressionAareAmostAf
avorableAwhenAtheyAareAcharacterized Aby:


Selected Intensive,Acontinuous Aadministration AofAindividuallyAtailored,Aone-on-
AAnswer:
oneAexpressiveAandAcreativeAwritingAtherapy




LindaAisAaA5-year-
oldAgirlAwhoAhasApersistent Apica;AsheAwasAfinallyAreferredAforAcareAwhenAherAkindergartenAte
acherAbecameAalarmedAbyAherAeatingAofApotentiallyAtoxicAnonfoodAsubstances.ALinda’sAmoth
erAadmitsAduringAtheAhistoryAthatALindaAhasAbeenAdoingAthisAforAyears,AbutAthoughtAitAwasAno
tAaAbigAdealAsinceALindaAdidn’tAeatAanythingAdangerous.
Linda’sAmotherAmustAworkAtwoAjobsAandAessentiallyAdidAnotAbotherAtoApursueALinda’s Au
nusualAsymptomAbecauseAitAdidn’tAseemAunsafe.AWhileAdiscussingAmanagement Astrategi
esAwithALinda’sAmother,AtheAPMHNPAcounselsAthatAtheAmostArapidlyAsuccessful Atreatme
ntAstrategyAappearsAtoAbe:


Selected A.
AAnswer: Aversion

, therapy



RuminationAisAaAfeedingAdisorderAmostAcommonlyAseenAinAinfants,AbutAitAcanAoccurAatAanyApo
intAinAtheAlifespan.ACharacteristicAfindingsAinAinfantsAinclude:


Selected C.
AAnswer: FailureAtoAthri
ve



KatelynAisAa16-year-
oldAgirlAwhoApresentsAforAtherapyAwithAherAmotherAandAfather.AKatelynAwasAbornAwithAmaleA
genitaliaAbutAhasAfeltAlikeAaAfemaleA“allAofAherAlife.”ASheAsaysAsheAknewAsomethingA wasAdiffe
rentA asA farA backA asA sheA canA remember.A SheA alwaysA wantedA toA wearAherAmother’s AclothesA
andAmakeupAandAplayAwithAotherAgirls.AKatelynAstartedAdressingAandAopenlyAidentifyingAasAaA
girlAwhenAsheAwasA13Ayears Aold,AandAherAparentsAareAtryingAtoAbeAsupportiveAbutAtheyAareAst
ruggling.AMostArecentlyAKatelynAhasAdevelopedAanAintimateApartnerArelationshipAwithAJennif
er,AaA15-year-oldAgirlAwhoAwasAgender-
assignedAfemaleAatAbirthAandAidentifies AasAaAfemale.AKatelyn’sAfatherAdoesAnotAunderstandAt
heArelationship.
TheA PMHNPA explainsAthatA Katelyn:


Selected C.
AAnswer: IsAaAtransgenderAfemaleAwhoAidentifiesAasAle
sbian



AllAtheAfollowingAareAtrueAwithArespectAtoAmakingAaAdiagnosisAofAmajorAdepressiveAdisorderAi
nAchildrenAexcept:


Selected C.
AAnswer: ThereAmustAbeAsomaticAorApsychomotorAcom
plaints.



DonnaAisAaA16-year-
oldAtransgenderAfemaleAwhoAhasAbeenAthroughAextensiveAindividualA andAfamilyAcounseling
Aand Ais Aready Ato Astart Ahormone Atherapy Awith Aestrogen,A progesterone, Aand Atestosterone-

blockingAagents.AWhenAcounselingAherAspecificallyAaboutAtheArisks,Abenefits,AandArequired
Amonitoring AofAhormonal Atherapy, Athe APMHNP Aadvises ADonna Athat:




Selected C.
AAnswer: SterilityAisAaAprobableAconsequence A
ofAhormoneAtherapy

,TheAleadingAcauseAofAdeathAinAyouthsAlivingAinAjuvenileAresidential AfacilitiesAis:


Selected A.
AAnswer: SuicidA
e



TheAPMHNPAisAworkingAwithAaApediatricianAcolleagueAonAaAjournalAarticleAtoAincreaseAaware
nessAandAimproveAdiagnosticAstrategies AforAearly-
onsetAbipolarAdisorder.ABasedAuponA aAreviewAofAtheAlongitudinalAresearchAonAthisAdisorder,A
theAliteratureAreviewAofAthisAarticleAshouldAincludeAallAtheAfollowingAexcept:


Selected C.
AAnswer: HigherAsocioeconomicAstatusAandAlifetimeApsychosisAareApredictors AofAmor
eArapidAcyclingAinAearly-onsetAbipolarAdisorder



TianaAisAaA10-year-
oldAgirlAwhoAisAbeingAreferredAforAevaluationAbecauseAherAschoolAperformanceAisAapprecia
blyAbelowAwhatAisAexpectedAatAherAage.AHistoricallyAsheAhasAbeenAaAveryAhappyAchild,Alikes
Aschool, Aand Alooks Aforward Ato Agoing. AHowever, Aover Athe Alast Aseveral Amonths Aher Ateacher Ar

eportsAthatAsheAisAmuchAslowerAthanAherApeersAinAreading,AandAsheAappearsAtoAbeAupsetAan
dAwithdrawnAwhenAaskedAtoAreadAinAclass.ATheAPMHNPAwouldAexpectAadditional AreportAfro
mAtheAteacherAtoAincludeAallAtheAfollowingAexcept:


Selected A.
AAnswer: InabilityAtoAcopyAcorrectlyAfromAaApri
ntedAtext



WhichAofAtheAfollowingAstatements AbestAcharacterizedAtheAtreatmentAcourseAandAprogr
essionAofAbulimiaAnervosa?


Selected A.
AAnswer: CognitiveAbehavioral AtherapyAisAconsideredAtheAbenchmark,Afirst-
Aline Atreatment.




KellyAisAaA14-year-
oldAfemaleAwhoAhasAfinallyAbeenAreferredAforAmanagementAofAanorexiaAnervosa.ASheAwasA
diagnosedAalmostA1AyearAagoAwithAtheAfood-
restrictingAsubtype,AbutAattempts AtoAgetAherAintoApsychiatricAcareAwereAunsuccessful. ASheA
continues AtoAbeAresistantAbutAherAcaloricAintakeAisAnowA<A400AdailyAandAsheAfinallyAappear
sAtoAbeAunableAtoAsustainAtheAsupraphysiologicAlevelsAofAexerciseAthatAsheAhasAmaintained
AtoAtryAandA“keepAherA weightAdown.”ASheAisA5’2”AtallAandAweighsA82 Albs.,Awhich AisAapproxi

matelyA75%Aof
idealAbodyAweightAforAherAheight.AHerAvitalAsignsAareAstableAandAsurprisinglyAthereAareAnoApr
ofoundAlaboratoryAorAECGAabnormalities. AWhenAcounselingAKellyAandAherAparents AaboutAtheA
recommendedAcourseAofAtreatment,AtheAPMHNPAadvises AthatAKellyAwillArequire:

, Selected B.
AAnswer: Hospitalization AforAcontrolled
Aweight Again




InA whichA demographicAisA depressionA twiceA asA prevalentA inA girlsA asA comparedA toA boys?


Selected C.
AAnswer: AdolescenA
ts



DebbieAisAaA10-year-
oldAfemaleAwhoAhasAbeenAreferredAtoAremediationAtherapyAforAherAreadingAdisorder.AW
hileAdesigningAherAtreatment Aprogram,AtheAPMHNPAknowsAthatAtheAmostAcurrentAstrate
giesAareAcharacterizedAby:


Selected C.
AAnswer: FocusingAtheAchild’sAattentionAtoAtheAconnections AbetweenAspeechAsoun
dsAandAspelling



WhichAofAtheAfollowingAsymptomAclustersAisAmostAlikelyAinAaA16-year-
oldAmaleAwithAmajorAdepressiveAdisorder?


Selected D.
AAnswer: PervasiveAanhedonia,Ahopelessness, AandAsevereApsychomotor
A retardation




TheAetiologyAofAchildhoodAdepressionAisAmultifactorial AandAmayAincludeAbiological Afactors.AWhi
chAofAtheAfollowingAisAaAtrueAstatementAwithArespectAtoAhormonalAstudiesAinAdepressedAchildren
?


Selected A.
AAnswer: Prepubertal AchildrenAhavingAaAdepressiveAepisodeAsecreteAsignificantlyAmo
reAgrowthAhormoneAduringAsleepAthanAnondepressedAchildren.



JaredAisAaA6-year-
oldAboyAwhoAcomesAtoAtheAPMHNPAforAanAevaluationAwithAhisAfather.ATheAfatherAreportsAth
atAheAisAworriedAaboutAJaredAbecauseAheAhasAhadAproblems AfittingAinAatAschoolAeverAsinceA
heAstartedAkindergarten.AHeAdoesAnotAhaveAanyAfriends AatAschoolAandAdoesAnotAseemAtoAkn
owAhowAtoAplayAwithAothers.ADadAreportsAthatAJaredAhasAneverAbeenA“veryAtalkative”AandA
sometimes Aswitches AfromAoneAtopicAtoAanotherAwithoutAanyAreason.AWhenAconsideringAear
ly-onsetAschizophrenia,AtheAPMHNPArecognizes AthatAwhichAofAthe