NRNP 6665 Final Exam Test Questions, NR 603 Week 7 COMPREHENSIVE FINAL PREP: VERIFIED QUESTIONS & EXPERT ANSWERS ULTIMATE EXAM PASS PACK – LATEST 2026/2027 UPDATES CERTIFIED TESTBANK: REAL QUESTIONS, ANSWERS, AND EXPLANATIONS

The PMHNP is assessing an infant with rhythmic tongue sucking, back arching, and swallowing. The examiner should consider: A. Gastroesophageal reflux disease B. Failure to thrive C. Iron deficiency D. Inadequate emotional attachment Correct Answer: A. Gastroesophageal reflux disease Rationale: Back arching (Sandifer-like behavior) with feeding is strongly associated with gastroesophageal reflux disease (GERD), especially in infants. Primary treatment for infant rumination disorder (no medical or attachment issues identified): A. Aversive therapies (e.g., lemon juice) B. Medication therapy (metoclopramide, cimetidine, haloperidol) C. Psychotherapy for parents D. Habit-reversal therapies Correct Answer: D. Habit-reversal therapies Rationale: Rumination disorder is best treated with behavioral interventions such as habit reversal and diaphragmatic breathing, not medication or aversive techniques. Father death before age 13 increasing depression risk supports: A. Molecular-genetic theory B. Biologic theory C. Psychosocial theory D. Stress-diathesis theory Correct Answer: D. Stress-diathesis theory Rationale: Depression risk emerging from environmental stress interacting with vulnerability reflects the stress-diathesis model. Transgender adolescent with female gender identity and female partner is best described as: A. Will revert to male identity after puberty B. Candidate for reparative therapy C. Transgender female who identifies as lesbian D. Heterosexual male with transvestic disorder Correct Answer: C. Transgender female who identifies as lesbian Rationale: Gender identity is female; sexual orientation is toward females → lesbian transgender female. All are etiologies of pica EXCEPT: A. Nutritional deficiencies B. Parental neglect C. Compensation for oral needs D. Autism spectrum disorder Correct Answer: C. Compensation for oral needs Rationale: Pica is linked to nutritional deficiencies, neglect, and neurodevelopmental disorders—not psychodynamic “oral compensation” as a recognized etiology. Unlike adults, children with schizophrenia typically do NOT have: A. Classic positive symptoms B. Poverty of speech content C. Social rejection D. Delusions of persecution Correct Answer: A. Classic positive symptoms Rationale: Positive symptoms are often less clear or less organized in early childhood schizophrenia. Adoption counseling: best outcome is associated with: A. Younger children from foster care B. Abuse/neglect adoptees do better than newborns C. Transracial adoption causes greater disruption D. Only-child adoptions are superior Correct Answer: A. Younger children adopted from foster care settings Rationale: Younger age at adoption is the strongest predictor of better psychosocial outcomes. Child with bipolar I + ADHD: best initial management approach: A. ADHD pharmacotherapy B. Bipolar I pharmacotherapy C. Behavioral interventions for ADHD D. Family-focused therapy for bipolar Correct Answer: B. Pharmacotherapy for bipolar I Rationale: Mood stabilization is prioritized before treating ADHD to avoid worsening mania. Genetic counseling for schizophrenia: A. First-degree relatives have up to 8× risk B. Gene isolated to chromosome 5 C. Age of onset predicts offspring risk most D. Environment equals genetics importance Correct Answer: A. First-degree relatives have significantly increased risk Rationale: Schizophrenia is polygenic; risk is increased in first-degree relatives (not single-gene or prenatal testable). Early-onset bipolar disorder literature EXCEPT: A. Lower recovery rates B. More mixed/rapid cycling C. SES and psychosis predict rapid cycling D. More conversion from bipolar II to I Correct Answer: C. SES and lifetime psychosis predict rapid cycling Rationale: This is not a well-established or consistent predictor in research. Clozapine vs olanzapine in early schizophrenia: superiority in: A. Alleviating negative symptoms B. Extrapyramidal effects C. Sustained remission D. Hallucination reduction Correct Answer: A. Alleviating negative symptoms Rationale: Clozapine is particularly effective for negative symptoms and treatment-resistant cases. Early-onset schizophrenia evaluation EXCEPT (missing option issue): A. [missing option] B. Hallucinations more predictive than delusions C. Symptoms likely due to developmental immaturity D. Family history considered but diagnosis unlikely Correct Answer: A Rationale: Option A is incomplete; thus it is the intended “EXCEPT.” Developmentally normal imagination and hallucination-like play are more consistent with normal development. Treatment for developmental coordination disorder: A. Modified physical education B. CBT C. Group sports participation D. Computer exercises Correct Answer: A. Modified physical education Rationale: Structured motor skill training and adapted physical education are first-line. Feature common in childhood-onset schizophrenia: A. Hallucinations before age 6 B. Confusion with ADHD C. Delayed motor/language milestones D. High expressed emotion Correct Answer: B. Symptoms easily confused with ADHD Rationale: Early schizophrenia often mimics ADHD and developmental disorders. Fluoxetine 40 mg → agitation, insomnia, irritability: A. Stop fluoxetine B. Add mood stabilizer C. Increase dose D. Continue current dose Correct Answer: A. Taper/stop fluoxetine Rationale: Symptoms suggest antidepressant-induced activation or mania. Cyclothymic disorder duration requirement: A. 1 year B. 2 years C. No conduct disorder features D. No suicidal ideation Correct Answer: A. 1 year (children/adolescents) Rationale: DSM-5 requires ≥1 year in children/adolescents. Bulimia nervosa treatment: A. CBT first-line B. Antidepressants ineffective C. Hospitalization always required D. Psychodynamic therapy best Correct Answer: A. CBT is first-line Rationale: CBT is the gold standard treatment. True hormonal finding in depressed children: A. Increased growth hormone during sleep B. Reduced REM sleep C. TSH elevated 50% in most cases D. MRI shows low ventricular volume Correct Answer: A. Increased growth hormone during sleep Rationale: Some studies show altered GH secretion; other options are inaccurate. Manic symptoms most associated with conduct disorder: A. Insomnia and irritability B. Physical restlessness and poor judgment C. Hallucinations and overeating D. Hypersexuality and inattention Correct Answer: B. Physical restlessness and poor judgment Rationale: These overlap strongly with behavioral dyscontrol in conduct disorder.