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NURS 6660N FINAL EXAM 1 – QUESTION AND
ANSWERS (75/75 POINTS)
Question 1
In which demographic is depression twice as prevalent in girls as compared to boys?
A. Preschoolers
B. School aged
C. Adolescents
D. All children
Question 2
Andrew is a 14-year-old male who is being managed for bipolar I disorder. He was started on
lithium 6 weeks ago and has achieved a serum level of 1.1 mEq/L according to his most recent
blood work. Andrew says he does not feel any different, but both his parents and teachers
report improvement in his mood. He has been more stable, is getting along better with friends
and siblings, and is even more interested in his schoolwork. The PMHNP plans to maintain
Andrew on this medication and knows that he will need which of the following ongoing
laboratory assessments?
A. Complete blood count, thyroid function tests, and serum calcium
B. Liver function tests, complete blood count, and 12-lead electrocardiogram
C. White blood cell differential, fasting glucose, and fasting lipid profile
D. Comprehensive metabolic panel, complete blood count, and thyroid function tests
Question 3
Confidentiality is a complex topic in the world of child and adolescent psychiatry. The last 40 to
50 years have been characterized by increased attention to this issue and the publication of
various ethical codes and practice position statements by professional organizations. Which of
the following is not a true statement with respect to confidentiality of the child or adolescent
client?
A. The PMHNP should not be concerned with consent for disclosure when child abuse or
maltreatment has occurred.
1
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WALDEN UNIVERSITY NURS 6660 FINAL EXAM
B. In 1979, the American Psychiatric Association (APA) stated that children 12 years of age
or older can give consent for disclosure.
C. The American Academy of Child and Adolescent Psychiatry (AACAP) Code of Ethics
2
, WALDEN UNIVERSITY NURS 6660 FINAL EXAM
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states that consent is not required for disclosure.
D. Regardless of code or position statement by any organization, the best approach is when
the child and PMHNP agree on disclosure.
Question 4
Debi is a 15-year-old girl who is currently being treated for depression. Her parents have been
very proactive and involved in her care, and Debi has achieved remission 2 months after
beginning treatment with a combination of pharmacotherapy and cognitive behavioral therapy.
While counseling Debi’s parents about important issues in management, the PMHNP advises
that:
A.
There is a > 50% likelihood that Debi’s younger sibling will develop depressive
symptoms
B.
The mean length of major depressive episode in adolescents is 4 months
C.
20 to 40% of adolescents who have major depressive disorder will develop bipolar I
within 5 years
D.
Adolescent-onset depression typically needs long-term pharmacologic management to
prevent relapse
Question 5
The therapeutic outcomes for children with disorders of written expression are most favorable
when they are characterized by:
Concomitant pharmacotherapy with a psychostimulant to promote attention and focus
Multimodal therapy to include group interaction with peer-to-peer feedback on writing
samples
A variety of tutors who will offer a variety of writing techniques, composition strategies,
and critiques
Intensive, continuous administration of individually tailored, one-on-one expressive and
creative writing therapy
3
, WALDEN UNIVERSITY NURS 6660 FINAL EXAM
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Question 6
When considering a diagnosis of developmental coordination disorder, the PMHNP knows that
the diagnosis may be associated with:
A. Above-average scores on performance subtests of standardized intelligence testing
B. Below-average scores on verbal subtests of standardized intelligence testing
C. Soft neurologic signs on physical examination such as slight reflex abnormalities
D. Physical findings consistent with neuromuscular disease such as muscular dystrophy
Question 7
Caylee is a 5-year-old girl who is referred for evaluation by child protective services. She was
recently removed from her biological family and placed in foster care, as her home
environment was reportedly unsafe due to conditions of extreme neglect. Her foster mother
reports that Caylee is very quiet and withdrawn and always appears sad and disinterested in her
surroundings; however, she becomes very irritable when anything unexpected or unplanned
occurs. The foster mother became very concerned when it appeared that Caylee was
hallucinating. The PMHNP considers that:
A. Caylee is at high risk for suicide and precautions should be taken
B. The hallucinations are consistent with brief psychotic disorder or schizophrenia
C. The history and reported symptoms are typical of depressive disorder in young children
D. This is a common situation when prepubertal children are removed from the biological
parents regardless of how dysfunctional they are
4
NURS 6660N FINAL EXAM 1 – QUESTION AND
ANSWERS (75/75 POINTS)
Question 1
In which demographic is depression twice as prevalent in girls as compared to boys?
A. Preschoolers
B. School aged
C. Adolescents
D. All children
Question 2
Andrew is a 14-year-old male who is being managed for bipolar I disorder. He was started on
lithium 6 weeks ago and has achieved a serum level of 1.1 mEq/L according to his most recent
blood work. Andrew says he does not feel any different, but both his parents and teachers
report improvement in his mood. He has been more stable, is getting along better with friends
and siblings, and is even more interested in his schoolwork. The PMHNP plans to maintain
Andrew on this medication and knows that he will need which of the following ongoing
laboratory assessments?
A. Complete blood count, thyroid function tests, and serum calcium
B. Liver function tests, complete blood count, and 12-lead electrocardiogram
C. White blood cell differential, fasting glucose, and fasting lipid profile
D. Comprehensive metabolic panel, complete blood count, and thyroid function tests
Question 3
Confidentiality is a complex topic in the world of child and adolescent psychiatry. The last 40 to
50 years have been characterized by increased attention to this issue and the publication of
various ethical codes and practice position statements by professional organizations. Which of
the following is not a true statement with respect to confidentiality of the child or adolescent
client?
A. The PMHNP should not be concerned with consent for disclosure when child abuse or
maltreatment has occurred.
1
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
WALDEN UNIVERSITY NURS 6660 FINAL EXAM
B. In 1979, the American Psychiatric Association (APA) stated that children 12 years of age
or older can give consent for disclosure.
C. The American Academy of Child and Adolescent Psychiatry (AACAP) Code of Ethics
2
, WALDEN UNIVERSITY NURS 6660 FINAL EXAM
Stuvia.com - The Marketplace to Buy and Sell your Study Material
states that consent is not required for disclosure.
D. Regardless of code or position statement by any organization, the best approach is when
the child and PMHNP agree on disclosure.
Question 4
Debi is a 15-year-old girl who is currently being treated for depression. Her parents have been
very proactive and involved in her care, and Debi has achieved remission 2 months after
beginning treatment with a combination of pharmacotherapy and cognitive behavioral therapy.
While counseling Debi’s parents about important issues in management, the PMHNP advises
that:
A.
There is a > 50% likelihood that Debi’s younger sibling will develop depressive
symptoms
B.
The mean length of major depressive episode in adolescents is 4 months
C.
20 to 40% of adolescents who have major depressive disorder will develop bipolar I
within 5 years
D.
Adolescent-onset depression typically needs long-term pharmacologic management to
prevent relapse
Question 5
The therapeutic outcomes for children with disorders of written expression are most favorable
when they are characterized by:
Concomitant pharmacotherapy with a psychostimulant to promote attention and focus
Multimodal therapy to include group interaction with peer-to-peer feedback on writing
samples
A variety of tutors who will offer a variety of writing techniques, composition strategies,
and critiques
Intensive, continuous administration of individually tailored, one-on-one expressive and
creative writing therapy
3
, WALDEN UNIVERSITY NURS 6660 FINAL EXAM
Stuvia.com - The Marketplace to Buy and Sell your Study Material
Question 6
When considering a diagnosis of developmental coordination disorder, the PMHNP knows that
the diagnosis may be associated with:
A. Above-average scores on performance subtests of standardized intelligence testing
B. Below-average scores on verbal subtests of standardized intelligence testing
C. Soft neurologic signs on physical examination such as slight reflex abnormalities
D. Physical findings consistent with neuromuscular disease such as muscular dystrophy
Question 7
Caylee is a 5-year-old girl who is referred for evaluation by child protective services. She was
recently removed from her biological family and placed in foster care, as her home
environment was reportedly unsafe due to conditions of extreme neglect. Her foster mother
reports that Caylee is very quiet and withdrawn and always appears sad and disinterested in her
surroundings; however, she becomes very irritable when anything unexpected or unplanned
occurs. The foster mother became very concerned when it appeared that Caylee was
hallucinating. The PMHNP considers that:
A. Caylee is at high risk for suicide and precautions should be taken
B. The hallucinations are consistent with brief psychotic disorder or schizophrenia
C. The history and reported symptoms are typical of depressive disorder in young children
D. This is a common situation when prepubertal children are removed from the biological
parents regardless of how dysfunctional they are
4
