Question 1
Children with gender dysphoria typically have higher rates of all the following except:
A. Depression
B. Impulse control disorders
C. Anxiety disorders
D. Eating disorder
Question 2
The current scholarly consensus is that the etiology of bulimia nervosa is multifactorial to
include biological, sociocultural, family, cognitive-behavioral, and psychodynamic factors.
When considering the etiology of bulimia nervosa, the PMHNP understands that:
A. Family factors contributing to bulimia nervosa include emotional restraint, tight parental
control of behavior, and avoidance of conflict.
B. Lowered serotonin activity is seen in the brains of patients with bulimia nervosa.
C. There is a disproportionate incidence in childhood sexual abuse in patients with bulimia
nervosa.
D. Cultural influences are much less implicit in the development of bulimia nervosa as compared
to anorexia nervosa.
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.
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 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:
A. Concomitant pharmacotherapy with a psychostimulant to promote attention and focus
B. Multimodal therapy to include group interaction with peer-to-peer feedback on writing
samples.
C. A variety of tutors who will offer a variety of writing techniques, composition strategies,
and critiques
D. Intensive, continuous administration of individually tailored, one-on-one expressive and
creative writing therapy
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
Question 8
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 9
Eileen is a 23-month-old girl who is being evaluated for autism spectrum disorder because her
pediatrician is concerned about the presence of developmental red flags. She has just a few
words of speech and has not put together any meaningful two-word phrases. While taking a
history from Eileen’s mother the PMHNP learns that for approximately the last 2 months Eileen
has been seen eating paint chips that are peeling off the baseboard and window sills in the family
home; when she sees one she puts it in her mouth. This is a concern because they live in an old
farmhouse and there may be lead-based paint in some of the paint layers. The PMHNP considers
that which of the following is not consistent with a diagnosis of pica?
A. A diagnosis of autism spectrum disorder
B. Symptoms < 6 months duration
C. The pattern of eating
D. Lack of potential consequences