(verified) NURS 660 FINAL EXAM Questions and Answers.

(verified) NURS 660 FINAL EXAM Questions and Answers Conventional antipsychotics are not first-line interventions in early-onset schizophrenia due to the risk of dystonic reactions. However, when children are not responsive to first- line therapy with atypical antipsychotics, which of the following is the most appropriate conventional choice? Selected Answer: D. Chlorpromazi ne The therapeutic outcomes for children with disorders of written expression are most favorable when they are characterized by: Selected Answer: Intensive, continuous administration of individually tailored, one-on-one expressive and creative writing therapy Linda is a 5-year-old girl who has persistent pica; she was finally referred for care when her kindergarten teacher became alarmed by her eating of potentially toxic nonfood substances. Linda’s mother admits during the history that Linda has been doing this for years, but thought it was not a big deal since Linda didn’t eat anything dangerous. Linda’s mother must work two jobs and essentially did not bother to pursue Linda’s unusual symptom because it didn’t seem unsafe. While discussing management strategies with Linda’s mother, the PMHNP counsels that the most rapidly successful treatment strategy appears to be: Selected Answer: A. Aversion therapy Rumination is a feeding disorder most commonly seen in infants, but it can occur at any point in the lifespan. Characteristic findings in infants include: Selected Answer: C. Failure to thrive Katelyn is a16-year-old girl who presents for therapy with her mother and father. Katelyn was born with male genitalia but has felt like a female “all of her life.” She says she knew something was different as far back as she can remember. She always wanted to wear her mother’s clothes and makeup and play with other girls. Katelyn started dressing and openly identifying as a girl when she was 13 years old, and her parents are trying to be supportive but they are struggling. Most recently Katelyn has developed an intimate partner relationship with Jennifer, a 15-year-old girl who was gender-assigned female at birth and identifies as a female. Katelyn’s father does not understand the relationship. The PMHNP explains that Katelyn: Selected Answer: C. Is a transgender female who identifies as lesbian All the following are true with respect to making a diagnosis of major depressive disorder in children except: Selected Answer: C. There must be somatic or psychomotor complaints. Donna is a 16-year-old transgender female who has been through extensive individual and family counseling and is ready to start hormone therapy with estrogen, progesterone, and testosterone-blocking agents. When counseling her specifically about the risks, benefits, and required monitoring of hormonal therapy, the PMHNP advises Donna that: Selected Answer: C. Sterility is a probable consequence of hormone therapy The leading cause of death in youths living in juvenile residential facilities is: Selected Answer: A. Suicid e The PMHNP is working with a pediatrician colleague on a journal article to increase awareness and improve diagnostic strategies for early-onset bipolar disorder. Based upon a review of the longitudinal research on this disorder, the literature review of this article should include all the following except: Selected Answer: C. Higher socioeconomic status and lifetime psychosis are predictors of more rapid cycling in early-onset bipolar disorder Tiana is a 10-year-old girl who is being referred for evaluation because her school performance is appreciably below what is expected at her age. Historically she has been a very happy child, likes school, and looks forward to going. However, over the last several months her teacher reports that she is much slower than her peers in reading, and she appears to be upset and withdrawn when asked to read in class. The PMHNP would expect additional report from the teacher to include all the following except: Selected Answer: A. Inability to copy correctly from a printed text Which of the following statements best characterized the treatment course and progression of bulimia nervosa? Selected Answer: A. Cognitive behavioral therapy is considered the benchmark, first- line treatment. Kelly is a 14-year-old female who has finally been referred for management of anorexia nervosa. She was diagnosed almost 1 year ago with the food-restricting subtype, but attempts to get her into psychiatric care were unsuccessful. She continues to be resistant but her caloric intake is now 400 daily and she finally appears to be unable to sustain the supraphysiologic levels of exercise that she has maintained to try and “keep her weight down.” She is 5’2” tall and weighs 82 lbs., which is approximately 75% of ideal body weight for her height. Her vital signs are stable and surprisingly there are no profound laboratory or ECG abnormalities. When counseling Kelly and her parents about the recommended course of treatment, the PMHNP advises that Kelly will require: Selected Answer: B. Hospitalization for controlled weight gain In which demographic is depression twice as prevalent in girls as compared to boys? Selected Answer: C. Adolescen ts Debbie is a 10-year-old female who has been referred to remediation therapy for her reading disorder. While designing her treatment program, the PMHNP knows that the most current strategies are characterized by: Selected Answer: C. Focusing the child’s attention to the connections between speech sounds and spelling Which of the following symptom clusters is most likely in a 16-year-old male with major depressive disorder? Selected Answer: D. Pervasive anhedonia, hopelessness, and severe psychomotor retardation The etiology of childhood depression is multifactorial and may include biological factors. Which of the following is a true statement with respect to hormonal studies in depressed children? Selected Answer: A. Prepubertal children having a depressive episode secrete significantly more growth hormone during sleep than nondepressed children. Jared is a 6-year-old boy who comes to the PMHNP for an evaluation with his father. The father reports that he is worried about Jared because he has had problems fitting in at school ever since he started kindergarten. He does not have any friends at school and does not seem to know how to play with others. Dad reports that Jared has never been “very talkative” and sometimes switches from one topic to another without any reason. When considering early-onset schizophrenia, the PMHNP recognizes that which of the following must be present? Selected Answer: B. Deteriorating function over the last several months Learning disorders affect at least 5% of all school-aged children in the United States. Since 1975, Public Law 94-142 mandates that all states provide free, appropriate services to all children. Among the various types of learning disorders, the PMHNP knows that the overwhelming majority are: Selected Answer: A. Reading disorders