NURS 6660 MIDTERM EXAM 2

Which of the following statements is true with respect to children who present to care acutely due to violent, enraged behavior? A. Under no circumstances should the PMHNP approach this patient. B. Prepubertal children typically require medication as they are too young to respond to conversation. C. Children who have a history of repeated, self-limited, severe tantrums require at least a 72-hour admission. D. If the child appears to be calming down in the emergency area, the clinician may ask the child for his version of events. CQuestion 2 Phillip is a 5-year-old boy who is in care after being referred for failure to speak at school. He has been in kindergarten for 5 months, and initially his teacher thought he was just shy, so she did not focus on him. However, it has become increasingly apparent that he flat out will not speak at school. Phillip’s parents are adamant that there is not any problem at home and that Phillip talks with them and his older sister routinely. Further assessment reveals that he has always been extremely shy and that he doesn’t like it when people make a fuss over him. The PMHNP suspects that Phillip has selective mutism, which is closely related to: A. A history of sexual abuse B. Fetal alcohol syndrome C. Early onset schizophrenia D. Social anxiety disorder D Question 3 Jason is a 17-month-old male who is referred for evaluation of an unusually high level of irritability. His mother says he cries ―all the time,‖ and sometimes he just cannot be comforted; Jason’s pediatrician felt that the complaint warranted an evaluation by child psychiatry. Comprehensive assessment of Jason’s irritability should include all the following except: A. A comprehensive medical assessment B. Standardized developmental measures C. Assessment without the parents present D. Observation of Jason during playD Question 4 Treatment of abused children is multimodal and long term. The single most important aspect of treatment is: A. Establishing a safe place for the child B. Exposure related to the feared experience C. Psychoeducation D. Cognitive-behavioral interventions D Question 5 Having child and adolescent patients rate their feelings and moods on a scale of 1–10 is most effective in which age group? A. 18-months to 3 years B. 3 to 5 years C. 5 to 11 years D. 12 to 17 years C Question 6The PMHNP is evaluating his data for the assessment of Eric, a 23-month-old male who was referred because he is having nightmares to the extent that most nights he is waking up family members with his crying and screaming. In addition to the clinical interview with the parents and patient, developmental assessment, and standardized tools, the assessment should include: A. Review of a video recording of a nightmare event and Eric’s immediate response B. Age-appropriate interview, e.g., ―If you had three wishes, what would they be?‖ C. Observation of Eric in a playroom where he is unaware that he is being watched D. Partially open-ended questions that provide some focus but allow expression of feeling A Question 7 What is the primary diagnostic difference between obsessive-compulsive disorders in children as compared to adults? A. Age of onset B. Response to treatment C. Recognition that the thoughts or behaviors are irrational D. The thoughts or behaviors occupy > 1 hour daily A Question 8 Psychiatric assessment of children and adolescents is best achieved by a combination of tools and techniques best suited to the child’s age and developmental stage. When interviewing a 10-year-old, the PMHNP may have the best success by having the patient: A. Talk with the examiner via dolls B. Respond to open-ended questionsC. Draw family members and peers D. Complete an MMPI