NURS 6660N FINAL EXAM 1 TO 5– QUESTION AND
ANSWERS (COMBINED PACKAGE)
375 QUESTIONS & ANSWERS
NURS 6660 FINAL EXAM 1 TO 5
VERIFIED EXAM FILE
2024UPDATE
NURS 6660N FINAL EXAM 1 – QUESTION AND
ANSWERS (75/75 POINTS)
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Therapeutic Outcomes for Children with Disorders of Written Expression - Prof. PURDUL, Exams of Nursing
The most favorable therapeutic outcomes for children with disorders of written expression. It highlights the importance of concomitant pharmacotherapy with a psychostimulant, multimodal therapy including group interaction and peer-to-peer feedback, a variety of tutors offering different writing techniques and strategies, and intensive, continuous one-on-one expressive and creative writing therapy. Insights into the management of these disorders, emphasizing the need for a comprehensive and tailored approach to support the development of written expression skills in affected children.
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NURS 6660N FINAL EXAM 1 TO 5– QUESTION AND
ANSWERS (COMBINED PACKAGE)
375 QUESTIONS & ANSWERS
NURS 6660 FINAL EXAM 1 TO 5
VERIFIED EXAM FILE
2024 UPDATE
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.
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
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
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 11
Standardized instructional programs used in the management of reading disorders include all the following except: A. The Orton Gillingham and Direct Instructional System for Teaching and Remediation B. Science Research Associates, Inc. Basic Reading Program C. Bridge Reading Program D. Woodcock-Johnson Psychoeducational Battery
Question 12
Which of the following symptom clusters is most likely in a 16-year-old male with major depressive disorder? A. Disturbance of mood, loss of interest, and mood-congruent hallucinations B. Irritability, persistent abdominal complaints, and insomnia C. Decreased concentration, social withdrawal, and substance abuse D. Pervasive anhedonia, hopelessness, and severe psychomotor retardation
Question 15
The literature indicates that boys whose fathers died before the age of 13 are at a greater risk for the development of depression as compared to controls. This is consistent with which general theory of depression etiology? A. Molecular-genetic B. Biologic C. Psychosocial D. Stress-diathesis
Question 16
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: A. (^) Is responding to the male hormonal surges of puberty and will ultimately identify with her physiologic gender B. (^) Does not have a clear sense of gender identity and may be a candidate for reparative therapy to correct her gender identity issues C. (^) Is a transgender female who identifies as lesbian D. (^) Is a heterosexual male with transvestic disorder
Question 17
All of the following are proposed etiologies of pica except: A. Nutritional deficiencies
Question 20
The PMHNP is working with a couple who has been trying for years to conceive and is now ready to pursue adoption as an option. They are considering all possibilities; private vs. government-mediated adoption, adopting from another country, adopting a child of a different race or ethnicity, adopting an older child rather than an infant, and adopting a child who is currently in foster care vs. one who lives in an orphanage. While counseling this couple, the PMHNP advises them that: A. Younger children adopted from foster care settings have the best outcomes B. Children adopted from abuse and neglect situations have better psychological adaptation than those adopted as newborns C. Transracial adoptions have demonstrated greater disruptions as compared to same-race adoptions D. Adoptions into families as an only child are more successful than those into families with biological children
Question 21
Mel is a 15-year-old male with a complex psychiatric assessment. He has a long history of mood instability, behavior problems, and trouble with schoolwork. He was an extremely active child who, at one time, was put on medication for hyperactivity. After a comprehensive evaluation, the PMHP recognizes that he meets diagnostic criteria for both bipolar I disorder and attention deficit hyperactivity disorder (ADHD). The most successful approach to his management is likely to begin with: A. Pharmacotherapy for ADHD B. Pharmacotherapy for bipolar I C. Parental training and behavioral interventions for ADHD D. Family-focused psychoeducational (FFT-A) for bipolar I
Question 22
Bruce and Debbie have made an appointment for a psychiatric consultation for what amounts to psychiatric genetic counseling. Bruce is 31 years old and Debbie is 28 years old. They have been married for 3 years and want to have children. Debbie is worried because she has a diagnosis of schizophrenia. Her symptoms first became evident when she was in her junior year of college; fortunately, she knew about the disease due to family history and sought care quickly. She has been very open with Bruce, and they are both well informed about the disease. Debbie is an only child and her father had schizophrenia that was not well controlled. He committed suicide when she was 15 years old. Debbie takes olanzapine and feels well overall. She has a part-time job, functions well, but is concerned about the genetic nature of her disease. Counseling for Bruce and Debbie includes which of the following pieces of information? A. (^) Schizophrenia is up to eight times more prevalent in first-degree relatives as compared to the general population. B. (^) Schizophrenia has been isolated to chromosome number 5 and antenatal testing is available to predict genetic predisposition of the fetus. C. (^) Debbie’s age of onset is more highly correlated with incidence in her offspring as compared to early-onset schizophrenia. D. (^) Environment is at least as important as genetics with respect to expression of schizophrenic symptoms.
Question 23
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: A. Recovery rates are lower when bipolar disorder has an early-childhood onset B. Early-onset bipolar disorder presents a greater likelihood of mixed states and rapid cycling as compared to adolescent and adult onset C. Higher socioeconomic status and lifetime psychosis are predictors of more rapid cycling in early-onset bipolar disorder D. There is a more frequent conversion from bipolar II to bipolar I in childhood as compared to adults
Question 26
While counseling the parents of Joshua, a 9-year-old patient with developmental coordination disorder, the PMHNP advised that the treatment will include: A. Modified physical education B. Cognitive behavioral interventions C. Group sports participation D. Computer-generated developmental exercises
Question 27
Maria is an 11-year-old girl who has been diagnosed with early-onset schizophrenia. In writing up her case report for publication, the PMHNP makes it a point to highlight which of the following historical features that are often seen in schizophrenia of middle childhood? A. Onset of hallucinations and delusions before age 6 B. Symptoms easily confused with attention deficit hyperactivity disorder C. Delayed motor milestones and language acquisition D. High expressed emotion characterized by overly critical family response
Question 28
Ramon is a 12-year-old male who was started on fluoxetine, 40 mg daily, for major depressive disorder 6 weeks ago. At his 2-week follow-up, he was feeling well with no adverse drug effects, and his dose was elevated from 20 to 40 mg. Today he presents for a routine follow-up visit. He reports that he has been “all wound up” and is frequently agitated. He cannot sleep well and has trouble focusing at school. His friends say that he gets upset quickly, and they are starting to avoid him. The most appropriate approach is to:
A. Taper the fluoxetine off and see if these symptoms improve
Question 31
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? A. (^) Prepubertal children having a depressive episode secrete significantly more growth hormone during sleep than nondepressed children. B. (^) Polysomnography demonstrates significantly reduced rapid eye movement (REM) during depressive episodes. C. (^) Thyroid stimulating hormone (TSH) levels are elevated > 50% above the upper limits of normal in the majority of children with depression. D. (^) Magnetic resonance imaging (MRI) studies in depressed adolescents reveals low ventricular volume and increased frontal lobe volume.
Question 32
There is a high incidence of overlap among children with bipolar disorder, attention deficit hyperactivity disorder, conduct disorder, and anxiety disorders. Which of the following manic symptoms of bipolar disorder are most closely correlated to conduct disorder? A. Insomnia and irritability B. Physical restlessness and poor judgment C. Hallucinations and overeating D. Hyper sexuality and inattention
Question 33
Linda is a 5-year-old girl who has persistent pica; she was finally referred for care when her eating of potentially toxic nonfood substances alarmed her kindergarten teacher. 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 did not eat anything dangerous. Linda’s mother must work two Jobs and essentially did not bother to pursue Linda’s unusual symptom because it did not seem unsafe. While discussing management strategies with Linda’s mother, the PMHNP counsels that the most rapidly successful treatment strategy appears to be:
A. Aversion therapy B. Play therapy C. Environmental control D. Cognitive behavioral therapy
Question 34
The leading cause of death in youths living in juvenile residential facilities is: A. Suicide B. Accident C. Homicide D. Illness
Question 35
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: A. An Individual Education Program (IEP) provided by the public school system B. Continuous practice with flash cards, workbooks, and computer games C. Focusing the child’s attention to the connections between speech sounds and spelling D. Direct practice in spelling and sentence writing and review of grammatical rules