NURS6660 Walden University Psychology Final Exam With Answers (75 Solved Questions)

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1Question 1In which demographic is depression twice as prevalent in girls as compared to boys?A.PreschoolersB. School agedC. AdolescentsD.All childrenQuestion 2Andrew is a 14-year-old male who is being managed for bipolar I disorder. He was started onlithium 6 weeks ago and has achieved a serum level of 1.1 mEq/L according to his most recentblood work. Andrew says he does not feel any different, but both his parents and teachersreport improvement in his mood. He has been more stable, is getting along better with friendsand siblings, and is even more interested in his schoolwork. The PMHNP plans to maintainAndrew on this medication and knows that he will need which of the following ongoinglaboratory assessments?A.Complete blood count, thyroid function tests, and serum calciumB. Liver function tests, complete blood count, and 12-lead electrocardiogramC. White blood cell differential, fasting glucose, and fasting lipid profileD. Comprehensive metabolic panel, complete blood count, and thyroid function testsQuestion 3Confidentiality is a complex topic in the world of child and adolescent psychiatry. The last 40 to50 years have been characterized by increased attention to this issue and the publication ofvarious ethical codes and practice position statements by professional organizations. Which ofthe following is not a true statement with respect to confidentiality of the child or adolescentclient?A.The PMHNP should not be concerned with consent for disclosure when child abuse ormaltreatment has occurred.

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2B. In 1979, the American Psychiatric Association (APA) stated that children 12 years of ageor older can give consent for disclosure.C. The American Academy of Child and Adolescent Psychiatry (AACAP) Code of Ethics

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3states that consent is not required for disclosure.D. Regardless of code or position statement by any organization, the best approach is whenthe child and PMHNP agree on disclosure.Question 4Debi is a 15-year-old girl who is currently being treated for depression. Her parents have beenvery proactive and involved in her care, and Debi has achieved remission 2 months afterbeginning treatment with a combination of pharmacotherapy and cognitive behavioral therapy.While counseling Debi’s parents about important issues in management, the PMHNP advisesthat:A.There is a > 50% likelihood that Debi’s younger sibling will develop depressivesymptomsB. The mean length of major depressive episode in adolescents is 4 monthsC. 20 to 40% of adolescents who have major depressive disorder will develop bipolar Iwithin 5 yearsD.Adolescent-onset depression typically needs long-term pharmacologic management toprevent relapseQuestion 5The therapeutic outcomes for children with disorders of written expression are most favorablewhen they are characterized by:Concomitant pharmacotherapy with a psychostimulant to promote attention and focusMultimodal therapy to include group interaction with peer-to-peer feedback on writingsamplesA variety of tutors who will offer a variety of writing techniques, composition strategies,and critiquesIntensive, continuous administration of individually tailored, one-on-one expressive andcreative writing therapy

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4Question 6When considering a diagnosis of developmental coordination disorder, the PMHNP knows thatthe diagnosis may be associated with:A.Above-average scores on performance subtests of standardized intelligence testingB. Below-average scores on verbal subtests of standardized intelligence testingC. Soft neurologic signs on physical examination such as slight reflex abnormalitiesD.Physical findings consistent with neuromuscular disease such as muscular dystrophyQuestion 7Caylee is a 5-year-old girl who is referred for evaluation by child protective services. She wasrecently removed from her biological family and placed in foster care, as her homeenvironment was reportedly unsafe due to conditions of extreme neglect. Her foster motherreports that Caylee is very quiet and withdrawn and always appears sad and disinterested in hersurroundings; however, she becomes very irritable when anything unexpected or unplannedoccurs. The foster mother became very concerned when it appeared that Caylee washallucinating. The PMHNP considers that:A. Caylee is at high risk for suicide and precautions should be takenB. The hallucinations are consistent with brief psychotic disorder or schizophreniaC. The history and reported symptoms are typical of depressive disorder in young childrenD.This is a common situation when prepubertal children are removed from the biologicalparents regardless of how dysfunctional they are

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5Question 8Children with gender dysphoria typically have higher rates of all the following except:A.DepressionB. Impulse control disordersC. Anxiety disordersD. Eating disorderQuestion 9Eileen is a 23-month-old girl who is being evaluated for autism spectrum disorder because herpediatrician is concerned about the presence of developmental red flags. She has just a fewwords of speech and has not put together any meaningful two-word phrases. While taking ahistory from Eileen’s mother the PMHNP learns that for approximately the last 2 months Eileenhas been seen eating paint chips that are peeling off the baseboard and window sills in the familyhome; when she sees one she puts it in her mouth. This is a concern because they live in an oldfarmhouse and there may be lead-based paint in some of the paint layers. The PMHNP considersthat which of the following is not consistent with a diagnosis of pica?A.A diagnosis of autism spectrum disorderB. Symptoms < 6 months durationC. The pattern of eatingD. Lack of potential consequencesQuestion 10The current scholarly consensus is that the etiology of bulimia nervosa is multifactorial toinclude biological, sociocultural, family, cognitive-behavioral, and psychodynamic factors.

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6When considering the etiology of bulimia nervosa, the PMHNP understands that:

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7A.Family factors contributing to bulimia nervosa include emotional restraint, tight parentalcontrol 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 bulimianervosa.D. Cultural influences are much less implicit in the development of bulimia nervosa ascompared to anorexia nervosa.Question 11Standardized instructional programs used in the management of reading disorders include all thefollowing except:A.The Orton Gillingham and Direct Instructional System for Teaching and RemediationB. Science Research Associates, Inc. Basic Reading ProgramC. Bridge Reading ProgramD. Woodcock-Johnson Psychoeducational BatteryQuestion 12Which of the following symptom clusters is most likely in a 16-year-old male with majordepressive disorder?A.Disturbance of mood, loss of interest, and mood-congruent hallucinationsB. Irritability, persistent abdominal complaints, and insomniaC. Decreased concentration, social withdrawal, and substance abuseD.Pervasive anhedonia, hopelessness, and severe psychomotor retardation

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8Question 13The PMHNP is working with rural primary care providers to increase awareness of mental healthdisorders in infancy and early childhood. The program includes a session on screening forfeeding disorders in infants. If an infant is either observed by the provider or reported by theparent to frequently suck the tongue rhythmically or appear to strain with his or her back archedand then swallow, the examiner should consider the possibility of:A. Gastroesophageal reflux diseaseB. Failure to thriveC. Iron deficiencyD.Inadequate emotional attachmentQuestion 14An astute pediatrician has referred Kyle, a 5-month-old infant, for evaluation of ruminationdisorder. His mother was concerned because he seemed to “want” to regurgitate every time heate and would even seem to “put his hand down his throat” in order to stimulate regurgitation.Kyle had a thorough evaluation and according to the pediatrician did not have gastroesophagealreflux or hiatal hernia. The mother-infant relationship appeared to be healthy and, viaassessment, the PMHNP could not identify any clear emotional issues. The primary treatmentstrategy for Kyle will likely focus on:A.Aversive therapies, e.g., squirting lemon juice into Kyle’s mouth when he ruminatesB. Medication therapies to include trials of first-line agents such as metoclopramine,cimetidine, or haloperidolC. Psychotherapy for the parentsD. Habit-reversal therapies

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9Question 15The literature indicates that boys whose fathers died before the age of 13 are at a greaterrisk for the development of depression as compared to controls. This is consistent withwhich general theory of depression etiology?A.Molecular-geneticB. BiologicC. PsychosocialD.Stress-diathesisQuestion 16Katelyn is a16-year-old girl who presents for therapy with her mother and father. Katelyn wasborn with male genitalia but has felt like a female “all of her life.” She says she knew somethingwas different as far back as she can remember. She always wanted to wear her mother’s clothesand makeup and play with other girls. Katelyn started dressing and openly identifying as a girlwhen 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 doesnot understand the relationship. The PMHNP explains that Katelyn:A.Is responding to the male hormonal surges of puberty and will ultimately identify withher physiologic genderB. Does not have a clear sense of gender identity and may be a candidate for reparativetherapy to correct her gender identity issuesC. Is a transgender female who identifies as lesbianD.Is a heterosexual male with transvestic disorderQuestion 17

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10All of the following are proposed etiologies of pica except:A. Nutritional deficiencies

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11B. Parental neglectC. Compensation for oral needsD.Autism spectrum disorderQuestion 18Christine is a 9-year-old female who presents for care after having been placed in the local fostercare system. She has been in and out of foster care for the last 4 years after her parents werekilled in an automobile accident. Christine has been placed in a variety of homes and residentialcare facilities. The PMHNP recognizes that Christine is at high risk for:A.Dissociative disordersB. Post-traumatic stress disorderC. Impulse-control disorderD. Attachment disorderQuestion 19While the core features of schizophrenia are essentially the same in children as they are in adults,the presentation or characterization is sometimes very different given developmental issues.Unlike adults with schizophrenia, children with schizophrenia do not have:A. Classic positive symptomsB. Poverty of speech contentC. Social rejectionD.Delusions of persecution

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12Question 20The PMHNP is working with a couple who has been trying for years to conceive and is nowready 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 differentrace or ethnicity, adopting an older child rather than an infant, and adopting a child who iscurrently in foster care vs. one who lives in an orphanage. While counseling this couple, thePMHNP advises them that:A.Younger children adopted from foster care settings have the best outcomesB. Children adopted from abuse and neglect situations have better psychological adaptationthan those adopted as newbornsC. Transracial adoptions have demonstrated greater disruptions as compared to same-raceadoptionsD. Adoptions into families as an only child are more successful than those into families withbiological childrenQuestion 21Mel is a 15-year-old male with a complex psychiatric assessment. He has a long history of moodinstability, behavior problems, and trouble with schoolwork. He was an extremely active childwho, 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 attentiondeficit hyperactivity disorder (ADHD). The most successful approach to his management islikely to begin with:A. Pharmacotherapy for ADHDB. Pharmacotherapy for bipolar IC. Parental training and behavioral interventions for ADHDD.Family-focused psychoeducational (FFT-A) for bipolar I

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13Question 22Bruce and Debbie have made an appointment for a psychiatric consultation for what amounts topsychiatric genetic counseling. Bruce is 31 years old and Debbie is 28 years old. They have beenmarried for 3 years and want to have children. Debbie is worried because she has a diagnosis ofschizophrenia. 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 hasbeen very open with Bruce, and they are both well informed about the disease. Debbie is an onlychild and her father had schizophrenia that was not well controlled. He committed suicide whenshe 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 Bruceand Debbie includes which of the following pieces of information?A. Schizophrenia is up to eight times more prevalent in first-degree relatives as compared tothe general population.B. Schizophrenia has been isolated to chromosome number 5 and antenatal testing isavailable to predict genetic predisposition of the fetus.C. Debbie’s age of onset is more highly correlated with incidence in her offspring ascompared to early-onset schizophrenia.D.Environment is at least as important as genetics with respect to expression ofschizophrenic symptoms.Question 23The PMHNP is working with a pediatrician colleague on a journal article to increase awarenessand improve diagnostic strategies for early-onset bipolar disorder. Based upon a review of thelongitudinal research on this disorder, the literature review of this article should include all thefollowing except:A.Recovery rates are lower when bipolar disorder has an early-childhood onsetB. Early-onset bipolar disorder presents a greater likelihood of mixed states and rapidcycling as compared to adolescent and adult onsetC. Higher socioeconomic status and lifetime psychosis are predictors of more rapid cyclingin early-onset bipolar disorderD. There is a more frequent conversion from bipolar II to bipolar I in childhood ascompared to adults

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