NURS 6660N FINAL EXAM 2020: WALDEN UNIVERSITY

Question: 1

The PMHNP is evaluating a 15-year-old male patient who has been referred by his courtappointed guardian. He has been in foster care for the last 6 years and maintained a steady pattern of low-level behavior problems such as skipping school and ignoring curfew. He is not openly defiant and has always been described as a ―loner.‖ He just does not follow most rules. During the mental status examination, the PMHNP notes that his expressions are sometimes inconsistent with the topic of conversation, and he does not seem to be able to transition effectively among levels of emotion. This represents an abnormality in:
A. Mood
B. Affect
C. Thought process and content
D. Judgment and insight

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Question: 2

A variety of diagnostic instruments are available to assist the PMHNP with comprehensive data collection. Which of the following tools is considered an ―interviewer-based‖ tool designed as a guide to clinicians designed to help clarify answers to questions?

A. The Children’s Interview for Psychiatric Symptoms (ChIPS)
B. The Diagnostic Interview for Children and Adolescents (DICA)
C. The Pictorial Instrument for Children and Adolescents (PICA-III-R)
D. The Child and Adolescent Psychiatric Assessment (CAPA)

3 61 Kevin is a 15-year-old male who presents for court-ordered psychiatric assessment. Kevin comes to his first appointment with both of his parents. He is sitting in the chair with his arms crossed and responds with ―yes‖ and ―no‖ answers to direct questions; otherwise, he volunteers no information. The parents are clearly upset and indicate they just ―don’t know what to do with him anymore.‖ The most appropriate action for the PMHNP would be to:

A. Ask the parents to step out and interview Kevin privately
B. Have Kevin complete the standardized-testing assessment
C. Schedule session two after reviewing court documentation
D. Arrange for three sessions with a family therapist then reevaluate Kevin

4 the PMHNP observes separation from and reunion with the parent as part the mental status exam of a 25-month-old toddler. Extremes of emotion during separation or reunion are most consistent with:

A. Normal developmental progression at that age
B. Cognitive dysfunction
C. Neurologic dysfunction
D. Problems with the parent-child relationship

5 the PMHNP is performing an emergency assessment on Renee, a 9-year-old girl who was initially brought to the attention of social services by her maternal grandmother. Renee is reluctant to talk about herself or her home life. The physical examination that accompanied this emergency assessment revealed a variety of ecchymoses in various stages of healing, and the examiner was suspicious that there was a history of sexual abuse. Renee is quiet and passive during the interview, but is rather aggressive when playing with dolls. While considering the need for removal from the home, the PMHNP knows that all the following are risk factors for predictors of further abuse and maltreatment except:

A. Neglect as the form of maltreatment
B. Parental conflict
C. Number of previous episodes
D. Gender of the victim

Question 22
6Harmony is a 4-year-old female who has been through several evaluations for behavioral
abnormalities that have become increasingly disruptive, and the family is concerned for the safety of both Harmony and her 2-year-old brother. Comprehensive assessment of Harmony includes neuropsychiatric testing. The PMHNP documents the presence of neurological hard signs. These suggest:

A. Brain lesions
B. Early-onset schizophrenia
C. Low intelligence
D. Learning disability

Question 20
7During the mental status exam of Oliver, a 4-year-old child, the PMHNP appreciates that he
appears to be having transient visual and auditory hallucinations. The PMHNP knows that the best approach to this finding is to consider that:

A. This is most consistent with early-onset schizophrenia
B. An organic brain disorder should be ruled out
C. These are normal findings in very young children
D. Comprehensive psychiatric assessment is indicated

8Question 54
The PMHNP has been retained by the local school board to provide comprehensive counseling
and guidance following an episode of tragic school violence. A 9th grader, acting alone, brought a gun into the school, fatally shooting a teacher and injuring four other teachers and students before he was subdued. In an effort to promote best healthy practices after this traumatic event, the school board is asking for advice on how to best manage the students. The PMHNP knows that the immediate priority must be: