Walden NURS6660 Midterm Exam Latest

Jack is a 3-year-old boy who is being evaluated for developmental delay. The mental status examination is significant for an inability to stack two blocks or draw a circle. The PMHNP also appreciates the inability to attend to any task for more than a few seconds. These findings indicate an abnormality in:

A.Social relatedness

B.Thought process andcontent

C.Motor behavior

D.Judgment and insight

During 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

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 play

Which of the following is the most common anxiety disorder of childhood?

A.Generalized anxiety disorder

B.Separation anxiety disorder

C.Social anxiety disorder

D.Obsessive-compulsive disorder

When evaluating treatment strategies for a 14-year-old patient with obsessive-compulsive disorder (OCD), the PMHNP considers that evidence-based data from the Pediatric OCD Treatment Study (POTS) suggests that best outcomes are achieved with cognitive behavioural therapy (CBT) and:

A. Clomipramine (Anafranil)

B. Sertraline (Zoloft)

C. Aripiprazole (Abilify)

D. Lithium (Eskalith)

Which of the following behaviors is least suspicious for an adolescent who is being bullied at school?

1. A significant change in study habits in which the patient is demonstrating higher academic achievement to the exclusion of a social life

B.A persistent, sustained increase in the number and variety of physical complaints thathave no obvious organic cause

C.Evidence that the patient has started smoking cigarettes and seems to spend more timealone than usual

D.Migration to a completely different peer group and a change in appearance and behaviorto aggressively mimic the new group

Michael is a 13-year-old boy who was involved in a traumatic automobile accident in whichhis mother, the driver, was killed. After suffering multiple injuries and weeks in the hospital,Michael was discharged to home with physical therapy. He ultimately made a completephysical recovery but is unable to get into a car. Just the thought of riding in a car producesprofound physiologic symptoms. He has been diagnosed with post-traumatic stress disorder(PTSD). His avoidance of riding in a car is conceptualized as:

A.Panic attacks

B.Operantconditioning

C.Hyper arousal

D.Flashbacks

Which of the following is a true statement with respect to developmental testing in infants?

A.None of the available validated developmental tools are reliable in infants under 6months of age.

B.An infant’s score on developmental assessment is a reliable predictor of futureintelligence quotient.

C.Infant assessments are helpful in detecting mental retardation and developmentaldisorders.

D.Assessment in older infants focuses on sensorimotor and social responses.

Wendy is a 6-year-old female being evaluated by the PMHNP following a suicide attempt. Thepolice were called when a neighbor saw Wendy jump out of the open window of her firstfloorapartment. She was unhurt, but when the neighbor asked why she jumped out she saidshe wanted to kill herself. Which coincident finding would warrant an inpatient psychiatricadmission for Wendy?

A.This was not the first episode.

B.The caretaker is incapable of arranging follow-up.

C.One or both of the biological parents has a history ofsuicide attempts.

D.Wendy was left with a babysitter when the incidentoccurred.

Caleb is a 10-year-old boy who is referred for assessment because he is not following any ofthe rules of discipline at home. His parents report that they have had three separate nanniesresign in the last 4 months because Caleb is unmanageable. This is a long-standing problem,going back to daycare even before kindergarten. The PMHNP knows that when conductingher initial interview of Caleb she should:

A.Anticipate that he can tolerate up to a 45-minute session

B.Consider that symbolic play with dolls will beinformative

C.Interview him alone before involving the parents

D.Be clear that he is there because of problembehavior

Treatment of abused children is multimodal and long term. The single most important aspectof treatment is:

A.Establishing a safe place for thechild

B.Exposure related to the fearedexperience

C.Psychoeducation

D.Cognitive-behavioral interventions

A Psychiatric assessment of the adolescent patient is different in several ways fromassessment of younger children. While trying to establish a therapeutic environment with anadolescent who is openly hostile, one of the most important things the PMHNP can do is to:

A.Be more liberal in terms of limit setting and tolerating hostility in order to facilitate honestcommunication

B.Ensure the patient that under no circumstances will anything said be repeated to theparents

C.Allow silences to last as long as necessary until the patient is inclined to offer any verbalinput

D.Communicate to the patient that his or her perspective is valued and will not be judgedor critiqued

A variety of questionnaires, scales, guided-interview tools, and other standardizedinstruments are available to aid with various aspects of assessment. The majority areintended only to be used as an aid to information gathering and not to make a diagnosis.Which of the following tools requires training to administer and can be used to determinediagnoses?

A.Child and Adolescent Psychiatric Assessment (CAPA)

B.Brief Impairment Scale

C.Pictorial Instrument for Children and Adolescents(PICA-III-R)

D.Achenbach Child Behavior Checklist

The PMHNP is drafting a proposal for research funding for a project to offer primaryprevention strategies designed to reduce the incidence of bullying. In support of this project,the PMHNP provides data supporting the fact that both perpetrators and victims of bullyingsuffer all of the following except:

A.Higher incidence of emotionalproblems

B.Greater difficulty making friends

C.Poorer academic achievement

D.Increased percentage of smoking

Which of the following manifestations of childhood anxiety disorders is considered apsychiatric emergency?

A.Schoolrefusal

B.Bedtimerefusal

C.Eatingrefusal

D.Speechrefusal

The PMHNP is performing an assessment on Julie, a 4-year-old girl who has been brought to

care by her mother. The mother was referred by the pediatrician because Julie has been

demonstrating an appreciable change in her behavior. She is developmentally on target and

has always been a happy and curious child, but for the last few months she seems to be

much more fearful and anxious. Which of the following recently acquired behaviors

described by the mother is most suspicious for sexual abuse?

A.Prolonged periods of daydreaming

B.Masturbating with a toy

C.Touching the genitals of her 3-year-oldcousin

D.Showing her genitals to other children atdaycare

What is the primary diagnostic difference between obsessive-compulsive disorders inchildren as compared to adults?

A.Age of onset

B.Response to treatment

C.Recognition that the thoughts or behaviors areirrational

D.The thoughts or behaviors occupy > 1 hourdaily

With respect to treatment of conduct disorder, the PMHNP knows that:

A.The reduction of violence and aggression in school is critical

B.Parental psychiatric intervention has not demonstratedimproved outcomes

C.Atypical antipsychotics are avoided due to the adverse effectprofile

D.Treatment with psychostimulants exacerbates aggressivebehaviors

Kelly is a 13-year-old girl who is being evaluated because her parents are very concernedabout her sudden disinterest in school. She does not want to go to any social activities andher grades have dropped markedly in the last several months. When considering bullying asa cause of her behavior change, the PMHP considers that which type of bullying is morecommon among girls?

A.Verbal

B.Physical

C.Relational

D.Cyber

Karen is a 7-year-old girl who has been started on atomoxetine 18 mg once daily for ADHD,which is just under the recommended starting dose of 0.5 mg/kg/day. After just 1 week, herparents report that she is not eating, complains of stomach pain almost every day, is havingtrouble sleeping, and is “really cranky.” Her teacher says she never seen anything like it;that Karen is actually worse on her ADHD medication. A careful review reveals that Karen istaking her medication just as prescribed. She is not on any other prescribed, over-thecounter,or herbal medications. The PMHNP considers that:

A.These are common in the first weeks of therapy and the dose should be increased to atherapeutic regimen

B.Karen may be a poor metabolizer of CYP2D6 medications and will need a change oftherapy

C.Behavioral modalities should be started as optimal management of ADHD is multimodal

D.Fluoxetine should be added to the regimen as it has demonstrated efficacy withcoincident anxiety

Carolyn is a 14-year-old female who is in care because she has developed increasinglydifficult behavior at home and school. She is inappropriately dressed for the interview,wearing heavy makeup and conducting herself in a suggestive manner. Her medical historyis significant only for childhood asthma and four urinary tract infections in the last year.Carolyn’s mother reveals that Carolyn’s stepfather has a history of sexually abusing hisbiological daughter, and the mother is beginning to wonder if something isn’t “going on” inher own home. Carolyn vigorously denies this, and indicates that her stepfather is very goodto her, takes care of her, and is her “best friend.” The PMHNP recognizes that Carolyn maybe in which phase of intrafamilial sexual abuse?

A.Engagement

B.Secrecy

C.Disclosure

D.Suppression

Phillip is a 5-year-old boy who is in care after being referred for failure to speak at school. Hehas been in kindergarten for 5 months, and initially his teacher thought he was just shy, soshe did not focus on him. However, it has become increasingly apparent that he flat out willnot speak at school. Phillip’s parents are adamant that there is not any problem at home andthat Phillip talks with them and his older sister routinely. Further assessment reveals that hehas always been extremely shy and that he doesn’t like it when people make a fuss overhim. The PMHNP suspects that Phillip has selective mutism, which is closely related to:A.

A history of sexualabuse

B.Fetal alcoholyndrome

C.Early onsetschizophrenia

D.Social anxietydisorder

With respect to psychiatric assessment, the PMNHP knows that in terms of confidentiality:

A.All information related to a minor may be shared with the parents without thechild’s consent.

B.Whenever there is a suspicion of neglect or abuse, the appropriate state agencymust be notified.

C.Every state has laws that emancipate children for issues of mental health.

D.All children are entitled to confidentiality unless they are a danger to themselvesor others.

The PMHNP is performing a series of court-ordered home visits to evaluate concerns about a4-month-old infant who presented for a well checkup with clear failure to thrive. Whileobserving the mother’s interaction with the infant, the PMHNP notes a negative pattern ofinteraction. This is characterized by:

A.The child refusing to feed and the mother feeling rejected and withdrawing

B.The mother not holding the child during feeding and the child withdrawing

C.The mother not responding to hunger cues, e.g., crying, and the child stoppingdemonstrating them

D.The mother being overly protective and trying to feed excessively, and the infantstopping eating

The PMHNP observes separation from and reunion with the parent as part the mental statusexam of a 25-month-old toddler. Extremes of emotion during separation or reunion are mostconsistent with:

A.Normal developmental progression atthat age

B.Cognitive dysfunction

C.Neurologic dysfunction

D.Problems with the parent-childrelationship

The PMHNP is reviewing assessment data on Richard, a 14-year-old boy who was brought infor evaluation by his parents. He has a longstanding history of being difficult, defiant, andargumentative with adults. While considering differential diagnosis of oppositional defiantdisorder and conduct disorder, which of the following findings meet criteria for conductdisorder?

A.Openly defies rules, argues with adults, is truant from school

B.Shoplifts valuable jewelry, is persistently angry and resentful, runs away from home

C.Often loses temper in the classroom, upturned a desk at school in anger, is verbally cruelto classmates

D.Has a history of physical cruelty to the family cat, broke into the neighbors’ house whilethey were on vacation, starting fist fights at school

Melanie is a 13-month-old female who has been referred by her primary care pediatrician.She has not had consistent well-child checks, and at her first visit with this pediatrician atage 1 year, there was a notable absence of verbal babbling, interactive play, or smiling.Comprehensive assessment of Melanie must include all the following except:

A.The Children’s Apperception Test(CAT)

B.A comprehensive history

C.A mental status examination

D.Neuropsychiatric assessment

Despite a wealth of data-based information on bullying, including information about itsforms, presenting symptoms, and consequences, current research suggests that accurateinformation about bullying is not influencing preventive and awareness strategies in mostschool systems. When advising school personnel, parents, and primary care providers aboutbullying, the PMHNP should emphasize that:

A.Physical bullying has the most dangerousoutcomes

B.Bullying is more common in boys than girls

C.Victims often develop alcohol abuseproblems

D.Verbal bullying is the most common form

Minor physical anomalies, such as high-arched palate, low-set ears, and transverse palmarcreases, occur in a higher than average distribution in children with all of the followingexcept:

A.Learning disabilities

B.Speech and languagedisorders

C.Hyperactivity

D.Delayed puberty

Comprehensive psychiatric assessment of young school-aged children requires a variety ofinformation sources. Input is necessary from parents, caregivers, and teachers becausechildren of this age group cannot reliably provide information about:

A.Their own fears and anxieties

B.Psychotic episodes they haveexperienced

C.The chronology of symptompresentation

D.Episodes of mood extremes

Mark is a 5-year-old boy brought in for evaluation because his behavior at school hasbecome so disruptive. According to the parents, Mark’s teacher says he just refuses to followthe rules of the classroom, openly defies her, and actually seems to try and upset hisclassmates. The teacher says Mark gets frustrated very easily when he cannot complete atask and is resistant to any effort to help him. This happens almost every day, and theteacher has indicated that she will not be able to keep him in the classroom if things do notchange. Mark’s parents admit that he has always been “willful” and difficult to manage, butas he is an only child with a stay-at-home mom, the family overlooked his disruptivetendencies and accommodated Mark. The parents report that they often skip social eventsand family outings because they don’t know how Mark will behave. While counseling Mark’sparents about the theories of causation of oppositional defiant disorder (ODD), the PMHNPtells the parents that psychiatric theories include all of the following except:

A.Unresolved conflict as a fuel for aggressive behavior targeting authority figures

B.The concept that oppositionality is a reinforced, learned behavior in which the child exertscontrol over authority figures

C.A maladaptive response to parents’ modeling of conflict avoidance as manifested byeven-tempered responses to parent-toddler struggles

D.That the behavior is reinforced by increased parental attention in response to theundesirable behavior

Having child and adolescent patients rate their feelings and moods on a scale of 1–10 ismost effective in which age group?

A.18-months to 3years

B.3 to 5 years

C 5 to 11 years

D.12 to 17 years

Which of the following is a true statement with respect to conduct disorder?

A.The diagnosis is distributed equally between boys and girls.

B.Boys with conduct disorder are more likely to develop somatic symptoms later in life.

C.About 80% of children with conduct disorder were previously diagnosed with oppositionaldefiant disorder (ODD).

D.The later the age of onset of conduct disorder, the greater the risk of antisocialpersonality disorder (ASPD) in adulthood.

Being Brave: A Program for Coping With Anxiety for Young Children and Their Parents is amanualized intervention for anxiety disorders in young children between the ages of 4 and 7years old. It uses a combination of parent-only and parent-child sessions and demonstratessignificant improvement in children with all forms of anxiety disorders except:

A.Separationanxiety

B.Social anxiety

C.Generalizedanxiety

D.Specific phobia

Eric is an 11-year-old male for whom an emergency assessment was requested due to firesetting.This is not Eric’s first fire, and his parents admit that he has had a bit of a fixationwith the fireplace and matches for a few years. During the evaluation, the PMHNP should beparticularly alert to other findings consistent with:

A.Childhoodschizophrenia

B.Bipolar disorder

C.Sexual abuse

D Conduct disorder

Which of the following is a true statement with respect to crisis intervention andpsychological debriefing as a preventive strategy for post-traumatic stress disorder (PTSD)?

A.Crisis intervention and psychologic debriefing is most effective if it occurs within 24hours of the event

B.The focus of crisis intervention and psychologic debriefing is management ofemotional reactions

C.Psychoeducation is not typically a component of crisis intervention and psychologicdebriefing

D.No controlled studies support that crisis intervention and psychologic debriefingimproves outcomes

Which of the following is not a true statement with respect to theorized etiologies of ADHD?

A.Psychosocial factors do not appear to contribute to the development of ADHD.

B.Some literature suggests that prenatal exposure to winter infection during the firsttrimester of pregnancy leads to ADHD

C.Biological parents of children with ADHD have a higher incidence of the disorder thanadoptive parents

D.Overall, no clear-cut evidence supports a single neurotransmitter in the development ofADHD

The clinical interview is an important part of psychiatric assessment and should beconducted early in the diagnostic process. However, a comprehensive assessment shouldinclude other information-gathering modalities because the clinical interview:

A.Does not offer flexibility in understanding the evolution ofthe problem

B.Frequently deemphasizes the influence of environmentalfactors

C.May not systematically cover all psychiatric diagnosticcategories

D.Creates a dialogue in which patients cannot give subjectiveresponses

e PMHNP is evaluating a 15-year-old male patient who has been referred by his courtappointedguardian. He has been in foster care for the last 6 years and maintained a steadypattern of low-level behavior problems such as skipping school and ignoring curfew. He isnot openly defiant and has always been described as a “loner.” He just does not follow mostrules. During the mental status examination, the PMHNP notes that his expressions aresometimes inconsistent with the topic of conversation, and he does not seem to be able totransition effectively among levels of emotion. This represents an abnormality in:

A.Mood

B.Affect

C.Thought process andcontent

D.Judgment and insight

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 a standardized-testing assessment

C.Schedule session two after reviewing court documentation

D.Arrange for three sessions with a family therapist thenreevaluate Kevin

Which of the following statements is true with respect to children who present to careacutely 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 toconversation.

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 thechild for his version of events.Comprehensive psychiatric/mental health assessment of children includes an interview withthe parents or caregivers. Which of the following is not a true statement with respect to theparental interview?

A.The parents’ own emotional adjustments should bedetermined.

B.The parents are usually more aware of symptomsthan the child.

C.The parents may prefer to speak with the PMHNPseparately.

D.The parents’ upbringings are relevant to the child’sdiagnosis.

The PMHNP is evaluating his data for the assessment of Eric, a 23-month-old male who wasreferred because he is having nightmares to the extent that most nights he is waking upfamily members with his crying and screaming. In addition to the clinical interview with theparents and patient, developmental assessment, and standardized tools, the assessmentshould include:

A.Review of a video recording of a nightmare event and Eric’s immediateresponse

B.Age-appropriate interview, e.g., “If you had three wishes, what wouldthey be?”

C.Observation of Eric in a playroom where he is unaware that he is beingwatched

D.Partially open-ended questions that provide some focus but allowexpression of feelingSarah is a 10-year-old patient who has been diagnosed with oppositional defiant disorder.While discussing the diagnosis, course and prognosis, and treatment strategies with Sarah’smother, the PMHNP emphasizes that successful management of oppositional defiantdisorder (ODD) must include:

A.Parent training

B.Pharmacotherapy

C.Time out

D.Conflictavoidance

Management of a child who has a pattern of fire-setting behavior must include:

A.Combination therapies that include medication with anSSRI

B.Parental counseling that the child should never be allowedhome alone

C.Inpatient admission for intensive individual and grouptherapy

D.Behavioral interventions characterized by negativereinforcement

The PMHNP is discussing autism spectrum disorder (ASD) treatment strategies with theparents of 4-year-old Jeffrey. He is nonverbal and has been completely unable to adapt toany changes of environment; an effort to put him in a preschool class was what precipitatedhis evaluation and eventual diagnosis. At this point, Jeffrey’s parents are very committed todoing anything necessary to support Jeffrey’s growth and development and promotion ofprosocial behavior. While developing his plan of care, the PMHNP suggests:

A.Structured classroom training with consistent behavioralprograms

B.Facilitated communication with a computer or letter/pictureboard

C.A trial of escitalopram daily to promote decreasedirritability

D.An atypical antipsychotic as needed to decrease selfinjuriousbehavior

Justin is a 3½ -year-old boy who comes in with his mother. She is concerned that he hasobsessive-compulsive disorder (OCD). Justin’s mother says that her husband has struggledwith OCD all his life; he was first diagnosed when he was 11 years old thanks to an alertteacher who suggested mental health care. Justin’s mother has been very proactive instudying genetic risk, and she knows that Justin is at significantly increased risk due to theearly-onset in his father. Which of the following behaviors by Justin would be most consistentwith OCD?

A.Clear social difficulties in addition to an apparently unusual need for cleanliness and orderin his bedroom

B.Refusal to go to bed without his blue stuffed elephant; this began over a year ago and isgetting progressively worse

C.Insistence upon precise placement of plate, cup, utensils and food on plate when eating;when he cannot achieve this, he will not eat

D.A concomitant diagnosis of ADHD for which the family is currently in behavioral therapy

The PMHNP is evaluating 12-year-old Dale after the police were called to the home. Dale isassessed as having a psychotic episode; he tells the NP that voices are telling him that he isbad and that he should hurt himself. According to the mother, he has no history ofpsychiatric disease, medications, or really any concerns at all. Mom says he goes to school,has friends, and has always seemed “normal.” An interview with his 13-year-old sisterreveals that while there is no long-term history of abnormal behavior, for the last couple ofweeks things have been very strange at home. His father has been arrested for “somethingto do with a teenage girl,” and their parents have been fighting. His father lost his job, andthere is a lot of talk about money and lawyers and jail. Dale has been very emotional as hehas always been close to his Dad; he seems to go from crying to laughing in a blink, and isgetting in fights at school. Even now, after he has calmed a bit, Dale’s reality testing isaltered. The PMHNP considers that Dale is demonstrating:

A.Symptoms of childhoodschizophrenia

B.A manic episode

C.Brief psychotic disorder

D.Intermittent explosive disorder

 

Trauma-focused cognitive behavior therapy is a CBT approach characterized by 10–16sessions comprised of four components: (1) psychoeducation, (2) stress inoculation, (3)gradual exposure, and (4) cognitive reprocessing. This is a management strategy for posttraumaticstress disorder (PTSD) that is:

A.Most effective when paired with eye movement desensitization and reprocessing (EMDR)

B.Considered by experts to be the first-line management approach for treatment of PTSDsymptoms

C Very effective in individuals but generally not recommended for group treatment, e.g.,. school-based traumas

D.Gaining widespread acceptance as a first-line management strategy for other forms ofanxiety disorders

The PMHNP is providing counseling for the family of a 6-year-old girl who was recentlyadopted. This girl reportedly was removed from a home in which she was subjected tosevere, long-term abuse in all forms: neglect, physical abuse, sexual abuse, malnutrition,and neglect of all medical care. Upon her rescue, which was incidental during a drug raid onthe home, she was hospitalized for over 1 month for physical maintenance, nutrition,hydration, and treatment for a variety of infections, including sexually transmitted diseases.The adoptive family is very committed to providing a healthy environment and is veryreceptive to long-term individual and family therapy. The PMHNP discusses with the newparents and siblings that which of the following is most often linked to this type of history:

A.Dissociative disorders

B.Negative attachment

C.Aggression towardsiblings

D.School refusal

Children who have been subjected to maltreatment will frequently demonstrate a variety ofbehavioral and psychologic symptoms, including increased aggressiveness, heightenedautonomic arousal, and memory problems. Neurobiologic explanations suggest that this maybe due to:

A.Scarring of the hippocampus

B.Hypertrophy of the corpus callosum

C.Limbic suppression

D.Decreased integration of left and righthemispheres

Evaluation of psychiatric emergencies in children must include:

A.A complete physical examination

B Psychiatric disorders in family members

C.A comprehensive toxicology screen

D.Interviews with teachers and noncustodialcaretakers

Susan is a 10-year-old girl who has been referred by her pediatrician for mental healthevaluation due to a persistent collection of somatic symptoms for which there is no apparentorganic cause. For the last 2 months Susan has been increasingly distraught at the prospectof leaving home. This has become very apparent since the start of the school year. She oftendevelops stomachaches and headaches when it is time to go to school. Lately she does notwant to go to bed unless her mother remains upstairs. The PMHNP considers a diagnosis of:

A.Separation anxietydisorder

B.Social anxiety disorder

C.Generalized anxietydisorder

D.Social phobia disorder

While evaluating Jennifer, a 32-month-old female, for autism spectrum disorder (ASD), thePMHNP conducts a detailed assessment, including a medical history of both the patient andall first-degree family members. This is critically important as the most common knowncause of ASD is:

A.Fragile X syndrome

B.Advanced maternal age

C.Autoimmune disease in > 2 first-degree familymembers

D.Being raised in a single-parent home during the firstyear of life

The PMHNP has been retained by the local school board to provide comprehensivecounseling and guidance following an episode of tragic school violence. A 9th grader, actingalone, brought a gun into the school, fatally shooting a teacher and injuring four otherteachers and students before he was subdued. In an effort to promote best healthy practicesafter this traumatic event, the school board is asking for advice on how to best manage thestudents. The PMHNP knows that the immediate priority must be:

A.Returning to normal routineimmediately

B.Development of peer counselinggroups

C.Establishing the perception ofsafety

D.A memorial service to process theloss

Comprehensive psychiatric assessment ultimately requires the integration of biologicalpredisposition, psychodynamic factors, environmental factors, and life events. These factors,along with a mental status exam, developmental assessment, and any appropriatestandardized testing is collectively referred to as:

A.Neuropsychiatric assessment

B.Biopsychosocial formulation

C.The Physical and Neurological Examination of Soft Signs(PANESS)

D.Kaufman Asse

Explanation & Answer

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