Nursing 6660 Final Exam _Walden University

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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

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)

Question: 3

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

Question: 4

The PMHNP observes separation from and reunion with the parent as part the mental status exam of a 25-monthold 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

Question: 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