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CEA Pregnancy Exam Questions And
Complete Answers
A 4 year old adopted child with unknown medical and social history has struggled to meet several expected developmental milestones in areas of intellectual functioning. This child has no deficits in reciprocal social communication or social interaction. Which of the following is the most accurate diagnosis? Turner Syndrome Autism Spectrum Disorder Global Developmental Delay Rett syndrome - answer The diagnosis of Global Developmental Delay is utilized for children under 5 years of age and clinical severity cannot be reliably assessed. This is especially true for children too young to participate in standardized testing, yet fail to meet expected developmental milestones. One would expect children with ASD to have impairments in social-emotional reciprocity and social interaction. The PMHNP is performing primary prevention in the high school regarding mental illness. The most common psychiatric emergency in children and adolescents is: Psychotic behavior Sexually inappropriate behavior Suicidal behavior Homicidal behavior - answer SI Which disorder is associated with higher rates of ADHD, enlarges testes, a long narrow face, hypotonia and short stature? Prader-Willis Syndrome Fragile X Asperger's syndrome
PKU - answer Fragile X is associated with a higher rate of ADHD, impaired intellectual ability, learning d/o's, autism spectrum d/o. Physical attributes include hypotonia, flat feet, enlarges testes, long narrow face, flexible fingers and short stature. The school psychologist refers a 7-year-old girl with difficulty reading, distractibility, and writing avoidance behaviors. The child has no diagnosed conditions, takes no medications, and met all of her developmental milestones. She loves arts and crafts and physical education. Prior to diagnosing a learning disorder, which of the following screening tests must be performed? Family history Complete history and physical exam Neurological evaluation Vision and hearing - answer Vision and hearing A pregnant woman with depression is reluctant to take medication for fear of causing her baby neonatal abstinence syndrome due to selective serotonin reuptake inhibitor (SSRI) medication. Her husband states they would like to use a faith healer instead. Which of the following is most accurate regarding the prognosis of depression during pregnancy? If the patient does not take medication she will continue to deteriorate There is no risk of adverse effect associated with SSRIs The patient will likely require involuntary commitment to a mental institution The actual course of depression cannot be predicted - answer The actual course of depression cannot be predicted An 8-year-old boy is referred to you for evaluation for disruptive behavior in school. The teachers report that without warning the boy will make disruptive sounds or shout out in class. Other than these instances the boy is described as polite and well kempt, but restless. This clinical presentation is most consistent with which of the following disorders? Tourette's syndrome Separation anxiety disorder Oppositional Defiant disorder Conduct disorder - answer Tourette's syndrome
Begin a second generation antipsychotic No treatment is required Trial pediatric DBT Start a low dose stimulant medication - answer No treatment is required for stereotypic movement disorder when not associated with other symptoms. This behavior should fade by 4 years of age. Which of the following is a potential risk factor for Anorexia Nervosa? A gay male orientation a male on a high school wrestling team Ballet school All of the statements listed are potential risk factors. - answer All of the above are potential risk factors for Anorexia Nervosa, Which of the following statements regarding intellectual developmental disorder is false? Children with mild intellectual disability are at risk of being manipulated by their peers IQ test scores remain the gold standard for determining intellectual disability Individuals with severe intellectual disability require support for all activities of daily living Co-occuring motor and sensory impairments may prevent functional use of objects in profound intellectual disability - answer IQ test scores are not the gold standard for determining intellectual disability. Furthermore, IQ tests fail to asses reasoning in real life scenarios and fail to measure mastery of practical tasks despite measuring conceptual capacity. A father brings his 6-year-old son to you because he is worried about him. He states that the son sits up in bed shortly after falling asleep and screams. He says he is inconsolable and unable to be awakened during these episodes but eventually he falls back asleep. The father states he is not able to fall back asleep after those episodes and is exhausted and falling asleep at work during the day. The child is energetic and playful during the day and has no memory of the episodes. What is the most appropriate response?
"I can see this is upsetting for you." "Are you worried you are doing something wrong?" "I can see you're upset, but really you are overreacting." "Tell me why you can't fall back asleep after your son does?" - answer "I can see this is upsetting for you." A 10-year-old boy is referred by the school nurse because of persistent stomachache every morning in school. In evaluating the boy, the PMHNP learned that he does not like to go to school and insists on coming home immediately, and that he sleeps in his parent's bed at night. His clinical description is most characteristic of which of the following conditions? Social phobia Reactive attachment disorder Separation anxiety Posttraumatic stress disorder (PTSD) - answer Separation anxiety A 35-year-old woman is being evaluated 7 months postpartum for recurrent thoughts about wanting to harm her baby by stabbing with a knife. She continues to breastfeed and care for the baby. Since having these thoughts, she has removed all sharp objects from the home and has started ordering take out food to feed her family. She is reluctant to share these thoughts with her husband. Which of the following medications would be most appropriate to prescribe? Doxepine Lorazepam Sertraline Benztropine - answer Sertraline In regards to Insecure Attachment: Ambivalent type children are more likely to
ADHD
Conduct disorder - answer Conduct disorder Early patterns of aggression and the violation of the basic rights of family and peers. Running away from home, truant before age 13, destruction of property, animal cruelty, bullying, forced sexual activity or robbery are consistent with conduct disorder. The key here is the lack of remorse, guilt or empathy with shallow affect. Which of the following regarding Rett syndrome is false? Scoliosis is common in Rett syndrome Typical Rett syndrome is associated with a regression of spoken language, purposeful hand skills, gait abnormalities and stereotypic hand movements around 18 months of age. Rett syndrome is a rare disorder that mostly occurs in males. Rett Syndrome is a genetic disorder. - answer Rett syndrome is a rare disorder that mostly occurs in males is false. This neurodevelopmental disorder affects girls almost exclusively. The PMHNP is evaluating a 22-month-old girl whose mother is concerned about aggressive behavior toward her 4-month-old brother. The mother states that her daughter is often angry and irritable with directed hostility toward the baby. Which of the following responses is best? Each day, schedule some time for you and your daughter to spend together without the baby You should ignore your daughter's behavior and it will pass Explain to your daughter that the baby needs more attention than she does right now Your daughter's behavior is normal for her age - answer Each day, schedule some time for you and your daughter to spend together without the baby
A 6 year old boy with no known medical conditions shrugs his shoulders many times a day for a very short duration. His parents first noticed this when he was 4.5 years old. According to his parents, he is unaware of this. On exam, he has no other symptoms, other than a sudden, rapid, recurrent, non-rhythmic shoulder shrug that persists for less than one second. What is the best diagnosis given the information provided? Provisional Tic Disorder Persistant Motor or Vocal Tic Disorder Tourette's Disorder Tardive Dyskinesia - answer The diagnostic criteria for Persistent Motor or Vocal Tic Disorder include the age of onset before 18, the tic(s) have persisted for more than one year and motor or vocal tics are present but not both. In Tourette's disorder both multiple motor tics and vocal tics are present at some point. With provisional Tic Disorder, the symptoms are less than one year from onset. Tardive Dyskinesia is a hyperkinetic movement disorder associated with dopamine receptor blocking agents A woman in her 20th week of pregnancy has been resumed on lithium for bipolar disorder. The PMHNP knows that the patient may become subtherapeutic despite taking the medication as prescribed due to: Reduced blood volume Increased blood volume Increased fetal metabolism Reduced muscle mass - answer Increased blood volume A 10-year-old girl is referred for evaluation of behavioral difficulties. Her teachers report that she is easily distracted and fails to complete any class work, and often stares off into space or tries to chat with her neighbor. Her mother reports that mornings are the most difficult because of her general disorganization and forgetfulness. Otherwise she is socially engaged and enjoys many activities. Which of the following is the most likely diagnosis?
here is the lack of remorse, guilt or empathy with shallow affect. The PMHNP is performing primary prevention in the high school regarding mental illness. The most common psychiatric emergency in children and adolescents is: Suicidal behavior Sexually inappropriate behavior Homicidal behavior Psychotic behavior - answer Suicidal behavior A 19-year-old female is being seen at a crisis pregnancy center for an unplanned pregnancy. She feels compelled by her boyfriend to get an abortion, but it goes against her deeply held religious beliefs. Which of the following reduces her risk of being the victim of domestic violence? Pregnancy Financial independence Poor social support Fear of isolation - answer Fear of isolation A 30-year-old G1P0,1 has become increasingly oddly related, neglecting self-care, sleeping much of the day, eating minimally, crying easily, and despite reassurance that her pregnancy is progressing normally, worries that she will lose the pregnancy. Which of the following medications is considered least harmful in pregnancy? Sertraline Divalproex Lithium
Haloperidol - answer Sertraline Sam is 11 years old without past psychiatric history. He was born by normal spontaneous vaginal delivery with normal APGAR scores. He has met all of his developmental milestones. He began sixth grade this year and has had increased trouble falling asleep. He has always had bedtime rituals but lately they are extending in complexity and length. Most of his time in the evening is spent checking that the lights are turned off and that the windows are locked. As a result, he is only getting 5 hours of sleep at night and now has excessive daytime sleepiness with decreased interest in socialization and failing grades. Which of the following infectious diseases may contribute to this clinical presentation? Treponema Streptococcus Human immunodeficiency virus Congenital herpes simplex virus - answer strep The PMHNP is providing psychoeducation and anticipatory guidance to the concerned parent regarding night terrors. At which stage of sleep is this most likely to occur? Stage 3 to 4 Stage 1 Any stage of sleep Stage 2 - answer Stage 3 to 4 Which of the following developmental milestones should a 2-year-old child be able to accomplish? Ride a tricycle Identify age and gender
nearby park. She is requesting a medication to help her relax because she feels as if she is walking on eggshells around her husband for fear of him "getting physical with me" if the baby cries too much. Which of the following best describes this woman's circumstance? Honeymoon phase Tension building phase Postpartum depression Abusive incident phase - answer Tension building phase When evaluating a new 40-year-old, 4-week postpartum woman complaining of fatigue, irritability, dry skin, and poor sleep quality for mood disorder, which of the following diagnostic tests should be ordered to aid in formulating a diagnosis? Urine pregnancy test Hemoglobin A1C Thyroid-stimulating hormone (TSH) and free T EKG - answer TSH T Which eating disorder is considered ego syntonic? Bulimia Nervosa Binge eating d/o The Mediterranean diet Anorexia Nervosa - answer Anorexia Nervosa is challenging to treat because it is ego syntonic. In other words, one's behaviors, feelings and values are in line with the needs of the ego and reliable to one's self image. Early onset Schizophrenia is considered what?
All of the statements listed are true. Treated with second generation antipsychotics. Rare More prevalent amongst 1st degree relatives, - answer Early onset schizophrenia is rare. It is 8X more prevalent amongst 1st degree relatives (Sadock, Sadock & Ruiz, 2014). Luanne is a 19-year-old single mother of a 3-year-old boy. She works during the day and attends classes for her high school equivalency exam several evenings per week. Her son is in daycare and an after-school program from 8 a.m. to 7 p.m. 5 days per week. She reports feeling so tired that she sometimes loses her patience with her son and gives him Benadryl to help calm him down and sleep through the night. Which of the following actions should the PMHNP take? Report the mother to child protective services Provide psychoeducation for her son's challenges Commend the mother on her efforts of handling work and school Provide dosing instructions to prevent accidental overdose - answer Report the mother to child protective services Eleanor is 16 months old. She has been eating dirt and other nonfood substances. As a PMHNP, you recognize this as which of the following? Encopresis Vitamin A deficiency Normal Behavior PICA - answer At 16 months old, eating nonfood substances is considered normal behavior. To be diagnosed with PICA, Eleanor must be at least 2 years old.
A foster home A nursing home A hospital A group home - answer A foster home A 10-year-old boy who had been prescribed fluoxetine for major depressive disorder presents to the psychiatric emergency department for running into the street in front of a car on the way home from school. In the emergency department, he has been selectively mute, but the nurse practitioner student was able to elicit his desire to be dead. He has been medically cleared pending a psychiatric evaluation. What is the most common sign of major depressive disorder in children? Hypersomnia Psychomotor agitation Weight change Hopelessness - answer Psychomotor agitation The certified nurse midwife is evaluating a 29-year-old woman 2 weeks postpartum and finds her neglecting her self-care and minimally attentive to the baby and will not allow anyone else to care for the baby. During the visit a PMHNP is able to provide webcam consultation and liaison services. Based on the information provided, what is the priority in the management of this patient? Admit the patient to the hospital Electronically prescribe an antipsychotic Electronically prescribe a mood stabilizer Electronically prescribe an antidepressant - answer Admit the patient to the hospital
An 8-year-old boy diagnosed with leukemia is referred to child psychiatry because he is consistently displaying a flat affect, irritability, angry acting out, and occasional physical aggression toward his 6-year-old brother. What approach should the PMHNP take when interviewing this child? Ask the child direct questions about how he feels about his disease Encourage the child to talk about whatever is on his mind Provide toys and allow the child to play Sit quietly and allow the child to talk - answer Provide toys and allow the child to play Which of the following best describes Child-Onset Fluency disorder? All of the statements listed are true. The symptoms emerge before age 8. Operant conditioning is helpful with treatment. Early intervention has the best outcome. - answer Child-Onset fluency disorder or stuttering: Early intervention crucial. Most develop before age 8. Parent praises child when the child does not stutter and asks child to correct word when stuttering present. This is operant conditioning. Which of the following statements is true? Insecure attachment ambivalent type is associated with nicotine addiction. Insecure attachment avoidant type is associated with helicopter parenting. Insecure attachment disorganized type is associated with abused children. A secure pattern of attachment is associated with mild to moderate sleep disorders. - answer Insecure attachment: Disorganized type. These are abused children. They are frightened of the caregiver. They are more likely to have conduct disorder (Green &
Fluoxetine Methylphenidate Trazodone - answer Imipramine A mother 4 months postpartum is referred to infant psychiatry as the baby has failed to gain weight over the last 2 months. He has dropped from the 75th percentile to the 50th percentile. The mother states that up until 8 weeks of age he was gaining weight and growing just fine. The baby is generally happy and continues to meet his developmental milestones. Of note, the mother has returned to work after her postpartum leave 2 months ago and the baby is in daycare 5 days a week. The mother notes that he has been increasingly spitting up for the last month soon after receiving breast milk via the bottle. She has also started to supplement with formula out of concern for his poor weight gain. This clinical description is most consistent with which type of disorder? Pica Anorexia Bulimia Nervosa Rumination disorder - answer Rumination disorder
