NR 606 MIDTERM EXAM QUESTIONS

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NR 606 MIDTERM EXAM QUESTIONS

Actual Qs and Ans - Expert-Verified Explanation -Guaranteed passing score -51 Questions and Answers

-Format: Multiple-choice / Flashcard

Question 1: 2. What are risk factors for maternal mental health disorders?

Answer:

History of mental illness (especially depression/anxiety), poor social support, history of trauma/survivor of abuse, unplanned pregnancy, pregnancy complications, economic stress, and sleep deprivation.

Question 2: . How do SSRIs affect bipolar disorder?

Answer:

SSRIs alone may trigger manic episodes in children with undiagnosed bipolar disorder. Always evaluate mood history before prescribing antidepressants

Question 3: How is pediatric OCD treated?

Answer:

First-line is a combination of SSRIs and CBT with exposure and response prevention (ERP).Clomipramine .Moderate to severe cases may benefit from antipsychotic augmentation or intensive therapy programs. ( in some children OCD is a diagnosis associated with strep infections.PANDAS- pediatric autoimmune neuropsychiatric disorders is associated with OCD

Question 4: 5. What considerations apply to psychotropic use during pregnancy?

Answer:

Risk-benefit analysis

is essential: untreated maternal illness may pose higher risks.

Medication selection:

SSRIs are generally first-line; some mood stabilizers and antipsychotics may also be acceptable.

Physical changes:

Increased volume of distribution and altered metabolism require dosing adjustments

Fetal risks:

Consider teratogenicity (e.g., certain mood stabilizers), withdrawal syndromes, or neonatal adaptation syndromes.

Question 5: What are key clinical signs and risk factors for postpartum PTSD?

Answer:

Clinical signs may include flashbacks, avoidance, hypervigilance, and guilt.Risk factors include traumatic delivery, prior trauma or PTSD, lack of support, and serious obstetric or neonatal complications.Question 6: A. Barriers to mental health care:

Answer:

Children/adolescents: Limited provider availability, insurance issues, transportation, stigma therefore many drop out, and misunderstanding of mental illness, scheduling conflicts, high staff turn over.Perinatal populations: Fear of legal consequences, limited maternity-SUD integration, childcare logistics, stigma.

B. Social determinants affecting access:

Income, insurance, transportation, neighborhood safety, and linguistic/cultural barriers impact service uptake, especially in youth.

C. Developmentally appropriate teaching:

Use simple language, visual aids, active learning (e.g., games), and involve parents/families. Ensure materials match the child's cognitive and emotional development.

D. Racial and ethnic barriers:

Distrust in healthcare systems, cultural stigma, lack of culturally tailored care, language limitations. The

result: delayed help-seeking and poorer outcomes.

E. Types of stigma:

Structural: Institutional policies that reduce access.women in states criminalizing opioid use during pregnancy are less likely to receive an accurate diagnosis and effective treatment; furthermore, criminalization strips these individuals of their ability to engage autonomously with their provider and impedes their ability to achieve recovery. Fear of legal repercussions and the involvement of children's services may lead women to avoid reporting substance use

Public: Community stereotypes and prejudice.

Self: Internalized shame that deters help-seeking.

Intervention: Stigma focused on treatments or providers, affecting treatment engagement.

F. Parental access to records:

Typically, parents have the right to access their child's health records-but adolescence may shift this depending on privacy laws for sensitive services (e.g., reproductive or sexual health).

G. Ethical/legal informed consent principles:

Include autonomy, be Question 7: What are barriers to points of care (POC) in perinatal mental health?

Answer:

Barriers include lack of provider integration, fear of child-welfare involvement, stigma, insurance or financial limits, childcare issues, and transportation difficulties.

Question 8: 10. How should providers screen for substance use during pregnancy?

Answer:

Use validated tools (e.g., 4Ps, CRAFFT, ASSIST).Apply routine screening for all patients.Screen continuously throughout prenatal care, recognizing dynamic usage.Question 9: I. Developmental Pharmacokinetics/pharmacodynamics in kids:

Answer:

Higher metabolic rates immature organs altered volumes of distribution -all affect how drugs act and are processed.

Question 10: . What are SSRI withdrawal symptoms in newborns?

Answer:

Newborns exposed to SSRIs in utero may experience irritability, feeding or sleep issues, tremors, hypoglycemia, respiratory distress, and jitteriness.These symptoms generally last a few days to a few weeks.

Question 11: What triggers mandatory reporting when treating minors?

Answer:

Providers must report suspected child abuse, neglect, or intent to harm self/others. Familiarity with your state's statutes and clear documentation are essential.Question 12: Seth, a 15-year-old with ASD, has a history of stereotypies including toe-walking and arm flapping.what medication would be appropriate

Answer:

clomipramine;clomipramine Tricyclic antidepressant medications may be used for clients with ASD who have repetitive behaviors and aggression.Question 13: 2. What are the key components of informed consent in pediatric mental health?

Answer:

Capacity & assent:

Children should give age-appropriate assent; adolescents may give informed consent in some states.Children should be included in discussions about medication and tx.

Understanding:

Present purpose, benefits, risks, alternatives, and limits (e.g., mandatory reporting) in developmentally appropriate language.

Voluntariness:

No coercion.

Documentation:

Consent and assent should be recorded formally.

Question 14: What are evidence-based ASD interventions?

Answer:

Applied behavior analysis therapy (ABA) , Speech and occupational therapy, OT, parent training, dietary therapy, Pharmacologic treatment addresses comorbid symptoms (e.g., irritability with risperidone or aripiprazole

• Serotonin agents, antipsychotics, beta blockers, alpha 2 agonist, mood stabilizer & stimulants. Use

MUCH LOWER

doses of stimulants