NR 548 EXAM TEST BANK QUESTIONS AND CORRECT
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Piaget's Stages of Cognitive Development - CORRECT ANSWER -Sensorimotor stage: Birth-2
yrs
• cognitive abilities based on reflexes
• object permanence & causality
-Preoperational stage: 2-7yrs
• can use mental representations, symbolic thought, & language
• thinking is egocentric
-Concrete operational stage: 7-11yrs
• logical operations when thinking/solving problems
• thinking is concrete
-Formal operational stage: 12yrs+
• Adolescent can use abstract reasoning in addition to logical operations
• Child can understand theories, hypothesize, comprehend abstract ideas (love & justice)
Screening, Brief Intervention, Referral to Treatment (SBIRT) - CORRECT ANSWER -
Screening
• Quickly assesses severity of substance use & ID the appropriate level of tx
-Brief intervention
• Focuses on increasing insight & awareness regarding substance use & motivation toward
behavioral change
-Referral
• Guidance to tx provides those identified as needing more extensive tx with access to specialty
care
Medication-Assisted Treatment (MAT) - CORRECT ANSWER Treatment for opioid use
disorder combining the use of medications (methadone, buprenorphine, or naltrexone) with
counseling and behavioral therapies.
Mental health and youth - CORRECT ANSWER -13% of children ages 8-15 experience a
mental health condition
-50% of children ages 8-15 experiencing a mental health condition do not receive tx
-13-20% of children living in the U.S. (1 out of 5 children) experience a mental health condition
in a given year
-17% of high school students seriously consider suicide
-1/2 of all lifetime cases of mental illness begin by age 14
,Barriers to Mental Health Treatment in Children and Adolescents - CORRECT ANSWER -lack
of sufficient information or access to services
-stigmas or negative perceptions towards mental health services
-many drop out before receiving effective treatment, often due to:
• poverty
• language barriers
• living in communities with scarce resources
• stressors such as
➣problems in the family
➣violence in the community
➣unstable housing
➣unemployment
➣food insecurity
-Cost
-scheduling conflicts
-long waitlists for services
-high staff turnover
Prescribing Considerations for Children and Adolescents - CORRECT ANSWER -physiologic
factors impact pediatric med selection & dosing
-Children, more rapid metabolism than adults, may require larger dose of med per unit of body
weight
-Around puberty, pharmacokinetic properties reach adult parameters
• dosing after puberty may need to be decreased
-Developmental considerations
• attuned to signs of adverse effects, younger children may not be able to communicate
complaints
Kassia, a 5-year-old, is prescribed a stimulant medication for ADHD for the first time.
Consider Piaget's stages, match the developmentally-appropriate education statements with the
correct client:
"It's kind of like you've got a great bike. The brakes just need some fixing. The medication is like
fixing the brakes."
"This medication can help you ignore distractions so you can complete tasks. They can also help
with self-control, which may help you get along better with your friends and parents. Do you
have any concerns about taking the medication?"
"Do you know how it's sometimes hard for you to sit still and pay attention at school? This
medicine will help you." - CORRECT ANSWER "Do you know how it's sometimes hard for
you to sit still and pay attention at school? This medicine will help you."
Rationale: Kassia is in the Preoperational Stage. This stage usually lasts from ages 2-7. Children
think symbolically. They learn to use words or pictures to represent objects. They are egocentric
,and have difficulty seeing things from others' perspectives. Preoperational thinking is very
concrete.
Oliver, a 10-year-old, is prescribed a stimulant medication for ADHD for the first time.
Consider Piaget's stages, match the developmentally-appropriate education statements with the
correct client:
"It's kind of like you've got a great bike. The brakes just need some fixing. The medication is like
fixing the brakes."
"This medication can help you ignore distractions so you can complete tasks. They can also help
with self-control, which may help you get along better with your friends and parents. Do you
have any concerns about taking the medication?"
"Do you know how it's sometimes hard for you to sit still and pay attention at school? This
medicine will help you." - CORRECT ANSWER "It's kind of like you've got a great bike. The
brakes just need some fixing. The medication is like fixing the brakes."
Rationale: Oliver is in the Concrete Operational Stage. This stage usually lasts from age 7-11.
Thinking becomes more logical and organized about concrete events. Children begin to reason
inductively, from specific information to general principles. The use of simile is a helpful
instructional strategy for children in this stage.
Tamika, a 15-year-old, is prescribed a stimulant medication for ADHD for the first time.
Consider Piaget's stages, match the developmentally-appropriate education statements with the
correct client:
"It's kind of like you've got a great bike. The brakes just need some fixing. The medication is like
fixing the brakes."
"This medication can help you ignore distractions so you can complete tasks. They can also help
with self-control, which may help you get along better with your friends and parents. Do you
have any concerns about taking the medication?"
"Do you know how it's sometimes hard for you to sit still and pay attention at school? This
medicine will help you." - CORRECT ANSWER "This medication can help you ignore
distractions so you can complete tasks. They can also help with self-control, which may help you
get along better with your friends and parents. Do you have any concerns about taking the
medication?"
Rationale: Tamika is in the Formal Operational stage. This stage typically occurs at age 12 and
up. Adolescents and young adults begin to reason abstractly and can consider hypothetical
problems. They begin to think more about moral, philosophical, ethical, social, and political
issues.
, Addressing Parental Concerns: Collaborative Treatment Plans - CORRECT ANSWER -tx plans
for children typically made in collaboration with parents or guardians
-Collaboration between the PMHNP, clients, and families when creating the treatment plan is
key to ensuring the plan meets the client's needs and is comfortable and manageable for the
family
Ethical Considerations in the Treatment of Children and Adolescents - CORRECT ANSWER
Privacy and HIPAA
Informed Consent
Mandatory Reporting
Ethical Considerations in the Treatment of Children and Adolescents: Privacy and HIPAA -
CORRECT ANSWER -parents have right to req access to a minor's mental health record,
including symptoms, diagnosis, tx plan
• circumstances may limit that right
➣see HIPAA fact sheet
Ethical Considerations in the Treatment of Children and Adolescents: Informed Consent -
CORRECT ANSWER -Parents may decide whether to allow tx child is unable to provide true
informed consent
-children may not be able to give legal consent, should be included in discussions about med &
tx whenever possible
• encourage tx adherence
Ethical Considerations in the Treatment of Children and Adolescents: Mandatory Reporting -
CORRECT ANSWER -PMHNPs mandated reporters in most states
• required to report suspicions about abuse or neglect to the appropriate authorities
-federal & state statutes include stipulations related to mandatory reporting
-PMHNPs responsible for following all relevant statutes in their state of practice
most common complication during the perinatal period? - CORRECT ANSWER Mental health
problems
Steps for Obtaining Informed Consent - CORRECT ANSWER -Assess pt ability to understand
medical info, tx options, to make a voluntary decision.
-Present relevant info with accuracy and sensitivity:
• diagnosis
• nature & purpose of tx options
• benefits, risks, burdens of all tx options, including forgoing tx
-Document informed consent conversation in the medical record, including all consent forms.
Underlying assumptions for child and adolescent psychotherapy - CORRECT ANSWER
Developmental considerations
Family involvement
Systems involvement
Resiliency
