Exam (elaborations) NURS 660 (NURS660) (NURS660) NEI questions on ADHD, Dementia, Substance Abuse & impulsive Compulsive Disorders. (Test 4) Answered.
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NURS 660 (NURS660)
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Maryville University Of St. Louis
NEI questions on ADHD, Dementia, Substance Abuse & impulsive Compulsive Disorders. (Test 4) Answered. 1. Peter, a 35-year-old stockbroker, has been advised by his supervisor to come and see you, the company mental health consultant. His supervisor is complaining that he often comes late to appointm...
Attention Deficit Hyperactivity Disorder
1. Peter, a 35-year-old stockbroker, has been advised by his supervisor to come and see you,
the company mental health consultant. His supervisor is complaining that he often comes
late to appointments, is inappropriately fidgety, interrupts people during meetings, has been
offensive towards coworkers, and has been known to party excessively on weeknights. Peter
asserts that he is just fine; he has a lot of projects on his mind and is simply standing up for
himself when speaking with others. He likes to go out in the evenings to unwind. Recognizing
probable ADHD, you interview both the patient and his work buddy, who is a longtime friend.
How would you start your questions?
Peer Answers Your Answer
A. Compared to his parents, how often
1%
does the patient…
B. Compared to other people his age, how
82%
often does the patient…
C. Compared to his childhood, how often
16%
does the patient…
D. Compared to his children, how often
0%
does the patient…
The symptoms of ADHD can present differently in patients at different ages.
While hyperactivity is a main symptom in children for example, this will frequently translate
into internal restlessness in adults.
A and D - Incorrect. While ADHD has a strong genetic component, it is not advised to ask him first to
compare himself to either his children or his parents. An accurate family history would be beneficial,
however.
B - Correct. When trying to diagnose this adult patient with ADHD, it is preferable to first ask him
to compare his behavior to that of other adults his age, as this will give a better idea of
the severity of his symptoms at this time.
C - Incorrect. While it is important to obtain a medical history, the patient might not have the best
recollection and might not be the best judge of his behaviors as a child.
2. According to DSM-5 criteria, what is the maximum age threshold for
symptom onset when making a diagnosis of attention deficit hyperactivity
disorder (ADHD)?
Peer Answers Your Answer
A. 5 3%
B. 7 12%
C. 12 77%
D. 15 6%
This study source was downloaded by 100000829216747 from CourseHero.com on 03-05-2022 09:51:16 GMT -06:00
, C - Correct. In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the
maximum age threshold for symptom onset for diagnosing ADHD changed from 7 to 12. Other
revisions included the fact that, although symptoms must have been present prior to age 12, there
does not have to have been impairment prior to age 12 when diagnosing someone who is older. The
symptom count threshold also changed for adults (defined as age 17 and older), with 5 (instead of 6)
symptoms required in the inattention and/or hyperactive/impulsive categories.
A, B, and D - Incorrect.
3. A 15-year-old with inattentive-type attention deficit hyperactivity disorder
has a hard time staying focused on the task at hand, has trouble organizing
her work, and relies heavily on her mother to follow through with her
homework. Problem solving is one of the hardest tasks for her. Her difficulty
with sustained attention could be related to aberrant activation in the:
Peer Answers Your Answer
A. Dorsolateral prefrontal cortex 69%
B. Prefrontal motor cortex 21%
C. Orbital frontal cortex 8%
D. Supplementary motor cortex 0%
A - Correct. Sustained attention is hypothetically modulated by the cortico-striatal-thalamic-
cortical loop involving the dorsolateral prefrontal cortex (DLPFC). Inefficient activation of
the DLPFC can lead to problems following through or finishing tasks, disorganization and trouble
sustaining mental effort; the patient exhibits all of these symptoms. The dorsal anterior
cingulate cortex is important in regulating selective attention, and is associated with
behaviors such as losing things, being distracted, and making careless mistakes. This area is
certainly also inefficient in this patient.
B - Incorrect. The prefrontal motor cortex hypothetically modulates behaviors such as
fidgeting, leaving one’s seat, running/climbing, having trouble being quiet.
C - Incorrect. The orbital frontal cortex regulates impulsivity, which includes symptoms such
as talking excessively, blurting things out and interrupting others.
D - Incorrect. Finally, the supplementary motor area is implicated in planning motor actions;
thus this brain area would be more involved in hyperactive symptoms.
4. Which of the following is true regarding cortical brain development in children with ADHD
compared to healthy controls?
Peer Answers Your Answer
A. The pattern (i.e., order) of cortical
7%
maturation is different
This study source was downloaded by 100000829216747 from CourseHero.com on 03-05-2022 09:51:16 GMT -06:00
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