4. Pharmacological treatment in autism spectrum disorder is most likely to have a positive effect on which of the following?
A. Aggressiveness
B. Gaze aversion
C. Prosodic modulation
D. Gestural communication - ANSWERA. Aggressiveness
27. The parents of a toddler are concerned about a recent i...
4. Pharmacological treatment in autism spectrum disorder is most likely to have a positive effect on
which of the following?
A. Aggressiveness
B. Gaze aversion
C. Prosodic modulation
D. Gestural communication - ANSWERA. Aggressiveness
27. The parents of a toddler are concerned about a recent increase in the frequency, intensity and
duration of the child's temper tantrums. The parents report that the toddler gets on the floor, kicks
and screams when they set limits. The child's health and developmental history is unremarkable.
Family history is significant for mood and anxiety disorders on the mother's side, and attention-
deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) on the father's side.
Which of the following would be the most appropriate step for the psychiatrist to take next?
A. Administer a Denver developmental screening test to the child.
B. Explore the parents' concerns about seemingly normal behavior.
C. Inquire about early separations and traumatic events in the child's life.
D. Administer an inventory to assess the parenting style of each parent.
E. Begin parent psychoeducation about ADHD and oppositional d - ANSWERB. Explore the parents'
concerns about seemingly normal behavior.
Questions 39 — 42 pertain to the following vignette.
A 9-year-old girl is brought in by her parents for an outpatient psychiatric evaluation due to behavior
difficulties at home. When frustrated, the girl screams, yells, curses and threatens to
kill herself. This behavior has been occurring more frequently whenever the girl does not get her
way. The parents usually give in and allow the girl to do what she wants. Similar episodes have
occurred at school. The girl is often irritable, argumentative and provocative. Her schoolwork is on
grade level. The girl has friends and interacts well with them, though she is described as "bossy." Her
appetite, energy and sleep patterns have been normal and stable. There are no other problems.
When seen with her parents and individually, the child is calm, cooperative and interactive. She
denies suicidal or homicidal ideation and says that she "just gets mad." Her mood is euthymic w -
ANSWERA. Send the patient home with the parents.
40 Which of the following would be the most appropriate initial diagnostic step by the physician?
A. Neuroimaging
B. Genetic testing
,C. Psychological testing
D. Neurological evaluation
E. Obtain a teacher report - ANSWERE. Obtain a teacher report
98. Parents report that their child who is almost 3 years old has not yet begun to talk. Since birth the
child has been distractible with an aversion to novelty and transitions. The
parents report that their child seems to have problems empathizing with siblings and
playmates at daycare. Which of the following questions should the psychiatrist ask first to
decide what type of advice to give the parents?
A. "Did you have a normal pregnancy?"
B. "Has your child's hearing been tested?"
C. "Has your child had a severe, traumatic loss?"
D. "Does your child experience separation anxiety?"
E. "Has your child had the measles-mumps-rubella immunization?" - ANSWERB. "Has your child's
hearing been tested?"
137. Parents bring their 10-year-old child for an evaluation due to concerns about the child's
reported difficulty paying attention in class and completing assignments in the expected time.
Parents report that the child has trouble staying on task while doing homework
assignments and they are concerned that the child has an attention disorder. At the
completion of the evaluation, the psychiatrist requests that both a parent and teacher fill out
a rating scale. The parent ratings fall into the clinical range, but the teacher's ratings do not
meet criteria for a clinical problem. How should the psychiatrist account for the
differences in observed ratings?
A. The child is exaggerating the problems due to dislike of school.
B. The child's symptoms are mild and don't require further evaluation.
C. Parents arc overly concerned about the child's school performance.
D. The teacher is too busy and overworked to notice the chi - ANSWERE. Rating discrepancies by
different observers are common in clinical practice
A 4th grader has a history of tics and attention-deficit hyperactivity disorder (ADHD), treated with a
stimulant medication. Recently, the tics worsened significantly and the
stimulant was discontinued; however, the tics persisted. When a psychiatrist is consulted,
the diagnoses of ADHD and Tourette syndrome are confirmed. Which of the following
21 A child with an IQ of 68 is most likely to exhibit adjustment issues and struggles during which of
the following developmental stages?
A. Infancy
B. Toddlerhood
C. Preschool
D. School-age
E. Adolescence - ANSWERE. Adolescence
41 A 9-year-old child has been successfully treated with methylphenidate for attention- deficit
hyperactivity disorder (ADHD) for several years. During the last 2 months, the
medication has not been as effective despite several dose adjustments. It is decided that
the child needs a different medication. Which of the following would be the best choice?
A. Buspirone
B. Atomoxetine
C. Desipramine
D. Risperidone
E. Mixed amphetamine salts - ANSWERE. Mixed amphetamine salts
48. Which of the following is the most widely used comprehensive (broad-band) rating scale for the
assessment of school-aged children due to the availability of age-based and
41. At a follow-up interview, the physician learns that the recent exacerbation of symptoms appears
to be related to increasing parental disagreement about how the patient's
outbursts should be handled. It would be most appropriate for the physician to next
obtain additional information about parental discipline and:
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