1. An abused child runs to hide in the bedroom closet at the sound of the garage door opening even though the abusive parent no longer lives in the home, and even though hiding never prevented the abuse when that parent was present. This fear response can best be explained with which of the followi...
1. An abused child runs to hide in the bedroom closet at the sound of the garage door opening even
though the abusive parent no longer lives in the home, and even though hiding never prevented the
abuse when that parent was present. This fear response can best be explained with which of the
following learning models?
A. Incentive learning
B. Operant conditioning
C. Learned helplessness
D. Classical conditioning
E. Contingency management - ANSWERD
2. A child suddenly screams in the early part of the night with associated diaphoresis and tachypnea,
lasting for 1-2 minutes. The child has no recall of the events the next day. These events are most
associated with which of the following parasomnias?
A. Nightmares
B. Sleep terrors
C. Sleep talking
D. Confusional arousals
E. REM sleep behavior disorder - ANSWERB
3. An emergency room physician evaluates a child with new-onset symptoms of obsessions and
compulsions. The physician cannot determine a cause for the child's symptoms. Which of the
following steps taken by the emergency room physician is considered lifelong learning?
A. Obtain a psychiatry consult
B. Pursue further medical evaluation
C. Refer the patient to an outpatient psychiatrist
D. Review evidence-based literature regarding the symptoms
E. Develop a committee to create a standard evaluation for mental illness - ANSWERD
,4. The medical director of an outpatient clinic for youth with disruptive behavior disorders was
concerned that patients treated with antipsychotic medications were developing metabolic
syndrome. The clinic implemented a system in the electronic medical record in which charts were
flagged for providers and the clinic manager if the patient's body mass index had increased by more
than 2 points since baseline. This system is an example of:
A. root cause analysis.
B. continuous quality improvement.
C. consumer satisfaction monitoring.
D. health-plan sponsored practice protocol.
E. disease-specific outcome measurement. - ANSWERB
10. Which scale for attention-deficit/hyperactivity disorder (ADHD) in children has a validated version
for the child to complete?
A. ADHD Rating Scale-5
B. Conners 3rd Edition Rating Scale
C. Vineland Adaptive Behavior Scales
D. Swanson, Nolan, and Pelham-IV Rating Scale
E. Strengths and Weaknesses of ADHD Symptoms and Normal Behavior - ANSWERB
11. An adolescent who has been recently diagnosed with non-epileptic seizures has been sent from
school to the emergency department on multiple occasions due to having episodes during class. The
adolescent and parents state that they do not want the school to be informed of the patient's
diagnosis. If the physician wanted to advocate that the diagnosis should be shared with the school,
which of the following statements made by the physician would be best?
A. "There are several potential legal ramifications of not informing the school."
B. "There is real potential risk of inappropriate and invasive medical treatment."
C. "If the school is not informed, the hospital will no longer be able to admit your child."
D. "We will have to make a report to child protective services if you do not disclose the diagnosis."
E. "Due to the potential dangerousness of not informing the school, we are obligated to share the
diagno - ANSWERB
12. Which of the following symptoms is more common in adolescents with depression compared to
younger children with the disorder?
A. Irritability
,B. Melancholia
C. Hallucinations
D. Temper outbursts
E. Somatic complaints - ANSWERB
13. An adolescent with insulin-dependent diabetes who is in treatment for medical non-adherence is
pregnant. She wants to keep her pregnancy a secret and not inform her parents, citing the right to
health care confidentiality. The physician feels obligated to inform the parents of the pregnancy.
Which of the following concepts may justify the physician informing the parents of the pregnancy?
A. Rights of the fetus
B. Family-centered care
C. Imminent danger to patient
D. Parents must consent to care
E. Inability to document patient is a mature minor - ANSWERC
14. In the mental status assessment, a unique component to evaluating infants may include
observation for:
A. speech.
B. hyperactivity.
C. affect regulation.
D. feeding behaviors.
E. dysmorphic features. - ANSWERD
15. During a routine visit to the pediatrician, the mother of a 24-month-old girl states that she has
witnessed her daughter touching her vulva during baths. The mother asks if this behavior is cause for
concern. How should the pediatrician respond?
A. "This behavior is only atypical if done in a public setting."
B. "Genital self-stimulation should raise concern for sexual abuse."
C. "This behavior is only atypical if she displayed interests in other people's genitalia."
D. "Exploration of the body is a typical behavior at this age and there is no reason to be concerned."
E. "Typically developing children do not begin to engage in genital self-stimulation until they are
older. - ANSWERD
16. Which of the following rating scales provides a general screening of behavioral health symptoms
that identifies risk for childhood psychiatric disorders in a primary care setting?
, A. Pediatric Symptom Checklist
B. Patient Health Questionnaire-9
C. Mood and Feelings Questionnaire
D. McMaster Family Assessment Device
E. Screen for Child Anxiety Related Disorders - ANSWERA
17. The therapeutic effects of second-generation antipsychotic medications are partly mediated
through action on which of the following receptor sites?
A. 5-HT 1A
B. 5-HT 1B/D
C. 5-HT 2A
D. 5-HT 2C
E. 5-HT 3 - ANSWERC
18. In psychiatric billing, current procedural terminology codes refer to the:
A. time required to perform the service.
B. insurance to be billed for the service.
C. diagnosis for which services are being billed.
D. specific service delivered in a treatment session.
E. level of training of the clinician performing the service. - ANSWERD
19. A 17-year-old patient with a diagnosis of bipolar disorder reports experiencing "fast" thoughts
and high energy over the past week despite sleeping four hours nightly. The patient says her mood
has been "really good" most of the time but admits to becoming irritable with her friends and
boyfriend. She has been spending extra time on her schoolwork and is doing well academically. She
was recently sent to the principal for being uncharacteristically rude towards her teacher. Parents
note stability with lithium treatment; however, the patient has decided that her diagnosis is incorrect
and that she doesn't need to take medications. Which of the following depicts the best first step in
the management of this patient?
A. Discontinue lithium and initiate an alternative mood stabilizer
B. Provide education on coping skills to use in stressful situations
C. Increase the current lithium dose to target breakthrough sym - ANSWERE
20. Which of the following physiologic factors is associated with persistent aggression?
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