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
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:
A. explore reasons for parental differences.
B. reinforce the parent with the best approach.
C. Explain the options for psychiatric interventions.
D. explore the parents' slowness in obtaining care.
E. Elicit the child's opinion about which parent's discipline style works best - ANSWERA. explore
reasons for parental differences.
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
63. A 5-year-old bilingual child is referred for evaluation and treatment of progressive refusal to
speak in public, especially in school. The child is described as very talkative at home but is completely
silent throughout the entire kindergarten day. Upon completing the evaluation, the psychiatrist
concludes that the child meets criteria for selective mutism. When meeting with the parents to
discuss possible options for intervention, it would be most appropriate for the psychiatrist to initially
recommend:
A. a 2-month course of a intermediate-acting benzodiazepine.
B. individual play therapy to help the child work out Oedipal conflicts.
C. a 6-month course of a selective serotonin reuptake inhibitor (SSRI).
D. family therapy to explore the family dynamics maintaining the symptom.
E. behavioral treatment to increase the child's tolerance for speaking in public. - ANSWERE.
behavioral treatment to increase the child's tolerance for speaking in public.
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