PRITE - CHILD PSYCHIATRY EXAM NEWEST 2024 WITH COMPLETE
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41. A 12-year-old child is referred to the psychiatrist for worsening attention, impulsive
behavior and hyperactivity. The child has recently begun to wet the bed, with no
daytime symptoms of urinary frequency or urgency. Parents report that it is difficult to
awaken the patient in the morning and note that the patient has been snoring more
frequently. On examination, the patient has significant central adiposity, broad-based
neck and enlarged tonsils. The remainder of the exam is unremarkable. The psychiatrist
is considering a diagnosis of attention-deficit hyperactivity disorder (ADHD) but is
concerned about the patient's sleep. Which of the following statements is most accurate
about the relationship of ADHD and sleep in this patient?
A. Treating the nocturnal enuresis should result in relief of ADHD symptoms.
B. Treatment with an atypical antipsychotic will address symptoms of ADHD and sleep.
C. Correcting the u - ✔✔ANSW✔✔..C. Correcting the underlying sleep disordered
breathing can improve ADHD symptoms.
41. A 7-year-old African-American child is being evaluated for academic difficulties. The
child was adopted at birth by a married couple who are Caucasian-American. The
adoption is an open one and the child has met the biological grandparents who are
supportive of the adoption. One biological parent has bipolar disorder. Which of the
following confers the highest risk for psychopathology for this child?
A. Being different race than adoptive parents
B. Having biological relatives with psychiatric illness
C. Being adopted by non-biologically-related individuals
D. Having an open adoption with knowledge of birth relatives
E. Being adopted as an infant, coming home at 3 days of age - ✔✔ANSW✔✔..B.
Having biological relatives with psychiatric illness
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 -
✔✔ANSW✔✔..A. explore reasons for parental differences.
42 The psychiatrist educates the parents about possible reasons for the perpetuation of
the child's temper tantrums. The psychiatrist teaches the parents how to develop and
implement an age-appropriate behavioral management plan with clear expectations and
consequences. Over the next month, the child's behavior improves. The parents state
that whenever the child has a temper tantrum they ignore the behavior, wait for the child
to calm down and then expect the child to obey the rules. The behavior has most likely
improved because the child has:
A. had negative reinforcement of the tantrums removed.
B. developed insight into the reasons for the oppositional behaviors.
C. realized how inappropriate and maladaptive the behavior had been.
D. learned to identify the maladaptive ideas that motivate the behavior.
E. acquired mindfulness and the ability to use the senses to self soothe -
✔✔ANSW✔✔..A. had negative reinforcement of the tantrums removed.
102. A 14-year-old patient recently released from juvenile detention is brought to the
emergency department by police for assessment of aggressive behavior. Parents called
the police after the teen started yelling, cursing, throwing things and hitting one of the
parents. The teen has had behavior problems since early elementary school, but no
psychiatric or medical history. In addition to diagnosing the behavior problem,which of
the following is the most appropriate initial step for the psychiatrist to take?
A. Evaluate the patient for additional psychopathology
B. Neuroimaging and hormonal screening of the patient
C. Neurological and physical examination of the patient
D. Documentation of patient's criminal history
E. Clarification of the patient's guardianship - ✔✔ANSW✔✔..A. Evaluate the patient for
additional psychopathology
103. The psychiatrist evaluates a 7-year-old child who was referred for having
"emotional outbursts" at school. The parents describe the child as a generally well-
behaved, and cannot identify stressors in the home. Parents indicate that the child was
initially excited about school, but has been increasingly reluctant to go in the morning,
often complaining of stomach aches as school time approaches. Which of the following
steps should the
psychiatrist take next?
A. Refer to a neurologist
B. Recommend homeschooling
C. Obtain neuropsychological testing
D. Obtain a release to speak with the child's teacher
, 4. Suggest the family return at the end of the school year to re-evaluate -
✔✔ANSW✔✔..D. Obtain a release to speak with the child's teacher
103. The Treatment for Adolescents with Depression Study (TADS) recommended
which of the following treatments for patients with moderate to severe depression?
A. Fluoxetine alone
B. Interpersonal psychotherapy (IPT) alone
C. Cognitive-behavioral therapy (CBT) alone
D. Fluoxetine and IPT
E. Fluoxetine and CBT - ✔✔ANSW✔✔..E. Fluoxetine and CBT
105. A child with intellectual disability is free of childhood seizures but develops epilepsy
in adolescence. This pattern of onset is often seen is which of the following
neurodevelopmental disabilities?
A. Down syndrome
B. Tuberous sclerosis
c. Angelman-syndrome
d. Prader-willi syndrome
e. autism spectrum disorder - ✔✔ANSW✔✔..E. autism spectrum disorder
107. A 4-year-old child is brought in for an evaluation. The child was hypotonic as an
infant and now is demonstrating developmental delays, foraging for food, and having
many temper tantrums. Which of the following is the most likely diagnosis?
A. Down syndrome
B. Williams syndrome
C. Fragile X syndrome
D. Angelman's Syndrome
E. Prader-Willi syndrome - ✔✔ANSW✔✔..E. Prader-Willi syndrome - is a condition that
is caused by Methylation of maternal genes and paternal is expressed. Patient may
have hyperphagia due to lesion on medial hypothalamus that is responsible for satiety
or his lateral hypothalamus may be firing uncontrollably, making him hungry or "forage
for food."
107. Which of the following comorbid diagnoses of childhood attention-deficit
hyperactivity disorder (ADHD) worsens the prognosis into adolescence and adulthood
to the greatest degree?
A. Conduct disorder
B. Tourette syndrome
C. Major depressive disorder
D. Generalized anxiety disorder
E. Expressive language disorder - ✔✔ANSW✔✔..A. Conduct disorder
11 . A 15-year-old patient is brought to the emergency department for agitation and
paranoia. The patient seems to be hallucinating, and comments that, "I'm walking on
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