Midterm Exam: NR 606/ NR 606 (Latest Update 2024/ 2025) Diagnosis & Management in Psychiatric Mental Health II Practicum Review |Weeks 1-4 Covered| Questions and Verified Answers| 100% Correct - Chamberlain Q: Piaget's Stages of Cognitive Development Answer: -Sensorimotor stage: Birth -2 yrs • cognitive abilities based on reflexes • object permanence & causality -Preoperational stage: 2 -7yrs • can use mental representations, symbolic thought, & language • thinking is egocentric -Concrete operational stage: 7 -11yrs • logical operations when thinking/solving problems • thinking is concrete -Formal operational stage: 12yrs+ • Adolescent can use abstract reasoning in addition to logical operations • Child can understand theories, hypothesize, comprehend abstract ideas (love & justice) Q: Screening, Brief Intervention, Referral to Treatment (SBIRT) Answer: -Screening • Quickly assesses severity of substance use & ID the appropriate level of tx -Brief intervention • Focuses on increasing insight & awareness regarding substance use & motivation toward behavioral change -Referral • Guidance to tx provides those identified as needing more extensive tx with access to specialty care Q: Medication -Assisted Treatment (MAT) Answer: Treatment for opioid use disorder combining the use of medications (methadone, buprenorphine, or naltrexone) with counseling and behavioral therapies. Q: Mental health and youth Answer: -13% of children ages 8 -15 experience a mental health condition -50% of children ages 8 -15 experiencing a mental health condition do not receive tx -13-20% of children living in the U.S. (1 out of 5 children) experience a mental health condition in a given year -17% of high school students seriously consider suicide -1/2 of all lifetime cases of mental illness begin by age 14 Q: Barriers to Mental Health Treatment in Children and Adolescents Answer: -lack of sufficient information or access to services -stigmas or negative perceptions towards mental health services -many drop out before receiving effective treatment, often due to: • poverty • language barriers • living in communities with scarce resources • stressors such as ➣problems in the family ➣violence in the community ➣unstable housing ➣unemployment ➣food insecurity -Cost -scheduling conflicts -long waitlists for services -high staff turnover Q: Prescribing Considerations for Children and Adolescents Answer: -physiologic factors impact pediatric med selection & dosing -Children, more rapid metabolism than adults, may require larger dose of med per unit of body weight -Around puberty, pharmacokinetic properties reach adult parameters • dosing after puberty may need to be decreased -Developmental considerations • attuned to signs of adverse effects, younger children may not be able to communicate complaints Q: Kassia, a 5 -year-old, is prescribed a stimulant medication for ADHD for the first time. Consider Piaget's stages, match the developmentally -appropriate education statements with the correct client: "It's kind of like you've got a great bike. The brakes just need some fixing. The medication is like fixing the brakes." "This medication can help you ignore distractions so you can complete tasks. They can also help with self -control, which may help you get along better with your friends and parents. Do you have any concerns about taking the medication?" "Do you know how it's sometimes hard for you to sit still and pay attention at school? This medicine will help you." Answer: "Do you know how it's sometimes hard for you to sit still and pay attention at school? This medicine will help you." Rationale: Kassia is in the Preoperational Stage. This stage usually lasts from ages 2 -7. Children think symbolically. They learn to use words or pictures to represent objects. They are egocentric and have difficulty seeing things from others' perspectives. Preoperational thinking is very concrete. Q: Oliver, a 10 -year-old, is prescribed a stimulant medication for ADHD for the first time. Consider Piaget's stages, match the developmentally -appropriate education statements with the correct client: "It's kind of like you've got a great bike. The brakes just need some fixing. The medication is like fixing the brakes." "This medication can help you ignore distractions so you can complete tasks. They can also help with self -control, which may help you get along better with your friends and parents. Do you have any concerns about taking the medication?" "Do you know how it's sometimes hard for you to sit still and pay attention at school? This medicine will help you." Answer: "It's kind of like you've got a great bike. The brakes just need some fixing. The medication is like fixing the brakes." Rationale: Oliver is in the Concrete Operational Stage. This stage usually lasts from age 7 -11. Thinking becomes more logical and organized about concrete events. Children begin to reason inductively, from specific information to general principles. The us e of simile is a helpful instructional strategy for children in this stage. Q: Tamika, a 15 -year-old, is prescribed a stimulant medication for ADHD for the first time. Consider Piaget's stages, match the developmentally -appropriate education statements with the correct client: "It's kind of like you've got a great bike. The brakes just need some fixing. The medication is like fixing the brakes." "This medication can help you ignore distractions so you can complete tasks. They can also help with self -control, which may help you get along better with your friends and parents. Do you have any concerns about taking the medication?" "Do you know how it's sometimes hard for you to sit still and pay attention at school? This medicine will help you."
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