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Nurse Practitioner:
doi: 10.1097/01.NPR.0000425987.49717.69
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Irritability in the pediatric population

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INSTRUCTIONS Irritability in the pediatric population

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Irritability in the pediatric population

General Purpose: The purpose of this learning activity is to provide information about irritability as a symptom of specific pediatric mental health disorders as well as diagnosis and treatment of the disorder. Learning Objectives: After reading this article and taking this test, the reader should be able to: 1. Differentiate between four mental health disorders using irritability as a diagnostic criterion. 2. Explain use of diagnostic tools for identifying each disorder. 3. Discuss treatment options for the four disorders described.

1. Which of the following statements is correct?

a. ADHD has an estimated heritability of 76%.

b. There is minimal symptom overlap between the common pediatric mental health disorders.

c. There are no pediatric screening tools for oppositional defiant disorders.

d. There is minimal evidence focused on conduct disorder.

2. Which of the following may be used to establish diagnoses of pediatric mental health disorders?

a. group therapy evaluation

b. targeted observation

c. inpatient observation and testing

d. targeted intelligence testing

3. The DSM-IV-TR defines irritable mood as

a. inability to concentrate.

b. mood swings.

c. easily annoyed and provoked to anger.

d. impairment of the thought process.

4. Which of the following statements about irritability is accurate?

a. It is never associated with bipolar disorder.

b. It is always normal during adolescence requiring no intervention.

c. It is one of the diagnoses found in the DSM-IV-TR.

d. It is a symptom associated with depression.

5. In the DSM-IV-TR, irritability is implied in the criteria for

a. ADHD.

b. major depressive disorder.

c. generalized anxiety disorder.

d. ODD.

6. Which is a DSM-IV-TR diagnostic criterion for major depressive disorder?

a. insomnia

b. decisiveness

c. defiant behavior

d. separation anxiety

7. DSM-IV-TR diagnostic criteria for ODD include all of the following except

a. often loses temper.

b. often feels worthless.

c. often argues with adults.

d. often blames others for his or her mistakes.

8. In the mnemonic, Worry WARTS, the S stands for

a. Sensitive.

b. Suicidal ideation

c. Sleepless.

d. Stress.

9. The Child Depression Inventory self-report version

a. reports symptoms including negative mood.

b. can be used by children as young as 5 years old.

c. can also be used by parents and teachers.

d. measures general anxiety and social phobia.

10. SCARED

a. screens children 6 to 8 years old.

b. measures negative mood and interpersonal problems.

c. measures social phobia and school phobia.

d. assesses symptom presence in classroom, home, and social settings.

11. Regarding the genetic component of common mental health disorders,

a. pediatric depression has an estimated heritability of 76%.

b. there is no heritability found with anxiety disorders.

c. ODD has a higher heritability than ADHD.

d. ADHD is one of the most heritable disorders.

12. One medication FDA-approved for pediatric major depressive disorder is

a. methylphenidate.

b. atomoxetine.

c. fluoxetine.

d. guanfacine.

13. Methylphenidate is FDA-approved to treat

a. major depressive disorders.

b. ADHD.

c. generalized anxiety disorder.

d. ODD.

14. Selective norepinephrine reuptake inhibitors (SNRI) are used for

a. ADHD when psychostimulants are not tolerated.

b. ODD as first-line treatment.

c. separation anxiety.

d. generalized anxiety disorder as first-line treatment.

15. Which of the following regarding FDA-approved medications for ODD is correct?

a. There are several psychostimulants approved.

b. Methylphenidate is approved.

c. Certain SSRIs are approved.

d. There are no FDA-approved medications for children.

16. Patients with severe depression and agitation or psychosis usually require

a. psychotherapy only.

b. psychotherapy and a stimulant.

c. cognitive behavioral therapy and antidepressant therapy.

d. cognitive behavioral therapy.

17. The first-line treatment for anxiety disorders is

a. parent management training.

b. cognitive behavioral therapy.

c. stimulant medication.

d. antidepressant therapy.

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