The mother of a 12-year-old boy is concerned about the increasing number of times he shrugs his shoulders, rapidly blinks, and clears his throat. He is not taking any medications that would cause these behaviors. Which psychiatric condition is characterized by these features?
Attention deficit-hyperactivity disorder
Stuttering
Oppositional defiant disorder
Tourette syndrome
The Correct Answer is D
Choice A reason: ADHD primarily affects attention and impulse control, not involuntary motor or vocal tics.
Choice B reason: Stuttering involves disruptions in speech fluency but does not include motor tics such as blinking or shoulder shrugging.
Choice C reason: Oppositional defiant disorder is characterized by defiant and argumentative behavior, not involuntary tics.
Choice D reason: Tourette syndrome is characterized by multiple motor tics and at least one vocal tic, which may include blinking, shoulder shrugging, and throat clearing, consistent with the patient’s presentation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Neuroimaging studies in children with ADHD often show reduced total brain volume, particularly in the prefrontal cortex, basal ganglia, and cerebellum, supporting neurodevelopmental involvement in the disorder.
Choice B reason: Slow-wave activity on EEG may be altered in some neurodevelopmental disorders, but decreased slow-wave activity is not a specific marker for ADHD.
Choice C reason: Thalamic volume reduction is not consistently associated with ADHD; abnormalities are more commonly observed in cortical and subcortical structures.
Choice D reason: ADHD is associated with delayed cortical maturation, particularly in the prefrontal cortex, rather than early posterior-to-anterior cortical maturation.
Correct Answer is B
Explanation
Choice A reason: Alterations in dopamine pathways are involved in ADHD, but the pattern described—decreased dopamine in the mesocortical and increased in the mesolimbic—is more characteristic of schizophrenia rather than ADHD. ADHD involves overall dysregulation and reduced activity in dopaminergic circuits that modulate attention and impulse control.
Choice B reason: Abnormalities of frontosubcortical pathways represent the most consistent neurobiological finding in ADHD. The frontosubcortical circuits connect the prefrontal cortex with subcortical structures like the striatum and thalamus. Dysfunction in these regions leads to deficits in executive function, attention regulation, impulse control, and working memory. Neuroimaging studies show reduced activity and smaller volumes in these regions among individuals with ADHD, correlating with the behavioral symptoms of inattention and hyperactivity.
Choice C reason: Increased activity in the ventral tegmental area and nucleus accumbens would lead to heightened reward-seeking behavior rather than impaired attention. These regions are part of the brain’s reward system, and their increased activity is associated more with addictive behaviors and mania than ADHD.
Choice D reason: Serotonin abnormalities can influence mood and anxiety but are not primary in ADHD’s pathophysiology. ADHD primarily involves dysregulation of dopaminergic and noradrenergic transmission in frontostriatal circuits.
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