The psychiatric-mental health nurse practitioner is treating a 6-year-old boy with autism spectrum disorder (ASD) who has not responded to 9 months of psychosocial therapy and continues hitting his younger brother. What is the most appropriate treatment for the PMHNP to initiate at this time?
Sertraline (Zoloft) 10 mg PO once per day
Carbamazepine (Tegretol) 200 mg PO once per day
Risperidone (Risperdal) 0.25 mg PO once per day
Venlafaxine (Effexor) 37.5 mg PO once per day
The Correct Answer is C
Choice A reason: Sertraline, an SSRI, may help with anxiety or repetitive behaviors but has limited evidence for treating aggression in children with ASD.
Choice B reason: Carbamazepine is an anticonvulsant, sometimes used for mood stabilization, but is not first-line for irritability or aggression in ASD.
Choice C reason: Risperidone is FDA-approved for irritability, aggression, and self-injurious behavior in children with ASD and is considered first-line pharmacologic treatment for these behaviors.
Choice D reason: Venlafaxine, an SNRI, is not indicated for aggression in ASD and lacks evidence for treating behavioral symptoms in this population.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This is the correct answer. Tic disorders, including Tourette disorder, frequently co-occur with obsessive-compulsive disorder and related disorders. Compulsive behaviors can exacerbate functional impairment and should be assessed for comprehensive management.
Choice B reason: While tic disorders can co-occur with autism spectrum disorder in some cases, the association is less common and not as characteristic as with OCD-related conditions.
Choice C reason: Global developmental delay is a broader developmental condition and is not typically associated with tic disorders.
Choice D reason: Intellectual disability is not commonly linked to tic disorders; most children with tics have normal cognitive development.
Correct Answer is B
Explanation
Choice A reason: Trichotillomania involves hair-pulling, but it is typically focused on the act of pulling as a tension-relieving behavior rather than an appearance-focused compulsion driven by perceived flaws.
Choice B reason: This is the correct answer. Body dysmorphic disorder involves preoccupation with perceived physical flaws, leading to repetitive behaviors (such as tweezing) to "correct" perceived imperfections. The patient’s anxiety about eyebrow asymmetry and time-consuming compulsive behavior aligns with BDD.
Choice C reason: Delusional disorder, somatic type, involves fixed false beliefs about bodily functioning or appearance, but the patient demonstrates insight that the asymmetry is “all in her head,” ruling out delusional disorder.
Choice D reason: Obsessive-compulsive disorder involves intrusive thoughts and compulsions but is not specifically focused on perceived physical flaws, which distinguishes it from BDD in this scenario.
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