Child and Adolescent Mental Health — Practice Questions
Psychiatry — Child and Adolescent Mental Health, NMC MBBS licence examination syllabus (Nepal Medical Council).
Child and adolescent mental health — NMC-style practice questions
Practice questions written for this chapter. These are not past NMC papers.
📋 About these questions: These are practice questions written to test the reasoning in this chapter. They are NOT reproduced from any past Nepal Medical Council examination, and no verified past NMC questions were supplied for this chapter. They test principles rather than milestone ages, which must come from the chart in current national use.
Level 1–2 — recall and understanding
Q1. A child who has LOST skills they previously had is
described as showing:
A. Normal variation
B. REGRESSION — always abnormal
C. Global delay
D. Isolated delay
ANSWER: B — regression.
Why: slow acquisition of a skill may be normal variation, but
losing a skill already gained is never normal and requires
urgent assessment rather than review in six months.
LEARNING POINT: this distinction answers a large number of
developmental questions.
Q2. Every child presenting with SPEECH delay should have:
A. Brain imaging
B. A HEARING test
C. Genetic testing
D. Reassurance only
ANSWER: B — hearing assessment.
Why: isolated delay points to the system involved, and hearing
loss is a common, treatable and frequently missed cause of
speech delay.
LEARNING POINT: similarly, assess vision in fine motor delay.
Level 3–4 — application and clinical reasoning
Q3. A 15-year-old has become irritable and withdrawn, his
grades have collapsed and he has stopped seeing friends.
His parents request advice on discipline. You should:
A. Advise on behavioural management
B. SEE HIM ALONE for part of the consultation and assess
for depression, including risk
C. Reassure that this is normal adolescence
D. Refer to school only
ANSWER: B.
Why: depression in adolescence commonly presents as
irritability and behaviour change rather than stated sadness.
Withdrawal and falling grades represent functional decline.
LEARNING POINT: explain confidentiality and its limits, then
ask directly about self-harm and suicidal thoughts.
Q4. A 10-year-old has attended four times with abdominal
pain, all investigations normal, and is refusing school.
The best next step is:
A. Further investigation
B. Explore HOME AND SCHOOL, including bullying and family
circumstances
C. Prescribe an analgesic
D. Reassure and discharge
ANSWER: B.
Why: recurrent unexplained pain with school refusal is a
common presentation of psychological distress in this age
group. The pain is genuinely felt, but more tests will not
explain it.
LEARNING POINT: see the child alone for part of the
consultation.
Q5. A 4-month-old who cannot yet roll presents with bruising,
explained as rolling off a bed, with a changing story and
two days' delay. The clinician is uncertain. He should:
A. Accept the explanation to avoid offending the family
B. DOCUMENT carefully, examine fully and ESCALATE
C. Wait for a second episode
D. Discharge with advice
ANSWER: B.
Why: an infant who cannot roll cannot roll off a bed, so the
explanation does not fit the developmental stage. Delay and a
changing account add to the concern.
LEARNING POINT: you do not need to be certain — concern is
enough to act on.
Level 5 — exception-based
Q6. Why should you NOT promise an adolescent complete
confidentiality?
A. Parents are always entitled to information
B. Serious risk of harm may require disclosure — and a
promise you cannot keep destroys trust
C. Confidentiality does not apply under 18
D. Records are shared automatically
ANSWER: B.
Why: confidentiality is strong but not absolute. Explaining
the limits at the start — and saying you would tell them
before telling anyone else — preserves the relationship.
LEARNING POINT: see the ethics chapter for the exceptions to
confidentiality.
Q7. Why is parental concern about a child's development
clinically valuable?
A. Parents are usually anxious without cause
B. Parents detect real problems EARLIER than clinicians do
C. It has no diagnostic value
D. It only matters after age five
ANSWER: B.
Why: parental concern is a sensitive screening indicator.
"I think he can't hear me" is a finding to be investigated,
not an anxiety to be soothed.
LEARNING POINT: combine it with structured assessment across
the four domains.
Syllabus points
Recall and understanding questions
Application and clinical reasoning questions
Exception-based questions
Create a free account to tick topics off, take notes as you read, watch the video lessons and get a day-by-day study plan built around your exam date.
Related topics in Child and Adolescent Mental Health