ADHD: ABFM practice questions

5 board-style questions on adhd in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 10-year-old boy presents with difficulty paying attention in school, frequently losing assignments, and being easily distracted for the past 8 months. His teacher reports he often fidgets, leaves his seat, and blurts out answers. These behaviors occur both at school and at home. His academic performance has declined. He has no history of trauma, sleep problems, or medical illness. Vanderbilt Assessment Scales from parents and teacher both indicate significant symptoms. What is the most appropriate next step?

  1. Confirm DSM-5-TR criteria are met and initiate combined stimulant medication plus behavioral therapy
  2. Order an EEG to rule out absence seizures
  3. Recommend behavioral therapy alone for 3 months before considering medication
  4. Start methylphenidate and schedule follow-up in 4 weeks

Sample question 2

A 9-year-old girl was recently started on methylphenidate extended-release for ADHD. At her 1-month follow-up, her parents report significant improvement in attention and school performance. However, they note she has lost 3 pounds, has difficulty falling asleep, and sometimes seems irritable in the evening. Her heart rate is 92 bpm and blood pressure is 108/68 mmHg. What is the most appropriate management?

  1. Continue methylphenidate, add sleep hygiene counseling with possible melatonin, monitor weight, and consider dosing adjustments
  2. Obtain an ECG before continuing the medication
  3. Discontinue methylphenidate and try behavioral therapy alone
  4. Switch to a non-stimulant medication such as atomoxetine

Create a free PulseMD account to answer these, see the explanations, and practice five minutes a day.

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