A 22-year-old woman presents for follow-up and evaluation 2 weeks after the initiation of fluoxetine (Prozac) for a diagnosis of major depressive disorder. At this visit, the PMHNP observes that the client has an elevated mood, her affect is expansive, and she is more talkative. The client says she has plans to write a novel that she believes will "change the face of American politics as we know it." When questioned about her potentially manic symptoms, the client becomes defensive. "I know you think I'm bipolar just because my mom was." She refuses to complete a self-rated mania symptom assessment tool. To further evaluate this client for mania, which of the following assessment tools will the PMHNP use?

A 19-year-old woman who prefers not to take medication uses a diffuser with lavender essential oil to help her calm down and fall asleep at night. Which biologically based therapy is she using?

The psychiatric-mental health nurse practitioner has just diagnosed a 23-year-old man with bipolar disorder. He has had one manic episode with suicidal ideation and no depressive episodes to date. Which of the following is the most appropriate at this time?

A 62-year-old woman presents to the PMHNP for an evaluation. She is concerned she is developing dementia due to her significant family history. Which of the following would help the PMHNP make a diagnosis of pseudodementia rather than dementia?

A 49-year-old female patient has been taking gabapentin for 6 months. It has produced some relief for her neuropathic pain, but she still rates her average daily pain at about a 5. What would be the next most appropriate treatment?

A 10-year-old boy displays deficits in intellectual functions that involve his ability to reason, solve problems, and learn from instruction or experience. He has been slow to develop skills in school and is behind his peers in reading, writing, and mathematical abilities. As a result, he has significant impairments in his ability to develop socially appropriate interpersonal communication skills and has developed no real friendships. He is dependent on others for assistance with his basic needs, such as dressing and feeding. Which of the following diagnoses most accurately represents this presentation?

A 25-year-old female pharmaceutical sales representative presents to the PMHNP for an evaluation due to what she calls an increasing level of anxiety about her job, which she has had for approximately 1 year. She works from a home office, and it has become unorganized and cluttered. She frequently forgets deadlines for submitting reports, and as a result she turns them in at the last minute. She has been chastised more than once by her boss for not paying attention to details on these necessary reports. Because she does not report to anyone on a day-to-day basis, she often gets completely overwhelmed by the autonomy of the job, and as a result she completely "shuts down." She knows she should be planning her time better, but she has never been good at time management or planning. During her evaluation, she reports making excellent grades until she got to college. She says she can remember not being able to pay attention to teachers as early as first grade, and her report cards frequently said she talked too much. She often got in trouble at home for not finishing chores because she was easily distracted and forgetful. Today, she says she is getting so overwhelmed and anxious about her job performance that she is thinking about quitting. She says her friends are tired of her complaining and tell her she has it "so good." She wishes someone would just tell her exactly what to do every day so she didn't have to think about anything.

Based on her understanding of the etiologic risk factors for Parkinson’s disease, the PMHNP asks about family history and:

An urgent care nurse practitioner comes in to examine his patient, a 77-year-old woman who was brought in by her family for altered mental status. He notes that the patient appears restless and does not know where she is. Upon further assessment, he notes that her pupils are sluggish to react to light and are unequal in size. She is unable to sit up at the side of the bed and her blood pressure is 190/88 mm Hg. Which of the following does the NP suspect?

A 52-year-old woman with a BMI of 31 is diagnosed with osteoarthritis of the knee. The nurse practitioner (NP) instructs the woman that weight loss will help minimize both pain and functional loss. Which of the following most closely explains the NP's advice to lose weight?

A 68-year-old male patient on an inpatient geropsychiatric unit scored 3 on the Lewy Body Composite Risk Score (LBCRS). What does this score indicate?