A 28-year-old woman presents to the psychiatric-mental health nurse practitioner for evaluation of depression and anxiety. She states that her older sister and her mother have been on antidepressants "for years." She has avoided coming to the "crazy doctor" for "a long time." She is nervous about taking medication because she is worried about side effects. She asks about getting a genetic test to see which medication would work best for her. What is the PMHNP's most appropriate response?
"You don't need a genetic test until you have failed a few medications."
"We can certainly conduct a genetic screening test if you would like."
"Which medications are your mother and sister taking?"
"We can certainly obtain a genetic test; while we wait for results, let's start with a medication that is working for your mother or sister."
The Correct Answer is C
Choice A reason: Waiting to perform a genetic test until after multiple medication failures unnecessarily delays personalized care and may contribute to patient anxiety.
Choice B reason: Offering a genetic test respects the patient’s interest in pharmacogenomics, supports shared decision-making, and can guide individualized treatment to minimize side effects and improve outcomes.
Choice C reason: Knowing family medication history is helpful but does not directly address the patient’s request for genetic testing or guide immediate personalized care.
Choice D reason: Initiating treatment based on family history before obtaining test results may compromise the principle of individualized care and ignores the patient’s expressed interest in genetic testing.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Lack of social engagement is common in autism spectrum disorder and is not specific to Rett syndrome.
Choice B reason: Lack of imaginative play is also a feature of autism but is not uniquely associated with Rett syndrome.
Choice C reason: Deceleration of head growth (microcephaly) around 6 months of age is a hallmark of Rett syndrome, distinguishing it from autism, and, combined with motor regression and stereotypic hand movements, strongly supports this diagnosis.
Choice D reason: Lack of eye contact can occur in both autism spectrum disorder and Rett syndrome, so it is not a differentiating factor.
Correct Answer is B
Explanation
Choice A reason: The practice constitutes fraud because billing does not reflect actual service provided, so stating it does not is incorrect.
Choice B reason: Upcoding occurs when a provider bills for a higher-level service than was actually provided, as in coding 30 minutes of psychotherapy when only 5 minutes of service occurred.
Choice C reason: Unbundling involves separating components of a service to increase reimbursement, which does not accurately describe this scenario.
Choice D reason: QuiTam refers to whistleblower lawsuits under the False Claims Act, not the type of billing fraud itself.
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