A 36-year-old man is evaluated by the PMHNP for a recent incident in which he stayed up for several nights in a row, had much more energy than usual, and believed he was talking to God. He was diagnosed with bipolar disorder. In reviewing his medications, the PMHNP finds he is taking acetaminophen 500 mg BID, bupropion XL (Wellbutrin) 150 mg once daily, Sam-E for pain from an old football injury, and alprazolam 0.5 mg pm for agitation. Which of these should be discontinued immediately?

A mom brings her 13-year-old daughter to the PMHNP for an evaluation of suspected attention-deficit hyperactivity disorder (ADHD). For an adolescent who presents with distractibility, which of the following additional features would suggest an association with bipolar II disorder rather than ADHD?

An 85-year-old female patient with dementia who is an inpatient in a facility with geriatric psychiatric services asks the PMHNP if she can have her lavender essential oil to smell when she is agitated. She states that it calms her down. The PMHNP instructs the staff to provide the patient with this oil, which is a type of complementary and alternative therapy known as:

A pregnant 30-year-old woman complains of persistent numbness on the palmar surface of her right hand and of pain in her right arm. Her symptoms are more severe in the morning. Neurologic examination reveals a sensory deficit in the right thumb and the index and middle fingers, as well as on the lateral half of the ring finger. The patient has weakness when abducting the thumb. Which of the following is considered first-line treatment?

The father of an 18-year-old girl who is being treated for generalized anxiety disorder with panic attacks calls the PMHNP with questions about the medications she was prescribed. He demands the information because the patient lives in his home and is on his health insurance plan. What should the nurse practitioner do?

A 37-year-old man presents to the PMHNP based on a referral from his primary care physician, who suspects rapid cycling bipolar I disorder. Which of the following should be ordered to rule out an underlying medical etiology?

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 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?

The PMHNP is evaluating a new client who reports symptoms of one hypomanic episode and at least one major depressive episode. Which psychiatric condition is most closely associated with these experiences?

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?

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