A 66-year-old man is a long-time client of the PMHNP. He has been taking several vitamins under the supervision of the provider. Recently, he had a transient ischemic attack (TIA) and was placed on warfarin (Coumadin). Which of the following vitamins or supplements will the client need to discontinue?

The APRN asks the patient to elevate his eyebrows, close his eyes, smile, frown, and puff out his cheeks. Which cranial nerve is the NP assessing by issuing these instructions?

Which of the following aspects of bipolar disorder predicts a favorable response to lithium 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?

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?

A 24-year-old woman presents to the PMHNP for a psychiatric evaluation with a chief complaint of depression. Upon questioning, the client states that during certain periods of time, she has needed little sleep but still felt energetic. She has had "creative spurts” during these periods, during which she has started new projects, such as home decorating and writing a book. Which of the following assessment tools will the PMHNP use to assist in diagnosis?

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 PMHNP is evaluating a 7-year-old boy who is brought in by his grandmother. The child has epicanthal skin folds, a short nose, a small head circumference, and a smooth, indistinct philtrum. What is the most likely diagnosis?

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?

In bipolar disorder, it is theorized that initial episodes are likely triggered by major life events that cause the brain to become overly sensitive to electrical stimulation. Successive episodes grow increasingly more autonomous due to neuronal misfiring. Which term represents this concept?

A 22-year-old woman diagnosed with bipolar disorder missed her last two appointments with the PMHNP after she was started on lithium (Eskalith). Her mother brought her to a third appointment. The patient was excited to see the PMHNP, as evidenced by her rapid rate of speech and discussion about the book she was writing. The patient went on to say that God had spoken directly to her and given her a message that only she could give to the world. She said she hadn’t been able to sleep for at least 1 week because she had been so busy working on this book, but she felt “absolutely incredible” despite her lack of sleep. Both the patient and the mother insist she has not stopped taking her medication. The PMHNP orders laboratory studies, including a lithium level. Which level of lithium will be subtherapeutic and indicate a need for an increased dose?