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 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?

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?

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?

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 16-year-old girl of South Asian descent presents to the PMHNP accompanied by her father. He reports that since the death of her mother 3 months ago, his daughter has been having episodes of strange behavior. He describes these episodes as beginning with a stomach ache and dizziness. Then she behaves as though her dead mother has taken control of her body. After a few minutes, she is back to herself again. Afterward, the patient states she cannot remember anything about these episodes. Which culture-bound syndrome should the PMHNP include in the differential diagnosis?

A 37-year-old woman who gave birth to twins 24 hours ago suddenly develops blurred vision, severe headaches, and upper abdominal pain under the ribs on her right side. Her last blood pressure reading was 146/92 mm Hg. Which of the following is the most appropriate treatment?

A 22-year-old woman recently began treatment with fluoxetine (Prozac) for major depressive disorder. She now exhibits symptoms of mania. She completes the Young Mania Rating Scale (YMRS) and her score is 25. What does this indicate?

A 63-year-old man was recently placed on warfarin (Coumadin) by his nurse practitioner. Which of the following supplements will he need to discontinue?

A 39-year-old Cambodian man presents to the PMHNP for an evaluation following an event that he refers to as "Khayal." Which culture-bound syndrome should the PMHNP include in the differential diagnosis?

The PMHNP is evaluating a 27-year-old woman who has been diagnosed with posttraumatic stress disorder due to a childhood history of sexual trauma. Today she has brought her husband with her. He reports that he sometimes feels he has "two wives who have different likes and dislikes, different tastes in food, clothing, and entertainment, and even talk in different voices." The patient says she has periods in which she has no memory of what took place. As an example, she says she may be dining out with her husband and have no recollection of how she got there. The PMHNP will evaluate for which of the following disorders?