A mother brings her 5-year-old daughter to the PMHNP for concerns about her speech articulation. She has never sustained a head injury, was not exposed to prenatal toxins, was delivered vaginally without problems, is otherwise healthy, and is developmentally in line with her peers. She has struggled with speech articulation; her daycare teachers first noticed it and she received speech therapy beginning at that time. She has no issues relating with her peers, and she is highly imaginative in her play. Despite having speech therapy, her speech is still difficult to understand. What is the most likely diagnosis?

A 31-year-old female patient with posttraumatic stress disorder (PTSD) takes prazosin (Minipress) for PTSD-associated nightmares. According to best practice guidelines, what nonpharmacologic treatment has the highest level of evidence for the treatment of nightmares in adults with PTSD?

Which virtue is associated with successful resolution of the psychosocial developmental stage Industry vs. Inferiority?

A 9-year-old boy is referred to the PMHNP by the school counselor after his parents request help with his behavioral issues. He is in third grade, and although he is doing "fine" academically, he constantly interrupts, fidgets, talks excessively, and gets out of his seat and walks around the classroom. He has friends, but they often get frustrated with him because he talks over them and he wants to play sports nonstop. At home, he can barely stay in his seat to do his homework or eat a meal. He often gets upset with his parents for trying to redirect him to finish his chores or his schoolwork, and they end up sending him to his room. He does show remorse when his behavior is pointed out to him, yet he is unable to inhibit himself. What is the most likely diagnosis?

A 3-year-old girl with a history of prenatal exposure to methamphetamines is brought to the PMHNP by her grandmother for an evaluation of her readiness to attend preschool. She demonstrates substantial delays across multiple domains of functioning, including communication, learning, attention, and motor development. These deficits will limit her ability to interact with same-age peers. She also requires substantial support in all activities of daily living at home. Due to custodial circumstances, her grandmother is a poor historian and is unable to provide information about the age of onset for these symptoms. What is the most appropriate diagnosis?

A 74-year-old client is diagnosed with COVID and is admitted to an inpatient hospital. Days later, he is more energetic than before his diagnosis. He exhibits flights of ideas, delusions of grandeur, and is ready to leave the hospital because he feels "so incredible." Which of the medications used in the treatment of COVID could have induced mania in this client?

A 9-year-old girl witnessed the violent murder of a close family member. She now says she is blind. However, she flinches when objects are quickly moved toward her face. There is no neurologic evidence of blindness. What is the most likely diagnosis?

A lumbar puncture would be contraindicated in a 68-year-old woman suspected of having Alzheimer's disease if she has a history of which of the following?

A 22-year-old man reports that he hears someone knocking on his door at night, but every time he answers the door, no one is there. He thinks he hears his neighbors outside talking, even when he knows they are not home. He says he knows it’s his “imagination," but he feels “compelled” to answer the door, “no matter what time of day,” even if he is sleeping. He says he has had similar episodes “in the past,” but this has been going on for at least 6 months, and it has become problematic. What is the most appropriate diagnosis?

The psychiatric-mental health nurse practitioner is treating a 6-year-old boy with autism spectrum disorder (ASD) who has not responded to 9 months of psychosocial therapy and continues hitting his younger brother. What is the most appropriate treatment for the PMHNP to initiate at this time?

A 26-year-old woman in her 37th week of pregnancy tested positive for Group B Streptococcus (GBS). To prevent passing the infection to her newborn, which antibiotic class is appropriate?