The expressive and receptive language development of a 5-year-old girl is severely impaired. The child also displays severe psychomotor retardation, poorly coordinated gait and trunk movements, and stereotypic hand movements. What other associated features would lead the PMHNP to suspect a diagnosis of Rett syndrome rather than autism spectrum disorder in this patient?

The parents of a 16-year-old adolescent girl come to the PMHNP requesting treatment for her "so-called gender issues." The mother cries while the father says, "She says she has wanted to be a boy ever since she was 4 years old. This is all just nonsense. It's a phase, and the sooner she gets over it, the better." The daughter acknowledges "feeling like a boy" since the age of 4, and she currently binds her breasts. She also wants to be called by a male name. Her father wants to send her to conversion therapy offered by their church. The mother wants to know the PMHNP's opinion. Which of the following is the most appropriate response?

A 40-year-old man tells his wife he thinks he is having a midlife crisis. In which Erikson stage does the midlife crisis occur?

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 27-year-old married woman reports to the PMHNP that she is experiencing significant distress in her marriage because she "hates" going to social events, and her husband's job requires attending regular social gatherings. She avoids these activities because she is "terrified" she will do or say something embarrassing, and she has started pretending she has headaches to get out of going to them. Her husband doesn't understand why she doesn't want to go to these parties, which are typically small gatherings of less than 15 people. She admits that when she does go, they end up being "no big deal." The PMHNP will diagnose this woman with which of the following?

A 16-year-old girl has a bald spot on her scalp and her mother brings her to the PMHNP on the advice of her primary care provider after all medical causes are ruled out. The girl admits to pulling out her hair in class when she is bored, but says she tends to pull it out more often in math class where she is making Cs. This is the first year she is not doing well in math, and her mother says it is "stressing her out." What is the most appropriate diagnosis?

Which of the following is a biological finding in patients with attention deficit-hyperactivity disorder (ADHD)?

A PMHNP was assigned to a COVID-19 unit during the pandemic. Her assignment was to assist dying patients in saying goodbye to their loved ones via telephone. She facilitated their phone conversations and watched the patients have their last conversations with their family, often crying in agony. More than 2 months after this assignment, during which she assisted hundreds of patients who died, the PMHNP began having nightmares about these experiences. She had flashbacks of some of the memories, often triggered when she received a phone call or looked at her phone. She began avoiding using her phone. She began having difficulty with concentration and often couldn't remember details of her time on the COVID-19 unit. She often felt detached from reality and the world. What diagnosis is most appropriate?

A 14-year-old boy is being treated for behavioral difficulties at home and at school and has been diagnosed with ADHD. He has been skipping class and often comes home smelling of cigarette smoke. His parents report he has developed sudden facial twitches and makes more frequent repetitive guttural sounds, especially since starting a new medication. His drug screen is negative for unprescribed substances of abuse. Which of the following is the most likely cause of his facial twitches and guttural sounds?

For a 39-year-old woman with a recent diagnosis of psoriatic arthritis who is treatment-naive with mild disease, which of the following would be considered an appropriate first-line therapy?

The mother of a 12-year-old boy is concerned about the increasing number of times he shrugs his shoulders, rapidly blinks, and clears his throat. He is not taking any medications that would cause these behaviors. Which psychiatric condition is characterized by these features?