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?

The PMHNP is evaluating a new 17-year-old client with a history of delinquent behavior, including a recent arrest for vandalism. The nurse practitioner suspects conduct disorder based on the client's history and current presentation. According to Erikson, such behavior is a result of the failure to resolve which psychosocial developmental stage?

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?

A 47-year-old man only travels by train despite the necessity of frequently traveling long distances for his job. This causes significant difficulty, since the train trips are much longer than the plane rides and he misses important meetings. He has tried flying on several occasions, only to have a panic attack each time, even when the flight was smooth with no turbulence. Which of the following is the correct diagnosis?

A 23-year-old graduate student is appointed to be the team leader for a group project. He is so rigid and inflexible about the rubric that other members of the team get frustrated, and the project almost collapses. He insists that each section must be completed and perfected before the next section can be started. The project is eventually finished, but no one on the team will work with him again. Which disorder best reflects this man's behaviors?

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?

A dentist refers a 21-year-old woman with a BMI of 26 to the PMHNP after he discovers significant enamel erosion and decay of her front teeth. What diagnosis does the dentist suspect?

The PMHNP has just diagnosed a patient with excoriation disorder. To fulfill diagnostic criteria for excoriation disorder, the skin-picking must be severe enough to result in which of the following?

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?

A mother brings her 9-year-old son to the PMHNP to evaluate him for attention deficit-hyperactivity disorder based on a chief complaint of lack of concentration in class and at home. The PMHNP finds the child also exhibits fatigue, insomnia, anhedonia, and agitation. The nurse practitioner plans to involve both the parent and the teacher in the assessment of these symptoms. Which of the following assessment tools will the PMHNP most likely utilize?

The PMHNP is evaluating a 6-year-old boy with suspected ADHD. Which of the following biological findings should she expect to find that might help confirm diagnosis?