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?

The psychiatric-mental health nurse practitioner is treating a 26-year-old woman diagnosed with bipolar I disorder who has exhibited a partial response to Lamictal 200 mg PO BID. The PMHNP wants to augment the Lamictal with valproate (Depakote). To do so, how must she change the dose of Lamictal?

A 23-year-old woman presents to the PMHNP with a chief complaint of "nervous tension." After a full evaluation and the administration of the Hamilton Anxiety Scale (HAM-A), the PMHNP diagnoses her with generalized anxiety disorder. He plans to use today's HAM-A score as a baseline and then readminister the scale at every follow-up appointment to monitor treatment. Her score today is 20. What does this score indicate?

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?

The PMHNP primarily works with older adult patients who frequently present with cognitive issues. He knows many people with Lewy body dementia are misdiagnosed or do not receive diagnosis for 18 months or more. Which of the following assessment tools does the PMHNP use to discriminate between Lewy body dementia (LBD), Parkinson's disease dementia (PDD), and mild cognitive impairment (MCI) due to Lewy body disease from other forms of cognitive impairment?

The PMHNP is evaluating a new client who reports symptoms of one hypomanic episode and at least one major depressive episode. Which psychiatric condition is most closely associated with these experiences?

The father of an 18-year-old girl who is being treated for generalized anxiety disorder with panic attacks calls the PMHNP with questions about the medications she was prescribed. He demands the information because the patient lives in his home and is on his health insurance plan. What should the nurse practitioner do?

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?

An urgent care nurse practitioner comes in to examine his patient, a 77-year-old woman who was brought in by her family for altered mental status. He notes that the patient appears restless and does not know where she is. Upon further assessment, he notes that her pupils are sluggish to react to light and are unequal in size. She is unable to sit up at the side of the bed and her blood pressure is 190/88 mm Hg. Which of the following does the NP suspect?

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

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?