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?

A 41-year-old man presents to the PMHNP with new-onset depression and motor abnormalities. These symptoms are indicative of which disorder?

A 42-year-old woman recently diagnosed with rheumatoid arthritis asks the nurse practitioner about disease-modifying antirheumatic drugs (DMARDs). Which of the following statements about DMARDs is INCORRECT?

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 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 36-year-old man is evaluated by the PMHNP for a recent incident in which he stayed up for several nights in a row, had much more energy than usual, and believed he was talking to God. He was diagnosed with bipolar disorder. In reviewing his medications, the PMHNP finds he is taking acetaminophen 500 mg BID, bupropion XL (Wellbutrin) 150 mg once daily, Sam-E for pain from an old football injury, and alprazolam 0.5 mg pm for agitation. Which of these should be discontinued immediately?

A 62-year-old woman presents to the PMHNP for an evaluation. She is concerned she is developing dementia due to her significant family history. Which of the following would help the PMHNP make a diagnosis of pseudodementia rather than dementia?

A nurse practitioner has just diagnosed a 14-year-old boy with Klinefelter syndrome. What is the most appropriate treatment?

The psychiatric-mental health nurse practitioner has just diagnosed a 23-year-old man with bipolar disorder. He has had one manic episode with suicidal ideation and no depressive episodes to date. Which of the following is the most appropriate at this time?

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 mother presents to the nurse practitioner with her 10-year-old son for a routine well check and a flu shot. She asks the NP if there are any vaccines he is not up-to-date on. The NP explains that the HPV vaccine (Gardasil 9) is indicated for which of the following groups?