The PMHNP has just accepted a position at an eating disorders clinic which offers a multi-disciplinary approach to the management of eating disorders, including psychiatric comorbidities and physical health deviations. In preparing for the role, the NP reviews strategies for managing which of the following laboratory abnormalities common in patients with anorexia nervosa? A. Hypercholesterolemia, leukopenia, low TSH B. Anemia, hyperkalemia, low T3. C. Hypokalemia, hypocholesterole...

A 14-year-old patient is being managed for generalized anxiety disorder and has been responding well to fluoxetine. However, both the patient and his mother report that he has chronic difficulty falling asleep. He denies any racing thoughts at bedtime; he just cannot seem to fall asleep. His mother has been giving him melatonin gummies purchased over the counter from the pharmacy and reports that there is some improvement but would like to know what else can be done. The PMHNP advises w...

A 5-year-old child is accompanied by the foster mother for evaluation of behavioral problems. The foster mother is experienced and has been very successful with children, but this child is very concerning. He has frequent, unexpected episodes of mood and reaction extremes including irritability, sadness, and fearfulness that are disproportionate to the situation. Suspecting reactive attachment disorder, the PMHNP anticipates which of the following to be reported by the foster mother? A....

Jennifer is a 27-year-old female who has been in psychiatric care for several months for a diagnosis of bipolar disorder. She has not responded to three different pharmacotherapeutic approaches and as a result she is now being evaluated by a new PMHNP provider. She maintains that she has always taken all medications as prescribed but all they do is make her tired. Further she is emphatic that the last provider “did not know what he was doing” but she has heard that the new NP is “really...

A patient is mandated to care by court for evaluation and treatment of substance use disorder. He has a history of polysubstance abuse including ETOH, benzodiazepines, and marijuana. He is very resistant to the interview, sits with arms crossed, avoids eye contact, and only offers minimal verbal responses. The PMHNP asks the patient why he doesn’t want to talk about why he is there. The patient responds, “You are just going judge me and blame me, what’s the point?” The PMHNP recog...

A 39-year-old male patient presents asking for pharmacotherapy to help with difficulty falling asleep. He denies any psychiatric history and is in good health. He is currently struggling with sleep because he is going through a difficult divorce and while he acknowledges that he has to work through it, the difficulty sleeping is so profound right now that it is making it difficult for him to be effective at work. The patient agrees to have an evaluation with a therapist, and the PMHNP agrees ...

The PMHNP has assumed care of a 32-year-old patient who is being managed for opioid use disorder with buprenorphine-naloxone 8.2 mg films t.i.d. The patient’s previous provider has moved out of state and no records are immediately available, the only information available is from the prescription monitoring program. The patient request to be treated with a buprenorphine-only formulation because he says that the he is allergic to naloxone. The NP considers which of the following? Choose ...

A 27-year-old female patient presents for a follow-up appointment for generalized anxiety disorder. She has a complex history including polysubstance use disorder and borderline personality disorder, but she had been doing well. She achieved remission of her symptoms over one year ago and has been well managed on escitalopram 10 mg daily. She has been substance free for over one year, and is in therapy for her personality disorder. Today she is not feeling well. She reports some major psychos...

The PMHNP is managing a patient of Chinese ancestry with a diagnosis of bipolar disorder. The patient is currently experiencing some symptoms consistent with an early manic episode. When considering prescribing carbamazepine, the NP considers that this patient is at particular risk for which of the following adverse effects? A. Drug-induced hepatitis B. Pancreatitis C. Hypothyroidism D. Toxic epidermal necrolysis --- YouTube: https://www.youtube.com/watch?v=5MaEx...

The PMHNP is called to the emergency department to evaluate a patient with an acute onset mental status change. The patient has a long history of schizophrenia and has been managed on a variety of antipsychotic therapies that have had some success, but the patient has not ever really achieved goal remission. Most recently he was started on a first generation antipsychotic along with benztropine (Cogentin). Today the patient is in the ED with confusion and muscle stiffness. Which o...