J.T. is a 38-year-old male patient who presents for assessment and treatment of substance use disorder. He has a long history of chronic alcohol use, typically drinking a 6-pack of beer every evening. According to his primary care provider his physical examination and laboratory studies are all within normal limits and there are no documented medical conditions. He admits that he personally does not truly believe he has substance use problem, but his wife does like the fact that h...

The PMHNP is seeing a 11-year-old patient who is being managed for obsessive-compulsive disorder. The patient has been in exposure response therapy for almost one year and has been taking fluoxetine 40 mg daily. For the last six months the patient was in an acceptable remission, but today he reports that his obsessive thought processes and compulsive hygiene behaviors have started to become intrusive and are making it difficult for him to manage his day appropriately. Additional assessment to...

An initial psychiatric evaluation should include a comprehensive risk assessment across the lifespan. Which of the following should be part of the initial intake for all patients aged 8 to 24 as part of that risk evaluation? A. The CAGE questionnaire B. The ASQ tool C. The SCARED tool D. The MCHAT-R questionnaire --- YouTube: https://www.youtube.com/watch?v=jB53p074Ze0&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=140

The PMHNP is performing a follow-up visit on a 32-year-old male. He is being treated with sertraline 100 mg daily for a major depressive episode that began when he started having serious marital problems. His depressive symptoms have much improved, and he currently denies depressed mood, anhedonia, hopelessness, worthlessness, guilt or irritability. Even sleep has improved, and he is currently satisfied with his response to pharmacotherapy. During the visit, the PMHNP notes that the patient r...

A 5-year-old child presents for evaluation with her mother. The mother is concerned that the child might have autism spectrum disorder and asks for a comprehensive evaluation. As part of a developmentally appropriate assessment, the PMHNP recognizes that which of the following is the appropriate approach to assessing the child’s affect, coordination and motor skills, speech, attention span, capacity for complex thinking and interaction? A. Playing with the child on the floor B. Administ...

The PMHNP is seeing a 22-year-old male patient for his initial evaluation. The appointment is court ordered and the patient seems very uncomfortable being there and answers direct questions with one-word responses. According to information provided by the court, the patient comes from a very dysfunctional upbringing, has been homeless for an indeterminate time period, and did not adapt well during his brief period of incarceration. The PMHNP is very open about all information that she h...

The PMHNP is evaluating a patient new to the practice. He is a 27-year-old male with a long history of bipolar depression, generalized anxiety disorder, and a remote history of substance use disorder for which he has been in remission for over 6 years. While discussing his medication history the patient reports that over the years he has been treated with a number of different medication to help with his symptoms. He denies any medication allergies but reports that one of the medications made...

Social determinants of health (SDOH) are recognized by the World Health Organization as non-medical conditions that can often outweigh genetic or clinical medical access in determining overall health. Addressing SDOH is endorsed as a priority with respect to improving population health. They are categorized in five major domains. Discrimination or systemic bias is an example of which domain? A. Economic stability B. Social and community context C. Neighborhood and built envi...

The PMHNP is working with a patient who is struggling with significant depressive symptoms. The patient is a 34-year-old female who is lives alone and works in a job that “pays the bills” but not much else. The patient has no close connections, she remains friendly with a few friends from college, but she feels “alone in the world.” At present her options are limited. She is not financially able to make major life changes, but she feels as if she is spiraling down and wants to feel better. In...

The PMHNP is managing a patient with bipolar disorder. While the patient has had manic episodes historically, the dominant pole of his disorder is depression. He is currently being treated with valproic acid and olanzapine. Today his depressive symptoms have exacerbated and he admits to increasing suicidal ideation. He is not acutely suicidal, but his ideation is more frequent, and twice in the last month he has called the suicide and crisis hotline at 988. Which of the following medic...