The APRN sees a 24-year old female for an initial evaluation. The patient is tearful because she cannot lose weight. BMI is 29.2. When asked about eating patterns, it becomes evident that the patient binges at least once a week on foods such as caramels, mints, and marshmallows. She says when these things are around, “I have to eat it until it is gone.” She has felt out of control with these binges for the past four months. She denies purging. She denies symptoms of depression and has been able to get to work every day on time although is having difficulty focusing on her work. The most appropriate of the following interventions is

A 9-year-old boy is brought to the clinic due to recurrent soiling and involuntary bowel movements, impacting his social interactions and causing great embarrassment for the child. The parents seek interventions to address the issue. Which approach should be used first by the PMHNP to address encopresis in this 9-year-old boy?

An 8-year old boy who is being treated for nocturnal enuresis does not respond to behavioral methods, so the parents ask for pharmacotherapy for the ongoing problem because the child suffers from much embarrassment and remorse. One medication that has shown some success in reducing nocturnal enuresis is

A patient reports extreme difficulty parting with possessions, and the accumulation of  possessions in her house has cluttered all the living areas to the point of not being able to walk through the house. She is late to work many days because she cannot find what she needs. Evidence from research shows which of the following to be the most effective to decrease symptoms?

In establishing appointments in an outpatient clinic, the nurse would schedule which situation as highest priority:

A mother brings in an 11 year old child for an initial psychiatric evaluation. The child reports his mood changes when he is reprimanded by mother. The mother is concerned because her child checks homework over and over to be sure it is right and it is often very late before he will calm down enough to put his books away and go to bed. She doesn’t have other complaints about his behavior—he keeps his room in perfect order and helps keep order in the house. He is rigid in routine and must check under his bed five times before he will get in bed. He also must turn the lights off and on six times before he gets into bed. If he “messes up”, he must start the ritual over again. The mother is concerned because it is interfering with his sleep time. He denies hallucinations and developmentally is normal. He has never been prescribed a psychotropic. Based on this, the APRN would be prudent to recommend first line which of the following based on current evidence?

A 9-year-old boy consistently displays a pattern of argumentativeness, defiance, and disobedience toward parents and teachers. He has trouble staying in his seat at school, deliberately annoys others, often loses his temper and often blames his peers and siblings for his mistakes. These behaviors occur across various settings and significantly impact his interpersonal relationships. What is the highest probability diagnosis for the described patterns exhibited in this 9-year-old boy?

During an intake in the ED, a patient with methamphetamine-induced psychosis becomes increasingly agitated and paces with clenched fists. As the PMHNP leading the crisis team, what is the MOST appropriate initial action to prevent escalation?

Which documentation practice by a PMHNP most effectively supports patient safety, continuity of care, and legal risk reduction in psychiatric practice?

A patient recently diagnosed with schizophrenia is being discharged with follow-up care arranged. His family expresses hope that he’ll “make a full recovery in a few months.” What is the PMHNP’s BEST response?