to be late

A patient presents with distractibility, impulsivity, mood lability, and increased activity. The PMHNP is considering bipolar disorder, ADHD, and borderline personality disorder. Which question would be most useful in distinguishing bipolar disorder from ADHD and borderline personality disorder?

A 14-year-old is referred for possible bipolar disorder because of irritability, impulsivity, decreased sleep, and declining school performance. Which assessment approach is most important for the PMHNP when evaluating for pediatric bipolar disorder?

A patient becomes distressed while discussing a traumatic experience and reports intense tightness in the chest. The clinician asks the patient to shift attention to the feet, which feel neutral and relaxed, and then gently move awareness back and forth between the two sensations. Which technique is being used?

A 5-year-old child with a history of severe early neglect and multiple caregiver changes readily approaches unfamiliar adults, sits on strangers’ laps, and is willing to leave with an unfamiliar adult without checking back with the foster parent. Which diagnosis is most likely?

A 29-year-old patient with bipolar I disorder presents with an acute manic episode characterized by decreased need for sleep, pressured speech, grandiosity, agitation, and excessive spending. The patient is medically stable and able to take oral medication. Which medication order is most appropriate to treat the acute manic episode?

A patient reports 5 days of elevated mood, decreased need for sleep, increased talkativeness, racing thoughts, and increased goal-directed activity. Family members confirm that the behavior is clearly different from the patient’s baseline. The patient continues to work and has not required hospitalization. There are no psychotic symptoms. Which finding most strongly supports hypomania rather than mania?

The PMHNP prescribe prazosin for a patient with posttraumatic stress disorder who complains of a great deal of insomnia due to nightmares. The patient has been on a moderate dose of tadalafil (Cialis) 20 mg/day for 6 months. What should the PMHNP educate the patient to monitor for with this combination of medications?

A 15-year-old has episodes several times each week in which she becomes intensely angry, yells, and throws objects. Her parents report that she is chronically irritable between episodes and has been this way for the past 18 months. Which finding would most strongly suggest bipolar disorder rather than disruptive mood dysregulation disorder (DMDD)?

Which clinical presentation is most consistent with the diagnostic criteria for cyclothymic disorder in an adult?