Which assessment finding would indicate refeeding syndrome in a patient with anorexia nervosa who has recently begun nutritional rehabilitation?

Through an initial interview, an APRN finds that a patient’s reported psychological factors are adversely affecting the patients documented heart condition, leading to significantly compromised functioning. An appropriate diagnosis is:

A psychiatric mental health nurse practitioner is determining the appropriate level of care for several patients diagnosed with anorexia nervosa. Which patient most clearly meets criteria for hospitalization?

A 20-year-old female is extremely distressed by a negligible deviation in her nasal septum. She is very self-conscious about it in public, and it hinders her from engaging with others socially. She checks it frequently—every time she comes across a mirror or another way to see her reflection —and spends 3 hours a day thinking about her nose. A thorough psychiatric interview reveals no psychotic symptoms, no past history of significant worry or depression, and no other untoward symptoms. The most likely diagnosis is:

A 19-year-old female presents to primary care with multiple physical complaints affecting different organ systems. She reports significant distress about the symptoms and has seen three providers in the past 6 months. She has missed work and stopped socializing due to worry about her health. The symptoms have persisted for more than six months. Which diagnosis is MOST consistent with this presentation?

A 30-year-old patient with obsessive-compulsive disorder (OCD) reports severe fear of contamination and spends several hours per day washing their hands. The PMHNP begins cognitive behavioral therapy (CBT) using exposure and response prevention (ERP). During treatment, the therapist asks the patient to touch a public door handle and then refrain from washing their hands afterward, while remaining in the situation until anxiety decreases. Which principle of CBT for OCD is demonstrated in this intervention?

A 21-year-old female client presents to the emergency department with “stomach issues.” She denies frequent vomiting, but states that she has frequent diarrhea that has recently included blood. Labs reveal: potassium of 2.9 mEq/L, and metabolic alkalosis. She later tells a nurse that she frequently uses laxative due to a “slow digestive system”. The patient’s BMI is 20.2 kg/m².  Which eating disorder does the PMHNP suspect most based on these assessment findings?

A 10-year-old client is brought to the emergency room with vomiting and severe stomach pain. A CT demonstrates an intestinal obstruction. The client’s parents report that the child frequently is found eating soil and grass in the backyard. Which disorder does the PMHNP suspect?

A 16-year old client is brought to the clinic by a parent due to noticeable hair loss on the scalp and eyebrows. Dermatologic evaluation reveals no medical condition causing the hair loss. Which of the following findings is required for diagnosis of trichotillomania according to DSM-5 criteria?

A 42-year-old patient that is prescribed olanzapine for schizophrenia presents to outpatient office for follow-up appointment. Patient’s yearly labs come back at: Triglycerides 210 mg/dL, HDL 35 mg/dL, and fasting glucose of 118 mg/dL. Patient’s family history is negative for diabetes, hypertension, and dyslipidemia. The patient’s waist-to-height ratio is calculated at 0.60. What is the most appropriate interpretation of these assessment findings?