A 10-year-old boy is referred by the school nurse because of persistent stomachaches every morning in school.  In evaluating the boy, the PMHNP learned that he does not like to go to school and insists on coming home immediately, and that he sleeps in his parent’s bed at night.  His clinical description is most characteristic of which of the following conditions?

A 25-year-old female presents to the emergency department, having just witnessed an accident.  Her speech is pressured.  She states, “There were a lot of people in need of care at the scene, and I should know because I have traveled to many Third World countries.  I know how bad needs can get.  The people were injured, and I was hit by a car before but I did not suffer any injuries.  There were a lot of police cars and ambulances.”  The patient was triaged to psychiatry.  The PMHNP describes her thought process as:

The psychiatric-mental health nurse practitioner uses a cognitive-behavioral approach to help a patient address self-defeating behaviors. After identifying the stressor that causes the inappropriate behavior, the initial strategy is to explore:

A 42-year-old man presents with recurrent episodes of major depressive disorder. He generally experiences remissions at therapeutic doses of serotonin reuptake inhibitors but has subsequently required dosage escalations to control symptoms. He was eventually changed to a new medication due to resistance to adequate trials at maximum dosages. His only current medication is sertraline 200 mg per day. His adult children brought him to the emergency department due to concerns that he is behaving differently than during past episodes of depression. They report he has withdrawn from them and refuses to speak to anyone. He sits in his recliner all day and stares straight ahead. They have been unable to get him to eat for two days. They even tried to put a glass of juice in his hand and lift it to his mouth, at which time he kept his hand up by his mouth but did not take a drink. They ended up removing the glass from his hand so that he did not accidentally break it. His mental status exam is significant for lack of speech and lack of movement except for purposelessly keeping his right arm up in the air. When the examiner attempts to lower the patient’s arm, he demonstrates slight, even resistance. Which of the following is the best initial step?

A patient meeting criteria for major depressive disorder is prescribed fluoxetine 20 mg daily.  The PMHNP is reviewing the chart for a meritorious negligence claim.  Which of the following conditions should have been documented and excluded from the differentials before prescribing a selective serotonin reuptake inhibitor (SSRI)?

The psychiatric-mental health nurse practitioner is concerned about access-to-care issues in the local community and wants to help develop health care policy to help clients access care more effectively. The nurse practitioner knows one of the most effective avenues for developing and advocating for policy is:

A patient who has been voluntarily admitted to an inpatient psychiatric hospital is experiencing symptoms of psychosis; he declares he has the right to refuse his medications despite the court order because God told him he would be healed by his faith alone. Based on your knowledge of the court-ordered treatment, which of the following statements is true?

Which of the following therapies is aimed at the treatment of Non-suicidal Self-Injurious Behaviors?

A patient is referred to an outpatient psychiatric clinic for evaluation of depressive episodes after bouts of overeating. Assessment reveals a five-year history of episodes of uncontrollable overeating precipitated by feelings of tension. This occurs about two to three times per week and for the past year has been associated with laxative use, self-induced vomiting, and periods of fasting to maintain body weight. The patient reports becoming increasingly depressed and has considered suicide in the past. The treatment plan first includes medical evaluation with electrolyte studies and:  

A 32-year-old woman has a history of two acute episodes of psychosis over the last 18 months. Her symptoms typically include paranoid delusions and auditory hallucinations. Her symptoms initially responded to treatment with risperidone, which was subsequently increased at the time of recurrence of symptoms. She did not have any significant mood disturbance during the initial six months. However, during the second acute episode of psychosis, she developed anhedonia, weight gain, psychomotor retardation, difficulty focusing, and suicidal ideation, which have persisted for the last year. She denies depressed mood, sleep difficulties, fatigue, and feelings of worthlessness or guilt. Which of the following is required for a diagnosis of schizoaffective disorder, depressed type in this case?