A 10-year-old boy who had been prescribed fluoxetine (Prozac) for major depressive disorder presents to the psychiatric emergency department for running in to the street in front of a car on the way home from school.  In the ED, he has been selectively mute, but the PMHNP was able to elicit his desire to be dead.  He has been medically cleared.  Which of the following symptoms often are endorsed or observed for children with MDD compared to adults

A 44-year-old female patient was told by her spouse 1 week ago that they wanted to get divorced.  They have 3 small children together.  The patient present to you as the PMHNP with symptoms of depression and anxiety; however, do not meet full criteria for major depressive disorder or generalized anxiety disorder and have no mental health history.  Which of the following is the most likely diagnosis?

A 22-year-old college graduate admits he has been sleeping more than usual for the past month, sometimes up to 14 hours a night.  However, he still feels significantly fatigued throughout his normal waking hours.  He has no romantic relationships in his life, and his appetite has decreased, resulting in a 10 lb weight loss over the past month.  When asked about his weight loss, he says that sometimes making the decision on what to eat is difficult.  He also recently quit his band, saying that he is no longer interested in drumming.  He denies recent triggers. Which of the following issues is this patient most likely experiencing? 

A patient has experienced 2 severe depressive episodes that lasted 4 and 6 weeks, during which he had decreased energy, loss of appetite, insomnia and suicidal ideation.  The patient also had one hypomanic episode that lasted about 5 days.  None of these episodes required hospitalization.  The PMHNP knows these symptoms are consistent with:

A 59-year-old man has been seeing the PMHNP for treatment of schizophrenia.  He was first diagnosed when he was 21 years old.  He remains medication adherent.  In getting to know the patient, it is revealed that he has very few social interactions, prefers to be alone, and has never had a romantic interest or desire to pursue one.  Which type of symptoms is pervasive in this clinical presentation?

The PMHNP is evaluating a 35 year old patient that meets criteria for major depressive disorder (MDD).  During the evaluation, the patient also endorses previous periods where they have increased goal directed behaviors, irritability, flights of ideas, decreased need for sleep, and distractibility, lasting 5 days at a time.  Which of the following diagnoses is MOST likely at this time?

An 18 year old male patient with depression has been taking fluoxetine (Prozac) for 10 days (10 mg daily in AM for 7 days and 20 mg daily for the last 3 days) but tells the PMHNP that the medication is not working as she feels the depression is unchanged.  The best response is for the PMHNP to: 

A PMHNP in private practice is experiencing feelings of resentment toward a patient who missed his last two appointments at the last minute because he forgot.  Which of the following is an example of a therapeutic response?

You are the PMHNP in an outpatient clinic assessing a new patient for initial evaluation.  The patient notes that they have had 3 years of hypomanic symptoms that you note do not meet criteria for a hypomanic episode per the DSM-5 and they also have numerous periods of depressive symptoms that do not meet criteria for a MDD episode.  Which of the following statements is most likely?

During the Babylonian captivity, the popes were all