A 67-year-old woman with a medical history of state III breast carcinoma is receiving palliative care. The patient has been bedridden for the past three months and has been taking increased amounts of morphine for pain relief over the last two weeks. The patient mentions that she is feeling miserable and requests medication that could accelerate her death. On further questioning, the PHQ-2 questionnaire score is 4, and the PHQ-9 questionnaire score is 10. Which of the following is the best next step in managing this patient? 

A 40-year-old man presents to his clinician for a follow-up appointment. For the last 2 months, he has had trouble concentrating, decreased appetite, loss of motivation, decreased energy, and difficulty waking up in the morning. He admits to having suicidal thoughts but states that he “does not intend to act on them.” He has been taking the first-line medication with long half-life for this illness for 6 weeks without any improvement. His clinician stops the first medication and prescribes a different medication for this illness that has been available for many years, and the patient immediately begins taking it. What serious adverse event is the patient at risk of developing? 

A 37-year-old man presents with a two-week history of sleeping only two hours per night and “feeling on top of the world.” His only medication is hydrochlorothiazide, which he takes for hypertension. Clinical evaluation is remarkable for pressured speech, racing thoughts, and frequent topic switching. Given the likely diagnosis, what is the most appropriate treatment?

An adult client expresses ambivalence about continuing therapy due to external stressors, but the counselor believes that stopping treatment at this stage could result in relapse. What is the most ethically appropriate action for the counselor to take in this situation? 

Which of the following best explains the concept of target symptom identification? 

A 44-year-old woman has been prescribed medication for treatment-resistant depression. She is told to discontinue her sertraline 14 days before starting this medication. At lower doses, this medication works selectively on an enzyme that metabolizes phenylethylamine. Which of the following medications was she most likely prescribed? 

What four elements need to be present for a malpractice lawsuit to be filed?

A 30-year-old woman presents for treatment of a major depressive episode. She reports sustaining a similar episode about 10 years earlier. The clinician discusses treatment options with her and wants to initiate therapy with a selective serotonin reuptake inhibitor. The patient expresses concern because she was treated with paroxetine and experienced significant adverse effects when it was discontinued, including insomnia, anxiety, moodiness, and headaches. She is adamant that she does not want to remain on antidepressant medication permanently and asks for a drug that can be discontinued without causing excessive withdrawal symptoms. Which of the following agents would be the best option? 

What is the purpose of the Psychiatric-Mental Health Nursing: Scope and Standards of Practice? 

A 44-year-old woman with 3 months of polyuria, polydipsia, weakness, dry skin, and frequent waking during the night to urinate. Her history is significant for bipolar disorder, and she is taking lithium carbonate. Vital signs are blood pressure 110/80 mmHg, heart rate 80 bpm, respiratory rate 16 breaths/min, and temperature of 98F (36.7C). Physical examination shows dry mucus membranes. Laboratory results are fasting glucose 90mg/dL, plasma osmolality 290 mOsmol/kg, and urine osmolality 300 mOsmol/kg. A water deprivation test results in serum osmolality of 310 mOsmol/kg and a urine osmolality of 300 mOsmol/kg. After the administration of desmopressin, urine osmolality remains at 300mOsmol/kg. What is the next best step in management?