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 They report he has withdrawn from them and refuses to speak to anyone.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?

Which of the following medications is FDA approved for the treatment of attention-deficit/hyperactivity disorder and relies on selective norepinephrine reuptake inhibition for its efficacy?

A patient has been prescribed olanzapine 15 mg daily for acute manic episodes associated with bipolar I disorder. Four days after beginning treatment, he has a sudden onset of fever (39 degrees C, 102 degrees F), tachycardia, and tachypnea. Oxygen saturation at rest is 93% and he exhibits muscular rigidity and some alteration is mental status. The most likely cause of these symptoms is:

Weight restoration has demonstrated greater efficacy than pharmacologic interventions in reducing anxiety and depressive symptoms in which one of the following disorders?