Transcranial Magnetic Stimulation (TMS) is an FDA-approved treatment for Major Depressive Disorder (MDD). Which of the following is a key characteristic of TMS therapy?

A 26 year old patient is brought into the emergency department by law enforcement after an explosive outburst at a local bar where the patient physically assaulted another patron causing injuries as well as property damage. Witnesses stated that the patient seemed “fine” and then suddenly became enraged and attacked the other person. The patient is now combative, screening obscenities, and threatening both officers and hospital staff. The action the psychiatric mental health nurse practitioner would take first to address this emergency is:

An adult patient is diagnosed with bipolar disorder. They want to stop medication due to side effects that are impacting their quality of life. They report they were once very physically active but have now gained weight and feel lethargic on their current medications. They have a history of multiple inpatient admissions due to severe decompensation and psychosis. The psychiatric mental health nurse practitioner feels that discontinuation of medication could potentially exacerbate the patient’s chronic mental illness. Currently the patient shows no signs of impaired thought process. Best course of action for the nurse practitioner is to provide information regarding the risks, benefits and treatment alternatives and to:

Which of the following is the most appropriate treatment for patients with frequent and dangerous sleepwalking episodes?

A 25 year-old man is brought in to see you because of a change in personality following a boating accident.  He fell off of his boat and landed head first on the dock.  He was previously friendly, happy and high functioning.  Now his speech is pressured and his mood is labile.  He has been irresponsible at work and has been fired from his job.  His memory is intact.  Which one of the following brain areas did he damage?

Prior to starting a patient suspected of having bipolar with mania on a mood stabilizer the nurse practitioner orders a thyroid panel to rule out a disorder based on the patient’s symptoms, which include tremor tachycardia profuse sweating and:

Which of the following is the most likely indication for prescribing an atypical antipsychotic (such as aripiprazole or quetiapine) in the treatment of depression?

You have diagnosed this patient with depression and anxiety, based on her current symptoms.  This patient has a history of suicidal thoughts, and one suicide prior suicide attempt (an overdoes on prescription medications).  You are reviewing your orders in preparation of discharging the patient.  You would question sending the patient home with a prescription of which of the following medications?

A 73-year-old male presents with depression and low energy for the past month. He has no significant medical issues. Memory and cognition are intact. You prescribe his paroxetine 20mg PO QAM for depression. Two weeks later he is brought into the emergency room by his family with disorientation, nausea and weakness. Which laboratory test is most likely to establish his diagnosis? 

After your intake of a patient exhibiting symptoms of Major depressive Disorder (which she has been exhibiting for months), you receive the results of your patients thyroid panel (below).  What is your next course of action?