39.  A 54 year old man is admitted to the inpatient treatment program for withdrawal from heroin.  Eighteen hours after his last injection of heroin, he becomes hypertensive, irritable, and restless.  He also has nausea, vomiting, and diarrhea.  Which medication would be her best treatment option?

34.    What is the therapeutic level of Lithium when used to treat Bipolar I Mania?

36.    A 35 year old woman is seeing a Psychiatric Mental Health Nurse Practitioner for treatment of Major Depressive Disorder.  After 8 weeks on Fluoxetine 60 mg daily, the PMHNP decides to augment the Fluoxetine for additional treatment.  Which of the following would be the most appropriate augmenting agent?

6.   A 36-year-old man with a history of seizures and schizoaffective disorder-bipolar type presents to your office with worsening auditory hallucinations.  He was recently started on Haldol, 10 mg daily (as this has worked in the past for increasing auditory hallucinations).  He has tolerated the Haldol well in the past, however, his mother contacts the clinic after two weeks to inform you that while his auditory hallucinations have diminished significantly, he now has developed extrapyramidal symptoms within the past 3 days.  Which of the following likely contributed to his worsening status?

18.    A patient presents with acute generalized anxiety disorder.  Due to the severity of the symptoms the nurse practitioner prescribes:

24.  A 40-year-old woman presents with a major depressive episode. Her clinician is considering prescribing the antidepressant vilazodone, which has what two major mechanisms of action?

20.   A 29 year old patient with schizophrenia has not responded to conventional anti-psychotics and is having increasing episodes of agitation, paranoia, and social isolation.  The Psychiatric Mental Health Nurse Practitioner (PMHNP) plans to switch the patient to clozapine.  For the next 6 months the PMHNP will expect to monitor:

26.   A patient with schizophrenia has been stabilized on medication but is complaining that he is so tired and sleepy all the time that he no longer wants to take it. Which of the following alternative options would be the least likely to cause sedation?

40.    A 44 year old woman comes to the Psychiatric Mental Health Nurse Practitioner for treatment of Major Depressive Disorder.  Her current BMI is 26.  She states that she has lost 50 lbs in the past year and is determined to not gain it back.  Which of the following medications would be the best option for treating her depression based on her statement:

4.    Which antidepressant is most sedating?