A 14-year-old with a new diagnosis of bipolar I disorder presents with grandiose delusions, flight of ideas, and markedly decreased need for sleep. The PMHNP is selecting initial pharmacotherapy. Based on current evidence, which agent class offers the fastest and most robust treatment response for early-onset bipolar manic states?

A psychiatric-mental health nurse practitioner is evaluating a 14-year-old male who has been experiencing increasing social withdrawal, flat affect, and unusual perceptual experiences over the past several months. His parents report he has become unusually nonreactive to peer teasing. Which of the following best describes this clinical presentation?

You continue to see Jessica for weekly psychotherapy and medication management. Her depression and anxiety have improved significantly. She continues to talk about her relationship with her new boyfriend. During today’s session, Jessica shares that, for the past few weeks, along with exchanging regular text messages, they also started exchanging sexually explicit photos and videos of themselves. She reported that this brought them “closer” in their relationship. She said that her boyfriend is not pressuring her to send these photos and that the exchange is consensual. She has not told her friends or parents about this, and she is confident that her boyfriend will keep this private. You know that, in your local jurisdiction, teenagers were charged with the felony of promoting a sexual performance or disseminating indecent material to minors in the first degree for similar behavior. Jessica continues to request that you keep this information confidential from her parents. She mentions that she is afraid that, if her parents find out, they will make her stop spending time with her boyfriend. Should you breach confidentiality and inform Jessica’s parents right away about this new behavior?

Which of the following is true of confidentiality between a minor patient and a psychiatric provider?

The parents of a 12-year-old girl with early-onset bipolar disorder ask the PMHNP about her long-term prognosis. She has had nonepisodic severe mood dysregulation since age 6, with no distinct manic episodes ever identified. Based on longitudinal research, which outcome is she most likely to experience?

Noah is a 15-year-old boy who is referred to your outpatient psychiatry clinic for “erratic behavior.” Noah’s parents are divorced, with joint custody. He spends his weekends with his father and weekdays with his mother. After a few sessions, Noah shares that he has been smoking cannabis daily for the past 6 months. He first began smoking after his father offered him a cannabis cigarette after dinner during his winter break, on the condition that he not tell his mother. Since then, Noah reports smoking daily when with his father and purchasing cannabis from a “cool kid” at high school with his allowance. However, with summer vacation approaching, he does not think that he can continue to secretly buy or use it without his mother finding out. He begs you not to tell his mother. What is your best response?

Write a paragraph which (a) identifies the author of the passage, and (b) explains its context and significance.  “The Brahmins assert that the world arose from an infinite spider, who spun this whole complicated mass from his bowels, and annihilates afterwards the whole or any part of it, by absorbing it again and resolving it into his own essence. Here is a species of cosmogony which appears to us ridiculous because a spider is a little contemptible animal whose operations we are never likely to take for a model of the whole universe. But still here is a new species of analogy, even in our globe. And were there a planet wholly inhabited by spiders (which is very possible), this inference would there appear as natural and irrefragable as that which in our planet ascribes the origin of all things to design and intelligence… Why an orderly system may not be spun from the belly as well as the brain, it will be difficult for him to give a satisfactory reason”.  

Which image shows an appropriate Mirror Setup? (Hint: eyes must be focused, no electronic devices should be in view)

75.0 grams of FeO react with 51.3 grams of Al in the un-balanced chemical reaction below:               __FeO (l) + __Al (l)  –> __Fe (l) + __Al2O3 (l)   1) What is the mass in grams of Fe produced? Show all work and Explain your answer. Report your answer in the correct amount of significant figures (6 points) 2) What is the limiting reactant? Show all work and Explain your answer. (1 point) 3) If the actual yield of Fe is 50.0 g, what is the % yield? Show all work and Explain your answer. Report your answer in the correct amount of significant figures (2 points)    

24.  The likelihood of SSRI discontinuation syndrome is most closely associated with what property of the medication?