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 A 49-year-old man uses alcohol nightly “to help me sleep.” You are considering prescribing a hypnotic. What is the most appropriate action?

A 54-year-old woman reports unrefreshing sleep and new nighttime symptoms. During evaluation, she states that her partner has witnessed episodes where she stops breathing briefly and then gasps loudly. She also reports waking up with a choking sensation several times in the past month. Based on clinical guidelines, which finding indicates the need for an overnight polysomnography (PSG)?

An APRN consults on a 78-year-old male admitted to the hospital three days ago for chest pain. He was diagnosed with heart failure months ago. He is prescribed medications to manage his condition, including lisinopril 20 mg by mouth daily and metoprolol ER 100 mg by mouth daily. The patient has a great deal of time attending to the APRN’s directions and is generally incoherent when spoken to. Recent memory has been getting worse, and he is unable to state correctly where he is. Nurses report that symptoms improve or worsen during different times of the day. His son reports these symptoms were not present prior to hospitalization. Based on presenting signs and symptoms, what condition would be imperative to consider in the differential diagnosis?

The PMHNP is seeing a 73 year old female patient diagnosed with dementia and taking a cholinesterase inhibitor. She has recently started displaying symptoms of significant agitation and aggression toward her care givers. What is the best initial choice for treatment among the following medications?

A 44-year-old man undergoes PSG (polysomnography) due to daytime fatigue. His apnea–hypopnea index (AHI) is 7 events per hour. Symptoms include loud snoring and concentration problems. According to diagnostic criteria, how should this finding be interpreted?

Which of the following is NOT true of tic disorders?

A 70-year-old patient with moderate neurocognitive disorder is brought to the clinic by his daughter, who reports progressive memory loss, poor judgment, and social withdrawal. During the intake, the psychiatric-mental health nurse practitioner learns that the patient’s brother was diagnosed with schizophrenia, and the family lives in an area with prevalent discrimination against individuals with mental illness. Which of the following is the most important factor to incorporate into the treatment plan to promote long-term adherence and support?

A 10 year old female has not been submitting assignments, grades have fallen and parents are concerned. The APRN notes frequent shoulder shrugging and eye blinking. The girl frequently clears her throat, grunts and sniffs, although mother says she does not have a cold and has been exhibiting these behaviors since age 8 and they tend to improve and then get worse again. The girl lifts a toy to her nose and sniffs it six or seven times during the interview. The child does not have a previous psychiatric history and has never taken medications.   An appropriate diagnosis is

Which of the following is it most important for the PMHNP to be aware of in regard to legal implications surrounding abuse of developmentally disabled children, child abuse and abuse of elderly in the states in which they practice?

An 68-year old male seen by the APRN for an initial psychiatric interview is accompanied by his son who provides the history. The patient’s personality has changed significantly over the past five to six years, leading to much embarrassment for his son due to disinhibition and the intrusive and inappropriate behaviors. The patient has very odd dietary changes and weird food cravings. The son describes his father as “cold and unfeeling towards others” and is quite frustrated with his father’s lack of motivation. The APRN notes repetitive movemets and stereotyped speech when the patient communicates.  The most evidence based treatment for the APRN to recommend is