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You are seeing a 14-year-old girl, Mathilda, who was referred by her school counselor for symptoms of depression. During your psychiatric evaluation, Mathilda discloses that she has been thinking about suicide. She reports having occasional thoughts of “wanting it all to end” but denies any current plan, intent, or preparatory behavior. She begs you not to tell her parents, fearing they will “make it worse.” What is the best initial response regarding confidentiality and Mathilda’s disclosure?

A patient is admitted with a severe laceration to the abdomen. The registered nurse is preparing to infuse one unit of blood. Which interventions should the nurse implement?  Select all that apply.

Please refer to the previous two questions. Which of the following is the most appropriate plan to implement for this patient?

Which situation would legally require breaking confidentiality without consent from the minor?

Select the following arterial blood gas that shows partially compensated respiratory acidosis with hypoxia.

The PMHNP has been working with a 31 year old male patient for about six months. Today, the patient endorses suicidal ideation without intent or plan, and shares that these feelings have been present for about a year and they come and go. He cannot identify any particular stressor associated with the feelings. This patient denies past suicide attempts. The PMHNP completes the Columbia-Suicide Severity Rating Scale, and the patient rates as low risk. What is the most likely next step based on this information? 

Refer to information from the previous question. As you are reviewing Jane’s psychiatric history, she reports she was previously treated with an anti-depressant/anxiolytic that she took at night. She stopped taking it after a month as it made her too sleepy, caused weight gain, and negatively impacted her sexual health. Which medication is most likely?

You are newly seeing a 39-year-old Native American male (Benny) who has a history of alcohol use disorder, severe, and he’s been sober for about 18 hours, since being admitted to the detox facility over the weekend. He has diabetes, chronic pain from a disc injury, obesity, and he abuses no other substances.  He is terrified he will relapse and continue to use, even after he completes the anticipated detoxification and residential rehabilitation for 14 days.  He asks, “I just need a medication that will stop me from drinking.”  What is the most appropriate response?

A wife telephones an adult psychiatric and mental health nurse practitioner to report that her 54-year-old husband has been unusually active, irritable, and unable to sleep for more than a few hours each night. The husband has been diagnosed with a major depressive disorder and has been taking fluoxetine (Prozac) for four weeks. The nurse practitioner is most concerned about the possibility that:

Which of the following patient scenarios carries the highest risk for suicide: