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A 19-year-old woman reports chronic worry, rumination, and impaired functioning due to anxiety. She has a history of one hypomanic episode at age 16, difficulty sleeping, and concern about mood fluctuations as she begins college. She is sexually active, not on contraception, and has a history of a spontaneous abortion nine months ago. She takes only a multivitamin and has no history of substance use. Which medication would be the least appropriate choice for the APRN to prescribe?

A 27-year-old man with a history of mood disorder experienced remission of depression 3 weeks ago while taking sertraline and engaging in psychotherapy. At follow-up, his wife reports that for the past week he has been irritable, sleeping very little, spending extravagantly, and engaging in reckless behaviors such as unsafe driving. What is the most likely cause of his current symptoms?

A 28-year-old woman presents with recurrent nightmares, flashbacks, avoidance of reminders, and hyperarousal symptoms that have persisted for 6 months following a sexual assault. She has no prior psychiatric history. She is motivated for treatment and asks about both therapy and medication options. Which of the following represents the most evidence-based approach for this patient?

All of the following are steps in the SHARE approach for decision-making, except:

A 35-year-old man presents with ongoing sleep disturbance, irritability, and difficulty concentrating. He reports feeling emotionally distant from his spouse and children. He avoids crowded places because they remind him of “bad experiences” during his military service. He also describes recurrent nightmares and vivid recollections of events from his deployment. These symptoms have persisted for the past 7 months and are significantly interfering with his relationships. What is the most appropriate diagnosis?

The directive style of communication:

A 35-year-old man with Bipolar I Disorder presents to the emergency department with nausea, vomiting, diarrhea, coarse tremor, and unsteady gait. On exam, he is confused and unable to walk without assistance. His wife reports he has been taking his medication daily for bipolar disorder, though he does not recall the name. She also notes he was recently started on hydrochlorothiazide for hypertension. Which of the following is the most likely explanation for his current presentation?

A 3-year-old child with a history of early maternal deprivation and minimal stable caregiving relationships presents with delayed motor development, limited social interactions, and difficulty forming attachments. Which of the following best describes the underlying pathophysiological process associated with Reactive Attachment Disorder?

Which of the following is considered the most clinically relevant symptoms linked to childhood sexual abuse?

Adoptive parents bring in an 8-year-old child with a history of adverse childhood experiences (ACEs), including exposure to domestic violence and parental substance use. The child struggles with anxiety and emotional regulation. To best mitigate the long-term impact of ACEs on the child’s health and development, what should the PMHNP do?