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Your client’s serum lithium level has just come back from the laboratory with the results of 2.0 mEq/L. What should you do?

A 75-year-old man with mild dementia states he has not been taking his prescribed medications. When asked why, he states, “My grandson wanted a new car, so he’s been using my money for his car payments and gasoline. Since then, he has not been able to afford my medications, and he didn’t seem to care when I told him about it.” What is the most appropriate next step?

Which of the following best explains the concept of target symptom identification? 

A 19-year-old boy presents accompanied by his mother due to abnormal behavior for the past few days. The mother says her son has not slept for 3 days and has been expressing ideas about how he plans to cure world hunger; he has also been very energetic and has not stopped talking. The patient has no medical history and takes no medications. He denies any recreational drug, tobacco, or alcohol use. The patient is verbose, hyperactive, and fidgeting on the mental status examination. He is uninterruptible and agitated. A mood stabilizer that is also used for seizures is recommended. The patient is advised that possible side effects of this medication include weight gain and sedation. Which of the following is another possible adverse effect of this medication? 

A 40-year-old woman in a locked inpatient psychiatric unit demonstrates pressured speech and flight of ideas. She appears restless and irritable and has not slept in 4 days. She has had multiple similar episodes throughout her life. She is currently on lithium. She is married and does not use birth control. Her medical history is positive for class 2 obesity and hyperlipidemia. Given the likely diagnosis, which of the following medications is best to treat the patient’s condition? 

In forming a therapeutic relationship with clients, the PMHNP must consider developing many characteristics that are known to be helpful in relationship building. Which of the following is an essential part of building a therapeutic relationship?

A 40-year-old man presents to his clinician for a follow-up appointment. For the last 2 months, he has had trouble concentrating, decreased appetite, loss of motivation, decreased energy, and difficulty waking up in the morning. He admits to having suicidal thoughts but states that he “does not intend to act on them.” He has been taking the first-line medication with long half-life for this illness for 6 weeks without any improvement. His clinician stops the first medication and prescribes a different medication for this illness that has been available for many years, and the patient immediately begins taking it. What serious adverse event is the patient at risk of developing? 

Many mood-stabilizing and antipsychotic medications used to treat bipolar disorder are known to have weight gain as one of their adverse effects. Which of the following agents is not correlated with weight gain during therapeutic use? 

An adult client expresses ambivalence about continuing therapy due to external stressors, but the counselor believes that stopping treatment at this stage could result in relapse. What is the most ethically appropriate action for the counselor to take in this situation? 

The cognitive behavioral theory of depression states that people with depression think differently from those without depression. Which of the following is an important concept involved in this theory?