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A client returns for a follow-up appointment 3 weeks after starting on fluoxetine 20 mg. During this appointment you notice that her speech is a little rapid, in marked contrast to the psychomotor retardation and paucity of spontaneous speech she displayed on her first visit. Instead of looking at the floor, she now makes normal eye contact. Her affect has gone from constricted to expansive. She continues to have difficulty sleeping, but her energy has improved and she states she feels “so much better!” What should you conclude about the shift in the client’s presentation?

SECCIÓN 1 |  COMPRENSIÓN AUDITIVA [17 puntos]

Responsibilities for the APRN in standards of advanced practice include:

Consider the following set of population data and calculate the variance. {13, 13, 20, 17, 20, 16, 17, 13, 20, 19} Make sure to type in your answer rounded to 2 decimal places. So if you thought the answer was 65.4321 then you would type in 65.43

Use the following data to answer the question: Pat and Marie have the following expenses and account balances: Pat’s annual 401(k) plan contribution: $16,500 Pat’s annual salary: $100,000 Current liabilities: $24,000 Housing costs (P&I&T&I) monthly: $2,167 Cash & Cash equivalents: $18,000 Monthly nondiscretionary cash flows: $6,000 Monthly debt payments other than housing $500 * Pat’s employer matches $1 for $1 up to 3% of Pat’s salary in his 401(k) plan. Based on the information above, calculate Pat and Marie’s housing ratio 1.  

 Showing a photo of an ID on  your phone is NOT allowed since phones are not allowed.

The Keller’s determined that they can reduce their mortgage interest rate from 10% to 4%. The value of homes in their neighborhood has been increasing at the rate of 5% annually. If the Keller’s were to refinance their house with $3,000 in closing costs added to the mortgage balance ($277,000) over a period of time which coincides with their chosen retirement age in 20 years, what would be the monthly payment for principal and interest?

The psychiatric review of systems in an important part of obtaining a history of present illness in your psychiatric interview. What are the 4 main categories included in a psychiatric review of systems?

Abe and Miriam would like to help fund the cost of their grandchildren’s college expenses using a 529 plan.  They have a large estate and would like to begin gifting for estate planning purposes.  What is the maximum amount that Abe and Miriam can gift to each of their grandchildren this year if they haven’t used any of their lifetime exemption or without incurring a gift tax?

SECCIÓN 4  |  CULTURA [14 puntos]