Blog

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?

A 32 year-old graduate student accompanied by her husband is seen in the clinic with concerns about having ADHD. She reports feeling “hyper” the past four or five days. She has been staying up studying until 3 or 4 a.m. and gets up by 7 a.m. to get ready for class. She reports being easily distracted, and finds it is difficult to maintain focus. She is afraid she will not be able to keep up with the semester expectations. Discussing this with her husband, this is a pattern over the past several years that he has noticed three or four times a year, and after several weeks of the frenetic pace, she sleeps 10 to 12 hours a night, complains of no energy, lacks motivation, stops engaging with him and tends not to eat. Her presentation is most consistent with

A 78-year-old woman presents for an initial psychiatric interview 7 months after the death of her husband. She is accompanied by her daughter. The patient has lost 8 pounds over the past year, reports daily crying episodes, low energy, insomnia, poor concentration, and no longer socializes with friends. Vitals and BMI are normal. She has a history of Type 2 diabetes (HgbA1C = 4.8). Which comorbidity is of primary importance to consider when making treatment recommendations?

Which of the following symptoms are consistent with significant trauma history and cause for significant concern in a 4 year old child?

A 37-year-old firefighter presents with flashbacks, avoidance of reminders, hypervigilance, and nightmares 6 months after surviving a warehouse explosion. He reports feeling detached from family and has difficulty concentrating at work. He asks about both therapy and medication options. Which of the following represents the most evidence-based treatment for this patient?

A 24-year-old college student presents for evaluation due to ongoing mood instability. For the past three years, she has experienced frequent shifts between periods of elevated mood with increased energy, talkativeness, and decreased need for sleep, and periods of feeling sad, fatigued, and withdrawn. None of the mood changes have lasted long enough or been severe enough to meet full criteria for hypomanic or major depressive episodes. She denies hallucinations, delusions, suicidal ideation, or prior psychiatric hospitalization. Her symptoms cause distress and interfere with her academic functioning. What is the most appropriate diagnosis?