A 27-year-old female presents via telehealth reporting diffi…

A 27-year-old female presents via telehealth reporting difficulty maintaining employment, impulsive spending, and “mood swings.” She describes rapid shifts in mood that occur multiple times per day, typically following conflicts with others. She reports a history of unstable relationships, chronic feelings of emptiness, and episodes of self-harm. She recalls being an average student with no significant behavioral issues in childhood. She reports occasional periods of increased productivity lasting several hours but denies decreased need for sleep or sustained elevated mood. Which is the MOST accurate diagnosis?

A 28-year-old female presents via telehealth reporting “mood…

A 28-year-old female presents via telehealth reporting “mood swings” and difficulty maintaining relationships. During the session, she becomes tearful and states, “Everyone leaves me eventually.” She then shows superficial cuts on her forearm and says, “I wasn’t trying to kill myself—I just needed to feel something.” She denies suicidal intent, has no plan, and agrees to a safety plan. Toward the end of the session, she asks, “Can I message you later tonight if I start to feel this way again?”Which of the following is the MOST appropriate combined response by the PMHNP?

A 35-year-old male presents reporting that coworkers “may be…

A 35-year-old male presents reporting that coworkers “may be trying to undermine him” and that conversations sometimes seem to reference him indirectly. He acknowledges that this “might just be his interpretation.” He has longstanding difficulty forming close relationships, appears socially anxious, and demonstrates eccentric behavior and speech. He denies hallucinations and maintains organized thought processes. Which is the MOST accurate diagnosis?

A 30-year-old male presents with impulsive decision-making,…

A 30-year-old male presents with impulsive decision-making, unstable employment, and frequent interpersonal conflicts. He reports acting “without thinking” in emotionally charged situations but denies childhood history of inattention or academic difficulties. Symptoms began in early adulthood and are most prominent in relationships. Which diagnosis is MOST consistent?