Which of the following is a key component of long-term management for individuals with Bipolar Disorder to reduce the risk of relapse?

An adult patient is diagnosed with bipolar disorder. They want to stop medication due to side effects that are impacting their quality of life. They report they were once very physically active but have now gained weight and feel lethargic on their current medications. They have a history of multiple inpatient admissions due to severe decompensation and psychosis. The psychiatric mental health nurse practitioner feels that discontinuation of medication could potentially exacerbate the patient’s chronic mental illness. Currently the patient shows no signs of impaired thought process. Best course of action for the nurse practitioner is to provide information regarding the risks, benefits and treatment alternatives and to:

Which of the following best describes the relationship between chronic pain and mental illness?

Which of the following is the most likely indication for prescribing an atypical antipsychotic (such as aripiprazole or quetiapine) in the treatment of depression?

A suicidal patient with chronic depressive disorder presents to your office in tears. He tells you he cannot stop thinking about ending his life because he is so depressed. You ask him if he has a plan, and he details where he could buy a gun and where he would go to shoot himself. You worry that the patient will carry out this plan because he has not had adequate control of his symptoms since his last antidepressant change one month ago. You discuss inpatient hospitalization for stabilization but the patient refuses. Your next step in management of this patient would be to:

Another psychiatric mental health nurse practitioner is reviewing a patient chart with you. You are a PMHNP student and eager to learn. The PMHNP asks you which of the following medications this patient may be taking.   Patient stated on admission: “I am on several medications. I have been on them for years, I have always been depressed and nothing works well. I don’t know what the medication names are. All I know if that they told me I can not eat fermented foods. Who wants to eat fermented foods anyways yuck!” Based on the statement made by the patient on intake when reviewing current medications, you determine that which medication is likely being taken?

A 73-year-old male presents with depression and low energy for the past month. He has no significant medical issues. Memory and cognition are intact. You prescribe his paroxetine 20mg PO QAM for depression. Two weeks later he is brought into the emergency room by his family with disorientation, nausea and weakness. Which laboratory test is most likely to establish his diagnosis? 

A 32-year-old female patient informs the psychiatric-mental health nurse practitioner that she is three months pregnant. She has been stable on fluoxetine hydrochloride (Prozac) for the last two years. The patient asks whether she may safely continue this medication during her pregnancy. The nurse practitioner responds: Choose the best answer

Which of the following is the most appropriate treatment for patients with frequent and dangerous sleepwalking episodes?

A 21 year-old telephones an adult psychiatric and mental health nurse practitioner to report that he has been unusually active, irritable, and unable to sleep for more than a few hours each night. He exhibits pressured speech and you may be concerned with mania based on how this individual is speaking.  This patient has been diagnosed with a major depressive disorder, and was started on fluoxetine (Prozac) a six weeks ago. The psychiatric mental health nurse practitioner is most concerned about the possibility that: