A patient taking lithium reports nausea, diarrhea, and a coarse tremor. Which finding most strongly suggests lithium toxicity?

A patient on lamotrigine develops a rash after a rapid dose increase. Which action is MOST appropriate?

A 38-year-old man with MDD and hypertension is started on venlafaxine 75 mg. At follow-up, his BP is 160/100 (baseline 130/80). What is the BEST next step?

A 29-year-old used heroin 4 hours ago and wants to start buprenorphine immediately. He has mild anxiety but no objective withdrawal signs. What is the BEST next step?

A 38-year-old woman presents with excessive worry occurring more days than not for the past year, accompanied by muscle tension, irritability, and difficulty sleeping. She denies panic attacks and substance use. Which medication is considered first-line pharmacologic treatment for generalized anxiety disorder (GAD)?

A 58-year-old with bipolar disorder and chronic hepatitis C has worsening LFTs. Which mood stabilizer most clearly requires caution or dose adjustment in hepatic impairment?

A 76-year-old with depression and insomnia takes multiple medications (antihypertensives, anticoagulant, diabetes meds). The PMHNP considers adding a sedative-hypnotic. Which risk is MOST heightened in older adults and should guide prescribing?

A 29-year-old patient with bipolar I disorder presents with decreased need for sleep, pressured speech, and grandiosity. Which medication is considered first-line for acute mania?

A 15-year-old with major depressive disorder is started on an SSRI. Which monitoring plan is MOST important early in treatment?

A 32-year-old woman with MDD presents for her first medication evaluation. She has no prior exposure to psychotropics, drinks alcohol socially, and takes levothyroxine. She works full-time and is concerned about daytime sedation and weight gain. As you consider first-line pharmacologic treatment, what is the MOST appropriate guiding principle?