The mother of a 3-year-old female brings her daughter in for a psychiatric evaluation. The mother is concerned because she sometimes sees her daughter talking to an “imaginary friend” and Mom is worried because she has a cousin with schizophrenia. Further the staff at her daughter’s daycare report that this little girl seems to prefer playing alone, even though there are lots of other children to play with. The child does not want to share her toys, and does not seem interested in playing with other children.

The PMHNP recognizes that it is likely that:

A. The child may be demonstrating early indicators of schizophrenia which is possible due to family history.

B. These behaviors are consistent with developmental stage and not a cause for concern.

C. Play therapy with an early-childhood therapist may help her integrate better with other children

D. Autism spectrum disorder is more likely than schizophrenia given the child’s age.

The PMNP is evaluating a patient who is being treated for obsessive compulsive disorder with fluoxetine 60 mg daily. The patient has been on fluoxetine for months without any concerning adverse effects, but today the patient reports that for the past few weeks she has had a distinct sense of agitation, racing heart, nausea, and has been really clumsy. Suspecting serotonin syndrome, the NP assess for:

A. New onset delusional thought

B. Constipation

C. Irritability

D. Recent use of OTC cough medicine

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YouTube: https://www.youtube.com/watch?v=VcyTSz7d4M4&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=76

The PMHNP is on call at the residential treatment facility and is called to urgently see a patient being treated for methamphetamine use disorder. The patient was admitted earlier this day and being and was still being assessed for appropriate psychotherapy and medication needs. Facility staff was performing routine observation rounds and found the patient unresponsive. You arrive at the bedside and find the patient to be unresponsive, with a blood pressure of 78/50 mm Hg and a respiratory rate of 7 breaths/minute.

The appropriate response is to:

A. Immediately review the records for all known substances of abuse

B. Administer intranasal naloxone

C. Begin CPR

D. Place oxygen and IV access

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YouTube: https://www.youtube.com/watch?v=VQTxgzSWDgk&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=75