A 78-year-old man presents for a follow-up visit. Two months ago he was started on sertraline for major depressive disorder and has been titrated up to 100 mg daily. Today his daughter reports that she cannot really evaluate if his mood has improved because he seems to have become confused. The patient’s daughter reports a distinct new onset confusion and forgetfulness.

The PMHNP considers the most likely cause of his confusion to be:

A. Urinary tract infection.

B. Hyponatremia

C. Alzheimer’s disease

D. Depression

Cognitive assessment in children characterizes stages of development consistent with Piaget’s developmental theory. One of the cognitive principles typically developed during the sensorimotor stage is:

A. Object permanence

B. Animalistic thinking

C. Phenomenalistic causality

D. Learning without reasoning.

A 12-year-old patient is being seen today in follow-up after being started on fluoxetine 1 month ago for a diagnosis of generalized anxiety disorder. The patient and her father both report that while there does appear to be a mild improvement in anxiety, some adverse effects have developed about which they are concerned.

Which of the following is not an expected adverse effect and is a cause for concern?

A. Vivid nightmares

B. Diaphoresis

C. Restless legs

D. Impulsivity

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YouTube: https://www.youtube.com/watch?v=6onROBl73UE&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=93