A 14-year-old patient has been managed for the last year with fluoxetine 40 mg daily for a diagnosis of generalized anxiety disorder. She had been doing well, but today her mother reports that ever since returning to school after the summer break she has been distant, sullen, argumentative and defiant. She has been spending time with new friends from school and is always out somewhere with them.

The PMHNP recognizes that today’s appointment should include use of which of the following objective tools?

A. The AIMS tool

B. The BPRS

C. The MDQ

D. The CRAFFT tool

PMHNP is asked to evaluate a 71-year-old male patient who is reportedly having visual hallucinations. His adult daughter accompanies him to the appointment and reports that he was diagnosed with Parkinson’s disease approximately 2 years ago. It began with the classic motor symptoms, but over the last year he has developed more and more difficulty with memory loss, difficulty with decision making, and episodes of depression and apathy. Sinemet has helped his motor symptoms, but he has not responded well to medications for cognitive symptoms. A few months ago he started having visual hallucinations. At first it was a sense of things moving in his peripheral vision, but lately he is seeing people who are not there, or interpreting inanimate objects as people.

Which of the following is the most appropriate medication for this patient?

A. Bupropion (Wellbutrin)

B. Pimavanserin (Nuplazid)

C. Quetiapine (Seroquel)

D. Sertraline (Zoloft)

A 71-year-old patient with neurocognitive disorder due to Lewy Body disease presents for a routine follow-up. His wife reveals that he seems to be hallucinating, sometimes at night becoming very agitated as a result of visual hallucinations, and she is afraid for his safety. The patient himself does not really seem to understand that there is a problem, but his wife is very concerned and firm that he seems to have visual hallucinations more and more frequently.

Which of the following medications would be most appropriate?

A. Risperidone

B. Olanzapine

C. Haloperidol

D. Quetiapine

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YouTube: https://www.youtube.com/watch?v=dtthgQAXpes&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=86