The neurotransmitter dopamine increases the sense of well-being and decreases hunger and cravings. Which of the following medications is a dopamine antagonist that increases the possibility of Parkinson's disease, anhedonia, and addiction?

• A. SNRIs
• B. Antipsychotics
• C. Amphetamines
• D. Buproprion

You are a PMHNP asked to consult on a 45-year-old male patient who is in a psychiatric crisis. The patient's urine drug screen was positive for methamphetamines. You learn that the patient has suffered from chronic schizophrenia since the age of 18 and had previously been stabilized on Abilify for psychosis and another medication for depression. The mother further endorses that her son refuses to take Abilify because he does not "feel" schizophrenic any longer. He has, however, continued to take his antidepressant medication for depression. Given the history provided, you suspect that the patient is in a psychotic crisis due to discontinuance of the Abilify and not methamphetamine intoxication.
What finding is most supportive of your diagnosis?

• A. The mother states that he takes Wellbutrin (bupropion) for depression
• B. The mother states that he takes Zoloft (sertraline) for depression
• C. The mother states that he recently took Nyquil for the flu for one week
• D. The mother states that he takes Valium (diazepam) when he has a panic attack

A new patient with a known diagnosis of bipolar disorder has recently been discharged from inpatient hospitalization for an acute exacerbation of manic symptoms. Since his diagnosis 3 years ago, he has had 3 inpatient admissions for manic episodes and one occurrence of lithium toxicity. On admission to the hospital, his lithium levels were subtherapeutic, and his lithium dose was increased during his stay. His follow-up lithium level was lower than his level when admitted to the hospital.
What initial step in assessing health literacy should be taken by the PMHNP?

• A. Ask the patient to explain his understanding of his illness and treatment
• B. Order blood work to assess for comorbid conditions that impact the absorption of lithium
• C. Increase the lithium level with repeated testing in one week
• D. Repeat the lithium level

Akinesia is often mistaken for what symptom?

• A. Anxiety
• B. Amotivation
• C. Pseudo-Parkinson's disease
• D. Agitation

A PMHNP is implementing a quality improvement project to improve the screening process for depression in their clinic. Which of the following steps of the Plan-Do-Study-Act (PDSA) cycle would involve developing a screening protocol and training staff on its use?

• A. Plan
• B. Act
• C. Do
• D. Study