The PMHNP is counseling a patient who wants to enter treatment for a substance use disorder. The patient has been using methamphetamine for over one year and freely acknowledges how much he likes the way it makes him feel. However, he is realizing that it is destroying his marriage, his professional reputation, and his health. He genuinely wants to stop using it, and is willing to do whatever he has to do, but admit that he has tried twice before and relapsed. Both he and his significant other do not understand why the desire to use is so powerful since there is not a true physical withdrawal phenomenon.

The PMHNP explains that there is a very strong physiological drive due to the influence of which reward neurotransmitter?

A. Serotonin
B. Glutamae
C. Norepinephrine
D. Dopamine

When managing a patient in the stabilization phase of schizophrenia primary goals and process include which of the following?

A. Self-management skills

B. Supported employment

C. Assertive community treatment

D. Minimizing stress and supporting recovery

A 50 -year-old female patient has been followed by the PMHNP for over 6 years for a diagnosis of major depressive disorder, recurrent. The patient has achieved a successful remission on sertraline, 75 mg daily. Today presents complaining of an acute onset depressed mood, tearful days, and difficulty concentrating for the last month. It has become a problem at work, and her boss has suggested that she might need to take some time off to “take care of her problem.” Further discussion reveals that the patient learned last month that her husband is having an affair with a coworker. She is so distraught and consumed that she cannot fulfill her work responsibilities and she has completely cut herself off socially from friends and family.

The PMHNP suggests that the next best step in her care should include which of the following?

A. Increasing her sertraline to 100 mg daily

B. A referral to psychotherapy

C. A referral to couples counseling

D. Changing her pharmacotherapy to an SNRI

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YouTube: https://www.youtube.com/watch?v=I1kYlCdi7cg&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=110