A 73-year-old patient presents at a veteran’s mental health clinic and reports having frequent nightmares that disturb their sleep. The patient experienced combat during the Vietnam War and states that the nightmares stem from this experience. The patient also reports a pervasive distrust of others, an inability to be happy, feeling angry most of the […]

A 13-year-old patient is becoming increasingly agitated toward the nurse practitioner during an initial assessment in an outpatient clinic. The patient is swearing at the nurse practitioner and aggressively posturing whenever a question is asked that they do not wish to answer, particularly questions about their relationship with their parents. How should the nurse practitioner […]

A 32-year-old patient who witnessed a shooting at a bank several months ago has been exhibiting symptoms of avoidance, irritability, disrupted sleep, recurring nightmares, feelings of detachment, decreased interest in activities, hypervigilance, anxiety, and intrusive flashbacks since the event. They have not left their home in more than a month due to being too afraid. […]

A nurse practitioner is completing a follow-up examination of a 24-year-old patient engaged in care for generalized anxiety disorder for the past year. The patient has been treated with a course of escitalopram (Lexapro) and psychotherapy. The patient appears uncomfortable today. They have bags under their eyes and seem out of character from past appointments. […]

A 77-year-old man with refractory cardiogenic shock has been under treatment in an intensive care unit for the last 7 days. Despite appropriate management, he fails to show improvement. After discussions with his relatives and obtaining informed consent, the team administers a novel drug to the patient. The drug is an adrenergic agonist that has […]

A 48-year-old patient arrives for an intake appointment at an outpatient clinic. The patient is observed to deliberately touch the door frame seven times before entering the room. When sitting in the chair, the patient first taps the chair seat seven times and, once seated, taps the chair arm seven times. When asked about this […]

A 32-year-old patient presents to the psychiatry clinic to discuss treatment for a psychiatric condition. The patient reports they are unable to maintain a job because they have recurring thoughts that they have left a door unlocked at their apartment. These thoughts lead to them returning to their apartment multiple times daily to ensure the […]

A 33-year-old patient is admitted involuntarily to an inpatient psychiatric unit after reporting thoughts of sexually and physically assaulting others to the police. The patient reports hearing voices telling them to carry out these acts. The patient believes that others have been trying to harm them for some time, which justifies any violent behavior. At […]

A 51-year-old man presents to the ED with chest pain and shortness of breath that began a few hours ago. He states that the pain radiates to his left shoulder. He admits to having similar but less severe episodes in the past, but testing at those times revealed only high cholesterol, for which he was […]

As a home health nurse working with a newly diagnosed 17-year-old man with schizophrenia who lives at home with his parents, you stop by to check on the patient at the request of his parents. The parents share their concerns that the patient’s medication, paliperidone (Invega), does not appear to be working as well as […]