A 64-year-old patient presents with new onset anxiety. She denies any history of anxiety disorder or any psychiatric disorder previously in her life, but for the last 9 months she has been having episodes that she describes as “attacks.” Out of the blue she will develop a sense of racing heart, hyperventilation, numbness and tingling in her arms, and feeling lightheaded. She worries about this a lot, and now worries virtually all the time about why this is happening. It is causing difficulty with sleeping, and she finds herself being very irritable at home and at work.

These episodes last for “a few minutes” and then subsides on its own. She takes medication for high blood pressure and high cholesterol, but otherwise reports being very healthy.

What aspect of this scenario is suggestive that there might be an underlying organic cause of her symptoms?

A. Age of onset

B. Character of episodes

C. Medical history

D. Duration of episodes

The dopamine hypothesis of schizophrenia postulates an abnormality in which of the following dopamine pathway as the etiology of symptoms? Select all that apply.

A. The mesolimbic pathway

B. The mesocortical pathway

C. The nigrostriatal pathway

D. The tuberoinfundibular pathway

---

YouTube: https://www.youtube.com/watch?v=oQ42kYfwJU4&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=103

The PMHNP is seeing a patient who presents with a chief complaint of feeling depressed. Further exploration reveals that while the patient does have several symptoms of a depressive episode, he does not quite meet criteria for any of the commonly encountered depressive disorders. The primary issue seems to center around the fact that the client feels as if his life has no meaning. He says he gets up, he gets dressed, goes to work, pays the bills, does all of the things he is supposed to do in life, but he struggles with the question, “what is the point? Why does any of it matter?

The PMHNP recognizes that the patient might benefit from which of the following types of therapy?

A. Cognitive behavioral therapy

B. Behavioral therapy

C. Psychodynamic therapy

D. Existential therapy

---

YouTube: https://www.youtube.com/watch?v=5CwRoe9maZQ&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=102