J.T. is a 38-year-old male patient who presents for assessment and treatment of substance use disorder. He has a long history of chronic alcohol use, typically drinking a 6-pack of beer every evening. According to his primary care provider his physical examination and laboratory studies are all within normal limits and there are no documented medical conditions.

He admits that he personally does not truly believe he has substance use problem, but his wife does like the fact that he drinks, and they argue about it often. He loves his wife and does not want to argue, but he enjoys his beer and feels strongly that it is not hurting anything when he drinks. He thinks she is being unreasonable.

The PMHNP recognizes that he is at what point in the change process?

A. Precontemplative

B. Focusing

C. Unfreezing

D. Planning

The PMHNP is seeing a 11-year-old patient who is being managed for obsessive-compulsive disorder. The patient has been in exposure response therapy for almost one year and has been taking fluoxetine 40 mg daily. For the last six months the patient was in an acceptable remission, but today he reports that his obsessive thought processes and compulsive hygiene behaviors have started to become intrusive and are making it difficult for him to manage his day appropriately. Additional assessment today must include which of the following?

Select all that apply

A. Subjective information from the patient

B. Subjective information from the parent

C. Subjective information from the teacher

D. Subjective information from the therapist

An initial psychiatric evaluation should include a comprehensive risk assessment across the lifespan. Which of the following should be part of the initial intake for all patients aged 8 to 24 as part of that risk evaluation?

A. The CAGE questionnaire

B. The ASQ tool

C. The SCARED tool

D. The MCHAT-R questionnaire

---

YouTube: https://www.youtube.com/watch?v=jB53p074Ze0&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=140