ANCC IQ domain 1

ANCC IQ domain 1 1. A 17-year-old female presents to your clinic reporting anhedonia, decreased energy, and hopelessness for the past 2 years. She denies drinking alcohol, smoking, or using illegal substances. Her physical examination results are within normal limits and she denies suicidal ideations. As the treating psychiatric mental health nurse practitioner, you decide to prescribe her bupropion (Wellbutrin). Of the following, which is a contraindication for bupropion? - Dysthymia - Fatigue - Smoking - Bulimia - Bulimia Rationale: Do not use bupropion if patient is bulimic, either currently or in the past. Prohibition for use in eating disorders due to increased risk of seizures. 2. The PMHNP would expect to see which of the following during a physical exam for a patient with bulimia nervosa? - Alopecia areata - Erosion of dental enamel - Obesity tachycardia - Erosion of dental enamel Rationale: Erosion of dental enamel from repeated self-induced vomiting, although some patients are able to vomit at will. Weight is usually normal, sometimes slightly underweight or slightly overweight, but typically not obese. Hair lost is not a predominant clinical feature and not in circular (areata) pattern for bulimia nervosa. While cardiac arrhythmias are more common in anorexia nervosa with severe weight loss, it is not a common or expected finding in bulimia nervosa with weight typically within normal range.