Solutions
_______________ women suffer from higher SUD
rates compared to other racial and ethnic groups
and are disproportionately affected by
criminalization laws at the federal, state, and tribal
levels. Correct Answers Indigenous
A program policy that prohibits individuals from
using specific forms of prescribed medication for
addiction (MAT) treatment is an example of
__________ stigma Correct Answers structural
A stereotypic belief that individuals choose to use
alcohol or other drugs and blame them for their
substance use disorder is an example of _________
stigma Correct Answers public
Addressing Parental Concerns: Collaborative
Treatment Plans Correct Answers -tx plans for
children typically made in collaboration with
parents or guardians
-Collaboration between the PMHNP, clients, and
families when creating the treatment plan is key to
ensuring the plan meets the client's needs and is
comfortable and manageable for the family
Alexandra has been taking lithium 1200 mg orally
in two divided doses of 600 mg each for bipolar I
,disorder. She has been in remission of symptoms
for 14 months. She is 7 weeks pregnant.
Which of the following is the most appropriate
recommendation for Alexandra?
obtain serum lithium levels before tapering the
lithium dose
decrease dose to 600 mg daily
decrease dose to 900 mg daily
discontinue lithium and switch to lamotrigine
Correct Answers obtain serum lithium levels
before tapering the lithium dose
Rationale: Lithium exposure during the first
trimester has a small but statistically significant
risk of cardiac malformations; the risk increases
with higher dosages of the medication. Obtaining
serum lithium levels before tapering the dose is
indicated since Alexandra has bipolar I disorder
and is stable. The development of the heart begins
as early as the third week of gestation with the 4-
chamber fetal heart formed by gestational week 7.
By the time Alexandra is weaned the risk has
passed as the heart is already formed. Although
lamotrigine is considered safe during pregnancy, it
may not be appropriate for clients who have
experienced mania in the past.
,Allie is a 26-year-old who has been receiving
treatment for bipolar I disorder for 3 years. Her
symptoms have been in remission with lithium 500
mg twice daily. She also completed 12 weeks of
interpersonal and social rhythm therapy (IPSRT)
upon diagnosis and used the life charting
methodology to track her symptoms. She calls her
PMHNP and states "I just found out I'm pregnant.
My partner and I were not expecting this, but we
are excited! I am worried about what lithium will do
to my baby. Sh Correct Answers schedule an
appointment for Allie and her husband to discuss a
treatment plan as soon as possible
ask Allie to continue taking lithium at the current
dose for now
recommend that Allie begin tracking her mood,
sleep schedule, and other symptoms
Rationale: Rationale: The PMHNP should schedule
an appointment as soon as possible to discuss
Allie's treatment plan during her pregnancy.
Discontinuation of medications for pregnancy is
associated with a relapse rate of 80-100% for
clients who take mood stabilizers; therefore, the
client should not abruptly cease taking lithium
(Ortega et al., 2023). Clients with a diagnosis of
bipolar disorder may benefit from tracking the
, symptoms of their illness, especially during
stressful times.
Although reassurance is appropriate, the PMHNP
should not minimize the potential risks of
continuing medication by telling the client that no
harm will come to the baby.
Barriers to Mental Health Treatment in Children
and Adolescents Correct Answers -lack of
sufficient information or access to services
-stigmas or negative perceptions towards mental
health services
-many drop out before receiving effective
treatment, often due to:
• poverty
• language barriers
• living in communities with scarce resources
• stressors such as
➣problems in the family
➣violence in the community
➣unstable housing
➣unemployment
➣food insecurity
-Cost
-scheduling conflicts
-long waitlists for services
-high staff turnover