PMHS case studies

PMHS · Put your knowledge to work in context.

The Pediatric Primary Care Mental Health Specialist (PMHS) is a certification offered by the Pediatric Nursing Certification Board (PNCB) that validates the added knowledge, skills, and expertise of advanced practice registered nurses in the early identification, intervention, and collaboration of care for children and adolescents with mental and behavioral health concerns. It is designed for advanced practice registered nurses - specifically PNPs, FNPs, PMHCNS-BCs, and PMHNP-BCs - who want to document competence in developmental, behavioral, and mental health care within pediatric primary care. The PMHS case studies are 5 cases and about 3,593 words.

8-Year-Old With ADHD: Dose Escalation Request, Weight Loss, and Delayed Sleep Onset

Marcus is 8 years 4 months old, in second grade, with ADHD combined type diagnosed 5 months ago. He takes methylphenidate extended-release 18 mg each morning.

755 words, about 4 min 2

15-Year-Old With Moderate Depression, Passive Suicidal Ideation, and a Request for Secrecy

Jade is 15 years 7 months old, a sophomore, brought by her mother for a sports physical. Alone, she says she has felt "empty" for 3 months, quit soccer, sleeps about 5 hours, and has dropped from A/B to C grades.

741 words, about 4 min 3

6-Year-Old in Kinship Foster Care: Aggression, Nightmares, and a School Request for "Mood Stabilizers"

Diego is 6 years 2 months old, in kindergarten, living with his aunt since removal from his mother 7 months ago because of neglect; he had two prior placements. His aunt reports 5-6 outbursts weekly lasting 10-20 minutes - hitting, throwing, screaming "I hate you" - usually triggered by transitions or being told no.

723 words, about 4 min 4

11-Year-Old With School Refusal, Somatic Complaints, and a Five-Month Therapy Waitlist

Aisha is 11 years 3 months old, in sixth grade. She has missed 21 of the last 26 school days; the absences began after a benign stomach flu in September, and she now reports morning stomachaches and headaches that fade by 10 am at home.

746 words, about 4 min 5

9-Year-Old With Autism on Risperidone: Rapid Weight Gain, Prediabetes Range HbA1c, and the Question of Stopping

Noah is 9 years 6 months old with autism spectrum disorder level 2 and limited expressive language. Four months ago his psychiatrist added risperidone 0.5 mg twice daily for aggression (hitting, biting) after parent training did not fully help.

628 words, about 3 min