Natalee Williams, a 10-year-old African American girl, comes to your psychiatric nurse
practitioner office for evaluation. She has been sad and withdrawn, complaining about
headaches and “tummy aches.”
Her mother, Trina, accompanies her to the appointment. Trina notes that Natalee has seemed
depressed and presents as irritable. The mother notes her daughter’s mood change occurred
about two months ago. Natalee’s school performance has fallen, and she is now doing C work.
Last term, she earned all As. She wants to sleep more, and her appetite has decreased. She
rarely wants to play with friends and spends a lot of time in her room alone. Her height and
weight are normal for her age, but she has lost 2 pounds over the last two months.

There is a history of depression in the family, as Natalee’s maternal grandmother and maternal
aunt both have had major depression. Her maternal grandmother was hospitalized for psychiatric
care 20 years ago for depression and a suicide attempt by an overdose of Tylenol.
Questions
From your perspective as Natalee’s psychiatric nurse practitioner, answer the following questions
in a paper no longer than two double-spaced pages (not including the reference page and
prescription) and in APA format. Include at least three peer-reviewed, evidence-based
references.
What are some differential diagnoses you would give – identify one medical differential diagnosis
and two psychiatric differential diagnoses?
What diagnosis would you give Natalee? On what evidence/symptoms do you base your
diagnosis?
What medication(s) would you prescribe for Natalee and why? Please note the medication, initial
dose, and dosing schedule.
How will you educate and inform Trina (Natalee’s mother) about how this medication will work?
How will you discuss with Trina the commonly expected side effects and potentially serious
adverse effects and risks for a child of this age with taking this medication?