Pearls and Prep

💎 Try Boss Pearl FREE for 7 days — the full library: every deep dive, the Diagnosing curriculum, and both books free the moment you're in — so you're ready for that first patient, not just studied for it. Then $20/month, cancel anytime:

https://www.patreon.com/checkout/pearlsandprep?rid=29362056

🎁 Join as a free member to access 50 Pearls from Pearls & Prep — 50 super high-yield pearls to sharpen your practice.

📚 Members get both books free — Board Bombs: PMHNP 250 Questions ($49.99) and the 100 Psychiatric Interview Tips E-Book ($39.99). Not a member yet? Both are in the shop: https://www.patreon.com/c/pearlsandprep/shop

⭐ Enjoying the show? Please rate and review Pearls and Prep on Apple Podcasts or Spotify — it really helps!

🌐 PearlsandPrep.com — scan this episode's Street Takes card, read the deep-dive articles, and unlock the full clinical library: https://pearlsandprep.com

✉️ Questions or a case you want covered? Write to NP Z: [email protected]

Through mock patient Dale's case, this episode explores ADHD versus bipolar disorder in outpatient care: avoiding anchoring bias, taking a meticulous longitudinal history, and distinguishing chronic traits from episodic mood shifts. Learn the differential diagnosis framework that keeps you honest — collateral, timelines, and the DSM-5-TR details that separate the two. Get the why behind each distinction and diagnose with clinical confidence on PMHNP boards.

🎧 Pearls & Prep — new episodes every Tuesday. Hosted by NP Z, Duke-trained Psychiatric Nurse Practitioner.

⚖️ Disclaimer: Pearls and Prep is an educational podcast and is not medical advice. All views expressed are exclusively those of NP Z and do not represent — and are not endorsed by — any other entity or organization. These perspectives are offered solely to build conceptual appreciation of psychiatric topics; they are not a substitute for clinical judgment, current clinical guidelines, or primary references. Always use appropriate resources and your own clinical judgment when making decisions about individual patients. Nothing in this episode creates a clinician–patient relationship.

🎓 NP Z's Most Recommended Resources — Pass Your Boards & See Your First Patient

The exact shelf behind this podcast: the textbooks open on NP Z's desk, and his own BOARD BOMBS™ + Interview Tips.

👉 pearlsandprep.com/resources

Your board date is already on the calendar, and your first patient is already on someone's schedule. Build the shelf they're both counting on — start today.

💎 Try Boss Pearl FREE for 7 days — the full library: every deep dive, the Diagnosing curriculum, and both books free the moment you're in — so you're ready for that first patient, not just studied for it. Then $20/month, cancel anytime:

https://www.patreon.com/checkout/pearlsandprep?rid=29362056

🎁 Join as a free member to access 50 Pearls from Pearls & Prep — 50 super high-yield pearls to sharpen your practice.

📚 Members get both books free — Board Bombs: PMHNP 250 Questions ($49.99) and the 100 Psychiatric Interview Tips E-Book ($39.99). Not a member yet? Both are in the shop: https://www.patreon.com/c/pearlsandprep/shop

⭐ Enjoying the show? Please rate and review Pearls and Prep on Apple Podcasts or Spotify — it really helps!

🌐 PearlsandPrep.com — scan this episode's Street Takes card, read the deep-dive articles, and unlock the full clinical library: https://pearlsandprep.com

✉️ Questions or a case you want covered? Write to NP Z: [email protected]

Three case-based Board Bombs every psych NP needs to master: illness anxiety disorder, lamotrigine titration and monitoring, and MAOI protocols including the tyramine diet. These high-risk, high-yield psychopharmacology scenarios test exactly what boards love — the details where real patients get hurt. Understand the why behind each protocol and walk into the ANCC exam with the clinical confidence to handle them safely.

🎧 Pearls & Prep — new episodes every Tuesday. Hosted by NP Z, Duke-trained Psychiatric Nurse Practitioner.

⚖️ Disclaimer: Pearls and Prep is an educational podcast and is not medical advice. All views expressed are exclusively those of NP Z and do not represent — and are not endorsed by — any other entity or organization. These perspectives are offered solely to build conceptual appreciation of psychiatric topics; they are not a substitute for clinical judgment, current clinical guidelines, or primary references. Always use appropriate resources and your own clinical judgment when making decisions about individual patients. Nothing in this episode creates a clinician–patient relationship.

🎓 NP Z's Most Recommended Resources — Pass Your Boards & See Your First Patient

The exact shelf behind this podcast: the textbooks open on NP Z's desk, and his own BOARD BOMBS™ + Interview Tips.

👉 pearlsandprep.com/resources

Your board date is already on the calendar, and your first patient is already on someone's schedule. Build the shelf they're both counting on — start today.

💎 Try Boss Pearl FREE for 7 days — the full library: every deep dive, the Diagnosing curriculum, and both books free the moment you're in — so you're ready for that first patient, not just studied for it. Then $20/month, cancel anytime:

https://www.patreon.com/checkout/pearlsandprep?rid=29362056

🎁 Join as a free member to access 50 Pearls from Pearls & Prep — 50 super high-yield pearls to sharpen your practice.

📚 Members get both books free — Board Bombs: PMHNP 250 Questions ($49.99) and the 100 Psychiatric Interview Tips E-Book ($39.99). Not a member yet? Both are in the shop: https://www.patreon.com/c/pearlsandprep/shop

⭐ Enjoying the show? Please rate and review Pearls and Prep on Apple Podcasts or Spotify — it really helps!

🌐 PearlsandPrep.com — scan this episode's Street Takes card, read the deep-dive articles, and unlock the full clinical library: https://pearlsandprep.com

✉️ Questions or a case you want covered? Write to NP Z: [email protected]

Mock patient Marcus still suffers PTSD nightmares years after trauma — even on sertraline (Zoloft). This episode dives into prazosin for trauma-related nightmares: the noradrenergic rationale, dosing pearls, and why pre-trauma history matters for treatment planning. Get the why behind alpha-1 blockade for nightmares and expand your PTSD psychopharmacology toolkit with clinical confidence — a high-yield topic for PMHNP boards.

🎧 Pearls & Prep — new episodes every Tuesday. Hosted by NP Z, Duke-trained Psychiatric Nurse Practitioner.

⚖️ Disclaimer: Pearls and Prep is an educational podcast and is not medical advice. All views expressed are exclusively those of NP Z and do not represent — and are not endorsed by — any other entity or organization. These perspectives are offered solely to build conceptual appreciation of psychiatric topics; they are not a substitute for clinical judgment, current clinical guidelines, or primary references. Always use appropriate resources and your own clinical judgment when making decisions about individual patients. Nothing in this episode creates a clinician–patient relationship.

🎓 NP Z's Most Recommended Resources — Pass Your Boards & See Your First Patient

The exact shelf behind this podcast: the textbooks open on NP Z's desk, and his own BOARD BOMBS™ + Interview Tips.

👉 pearlsandprep.com/resources

Your board date is already on the calendar, and your first patient is already on someone's schedule. Build the shelf they're both counting on — start today.

💎 Try Boss Pearl FREE for 7 days — the full library: every deep dive, the Diagnosing curriculum, and both books free the moment you're in — so you're ready for that first patient, not just studied for it. Then $20/month, cancel anytime:

https://www.patreon.com/checkout/pearlsandprep?rid=29362056

🎁 Join as a free member to access 50 Pearls from Pearls & Prep — 50 super high-yield pearls to sharpen your practice.

📚 Members get both books free — Board Bombs: PMHNP 250 Questions ($49.99) and the 100 Psychiatric Interview Tips E-Book ($39.99). Not a member yet? Both are in the shop: https://www.patreon.com/c/pearlsandprep/shop

⭐ Enjoying the show? Please rate and review Pearls and Prep on Apple Podcasts or Spotify — it really helps!

🌐 PearlsandPrep.com — scan this episode's Street Takes card, read the deep-dive articles, and unlock the full clinical library: https://pearlsandprep.com

✉️ Questions or a case you want covered? Write to NP Z: [email protected]

Mock patient Sarah's academic struggles, overwhelming anxiety, and obsessive-compulsive behaviors could point to ADHD, OCD, or something else entirely. This case study demonstrates gathering comprehensive information before jumping to an anxiety diagnosis: developmental history, symptom timelines, and the DSM-5-TR criteria that distinguish them. Sharpen your careful differential diagnosis discipline, understand the why behind each criterion, and diagnose with real clinical confidence.

🎧 Pearls & Prep — new episodes every Tuesday. Hosted by NP Z, Duke-trained Psychiatric Nurse Practitioner.

⚖️ Disclaimer: Pearls and Prep is an educational podcast and is not medical advice. All views expressed are exclusively those of NP Z and do not represent — and are not endorsed by — any other entity or organization. These perspectives are offered solely to build conceptual appreciation of psychiatric topics; they are not a substitute for clinical judgment, current clinical guidelines, or primary references. Always use appropriate resources and your own clinical judgment when making decisions about individual patients. Nothing in this episode creates a clinician–patient relationship.

🎓 NP Z's Most Recommended Resources — Pass Your Boards & See Your First Patient

The exact shelf behind this podcast: the textbooks open on NP Z's desk, and his own BOARD BOMBS™ + Interview Tips.

👉 pearlsandprep.com/resources

Your board date is already on the calendar, and your first patient is already on someone's schedule. Build the shelf they're both counting on — start today.

💎 Try Boss Pearl FREE for 7 days — the full library: every deep dive, the Diagnosing curriculum, and both books free the moment you're in — so you're ready for that first patient, not just studied for it. Then $20/month, cancel anytime:

https://www.patreon.com/checkout/pearlsandprep?rid=29362056

🎁 Join as a free member to access 50 Pearls from Pearls & Prep — 50 super high-yield pearls to sharpen your practice.

📚 Members get both books free — Board Bombs: PMHNP 250 Questions ($49.99) and the 100 Psychiatric Interview Tips E-Book ($39.99). Not a member yet? Both are in the shop: https://www.patreon.com/c/pearlsandprep/shop

⭐ Enjoying the show? Please rate and review Pearls and Prep on Apple Podcasts or Spotify — it really helps!

🌐 PearlsandPrep.com — scan this episode's Street Takes card, read the deep-dive articles, and unlock the full clinical library: https://pearlsandprep.com

✉️ Questions or a case you want covered? Write to NP Z: [email protected]

Aripiprazole (Abilify) isn't just another antipsychotic — it's a dopamine-serotonin system stabilizer, modulating receptors like a dimmer switch rather than simply blocking them. This episode decodes its unique psychopharmacology: partial agonism, the metabolic advantages over other second-generation antipsychotics, and where it fits clinically. Get the why behind aripiprazole's distinctive profile and prescribe — and answer boards questions — with clinical confidence.

🎧 Pearls & Prep — new episodes every Tuesday. Hosted by NP Z, Duke-trained Psychiatric Nurse Practitioner.

⚖️ Disclaimer: Pearls and Prep is an educational podcast and is not medical advice. All views expressed are exclusively those of NP Z and do not represent — and are not endorsed by — any other entity or organization. These perspectives are offered solely to build conceptual appreciation of psychiatric topics; they are not a substitute for clinical judgment, current clinical guidelines, or primary references. Always use appropriate resources and your own clinical judgment when making decisions about individual patients. Nothing in this episode creates a clinician–patient relationship.

🎓 NP Z's Most Recommended Resources — Pass Your Boards & See Your First Patient

The exact shelf behind this podcast: the textbooks open on NP Z's desk, and his own BOARD BOMBS™ + Interview Tips.

👉 pearlsandprep.com/resources

Your board date is already on the calendar, and your first patient is already on someone's schedule. Build the shelf they're both counting on — start today.

💎 Try Boss Pearl FREE for 7 days — the full library: every deep dive, the Diagnosing curriculum, and both books free the moment you're in — so you're ready for that first patient, not just studied for it. Then $20/month, cancel anytime:

https://www.patreon.com/checkout/pearlsandprep?rid=29362056

🎁 Join as a free member to access 50 Pearls from Pearls & Prep — 50 super high-yield pearls to sharpen your practice.

📚 Members get both books free — Board Bombs: PMHNP 250 Questions ($49.99) and the 100 Psychiatric Interview Tips E-Book ($39.99). Not a member yet? Both are in the shop: https://www.patreon.com/c/pearlsandprep/shop

⭐ Enjoying the show? Please rate and review Pearls and Prep on Apple Podcasts or Spotify — it really helps!

🌐 PearlsandPrep.com — scan this episode's Street Takes card, read the deep-dive articles, and unlock the full clinical library: https://pearlsandprep.com

✉️ Questions or a case you want covered? Write to NP Z: [email protected]

When SSRIs leave major depression incompletely treated, second-generation antipsychotics can augment — targeting serotonin receptors to address residual symptoms like anxiety and insomnia. This deep dive into SGA augmentation strategy covers which agents carry FDA approval, the metabolic monitoring they demand, and how to choose. Understand the why behind augmentation psychopharmacology and build the clinical confidence to finish what the SSRI started — a PMHNP boards staple.

🎧 Pearls & Prep — new episodes every Tuesday. Hosted by NP Z, Duke-trained Psychiatric Nurse Practitioner.

⚖️ Disclaimer: Pearls and Prep is an educational podcast and is not medical advice. All views expressed are exclusively those of NP Z and do not represent — and are not endorsed by — any other entity or organization. These perspectives are offered solely to build conceptual appreciation of psychiatric topics; they are not a substitute for clinical judgment, current clinical guidelines, or primary references. Always use appropriate resources and your own clinical judgment when making decisions about individual patients. Nothing in this episode creates a clinician–patient relationship.

🎓 NP Z's Most Recommended Resources — Pass Your Boards & See Your First Patient

The exact shelf behind this podcast: the textbooks open on NP Z's desk, and his own BOARD BOMBS™ + Interview Tips.

👉 pearlsandprep.com/resources

Your board date is already on the calendar, and your first patient is already on someone's schedule. Build the shelf they're both counting on — start today.

💎 Try Boss Pearl FREE for 7 days — the full library: every deep dive, the Diagnosing curriculum, and both books free the moment you're in — so you're ready for that first patient, not just studied for it. Then $20/month, cancel anytime:

https://www.patreon.com/checkout/pearlsandprep?rid=29362056

🎁 Join as a free member to access 50 Pearls from Pearls & Prep — 50 super high-yield pearls to sharpen your practice.

📚 Members get both books free — Board Bombs: PMHNP 250 Questions ($49.99) and the 100 Psychiatric Interview Tips E-Book ($39.99). Not a member yet? Both are in the shop: https://www.patreon.com/c/pearlsandprep/shop

⭐ Enjoying the show? Please rate and review Pearls and Prep on Apple Podcasts or Spotify — it really helps!

🌐 PearlsandPrep.com — scan this episode's Street Takes card, read the deep-dive articles, and unlock the full clinical library: https://pearlsandprep.com

✉️ Questions or a case you want covered? Write to NP Z: [email protected]

Mock patient Michael, 32, presents with manic and delusional behavior leading to an ER visit. This episode works through bipolar I diagnostic criteria step by step — the DSM-5-TR mania requirements, the differentials that mimic it, and clinical strategies for complex, high-acuity presentations. Get the why behind each criterion and build the clinical confidence to diagnose and stabilize bipolar I, on boards and in the emergency setting.

🎧 Pearls & Prep — new episodes every Tuesday. Hosted by NP Z, Duke-trained Psychiatric Nurse Practitioner.

⚖️ Disclaimer: Pearls and Prep is an educational podcast and is not medical advice. All views expressed are exclusively those of NP Z and do not represent — and are not endorsed by — any other entity or organization. These perspectives are offered solely to build conceptual appreciation of psychiatric topics; they are not a substitute for clinical judgment, current clinical guidelines, or primary references. Always use appropriate resources and your own clinical judgment when making decisions about individual patients. Nothing in this episode creates a clinician–patient relationship.

🎓 NP Z's Most Recommended Resources — Pass Your Boards & See Your First Patient

The exact shelf behind this podcast: the textbooks open on NP Z's desk, and his own BOARD BOMBS™ + Interview Tips.

👉 pearlsandprep.com/resources

Your board date is already on the calendar, and your first patient is already on someone's schedule. Build the shelf they're both counting on — start today.

💎 Try Boss Pearl FREE for 7 days — the full library: every deep dive, the Diagnosing curriculum, and both books free the moment you're in — so you're ready for that first patient, not just studied for it. Then $20/month, cancel anytime:

https://www.patreon.com/checkout/pearlsandprep?rid=29362056

🎁 Join as a free member to access 50 Pearls from Pearls & Prep — 50 super high-yield pearls to sharpen your practice.

📚 Members get both books free — Board Bombs: PMHNP 250 Questions ($49.99) and the 100 Psychiatric Interview Tips E-Book ($39.99). Not a member yet? Both are in the shop: https://www.patreon.com/c/pearlsandprep/shop

⭐ Enjoying the show? Please rate and review Pearls and Prep on Apple Podcasts or Spotify — it really helps!

🌐 PearlsandPrep.com — scan this episode's Street Takes card, read the deep-dive articles, and unlock the full clinical library: https://pearlsandprep.com

✉️ Questions or a case you want covered? Write to NP Z: [email protected]

Mock patient Benny, 34, juggles depression and cannabis use. This episode explores diagnostic and treatment strategies for the co-occurring pair: motivational interviewing that actually engages, medication nuances including why bupropion (Wellbutrin) enters the conversation, and how substance use reshapes the differential. Understand the why behind integrated treatment and build the clinical confidence to manage complexity — on PMHNP boards and in practice.

🎧 Pearls & Prep — new episodes every Tuesday. Hosted by NP Z, Duke-trained Psychiatric Nurse Practitioner.

⚖️ Disclaimer: Pearls and Prep is an educational podcast and is not medical advice. All views expressed are exclusively those of NP Z and do not represent — and are not endorsed by — any other entity or organization. These perspectives are offered solely to build conceptual appreciation of psychiatric topics; they are not a substitute for clinical judgment, current clinical guidelines, or primary references. Always use appropriate resources and your own clinical judgment when making decisions about individual patients. Nothing in this episode creates a clinician–patient relationship.

🎓 NP Z's Most Recommended Resources — Pass Your Boards & See Your First Patient

The exact shelf behind this podcast: the textbooks open on NP Z's desk, and his own BOARD BOMBS™ + Interview Tips.

👉 pearlsandprep.com/resources

Your board date is already on the calendar, and your first patient is already on someone's schedule. Build the shelf they're both counting on — start today.

💎 Try Boss Pearl FREE for 7 days — the full library: every deep dive, the Diagnosing curriculum, and both books free the moment you're in — so you're ready for that first patient, not just studied for it. Then $20/month, cancel anytime:

https://www.patreon.com/checkout/pearlsandprep?rid=29362056

🎁 Join as a free member to access 50 Pearls from Pearls & Prep — 50 super high-yield pearls to sharpen your practice.

📚 Members get both books free — Board Bombs: PMHNP 250 Questions ($49.99) and the 100 Psychiatric Interview Tips E-Book ($39.99). Not a member yet? Both are in the shop: https://www.patreon.com/c/pearlsandprep/shop

⭐ Enjoying the show? Please rate and review Pearls and Prep on Apple Podcasts or Spotify — it really helps!

🌐 PearlsandPrep.com — scan this episode's Street Takes card, read the deep-dive articles, and unlock the full clinical library: https://pearlsandprep.com

✉️ Questions or a case you want covered? Write to NP Z: [email protected]

Mock patient Carly, a 32-year-old librarian suddenly facing a eulogy, is overwhelmed by public-speaking anxiety. This episode explains how propranolol — a beta blocker — quiets performance anxiety: the autonomic mechanism, dosing and timing pearls, and key safety considerations for psych NP students. Get the why behind the physiology and prescribe with clinical confidence, on boards and when it counts in real life.

🎧 Pearls & Prep — new episodes every Tuesday. Hosted by NP Z, Duke-trained Psychiatric Nurse Practitioner.

⚖️ Disclaimer: Pearls and Prep is an educational podcast and is not medical advice. All views expressed are exclusively those of NP Z and do not represent — and are not endorsed by — any other entity or organization. These perspectives are offered solely to build conceptual appreciation of psychiatric topics; they are not a substitute for clinical judgment, current clinical guidelines, or primary references. Always use appropriate resources and your own clinical judgment when making decisions about individual patients. Nothing in this episode creates a clinician–patient relationship.

🎓 NP Z's Most Recommended Resources — Pass Your Boards & See Your First Patient

The exact shelf behind this podcast: the textbooks open on NP Z's desk, and his own BOARD BOMBS™ + Interview Tips.

👉 pearlsandprep.com/resources

Your board date is already on the calendar, and your first patient is already on someone's schedule. Build the shelf they're both counting on — start today.

💎 Try Boss Pearl FREE for 7 days — the full library: every deep dive, the Diagnosing curriculum, and both books free the moment you're in — so you're ready for that first patient, not just studied for it. Then $20/month, cancel anytime:

https://www.patreon.com/checkout/pearlsandprep?rid=29362056

🎁 Join as a free member to access 50 Pearls from Pearls & Prep — 50 super high-yield pearls to sharpen your practice.

📚 Members get both books free — Board Bombs: PMHNP 250 Questions ($49.99) and the 100 Psychiatric Interview Tips E-Book ($39.99). Not a member yet? Both are in the shop: https://www.patreon.com/c/pearlsandprep/shop

⭐ Enjoying the show? Please rate and review Pearls and Prep on Apple Podcasts or Spotify — it really helps!

🌐 PearlsandPrep.com — scan this episode's Street Takes card, read the deep-dive articles, and unlock the full clinical library: https://pearlsandprep.com

✉️ Questions or a case you want covered? Write to NP Z: [email protected]

New here? Pearls & Prep delivers mock psychiatric cases that teach you to think like a psych NP — patient charts, lab reviews, DSM-5-TR criteria, and practical psychopharmacology from SSRIs to second-generation antipsychotics. Every episode is built to help you get the why behind clinical decisions and build the clinical confidence boards demand. Start here to see what the show is about — then join thousands of PMHNP students prepping smarter.

🎧 Pearls & Prep — new episodes every Tuesday. Hosted by NP Z, Duke-trained Psychiatric Nurse Practitioner.

⚖️ Disclaimer: Pearls and Prep is an educational podcast and is not medical advice. All views expressed are exclusively those of NP Z and do not represent — and are not endorsed by — any other entity or organization. These perspectives are offered solely to build conceptual appreciation of psychiatric topics; they are not a substitute for clinical judgment, current clinical guidelines, or primary references. Always use appropriate resources and your own clinical judgment when making decisions about individual patients. Nothing in this episode creates a clinician–patient relationship.

🎓 NP Z's Most Recommended Resources — Pass Your Boards & See Your First Patient

The exact shelf behind this podcast: the textbooks open on NP Z's desk, and his own BOARD BOMBS™ + Interview Tips.

👉 pearlsandprep.com/resources

Your board date is already on the calendar, and your first patient is already on someone's schedule. Build the shelf they're both counting on — start today.