Mr. Jones is a 52-year-old man who presents as a new patient to the PMHNP because his psychiatrist recently retired. He is stable on his medications for depression and anxiety, and he says he hasn't had labs drawn in "at least 2 years." His current medication regimen is: acetaminophen (Tylenol) 500 mg PO prn for knee pain, omeprazole (Prilosec) 20 mg PO BID, escitalopram (Lexapro) 20 mg PO daily, and brexpiprazole (Rexulti) 1 mg PO daily. What screening labs are appropriate for this patient?

Choice A reason: While CBC and CMP are essential baseline labs, they are insufficient for a middle-aged patient on psychotropic medications and with chronic medical conditions, as they do not assess nutritional deficiencies or lipid status. Choice B reason: Adding a lipid profile and thyroid panel increases the scope of monitoring but still omits critical nutritional labs like vitamin B12 and D, which are relevant for long-term mental health, bone health, and medication effects. Choice C reason: This comprehensive lab panel covers blood counts, metabolic status, lipid profile, thyroid function, and essential vitamins. Vitamin B12 and D deficiencies are common in adults on chronic psychotropic medications and can impact mood, cognition, and overall health. Choice D reason: Using a BMP instead of CMP provides less information about liver function, which is important for monitoring medication safety. Omitting vitamin B12 also leaves a gap in assessing nutritional risk factors.