The pmhnp is evaluating jared, a 47-year-old male who is brought to care by his wife because “he’s not the man i married 20 years ago.” according to his wife, she and jared have been married for 20 years, have two children, and have lived a “normal” life. jared owns a local construction company and their marriage has been a solid one, characterized by the typical day-to-day issues that occur in most marriages, but otherwise happy. for the last 2–3 months, she says jared has completely changed. he will get angry for no apparent reason and even broke a lamp once. he tells stupid and offensive jokes that no one else thinks are funny, and even had someone call the police when he continued to make inappropriate remarks to a woman in a restaurant. jared seems unsure what to say, but his wife is adamant that this is a totally different man from the one she has known. the pmhnp knows that jared should be evaluated for: