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Question
A PMHNP is caring for a 17-year-old girl who is experiencing gradually worsening neuropsychiatric symptoms of apathy, irritability, and an inability to sleep. She reports she is also experiencing skin problems, tingling in her hands and feet, and diarrhea. The patient reports a normal appetite and has followed a raw vegan diet for over a year. Which nutritional deficiency should the PMHNP first rule out based on the presenting symptoms and diet?
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