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LMR Georgette’s PMHNP Certification Exam Review | Latest 2025/ 2026 Update | Questions and Verified Answers | 100% Correct | GRADED A |
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Question: When many answers are remarkably similar, they are usually _____________ Answer: wrong Question: Interprofessional collaboration is encouraged. Answer: Collaborate is usually right. Delegate is usually wrong. Question: ADPIER Answer: Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
Question: Lithium Answer: Normal 0.6-1. Question: Lithium toxicity occurs at levels Answer:
Question: Signs of Lithium toxicity Answer: severe nausea, diarrhea, vomiting, confusion, drowsiness, muscle weakness, heart palpitation, coarse hand tremors, unsteady gait Question: Lithium is gold standard for Answer: MANIA
HCG (all psychotropics females 12-51) EKG 50+ Urinalysis (check for proteins, 4+ may indicate kidney disease) Question: Side Effects of Lithium Answer: hypothyroidism coase hand tremors with toxicity maculopapular rash diarrhea, vomiting, cramps--signs of toxicity. Monitor closely. anorexia t wave inversions leukocytosis Question: Pt education for lithimum Answer: staying hydrated avoiding NSAIDS compliance
Question: Depakote normal level Answer: 50 - 125 Question: Depakote toxicity level Answer: greater than 150 Question: Teratogenic effects of Depakote Answer: spina bifida Question: Adverse effects of depakote Answer: alopecia hepatotoxicity (RUQ pain or brown/red urine--order LFTs) AST 5-40, ALT 5-35, yellowing of skin or eyes, fatigue
sudden explosive like headache facial flushing palpitations pupillary dilation diaphoresis fever Question: Hypertensive crisis occurs with MAOI + Answer: MEPERIDINE STIMULANTS decongestants TCAs atypicals St. John's wart L-tryptophan asthma meds Question: Treatment for hypertensive crisis Answer: DC offending agent
Administer PHENTOLAMINE Question: Teratogenic effects of benzos Answer: floppy baby, cleft palate Question: Teratogenic effects of tegratol Answer: neural tube defect Question: teratogenic effects of lithium Answer: ebstein anomaly (heart defect) (avoid, especially 1st trimester) Question: teratogenic effects of depakote Answer: neural tube defects/spina bifida
Lamotrigine is least likely to cause Answer: sedation or weight gain Question: Carbamazepine (tegretol) black box warning agranulocytosis (decrease WBCs) Answer: aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin rash, SOA) Question: Carbamazepine and asians Answer: Screen for HLAB-1502 allele before initiating, due to high incidence of SJS if positive for allele. Question: Child-bearing aged women Answer: check for pregnancy before starting mood stabilizer start on folic acid to support neural tube development during the first month that a woman is pregnant
Question: Clozaril/clozapine can cause Answer: agranulocytosis and neutropenia Question: For monitoring neutropenia in Clozaril, monitor Answer: ANC Question: DC clozarli if ANC Answer: less than 1000 Question: DC clozaril if WBC Answer: 2000 - 3000, risk of agranulocytosis
Mary is a 45-year-old African American female who has been treated on Isocarboxazid (Marplan) for over 6 years. Mary is going in for a surgical procedure. Which medication is strictly contraindicated with Isocarboxazid? A. Morphine B. NSAIDS C. Methylphenidate D. Acetaminophen Answer: Answer: Methylphenidate Question: You are treating a client with schizophrenia who takes clozapine. What lab values will indicate the client needs to discontinue treatment? A. WBC less than 1800 and ANC less than 1200 B. ANC less than 1, C. WBC less than 5, D. ANC less than 2000 Answer: Answer: ANC less than 1000 Question: If given during pregnancy, socium valproate can cause which of the following medical problems in the baby? A. SJS B. Ebstein's anomaly
C. Spina bifida D. Cleft palate Answer: A. Spina bifida Question: Which mood stabilizer is associated with potential life-threatening rash in the Asian population? A. Carbamazepine (tegretol) B. Depakote C. Lithium D. Lamictal Answer: A. Carbamazepine Question: Bulimia, weight is ___________ Answer: within the normal range. Question: Pharm treatment for bulimia Answer:
B. Low BMI C. Erosion of dental enamel D. Hypertrophy of salivary glands Low BMI Question: If a patient is depression, low energy, fatigued, you would prescribe Answer: Wellbutrin Question: Wellbutrin is contraindicated in patients with Answer: seizure disorder or conditions that increase risk of seizures such as eating disorder. Question: Which of the following medications has a unique mechanism that is both a norepinephrine and dopamine reuptake inhibitor? A. Bupropion (Wellbutrin) B. Sertraline (Zoloft) C. Clomipramine (Anafranil) D. Duloxetine (Cymbalta) Answer:
bupropion Question: CLozaril is metabolized by Answer: cytochrome P450 enzyme CYP1A Question: INducers Answer: induce metabolism and therefore decrease serum levels of other drugs that are substrates Question: Smoking will do what to drug levels Answer: decrease therapeutic levels of the drug Question: Bull Shit CRAP GPS Induces my rage Answer: Barbituates
Sodium valproate Isoniazid Cimetidine Ketoconazole Alcohol Chloramphenicol Erythromycin Sulfonamine Cipro Omeprazole Metronidazole Question: Which cytochrome enzyme is implicated as a tobacco inducer when an individual is treated with clozapine Answer: a. 2D b. 1A c. 2C 19 d. 2C 1A (want A 2 cigarette break) Question:
When treating older adults, you should keep in mind that they are more sensitive to issues of drug toxicity because of which of the following reasons? A. Decreased body fat B. Increased liver capacity C. Decreased protein binding D. Increased muscle concentration Answer: Decreased protein binding Question: For 12 years, a 65 year old patient with bipolar affective disorder has been treated with lithium 900 mg daily. When oral HCTC 12.5 daily is added for hypertension, the patient develops nausea, vomiting, ataxia, and muscle weakness and the patient's serum lithium level is 2.0. The interaction of the lithium and the thiazide diuretic has induced: A. hypokalemia B. hyponatremia C. Increased renal clearance of lithium D. Decreased renal clearance of lithium Answer: A. decreased renal clearance of lithium Question: Where is norepinephrine produced Answer:
