b.
c.
d.
LMR GEORGETTE’S PMHNP FINAL EXAM
LATEST UPDATE 2025 QUESTIONS AND
CORRECT ANSWERS
QUESTIONWhat should you do if a patient presents with cherry colored urine? - answer-Check for
rhabdo with CPK
QUESTIONs/s of serotonin syndrome - answer-hyperreflexia, muscle spasms, myoclonus (involuntary
muscle jerk), fever, tachycardia, HTN, shits and shivers
QUESTIONWhat two medications to give with NMS? - answer-bromocriptine (Parlodel)- D2 agonist
dantrolene- muscle relaxer
QUESTIONWhat medication to give during SS? - answer-cyproheptadine (Periactin)- 5HT-2A receptor
antagonist
QUESTIONWhat is the onset and typical length of NMS? - answer-Slow onset (1-2 weeks after
changing or starting therapy) and resolves within 9-14 days
What does ADPIE stand for? - answer-Assessment
Diagnosis
Planning
Implementation
Evaluation
QUESTIONWhat should you do when a mother reports her child woke up screaming in the middle of
the night? - answer-Ask her if it's happened before to assess for sleep issue patterns
QUESTIONWhat do you do if a patient comes in with fungus on their toenail? - answer-Scrape nail and
send for testing
QUESTIONWhat do you do if a patient on lithium has dark brown urine? - answer-Check renal function
, b.
c.
d.
QUESTIONWhat do you do if a patient presents with fever while on Clozaril? - answer-Check ANC
level to assess for agranulocytosis
QUESTIONWhat can cause serotonin syndrome? - answer-Antidepressants, St. John's Wort, Same-E,
Kava Kava, and Tryptophan
QUESTIONWhat labs are indicative of NMS? - answer-Elevated WBC (over 11,000) and elevated CPK
QUESTIONS/S of NMS - answer-muscle rigidity, hyperthermia, tachycardia, abnormal bp, sweating,
altered mental status, cherry colored urine
QUESTIONWhat is the onset of SS? - answer-Within 24 hours of starting/changing medication and
resolves within a few days
QUESTIONHow do you distinguish between NMS and acute dystonia? - answer-NMS has a slower
onset while acute dystonia occurs within hours
QUESTIONWhat happens with lithium and NSAIDs? - answer-Increased risk of lithium toxicity (gout
meds, ibuprophen, naproxen, etc.)
QUESTIONWhat happens with lithium and ACE inhibitors? - answer-Increased risk of lithium toxicity
related to the increased urination from the ACE inhibitors
QUESTIONWhy should a patient on lithium avoid calcium channel blockers? - answer-Risk of fatal
nephrotoxicity
QUESTIONWhat is a fetal side effect of lithium? - answer-Epstein's anomaly
QUESTIONWhat lab should you check for athletes on lithium? - answer-Specific gravity to assess for
dehydration (dehydration is >1.015)
QUESTIONWhat do you do if the lithium level is 1.3? - answer-Do not give the next dose and assess for
s/s
QUESTIONAt what level is lithium toxicity a medical emergency? - answer->3
, b.
c.
d.
QUESTIONS/S of lithium toxicity - answer-vomiting, diarrhea, slurred speech, hand tremor, dry
mouth/thirst, muscle weakness/twitching
QUESTIONWhy check an EKG with lithium? - answer-Inverted T-waves
QUESTIONWhat medication should treat hypothyroidism caused by lithium use? - answer-Synthroid
QUESTIONWhat do you do if patient is prescribed both depakote and lamictal? - answer-Decreased
lamictal dose by 50%
QUESTIONDepakote and pregnancy - answer-Spina bifida
QUESTIONWhat emergency may be occuring if patient on depakote reports upper abdominal pain? -
answer-Pancreatitis
QUESTIONWhat lab should you check if patient has right upper quadrant pain and dark brown urine? -
answer-LFTs
QUESTIONWhat lab means pregnancy? - answer-HCG
QUESTIONWhy is Clozaril used? - answer-Treatment resistant schizophrenia, improves SI, and
improves negative symptoms of schizophrenia
QUESTIONWhat two medications have the highest risk of agranulocytosis and aplastic anemia? -
answer-Clozaril and Tegretol
QUESTIONWhat symptoms may mean a Clozaril induced infection? - answer-Sore throats, sores in
mouth/gums, fever
QUESTIONparasympathetic nervous system - answer-the division of the autonomic nervous system that
calms the body, conserving its energy
QUESTIONsympathetic nervous system - answer-the division of the autonomic nervous system that
arouses the body, mobilizing its energy in stressful situations
QUESTIONprefrontal cortex - answer-part of frontal lobe responsible for thinking, planning, and
language
c.
d.
LMR GEORGETTE’S PMHNP FINAL EXAM
LATEST UPDATE 2025 QUESTIONS AND
CORRECT ANSWERS
QUESTIONWhat should you do if a patient presents with cherry colored urine? - answer-Check for
rhabdo with CPK
QUESTIONs/s of serotonin syndrome - answer-hyperreflexia, muscle spasms, myoclonus (involuntary
muscle jerk), fever, tachycardia, HTN, shits and shivers
QUESTIONWhat two medications to give with NMS? - answer-bromocriptine (Parlodel)- D2 agonist
dantrolene- muscle relaxer
QUESTIONWhat medication to give during SS? - answer-cyproheptadine (Periactin)- 5HT-2A receptor
antagonist
QUESTIONWhat is the onset and typical length of NMS? - answer-Slow onset (1-2 weeks after
changing or starting therapy) and resolves within 9-14 days
What does ADPIE stand for? - answer-Assessment
Diagnosis
Planning
Implementation
Evaluation
QUESTIONWhat should you do when a mother reports her child woke up screaming in the middle of
the night? - answer-Ask her if it's happened before to assess for sleep issue patterns
QUESTIONWhat do you do if a patient comes in with fungus on their toenail? - answer-Scrape nail and
send for testing
QUESTIONWhat do you do if a patient on lithium has dark brown urine? - answer-Check renal function
, b.
c.
d.
QUESTIONWhat do you do if a patient presents with fever while on Clozaril? - answer-Check ANC
level to assess for agranulocytosis
QUESTIONWhat can cause serotonin syndrome? - answer-Antidepressants, St. John's Wort, Same-E,
Kava Kava, and Tryptophan
QUESTIONWhat labs are indicative of NMS? - answer-Elevated WBC (over 11,000) and elevated CPK
QUESTIONS/S of NMS - answer-muscle rigidity, hyperthermia, tachycardia, abnormal bp, sweating,
altered mental status, cherry colored urine
QUESTIONWhat is the onset of SS? - answer-Within 24 hours of starting/changing medication and
resolves within a few days
QUESTIONHow do you distinguish between NMS and acute dystonia? - answer-NMS has a slower
onset while acute dystonia occurs within hours
QUESTIONWhat happens with lithium and NSAIDs? - answer-Increased risk of lithium toxicity (gout
meds, ibuprophen, naproxen, etc.)
QUESTIONWhat happens with lithium and ACE inhibitors? - answer-Increased risk of lithium toxicity
related to the increased urination from the ACE inhibitors
QUESTIONWhy should a patient on lithium avoid calcium channel blockers? - answer-Risk of fatal
nephrotoxicity
QUESTIONWhat is a fetal side effect of lithium? - answer-Epstein's anomaly
QUESTIONWhat lab should you check for athletes on lithium? - answer-Specific gravity to assess for
dehydration (dehydration is >1.015)
QUESTIONWhat do you do if the lithium level is 1.3? - answer-Do not give the next dose and assess for
s/s
QUESTIONAt what level is lithium toxicity a medical emergency? - answer->3
, b.
c.
d.
QUESTIONS/S of lithium toxicity - answer-vomiting, diarrhea, slurred speech, hand tremor, dry
mouth/thirst, muscle weakness/twitching
QUESTIONWhy check an EKG with lithium? - answer-Inverted T-waves
QUESTIONWhat medication should treat hypothyroidism caused by lithium use? - answer-Synthroid
QUESTIONWhat do you do if patient is prescribed both depakote and lamictal? - answer-Decreased
lamictal dose by 50%
QUESTIONDepakote and pregnancy - answer-Spina bifida
QUESTIONWhat emergency may be occuring if patient on depakote reports upper abdominal pain? -
answer-Pancreatitis
QUESTIONWhat lab should you check if patient has right upper quadrant pain and dark brown urine? -
answer-LFTs
QUESTIONWhat lab means pregnancy? - answer-HCG
QUESTIONWhy is Clozaril used? - answer-Treatment resistant schizophrenia, improves SI, and
improves negative symptoms of schizophrenia
QUESTIONWhat two medications have the highest risk of agranulocytosis and aplastic anemia? -
answer-Clozaril and Tegretol
QUESTIONWhat symptoms may mean a Clozaril induced infection? - answer-Sore throats, sores in
mouth/gums, fever
QUESTIONparasympathetic nervous system - answer-the division of the autonomic nervous system that
calms the body, conserving its energy
QUESTIONsympathetic nervous system - answer-the division of the autonomic nervous system that
arouses the body, mobilizing its energy in stressful situations
QUESTIONprefrontal cortex - answer-part of frontal lobe responsible for thinking, planning, and
language
