PMHNP EXAM FINAL STUDY GUIDE 2026
QUESTIONS AND ACCURATE ANSWERS
Reflexes expected at 1 month - ANSWER-Moro until 4 months, Palmer until 4 months, Plantar
util 8 months, Babinski (2 years is disease)
Signs of fetal alcohol syndrome - ANSWER-small head, shoey palpebral fissure, inner epicanthal
folds. Do IEP and early intervention specialist
Rhett Syndrome - ANSWER-a rare disorder found virtually exclusively in girls, is a
neurodevelopmental disorder in which the child usually develops normally unitl about 6 to 18
months of age at which characteristics of the syndrome emerge; characteristics include:
hypotonia (loss of muscle tone), reduced eye contact, decelerated head growth, and disinterest
in play activities
EPS types - ANSWER-Tardive dyskinesia happen after years (eps is a precursor). Acute dystonia
(hours), Parkinsons (weeks), Akathisia (days)
Where do EPS originate - ANSWER-nigrostiatal tract.
How does tegretol interact with cipro - ANSWER-cipro and erythromycin are inhibitors. Cause
increased level of Tegretol. Black box warning
Tegretol side effects - ANSWER-Aplastic anemia, agranulocytosis, steven johnsons,
hyponatremia. Watch with cipro and erythro
nuchal rigidity - ANSWER-stiffness in cervical neck area, meningitis
ACE inhibitors - ANSWER--pril, CHF
signs of serotonin syndrome - ANSWER--shivering
-anxiety
-diaphoresis
-hyperthermia
Shits and Shivers
diarrhea, shivering, hyperreflexia/myoclonis, increased temperature, vital sign instability,
encephalopathy, restlessness, sweating
, Serotonin Discontinuation Syndrome - ANSWER-syndrome caused by abrupt withdrawal of an
antidepressant drug, resulting in sensory disturbances, sleeping disturbances, disequilibrium,
flu-like symptoms, dizzy, vertigo, paresthesia (brain zaps), nausea/vomiting, and gastrointestinal
effects
NMS - ANSWER-neuroleptic malignant syndrome
*S*evere fever
*C*hanging LOC
*A*utonomic instability
*R*igidity
*S*weating and drooling
FEVERS- fever, encephalopathy, vitals instability, elevated white blood cell count/cpk, rigidity
Levels of Prevention - ANSWER-Primary: prevent/promotion, classes, safety initiatives,
education, classes, modifying environment
Secondary: screen-early detection, crisis hotlines, disaster
Tertiary: treat- to prevent further deterioration, rehab, restoration, day treatment, social skills
Risk factors for serotonin syndrome - ANSWER-more than 1 SSRI, st johns wart, tramadol,
demerol, ultram, maperidone, 5HT
Grade 2/5 hoarse systolic heart murmur - ANSWER-aortic stenosis
Woman with GAD advise on medication - ANSWER-stop benzos because can cause floppy baby
syndrome and cleft palate, cotinue buspar
What to give to agitated pt in seclusion - ANSWER-IM Geodon
Labs for macrocytic anemia - ANSWER-Folic acid, vitamin B12, ESR/CRP, HGB, MCV (liver)
When to assess a patient in restraints for face/face - ANSWER-1 hour then 8 hours
therapeutic communication - ANSWER-open ended, 'tell me'
Reluctant/silent patient - ANSWER-open ended questions
Patients husband shows up but not the patient - ANSWER-both people need to be present,
reschedule
QUESTIONS AND ACCURATE ANSWERS
Reflexes expected at 1 month - ANSWER-Moro until 4 months, Palmer until 4 months, Plantar
util 8 months, Babinski (2 years is disease)
Signs of fetal alcohol syndrome - ANSWER-small head, shoey palpebral fissure, inner epicanthal
folds. Do IEP and early intervention specialist
Rhett Syndrome - ANSWER-a rare disorder found virtually exclusively in girls, is a
neurodevelopmental disorder in which the child usually develops normally unitl about 6 to 18
months of age at which characteristics of the syndrome emerge; characteristics include:
hypotonia (loss of muscle tone), reduced eye contact, decelerated head growth, and disinterest
in play activities
EPS types - ANSWER-Tardive dyskinesia happen after years (eps is a precursor). Acute dystonia
(hours), Parkinsons (weeks), Akathisia (days)
Where do EPS originate - ANSWER-nigrostiatal tract.
How does tegretol interact with cipro - ANSWER-cipro and erythromycin are inhibitors. Cause
increased level of Tegretol. Black box warning
Tegretol side effects - ANSWER-Aplastic anemia, agranulocytosis, steven johnsons,
hyponatremia. Watch with cipro and erythro
nuchal rigidity - ANSWER-stiffness in cervical neck area, meningitis
ACE inhibitors - ANSWER--pril, CHF
signs of serotonin syndrome - ANSWER--shivering
-anxiety
-diaphoresis
-hyperthermia
Shits and Shivers
diarrhea, shivering, hyperreflexia/myoclonis, increased temperature, vital sign instability,
encephalopathy, restlessness, sweating
, Serotonin Discontinuation Syndrome - ANSWER-syndrome caused by abrupt withdrawal of an
antidepressant drug, resulting in sensory disturbances, sleeping disturbances, disequilibrium,
flu-like symptoms, dizzy, vertigo, paresthesia (brain zaps), nausea/vomiting, and gastrointestinal
effects
NMS - ANSWER-neuroleptic malignant syndrome
*S*evere fever
*C*hanging LOC
*A*utonomic instability
*R*igidity
*S*weating and drooling
FEVERS- fever, encephalopathy, vitals instability, elevated white blood cell count/cpk, rigidity
Levels of Prevention - ANSWER-Primary: prevent/promotion, classes, safety initiatives,
education, classes, modifying environment
Secondary: screen-early detection, crisis hotlines, disaster
Tertiary: treat- to prevent further deterioration, rehab, restoration, day treatment, social skills
Risk factors for serotonin syndrome - ANSWER-more than 1 SSRI, st johns wart, tramadol,
demerol, ultram, maperidone, 5HT
Grade 2/5 hoarse systolic heart murmur - ANSWER-aortic stenosis
Woman with GAD advise on medication - ANSWER-stop benzos because can cause floppy baby
syndrome and cleft palate, cotinue buspar
What to give to agitated pt in seclusion - ANSWER-IM Geodon
Labs for macrocytic anemia - ANSWER-Folic acid, vitamin B12, ESR/CRP, HGB, MCV (liver)
When to assess a patient in restraints for face/face - ANSWER-1 hour then 8 hours
therapeutic communication - ANSWER-open ended, 'tell me'
Reluctant/silent patient - ANSWER-open ended questions
Patients husband shows up but not the patient - ANSWER-both people need to be present,
reschedule
