LMR GEORGETTE’S PMHNP
CERTIFICATION ACTUAL
EXAM LATEST 2026
QUESTIONS AND CORRECT
ANSWERS
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
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
QUESTIONWhat do you do if a patient presents with fever while
on Clozaril? - answer-Check ANC level to assess for
agranulocytosis
QUESTIONS/S of NMS - answer-muscle rigidity, hyperthermia,
tachycardia, abnormal bp, sweating, altered mental status, cherry
colored urine
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
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
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 medication to give during SS? - answer-
cyproheptadine (Periactin)- 5HT-2A receptor antagonist
CERTIFICATION ACTUAL
EXAM LATEST 2026
QUESTIONS AND CORRECT
ANSWERS
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
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
QUESTIONWhat do you do if a patient presents with fever while
on Clozaril? - answer-Check ANC level to assess for
agranulocytosis
QUESTIONS/S of NMS - answer-muscle rigidity, hyperthermia,
tachycardia, abnormal bp, sweating, altered mental status, cherry
colored urine
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
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
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 medication to give during SS? - answer-
cyproheptadine (Periactin)- 5HT-2A receptor antagonist
