GEORGETTE REVIEW PMHNP ACTUAL
EXAMINATION 2026 COMPREHENSIVE
ONE HUNDRED EIGHTY PLUS QUESTIONS
WITH THOROUGHLY ANALYZED CORRECT
ANSWERS GRADED A+
⩥ ADPIER. Answer: Assessment, diagnosis, Plan, intervention,
evaluate, refer out last.
⩥ Lithium. Answer: Normal 0.6-1.2
⩥ Lithium toxicity occurs at levels. Answer: > 1.5
⩥ Signs of Lithium toxicity. Answer: severe nausea, diarrhea, vomiting,
confusion, drowsiness, muscle weakness, heart palpitation, coarse hand
tremors, unsteady gait
⩥ Lithium is gold standard for. Answer: MANIA
⩥ Lithium has evidence shown to. Answer: reduce suicidal ideation
,⩥ What does lithium cause in neonate, especially 1st trimester. Answer:
Ebstein anomaly (congenital heart defect)
⩥ dehydration and hyponatremia cause lithium levels to. Answer: rise
⩥ Baseline labs before initiation of lithium. Answer: TSH
creatinine (0.6-1.2)
BUN (10-20)
HCG (all psychotropics females 12-51)
EKG 50+
Urinalysis (check for proteins, 4+ may indicate kidney disease)
⩥ 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
⩥ Pt education for lithimum. Answer: staying hydrated
avoiding NSAIDS
,compliance
⩥ Depakote normal level. Answer: 50-125
⩥ Depakote toxicity level. Answer: greater than 150
⩥ Teratogenic effects of Depakote. Answer: spina bifida
⩥ 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
⩥ Signs of Depakote toxicity. Answer: disorientation, lethargy,
respiratory depression, nausea/vomiting
⩥ Intervention for depakote toxicity. Answer: DC med
check level
LFT
ammonia
⩥ MAOI + tyramine causes. Answer: hypertensive crisis
, ⩥ Symptoms of hypertensive crisis. Answer: elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
⩥ Hypertensive crisis occurs with MAOI +. Answer: MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
⩥ Treatment for hypertensive crisis. Answer: DC offending agent
Administer PHENTOLAMINE
⩥ Teratogenic effects of benzos. Answer: floppy baby, cleft palate
EXAMINATION 2026 COMPREHENSIVE
ONE HUNDRED EIGHTY PLUS QUESTIONS
WITH THOROUGHLY ANALYZED CORRECT
ANSWERS GRADED A+
⩥ ADPIER. Answer: Assessment, diagnosis, Plan, intervention,
evaluate, refer out last.
⩥ Lithium. Answer: Normal 0.6-1.2
⩥ Lithium toxicity occurs at levels. Answer: > 1.5
⩥ Signs of Lithium toxicity. Answer: severe nausea, diarrhea, vomiting,
confusion, drowsiness, muscle weakness, heart palpitation, coarse hand
tremors, unsteady gait
⩥ Lithium is gold standard for. Answer: MANIA
⩥ Lithium has evidence shown to. Answer: reduce suicidal ideation
,⩥ What does lithium cause in neonate, especially 1st trimester. Answer:
Ebstein anomaly (congenital heart defect)
⩥ dehydration and hyponatremia cause lithium levels to. Answer: rise
⩥ Baseline labs before initiation of lithium. Answer: TSH
creatinine (0.6-1.2)
BUN (10-20)
HCG (all psychotropics females 12-51)
EKG 50+
Urinalysis (check for proteins, 4+ may indicate kidney disease)
⩥ 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
⩥ Pt education for lithimum. Answer: staying hydrated
avoiding NSAIDS
,compliance
⩥ Depakote normal level. Answer: 50-125
⩥ Depakote toxicity level. Answer: greater than 150
⩥ Teratogenic effects of Depakote. Answer: spina bifida
⩥ 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
⩥ Signs of Depakote toxicity. Answer: disorientation, lethargy,
respiratory depression, nausea/vomiting
⩥ Intervention for depakote toxicity. Answer: DC med
check level
LFT
ammonia
⩥ MAOI + tyramine causes. Answer: hypertensive crisis
, ⩥ Symptoms of hypertensive crisis. Answer: elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
⩥ Hypertensive crisis occurs with MAOI +. Answer: MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
⩥ Treatment for hypertensive crisis. Answer: DC offending agent
Administer PHENTOLAMINE
⩥ Teratogenic effects of benzos. Answer: floppy baby, cleft palate
