Georgette Review PMHNP Exam 2026 Updated Assured Success
When many answers are remarkably similar, they are usually _____________answerwrong
Interprofessional collaboration is encouraged.answerCollaborate is usually right.
Delegate is usually wrong.
ADPIERanswerAssessment, diagnosis, Plan, intervention, evaluate, refer out last.
LithiumanswerNormal 0.6-1.2
Lithium toxicity occurs at levelsanswer> 1.5
Signs of Lithium toxicityanswersevere nausea, diarrhea, vomiting, confusion, drowsiness, muscle
weakness, heart palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard foranswerMANIA
Lithium has evidence shown toanswerreduce suicidal ideation
What does lithium cause in neonate, especially 1st trimesteranswerEbstein anomaly (congenital heart
defect)
dehydration and hyponatremia cause lithium levels toanswerrise
Baseline labs before initiation of lithiumanswerTSH
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 Lithiumanswerhypothyroidism
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Pt education for lithimumanswerstaying hydrated
avoiding NSAIDS
compliance
Depakote normal levelanswer50-125
Depakote toxicity levelanswergreater than 150
Teratogenic effects of Depakoteanswerspina bifida
Adverse effects of depakoteansweralopecia
hepatotoxicity (RUQ pain or brown/red urine--order LFTs) AST 5-40, ALT 5-35, yellowing of skin or eyes,
fatigue
Signs of Depakote toxicityanswerdisorientation, lethargy, respiratory depression, nausea/vomiting
Intervention for depakote toxicityanswerDC med
check level
,LFT
ammonia
MAOI + tyramine causesanswerhypertensive crisis
Symptoms of hypertensive crisisanswerelevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI +answerMEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisisanswerDC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzosanswerfloppy baby, cleft palate
Teratogenic effects of tegratolanswerneural tube defect
, teratogenic effects of lithiumanswerebstein anomaly (heart defect) (avoid, especially 1st trimester)
teratogenic effects of depakoteanswerneural tube defects/spina bifida
Adverse reaction to LamictalanswerSteven Johnson's Syndrome
Signs of SJSanswerFEVER --high yield
sore throat
facial swelling
tongue swelling
red rash
skin sloughing
body aches
prodromal headache
malaise
arthralgia
painful mucus membranes
Lamotrigine is least likely to causeanswersedation or weight gain
Carbamazepine (tegretol) black box warningansweragranulocytosis (decrease WBCs)
aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin rash, SOA)
Carbamazepine and asiansanswerScreen for HLAB-1502 allele before initiating, due to high incidence of
SJS if positive for allele.
Child-bearing aged womenanswercheck for pregnancy before starting mood stabilizer
start on folic acid to support neural tube development during the first month that a woman is pregnant
When many answers are remarkably similar, they are usually _____________answerwrong
Interprofessional collaboration is encouraged.answerCollaborate is usually right.
Delegate is usually wrong.
ADPIERanswerAssessment, diagnosis, Plan, intervention, evaluate, refer out last.
LithiumanswerNormal 0.6-1.2
Lithium toxicity occurs at levelsanswer> 1.5
Signs of Lithium toxicityanswersevere nausea, diarrhea, vomiting, confusion, drowsiness, muscle
weakness, heart palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard foranswerMANIA
Lithium has evidence shown toanswerreduce suicidal ideation
What does lithium cause in neonate, especially 1st trimesteranswerEbstein anomaly (congenital heart
defect)
dehydration and hyponatremia cause lithium levels toanswerrise
Baseline labs before initiation of lithiumanswerTSH
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 Lithiumanswerhypothyroidism
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Pt education for lithimumanswerstaying hydrated
avoiding NSAIDS
compliance
Depakote normal levelanswer50-125
Depakote toxicity levelanswergreater than 150
Teratogenic effects of Depakoteanswerspina bifida
Adverse effects of depakoteansweralopecia
hepatotoxicity (RUQ pain or brown/red urine--order LFTs) AST 5-40, ALT 5-35, yellowing of skin or eyes,
fatigue
Signs of Depakote toxicityanswerdisorientation, lethargy, respiratory depression, nausea/vomiting
Intervention for depakote toxicityanswerDC med
check level
,LFT
ammonia
MAOI + tyramine causesanswerhypertensive crisis
Symptoms of hypertensive crisisanswerelevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI +answerMEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisisanswerDC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzosanswerfloppy baby, cleft palate
Teratogenic effects of tegratolanswerneural tube defect
, teratogenic effects of lithiumanswerebstein anomaly (heart defect) (avoid, especially 1st trimester)
teratogenic effects of depakoteanswerneural tube defects/spina bifida
Adverse reaction to LamictalanswerSteven Johnson's Syndrome
Signs of SJSanswerFEVER --high yield
sore throat
facial swelling
tongue swelling
red rash
skin sloughing
body aches
prodromal headache
malaise
arthralgia
painful mucus membranes
Lamotrigine is least likely to causeanswersedation or weight gain
Carbamazepine (tegretol) black box warningansweragranulocytosis (decrease WBCs)
aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin rash, SOA)
Carbamazepine and asiansanswerScreen for HLAB-1502 allele before initiating, due to high incidence of
SJS if positive for allele.
Child-bearing aged womenanswercheck for pregnancy before starting mood stabilizer
start on folic acid to support neural tube development during the first month that a woman is pregnant
