PMHNP ANCC REVIEW QUESTIONS AND ANSWERS
What drugs should be avoided with Kava Alprazolam
Kava? CNS depressants (e.g., phenobarbital, zolpidem)
What is the normal range for TSH? 0.5 - 5.0 mu/L
Decreased TSH
What are lab values in Hyperthyroidism
Increased T4 and T3
Increased TSH
What are labs in Hypothyroidism?
Decreased T4 and T3
Heat intolerance
Agitation, Anxiety, Irritability
What are 5 primary symptoms of
Tachycardia
Hyperthyroidism?
Mood swings
Weight loss
Cold intolerance
What are 4 primary symptoms of Lethargy
Hypothyroidism? Weight gain
Decreased libido
Hypothyroidism mimics symptoms of what Depression
psychiatric disorder?
Hyperthyroidism mimics symptoms of what Mania
psychiatric disorder?
Valproic acid produces what teratogenic Spina bifida (neural tube defect)
effect?
What is the primary organ where valproic Liver (hepatoxicity)
acid is toxic?
, Abdominal pain in the URQ
Reddish-brown urine
What are 4 signs of hepatoxicity?
Yellowing of the skin and sclera
Fatigue
What is the therapeutic range for valproic 50-125 mcg/ml
acid?
What is a toxic level of valproic acid? >150 mcg/ml
Disorientation
Lethargy
What are 4 signs of valproic acid toxicity?
Respiratory depression
Nausea/vomiting
A pt on Depakote C/O Abdominal pain in Hepatotoxicity; hold med, draw LFT's (priority), DVP level
the URQ and Reddish-brown urine. What
do you suspect? What do you do?
D/C drug
With suspected toxicity with valproic acid, Check drug level
what steps/labs should be drawn? Obtain LFTs
Obtain ammonia level
A pregnant pt is taking accutane, zyprexa Accutane (used for acne; Causes birth Defects!!!)
and abilify; what med needs to be d/c'd?
What herbal supplement is used for Kava Kava
anxiety, stress, and insomnia? What is the liver damage
major side effect with Kava Kava?
Fever -Key sx to suspect SJS; high yield (HY)
burning of mouth/eyes -HY
What are 5 symptoms of Stephen's Johnson Body aches
Syndrome? Severe red rash
Peeling skin
Facial and tongue swelling
Which mood stabilizer causes the least Lamotrigine (Lamictal)
weight gain?
Lurasidone (Latuda)
Which 3 SGAs cause the least weight gain? Aripiprazole (Abilify)
Ziprasidone (Geodon)
Which SGA is the least sedating? Aripiprazole (Abilify)
Your pt is taking Kava and you need to add Aripiprazole (least sedating)
an AS to manage their SCZ, which do you
add?
Acute onset
disturbance of LOC
What are 2 hallmark symptoms of delirium?
impaired cognition
inattention
How are agitation and psychotic symptoms Low dose Haldol (QTc check first)
treated in delirium?
16 y/o C/O feeling funny after inhaling Do UDS; chances are they may be abusing other substances
Acetone (nail polish remover). What is your
action?
What drugs should be avoided with Kava Alprazolam
Kava? CNS depressants (e.g., phenobarbital, zolpidem)
What is the normal range for TSH? 0.5 - 5.0 mu/L
Decreased TSH
What are lab values in Hyperthyroidism
Increased T4 and T3
Increased TSH
What are labs in Hypothyroidism?
Decreased T4 and T3
Heat intolerance
Agitation, Anxiety, Irritability
What are 5 primary symptoms of
Tachycardia
Hyperthyroidism?
Mood swings
Weight loss
Cold intolerance
What are 4 primary symptoms of Lethargy
Hypothyroidism? Weight gain
Decreased libido
Hypothyroidism mimics symptoms of what Depression
psychiatric disorder?
Hyperthyroidism mimics symptoms of what Mania
psychiatric disorder?
Valproic acid produces what teratogenic Spina bifida (neural tube defect)
effect?
What is the primary organ where valproic Liver (hepatoxicity)
acid is toxic?
, Abdominal pain in the URQ
Reddish-brown urine
What are 4 signs of hepatoxicity?
Yellowing of the skin and sclera
Fatigue
What is the therapeutic range for valproic 50-125 mcg/ml
acid?
What is a toxic level of valproic acid? >150 mcg/ml
Disorientation
Lethargy
What are 4 signs of valproic acid toxicity?
Respiratory depression
Nausea/vomiting
A pt on Depakote C/O Abdominal pain in Hepatotoxicity; hold med, draw LFT's (priority), DVP level
the URQ and Reddish-brown urine. What
do you suspect? What do you do?
D/C drug
With suspected toxicity with valproic acid, Check drug level
what steps/labs should be drawn? Obtain LFTs
Obtain ammonia level
A pregnant pt is taking accutane, zyprexa Accutane (used for acne; Causes birth Defects!!!)
and abilify; what med needs to be d/c'd?
What herbal supplement is used for Kava Kava
anxiety, stress, and insomnia? What is the liver damage
major side effect with Kava Kava?
Fever -Key sx to suspect SJS; high yield (HY)
burning of mouth/eyes -HY
What are 5 symptoms of Stephen's Johnson Body aches
Syndrome? Severe red rash
Peeling skin
Facial and tongue swelling
Which mood stabilizer causes the least Lamotrigine (Lamictal)
weight gain?
Lurasidone (Latuda)
Which 3 SGAs cause the least weight gain? Aripiprazole (Abilify)
Ziprasidone (Geodon)
Which SGA is the least sedating? Aripiprazole (Abilify)
Your pt is taking Kava and you need to add Aripiprazole (least sedating)
an AS to manage their SCZ, which do you
add?
Acute onset
disturbance of LOC
What are 2 hallmark symptoms of delirium?
impaired cognition
inattention
How are agitation and psychotic symptoms Low dose Haldol (QTc check first)
treated in delirium?
16 y/o C/O feeling funny after inhaling Do UDS; chances are they may be abusing other substances
Acetone (nail polish remover). What is your
action?
