1|Page
PSYCHIATRIC NURSING EXAM PREP GUIDE
2026/2027: MASTER LAB VALUES &
THERAPEUTIC COMMUNICATION TO PASS
YOUR EXAMS FIRST TIME
## Table of Contents
1. How to Use This Guide for Maximum Retention
2. Part 1 – High-Yield Lab Values for Psychiatric Medications
- Lithium
- Valproate (Depakote)
- Clozapine
- Antipsychotics (Metabolic & Cardiac)
- SSRIs/SNRIs (Hyponatremia)
- Thyroid Function
- Rapid Reference Table (Exam Must-Know)
3. Part 2 – Therapeutic Communication: The Exam Gold Standard
- 4 Golden Rules
- Non-Therapeutic Statements to Avoid (Always Wrong)
- Diagnosis-Specific Communication (Depression, Mania,
Schizophrenia, Anxiety, Borderline, Suicidal)
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4. Part 3 – NGN-Style Application: Case Study Shortcut
5. Part 4 – 25 High-Yield Exam Questions with Rationales
6. Part 5 – Final Exam Day Cheat Sheet (One-Pager)
---
## How to Use This Guide for Maximum Retention
| Step | Action |
| :--- | :--- |
| 1 | Read the **Critical Alerts** first – these are guaranteed exam
questions. |
| 2 | Memorize the **Rapid Reference Table** (Part 1). |
| 3 | Practice the **25 questions** with rationales. |
| 4 | Cut out or copy the **Final Exam Day Cheat Sheet** (last page). |
---
# Part 1: High-Yield Lab Values for Psychiatric Nursing
> *Exam fact: Psychiatric medications cause life-threatening side
effects. Labs are not optional.*
, 3|Page
## 1. Lithium (Mood Stabilizer)
| Lithium Level (mEq/L) | Clinical Meaning | Nursing Action |
| :--- | :--- | :--- |
| <0.6 | Subtherapeutic | Increase dose (provider order) |
| 0.6 – 1.2 | **Therapeutic range** | Maintenance: 0.6–0.8; Acute: 0.8–
1.2 |
| 1.5 – 2.0 | Mild toxicity | Nausea, fine tremor, ataxia → hold next dose,
notify provider |
| >2.0 | Severe toxicity | Seizures, coma, permanent brain damage →
emergency |
** Critical Alert (Exam Favorite):**
Hold lithium if:
- Creatinine increases (kidney damage)
- Sodium decreases (<135 mEq/L)
- Patient has vomiting/diarrhea/dehydration
**Patient teaching:** Drink 2–3 L water daily; avoid NSAIDs
(ibuprofen, naproxen – increase lithium level).
---
PSYCHIATRIC NURSING EXAM PREP GUIDE
2026/2027: MASTER LAB VALUES &
THERAPEUTIC COMMUNICATION TO PASS
YOUR EXAMS FIRST TIME
## Table of Contents
1. How to Use This Guide for Maximum Retention
2. Part 1 – High-Yield Lab Values for Psychiatric Medications
- Lithium
- Valproate (Depakote)
- Clozapine
- Antipsychotics (Metabolic & Cardiac)
- SSRIs/SNRIs (Hyponatremia)
- Thyroid Function
- Rapid Reference Table (Exam Must-Know)
3. Part 2 – Therapeutic Communication: The Exam Gold Standard
- 4 Golden Rules
- Non-Therapeutic Statements to Avoid (Always Wrong)
- Diagnosis-Specific Communication (Depression, Mania,
Schizophrenia, Anxiety, Borderline, Suicidal)
,2|Page
4. Part 3 – NGN-Style Application: Case Study Shortcut
5. Part 4 – 25 High-Yield Exam Questions with Rationales
6. Part 5 – Final Exam Day Cheat Sheet (One-Pager)
---
## How to Use This Guide for Maximum Retention
| Step | Action |
| :--- | :--- |
| 1 | Read the **Critical Alerts** first – these are guaranteed exam
questions. |
| 2 | Memorize the **Rapid Reference Table** (Part 1). |
| 3 | Practice the **25 questions** with rationales. |
| 4 | Cut out or copy the **Final Exam Day Cheat Sheet** (last page). |
---
# Part 1: High-Yield Lab Values for Psychiatric Nursing
> *Exam fact: Psychiatric medications cause life-threatening side
effects. Labs are not optional.*
, 3|Page
## 1. Lithium (Mood Stabilizer)
| Lithium Level (mEq/L) | Clinical Meaning | Nursing Action |
| :--- | :--- | :--- |
| <0.6 | Subtherapeutic | Increase dose (provider order) |
| 0.6 – 1.2 | **Therapeutic range** | Maintenance: 0.6–0.8; Acute: 0.8–
1.2 |
| 1.5 – 2.0 | Mild toxicity | Nausea, fine tremor, ataxia → hold next dose,
notify provider |
| >2.0 | Severe toxicity | Seizures, coma, permanent brain damage →
emergency |
** Critical Alert (Exam Favorite):**
Hold lithium if:
- Creatinine increases (kidney damage)
- Sodium decreases (<135 mEq/L)
- Patient has vomiting/diarrhea/dehydration
**Patient teaching:** Drink 2–3 L water daily; avoid NSAIDs
(ibuprofen, naproxen – increase lithium level).
---
