LMR Georgette’s PMHNP Certification Updated Exam 2026
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Questions (Actual Exam 2026-2027) Correct Detailed &
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What does ADPIE stand for? - ANSWERS-Assessment
Diagnosis
Planning
Implementation
Evaluation
What do you do if a patient comes in with fungus on their toenail? - ANSWERS-Scrape
nail and send for testing
What do you do if a patient on lithium has dark brown urine? - ANSWERS-Check renal
function
What do you do if a patient presents with fever while on Clozaril? - ANSWERS-Check
ANC level to assess for agranulocytosis
What can cause serotonin syndrome? - ANSWERS-Antidepressants, St. John's Wort,
Same-E, Kava Kava, and Tryptophan
What labs are indicative of NMS? - ANSWERS-Elevated WBC (over 11,000) and
elevated CPK
S/S of NMS - ANSWERS-muscle rigidity, hyperthermia, tachycardia, abnormal bp,
sweating, altered mental status, cherry colored urine
,What should you do if a patient presents with cherry colored urine? - ANSWERS-Check
for rhabdo with CPK
s/s of serotonin syndrome - ANSWERS-hyperreflexia, muscle spasms, myoclonus
(involuntary muscle jerk), fever, tachycardia, HTN, shits and shivers
What two medications to give with NMS? - ANSWERS-bromocriptine (Parlodel)- D2
agonist dantrolene- muscle relaxer
What should you do when a mother reports her child woke up screaming in the middle
of the night? - ANSWERS-Ask her if it's happened before to assess for sleep issue
patterns
What medication to give during SS? - ANSWERS-cyproheptadine (Periactin)- 5HT-2A
receptor antagonist
What is the onset and typical length of NMS? - ANSWERS-Slow onset (1-2 weeks after
changing or starting therapy) and resolves within 9-14 days
What is the onset of SS? - ANSWERS-Within 24 hours of starting/changing medication
and resolves within a few days
How do you distinguish between NMS and acute dystonia? - ANSWERS-NMS has a
slower onset while acute dystonia occurs within hours
What happens with lithium and NSAIDs? - ANSWERS-Increased risk of lithium toxicity
(gout meds, ibuprophen, naproxen, etc.)
What happens with lithium and ACE inhibitors? - ANSWERS-Increased risk of lithium
toxicity related to the increased urination from the ACE inhibitors
, Why should a patient on lithium avoid calcium channel blockers? - ANSWERS-Risk of
fatal nephrotoxicity
What is a fetal side effect of lithium? - ANSWERS-Epstein's anomaly
What lab should you check for athletes on lithium? - ANSWERS-Specific gravity to
assess for dehydration (dehydration is >1.015)
What do you do if the lithium level is 1.3? - ANSWERS-Do not give the next dose and
assess for s/s
At what level is lithium toxicity a medical emergency? - ANSWERS->3
S/S of lithium toxicity - ANSWERS-vomiting, diarrhea, slurred speech, hand tremor, dry
mouth/thirst, muscle weakness/twitching
Why check an EKG with lithium? - ANSWERS-Inverted T-waves
What medication should treat hypothyroidism caused by lithium use? - ANSWERS-
Synthroid
What do you do if patient is prescribed both depakote and lamictal? - ANSWERS-
Decreased lamictal dose by 50%
Depakote and pregnancy - ANSWERS-Spina bifida
What emergency may be occuring if patient on depakote reports upper abdominal pain?
- ANSWERS-Pancreatitis
What lab should you check if patient has right upper quadrant pain and dark brown
urine? - ANSWERS-LFTs
WITH Recent Newest Verified And Well Analyzed Exam
Questions (Actual Exam 2026-2027) Correct Detailed &
Verified ANSWERS (100% Accurate Solutions) ALREADY
GRADED A+||NEWEST VERSION Of The Exam Guarantee
Pass!!
What does ADPIE stand for? - ANSWERS-Assessment
Diagnosis
Planning
Implementation
Evaluation
What do you do if a patient comes in with fungus on their toenail? - ANSWERS-Scrape
nail and send for testing
What do you do if a patient on lithium has dark brown urine? - ANSWERS-Check renal
function
What do you do if a patient presents with fever while on Clozaril? - ANSWERS-Check
ANC level to assess for agranulocytosis
What can cause serotonin syndrome? - ANSWERS-Antidepressants, St. John's Wort,
Same-E, Kava Kava, and Tryptophan
What labs are indicative of NMS? - ANSWERS-Elevated WBC (over 11,000) and
elevated CPK
S/S of NMS - ANSWERS-muscle rigidity, hyperthermia, tachycardia, abnormal bp,
sweating, altered mental status, cherry colored urine
,What should you do if a patient presents with cherry colored urine? - ANSWERS-Check
for rhabdo with CPK
s/s of serotonin syndrome - ANSWERS-hyperreflexia, muscle spasms, myoclonus
(involuntary muscle jerk), fever, tachycardia, HTN, shits and shivers
What two medications to give with NMS? - ANSWERS-bromocriptine (Parlodel)- D2
agonist dantrolene- muscle relaxer
What should you do when a mother reports her child woke up screaming in the middle
of the night? - ANSWERS-Ask her if it's happened before to assess for sleep issue
patterns
What medication to give during SS? - ANSWERS-cyproheptadine (Periactin)- 5HT-2A
receptor antagonist
What is the onset and typical length of NMS? - ANSWERS-Slow onset (1-2 weeks after
changing or starting therapy) and resolves within 9-14 days
What is the onset of SS? - ANSWERS-Within 24 hours of starting/changing medication
and resolves within a few days
How do you distinguish between NMS and acute dystonia? - ANSWERS-NMS has a
slower onset while acute dystonia occurs within hours
What happens with lithium and NSAIDs? - ANSWERS-Increased risk of lithium toxicity
(gout meds, ibuprophen, naproxen, etc.)
What happens with lithium and ACE inhibitors? - ANSWERS-Increased risk of lithium
toxicity related to the increased urination from the ACE inhibitors
, Why should a patient on lithium avoid calcium channel blockers? - ANSWERS-Risk of
fatal nephrotoxicity
What is a fetal side effect of lithium? - ANSWERS-Epstein's anomaly
What lab should you check for athletes on lithium? - ANSWERS-Specific gravity to
assess for dehydration (dehydration is >1.015)
What do you do if the lithium level is 1.3? - ANSWERS-Do not give the next dose and
assess for s/s
At what level is lithium toxicity a medical emergency? - ANSWERS->3
S/S of lithium toxicity - ANSWERS-vomiting, diarrhea, slurred speech, hand tremor, dry
mouth/thirst, muscle weakness/twitching
Why check an EKG with lithium? - ANSWERS-Inverted T-waves
What medication should treat hypothyroidism caused by lithium use? - ANSWERS-
Synthroid
What do you do if patient is prescribed both depakote and lamictal? - ANSWERS-
Decreased lamictal dose by 50%
Depakote and pregnancy - ANSWERS-Spina bifida
What emergency may be occuring if patient on depakote reports upper abdominal pain?
- ANSWERS-Pancreatitis
What lab should you check if patient has right upper quadrant pain and dark brown
urine? - ANSWERS-LFTs
