Georgette PMHNP Review Questions and Answers | Full Test Bank with Verified Solutions | A+ Pass Guaranteed

Georgette PMHNP Review Questions and
Answers | Full Test Bank with Verified
Solutions | A+ Pass Guaranteed

• Interprofessional collaboration is encouraged. -✓✓Collaborate is usually right.
Delegate is usually wrong.

• ADPIER -✓✓Assessment, diagnosis, Plan, intervention, evaluate, refer out last.

• Lithium -✓✓Normal 0.6-1.2

• Lithium toxicity occurs at levels -✓✓> 1.5

• Signs of Lithium toxicity -✓✓severe nausea, diarrhea, vomiting, confusion, drowsiness,
muscle weakness, heart palpitation, coarse hand tremors, unsteady gait

• Lithium is gold standard for -✓✓MANIA

• Lithium has evidence shown to -✓✓reduce suicidal ideation

• What does lithium cause in neonate, especially 1st trimester -✓✓Ebstein anomaly
(congenital heart defect)

• dehydration and hyponatremia cause lithium levels to -✓✓rise

• Baseline labs before initiation of lithium -✓✓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 -✓✓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 -✓✓staying hydrated

,avoiding NSAIDS
compliance

• Depakote normal level -✓✓50-125

• Depakote toxicity level -✓✓greater than 150

• Teratogenic effects of Depakote -✓✓spina bifida

• Adverse effects of depakote -✓✓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 -✓✓disorientation, lethargy, respiratory depression,
nausea/vomiting

• Intervention for depakote toxicity -✓✓DC med
check level
LFT
ammonia

• MAOI + tyramine causes -✓✓hypertensive crisis

• Symptoms of hypertensive crisis -✓✓elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever

• Hypertensive crisis occurs with MAOI + -✓✓MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds

• Treatment for hypertensive crisis -✓✓DC offending agent
Administer PHENTOLAMINE

• Teratogenic effects of benzos -✓✓floppy baby, cleft palate

,• Teratogenic effects of tegratol -✓✓neural tube defect

• teratogenic effects of lithium -✓✓ebstein anomaly (heart defect) (avoid, especially 1st
trimester)

• teratogenic effects of depakote -✓✓neural tube defects/spina bifida

• Adverse reaction to Lamictal -✓✓Steven Johnson's Syndrome

• Signs of SJS -✓✓FEVER --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 cause -✓✓sedation or weight gain

• Carbamazepine (tegretol) black box warning -✓✓agranulocytosis (decrease WBCs)
aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin rash, SOA)

• Carbamazepine and asians -✓✓Screen for HLAB-1502 allele before initiating, due to
high incidence of SJS if positive for allele.

• Child-bearing aged women -✓✓check for pregnancy before starting mood stabilizer
start on folic acid to support neural tube development during the first month that a
woman is pregnant

• Clozaril/clozapine can cause -✓✓agranulocytosis and neutropenia

• For monitoring neutropenia in Clozaril, monitor -✓✓ANC

• DC clozarli if ANC -✓✓less than 1000

• DC clozaril if WBC -✓✓2000-3000, risk of agranulocytosis

• When on clozaril monitor for -✓✓signs and symptoms of infection: sudden fever, chills,
sore throat, weakness

, • Clozaril only known antipsychotic to -✓✓decrease risk of suicide in patients with
schizophrenia.

• Your patient with bipolar disorder is admitted to a medical hospital. The internist
contacts your office and asks whether the lithium you prescribed him is effecting his
ECG. How do you respond?
A. Lithium can prolong the QT interval
B. Lithium has no effect on his ECG
C. Lithium can invert the t waves
D. Lithium can shorten the PR interval -✓✓Answer: Lithium can invert the t waves.

• Mary is a 45-year-old African American female who has been treated on Isocarboxazid
(Marplan) for over 6 years. Mary is going in for a surgical procedure. Which medication
is strictly contraindicated with Isocarboxazid?
A. Morphine
B. NSAIDS
C. Methylphenidate
D. Acetaminophen -✓✓Answer: Methylphenidate

• You are treating a client with schizophrenia who takes clozapine. What lab values will
indicate the client needs to discontinue treatment?
A. WBC less than 1800 and ANC less than 1200
B. ANC less than 1,000
C. WBC less than 5,000
D. ANC less than 2000 -✓✓Answer: ANC less than 1000

• If given during pregnancy, socium valproate can cause which of the following medical
problems in the baby?
A. SJS
B. Ebstein's anomaly
C. Spina bifida
D. Cleft palate -✓✓A. Spina bifida

• Which mood stabilizer is associated with potential life-threatening rash in the Asian
population?
A. Carbamazepine (tegretol)
B. Depakote
C. Lithium
D. Lamictal -✓✓A. Carbamazepine

• Bulimia, weight is ___________ -✓✓within the normal range.

• Pharm treatment for bulimia -✓✓Fluoxetine
SSRIs and TCAs effective in reducing binging and purging