LMR Georgette’s PMHNP
Certification Exam Latest 2023-
2024 Q&A | (A+ Guarantee) | PDF
2026
What does ADPIE stand for?
Correct answer(s) :
Assessment
Diagnosis
Planning
Implementation
Evaluation
What should you do when a mother reports her child woke
up screaming in the middle of the night?
Correct answer(s) :
Ask her if it's happened before to assess for sleep issue
patterns
What do you do if a patient comes in with fungus on their
toenail?
Correct answer(s) :
Scrape nail and send for testing
What do you do if a patient on lithium has dark brown
urine?
Correct answer(s) :
Check renal function
1
,What do you do if a patient presents with fever while on
Clozaril?
Correct answer(s) :
Check ANC level to assess for agranulocytosis
What can cause serotonin syndrome?
Correct answer(s) :
Antidepressants, St. John's Wort, Same-E, Kava Kava,
and Tryptophan
What labs are indicative of NMS?
Correct answer(s) :
Elevated WBC (over 11,000) and elevated CPK
S/S of NMS
Correct answer(s) :
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?
Correct answer(s) :
Check for rhabdo with CPK
s/s of serotonin syndrome
Correct answer(s) :
hyperreflexia, muscle spasms, myoclonus (involuntary
muscle jerk), fever, tachycardia, HTN, shits and shivers
What two medications to give with NMS?
2
,Correct answer(s) :
bromocriptine (Parlodel)- D2 agonist dantrolene- muscle
relaxer
What medication to give during SS?
Correct answer(s) :
cyproheptadine (Periactin)- 5HT-2A receptor antagonist
What is the onset and typical length of NMS?
Correct answer(s) :
Slow onset (1-2 weeks after changing or starting therapy)
and resolves within 9-14 days
What is the onset of SS?
Correct answer(s) :
Within 24 hours of starting/changing medication and
resolves within a few days
How do you distinguish between NMS and acute dystonia?
Correct answer(s) :
NMS has a slower onset while acute dystonia occurs
within hours
What happens with lithium and NSAIDs?
Correct answer(s) :
Increased risk of lithium toxicity (gout meds, ibuprophen,
naproxen, etc.)
What happens with lithium and ACE inhibitors?
Correct answer(s) :
3
, Increased risk of lithium toxicity related to the increased
urination from the ACE inhibitors
Why should a patient on lithium avoid calcium channel
blockers?
Correct answer(s) :
Risk of fatal nephrotoxicity
What is a fetal side effect of lithium?
Correct answer(s) :
Epstein's anomaly
What lab should you check for athletes on lithium?
Correct answer(s) :
Specific gravity to assess for dehydration (dehydration
is >1.015)
What do you do if the lithium level is 1.3?
Correct answer(s) :
Do not give the next dose and assess for s/s
At what level is lithium toxicity a medical emergency?
Correct answer(s) :
>3
S/S of lithium toxicity
Correct answer(s) :
vomiting, diarrhea, slurred speech, hand tremor, dry
mouth/thirst, muscle weakness/twitching
Why check an EKG with lithium?
4
Certification Exam Latest 2023-
2024 Q&A | (A+ Guarantee) | PDF
2026
What does ADPIE stand for?
Correct answer(s) :
Assessment
Diagnosis
Planning
Implementation
Evaluation
What should you do when a mother reports her child woke
up screaming in the middle of the night?
Correct answer(s) :
Ask her if it's happened before to assess for sleep issue
patterns
What do you do if a patient comes in with fungus on their
toenail?
Correct answer(s) :
Scrape nail and send for testing
What do you do if a patient on lithium has dark brown
urine?
Correct answer(s) :
Check renal function
1
,What do you do if a patient presents with fever while on
Clozaril?
Correct answer(s) :
Check ANC level to assess for agranulocytosis
What can cause serotonin syndrome?
Correct answer(s) :
Antidepressants, St. John's Wort, Same-E, Kava Kava,
and Tryptophan
What labs are indicative of NMS?
Correct answer(s) :
Elevated WBC (over 11,000) and elevated CPK
S/S of NMS
Correct answer(s) :
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?
Correct answer(s) :
Check for rhabdo with CPK
s/s of serotonin syndrome
Correct answer(s) :
hyperreflexia, muscle spasms, myoclonus (involuntary
muscle jerk), fever, tachycardia, HTN, shits and shivers
What two medications to give with NMS?
2
,Correct answer(s) :
bromocriptine (Parlodel)- D2 agonist dantrolene- muscle
relaxer
What medication to give during SS?
Correct answer(s) :
cyproheptadine (Periactin)- 5HT-2A receptor antagonist
What is the onset and typical length of NMS?
Correct answer(s) :
Slow onset (1-2 weeks after changing or starting therapy)
and resolves within 9-14 days
What is the onset of SS?
Correct answer(s) :
Within 24 hours of starting/changing medication and
resolves within a few days
How do you distinguish between NMS and acute dystonia?
Correct answer(s) :
NMS has a slower onset while acute dystonia occurs
within hours
What happens with lithium and NSAIDs?
Correct answer(s) :
Increased risk of lithium toxicity (gout meds, ibuprophen,
naproxen, etc.)
What happens with lithium and ACE inhibitors?
Correct answer(s) :
3
, Increased risk of lithium toxicity related to the increased
urination from the ACE inhibitors
Why should a patient on lithium avoid calcium channel
blockers?
Correct answer(s) :
Risk of fatal nephrotoxicity
What is a fetal side effect of lithium?
Correct answer(s) :
Epstein's anomaly
What lab should you check for athletes on lithium?
Correct answer(s) :
Specific gravity to assess for dehydration (dehydration
is >1.015)
What do you do if the lithium level is 1.3?
Correct answer(s) :
Do not give the next dose and assess for s/s
At what level is lithium toxicity a medical emergency?
Correct answer(s) :
>3
S/S of lithium toxicity
Correct answer(s) :
vomiting, diarrhea, slurred speech, hand tremor, dry
mouth/thirst, muscle weakness/twitching
Why check an EKG with lithium?
4
