GEORGETTE REVIEW EXAM QUESTIONS WITH CORRECT
ANSWERS, ANCC REVIEW MANUAL PMHNP | LATEST
UPDATE 2026
Terms in this set (717)
QUESTIONS ANSWERS
When many answers are remarkably wrong
similar, they are usually _____________
Interprofessional collaboration is Collaborate is
encouraged. 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, Ebstein anomaly (congenital heart defect)
especially 1st trimester
dehydration and hyponatremia cause rise
lithium levels to
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
leukocytos
is
Pt education for lithimum staying
hydrated
avoiding
NSAIDS
complianc
e
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
diaphoresi
s
fever
Hypertensive crisis occurs with MEPERID
MAOI + INE
STIMULA
NTS
decongesta
nts TCAs
atypicals
St. John's
wart L-
tryptoph
an
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 agranulocytosis (decrease WBCs)
warning 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, ANC
monitor
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 Answer: Lithium can invert the t waves.
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?
Mary is a 45-year-old African American Answer: Methylphenidate
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?
You are treating a client with Answer: ANC less than 1000
schizophrenia who takes
clozapine. What lab values will indicate
the client needs to discontinue
treatment?
If given during pregnancy, sodium Spina bifida
valproate can cause which of the
following medical problems in the
baby?
Which mood stabilizer is associated Carbamazepine
ANSWERS, ANCC REVIEW MANUAL PMHNP | LATEST
UPDATE 2026
Terms in this set (717)
QUESTIONS ANSWERS
When many answers are remarkably wrong
similar, they are usually _____________
Interprofessional collaboration is Collaborate is
encouraged. 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, Ebstein anomaly (congenital heart defect)
especially 1st trimester
dehydration and hyponatremia cause rise
lithium levels to
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
leukocytos
is
Pt education for lithimum staying
hydrated
avoiding
NSAIDS
complianc
e
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
diaphoresi
s
fever
Hypertensive crisis occurs with MEPERID
MAOI + INE
STIMULA
NTS
decongesta
nts TCAs
atypicals
St. John's
wart L-
tryptoph
an
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 agranulocytosis (decrease WBCs)
warning 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, ANC
monitor
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 Answer: Lithium can invert the t waves.
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?
Mary is a 45-year-old African American Answer: Methylphenidate
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?
You are treating a client with Answer: ANC less than 1000
schizophrenia who takes
clozapine. What lab values will indicate
the client needs to discontinue
treatment?
If given during pregnancy, sodium Spina bifida
valproate can cause which of the
following medical problems in the
baby?
Which mood stabilizer is associated Carbamazepine
