LMR GEORGETTE’S PMHNP CERTIFICATION EXAM |250 COMPLETE
QUESTIONS WITH EXPERT SOLUTIONS | 2026 LATEST UPDATED |
GET A+
What does ADPIE stand for? - (Answer)Assessment
Diagnosis
Planning
Implementation
Evaluation
What should you do when a mother reports her child woke up screaming in the middle of the
night? - (Answer)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? - (Answer)Scrape nail and
send for testing
What do you do if a patient on lithium has dark brown urine? - (Answer)Check renal function
What do you do if a patient presents with fever while on Clozaril? - (Answer)Check ANC level
to assess for agranulocytosis
,What can cause serotonin syndrome? - (Answer)Antidepressants, St. John's Wort, Same-E, Kava
Kava, and Tryptophan
What labs are indicative of NMS? - (Answer)Elevated WBC (over 11,000) and elevated CPK
S/S of NMS - (Answer)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? - (Answer)Check for rhabdo
with CPK
s/s of serotonin syndrome - (Answer)hyperreflexia, muscle spasms, myoclonus (involuntary
muscle jerk), fever, tachycardia, HTN, shits and shivers
What two medications to give with NMS? - (Answer)bromocriptine (Parlodel)- D2 agonist
dantrolene- muscle relaxer
What medication to give during SS? - (Answer)cyproheptadine (Periactin)- 5HT-2A receptor
antagonist
,What is the onset and typical length of NMS? - (Answer)Slow onset (1-2 weeks after changing
or starting therapy) and resolves within 9-14 days
What is the onset of SS? - (Answer)Within 24 hours of starting/changing medication and
resolves within a few days
How do you distinguish between NMS and acute dystonia? - (Answer)NMS has a slower onset
while acute dystonia occurs within hours
What happens with lithium and NSAIDs? - (Answer)Increased risk of lithium toxicity (gout
meds, ibuprophen, naproxen, etc.)
What happens with lithium and ACE inhibitors? - (Answer)Increased risk of lithium toxicity
related to the increased urination from the ACE inhibitors
Why should a patient on lithium avoid calcium channel blockers? - (Answer)Risk of fatal
nephrotoxicity
What is a fetal side effect of lithium? - (Answer)Epstein's anomaly
, What lab should you check for athletes on lithium? - (Answer)Specific gravity to assess for
dehydration (dehydration is >1.015)
What do you do if the lithium level is 1.3? - (Answer)Do not give the next dose and assess for s/s
At what level is lithium toxicity a medical emergency? - (Answer)>3
S/S of lithium toxicity - (Answer)vomiting, diarrhea, slurred speech, hand tremor, dry
mouth/thirst, muscle weakness/twitching
Why check an EKG with lithium? - (Answer)Inverted T-waves
What medication should treat hypothyroidism caused by lithium use? - (Answer)Synthroid
What do you do if patient is prescribed both depakote and lamictal? - (Answer)Decreased
lamictal dose by 50%
Depakote and pregnancy - (Answer)Spina bifida
QUESTIONS WITH EXPERT SOLUTIONS | 2026 LATEST UPDATED |
GET A+
What does ADPIE stand for? - (Answer)Assessment
Diagnosis
Planning
Implementation
Evaluation
What should you do when a mother reports her child woke up screaming in the middle of the
night? - (Answer)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? - (Answer)Scrape nail and
send for testing
What do you do if a patient on lithium has dark brown urine? - (Answer)Check renal function
What do you do if a patient presents with fever while on Clozaril? - (Answer)Check ANC level
to assess for agranulocytosis
,What can cause serotonin syndrome? - (Answer)Antidepressants, St. John's Wort, Same-E, Kava
Kava, and Tryptophan
What labs are indicative of NMS? - (Answer)Elevated WBC (over 11,000) and elevated CPK
S/S of NMS - (Answer)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? - (Answer)Check for rhabdo
with CPK
s/s of serotonin syndrome - (Answer)hyperreflexia, muscle spasms, myoclonus (involuntary
muscle jerk), fever, tachycardia, HTN, shits and shivers
What two medications to give with NMS? - (Answer)bromocriptine (Parlodel)- D2 agonist
dantrolene- muscle relaxer
What medication to give during SS? - (Answer)cyproheptadine (Periactin)- 5HT-2A receptor
antagonist
,What is the onset and typical length of NMS? - (Answer)Slow onset (1-2 weeks after changing
or starting therapy) and resolves within 9-14 days
What is the onset of SS? - (Answer)Within 24 hours of starting/changing medication and
resolves within a few days
How do you distinguish between NMS and acute dystonia? - (Answer)NMS has a slower onset
while acute dystonia occurs within hours
What happens with lithium and NSAIDs? - (Answer)Increased risk of lithium toxicity (gout
meds, ibuprophen, naproxen, etc.)
What happens with lithium and ACE inhibitors? - (Answer)Increased risk of lithium toxicity
related to the increased urination from the ACE inhibitors
Why should a patient on lithium avoid calcium channel blockers? - (Answer)Risk of fatal
nephrotoxicity
What is a fetal side effect of lithium? - (Answer)Epstein's anomaly
, What lab should you check for athletes on lithium? - (Answer)Specific gravity to assess for
dehydration (dehydration is >1.015)
What do you do if the lithium level is 1.3? - (Answer)Do not give the next dose and assess for s/s
At what level is lithium toxicity a medical emergency? - (Answer)>3
S/S of lithium toxicity - (Answer)vomiting, diarrhea, slurred speech, hand tremor, dry
mouth/thirst, muscle weakness/twitching
Why check an EKG with lithium? - (Answer)Inverted T-waves
What medication should treat hypothyroidism caused by lithium use? - (Answer)Synthroid
What do you do if patient is prescribed both depakote and lamictal? - (Answer)Decreased
lamictal dose by 50%
Depakote and pregnancy - (Answer)Spina bifida
