NURS PMHNP EXAM 1 BEST QUESTIONS WITH ANSWERS
2022/2023 UPDATE GRADED A+ ACTUAL EXAM
When monitoring for agranulocytosis in patients look for s/s of what?: -
Infection
-Fever, sore throat, fatigue, chills
Before starting any mood stabilizer in a female of childbearing age
be sure to check?: HCG
Which two medications may decrease the risk of suicide?: clozaril
and lithium
Medications that increase lithium level: NSAID-ibuprofen,
INDOCIN THIAZIDES-hydrochlorithiazide ACE INHIBITORS-
lisinopril
Ace inhibitors are treatment of choice for?: Heart Failure
Certain medications are known to increase lithium level, but HOW?:
by reducing renal clearance
When educating a patient about lithium teach them about:
Hyponatremia Dehydration-hot days, exercise
Normal Lithium Level: 0.6-1.2
Lithium Toxicity: 1.5 or above
Discontinue and re-order lithium
level
Lithium level of 1.4: Monitor for toxicity
Labs before starting lithium: TSH, BUN, CREATININE, HCG, U/A to
check for presence of protein in the urine (4+ protein is concerning
for renal impair- ment)à4+ protein in urine=MONITOR FOR TOXICITY
4+ protein in the urine of a patient on lithium: 4+ protein is
concerning for renal impairment
4+ protein in urine=MONITOR FOR TOXICITY
Lithium side effects: hypothyroid, leukocytosis, maculopapular rash,
t-wave inversion, Coarse Hand Tremor, GI upset (nausea, vomiting,
anorexia)
-Some of these are also signs of toxicity
Signs of lithium toxicity: confusion, ataxia, GI upset, palpitation,
tremor
NMS: muscle rigidity, mutism (because of muscle rigidity),
, NURS PMHNP EXAM 1 BEST QUESTIONS WITH ANSWERS
2022/2023 UPDATE GRADED A+ ACTUAL EXAM
increased CPK (caused by muscle contraction and muscle destruction),
increase WBC, increased WBC, myoglobinuria (also from muscle
destruction)
Cherry colored urine in a patient that exercises a lot: test for
myoglobinuria may be a sign of rhabdo
, NURS PMHNP EXAM 1 BEST QUESTIONS WITH ANSWERS
2022/2023 UPDATE GRADED A+ ACTUAL EXAM
Serotonin Syndrome: With any drug that increases 5-HT (e.g., MAO
in- hibitors, SNRIs, TCAs) hyperthermia, confusion, myoclonus,
cardiovascular insta- bility, flushing, diarrhea, seizures.
-Treatment: cyproheptadine (5-HT2 receptor antagonist).
Treatment for NMS: Stop Offending Medication
-Dantrolene (muscle relaxer)
-Bromocriptine (Dopamine D2 agonist).
*In question focus on what they are asking for....dopamine agonist vs
muscle relaxer
Treatment for Serotonin Syndrome: Stop Med (1 or more SSRI,
SSNRI, TCA, MOAI)
-Cyproheptadine
Triptans: Used for MIGRAINES
-These meds increase
serotonin example
SUMATRIPTAN
patient taking Prozac and started on sumatriptan: -call PCP to ask
them to switch the migraine med if patient already on SUMATRIPTAN
do not start antidepressant without talking to PCP
How long do you wait when switching between an SSRI to an MAOI?:
2 weeks
How long do you wait when switching between Prozac and MAOI?: 5-
6 weeks wash out period
What is the first line treatment for depression and why?: SSRI-First
line treatment for depression due to less risk of injury from
OVERDOSE
If a cancer patient has depression what should you consider?:
Treating with a medication with minimal drug/drug side effects like
Lexapro
Patient with depression worries about sexual dysfunction what would
be the medication of choice?: Wellbutrin
Primary symptoms of depression include fatigue and low energy
what med would you chose?: Wellbutrin
Wellbutrin is contraindicated in patients with: Seizures and anorexia
Which medications are best for neuropathic pain?:
, NURS PMHNP EXAM 1 BEST QUESTIONS WITH ANSWERS
2022/2023 UPDATE GRADED A+ ACTUAL EXAM
SNRI Gabapentin
TCA
2022/2023 UPDATE GRADED A+ ACTUAL EXAM
When monitoring for agranulocytosis in patients look for s/s of what?: -
Infection
-Fever, sore throat, fatigue, chills
Before starting any mood stabilizer in a female of childbearing age
be sure to check?: HCG
Which two medications may decrease the risk of suicide?: clozaril
and lithium
Medications that increase lithium level: NSAID-ibuprofen,
INDOCIN THIAZIDES-hydrochlorithiazide ACE INHIBITORS-
lisinopril
Ace inhibitors are treatment of choice for?: Heart Failure
Certain medications are known to increase lithium level, but HOW?:
by reducing renal clearance
When educating a patient about lithium teach them about:
Hyponatremia Dehydration-hot days, exercise
Normal Lithium Level: 0.6-1.2
Lithium Toxicity: 1.5 or above
Discontinue and re-order lithium
level
Lithium level of 1.4: Monitor for toxicity
Labs before starting lithium: TSH, BUN, CREATININE, HCG, U/A to
check for presence of protein in the urine (4+ protein is concerning
for renal impair- ment)à4+ protein in urine=MONITOR FOR TOXICITY
4+ protein in the urine of a patient on lithium: 4+ protein is
concerning for renal impairment
4+ protein in urine=MONITOR FOR TOXICITY
Lithium side effects: hypothyroid, leukocytosis, maculopapular rash,
t-wave inversion, Coarse Hand Tremor, GI upset (nausea, vomiting,
anorexia)
-Some of these are also signs of toxicity
Signs of lithium toxicity: confusion, ataxia, GI upset, palpitation,
tremor
NMS: muscle rigidity, mutism (because of muscle rigidity),
, NURS PMHNP EXAM 1 BEST QUESTIONS WITH ANSWERS
2022/2023 UPDATE GRADED A+ ACTUAL EXAM
increased CPK (caused by muscle contraction and muscle destruction),
increase WBC, increased WBC, myoglobinuria (also from muscle
destruction)
Cherry colored urine in a patient that exercises a lot: test for
myoglobinuria may be a sign of rhabdo
, NURS PMHNP EXAM 1 BEST QUESTIONS WITH ANSWERS
2022/2023 UPDATE GRADED A+ ACTUAL EXAM
Serotonin Syndrome: With any drug that increases 5-HT (e.g., MAO
in- hibitors, SNRIs, TCAs) hyperthermia, confusion, myoclonus,
cardiovascular insta- bility, flushing, diarrhea, seizures.
-Treatment: cyproheptadine (5-HT2 receptor antagonist).
Treatment for NMS: Stop Offending Medication
-Dantrolene (muscle relaxer)
-Bromocriptine (Dopamine D2 agonist).
*In question focus on what they are asking for....dopamine agonist vs
muscle relaxer
Treatment for Serotonin Syndrome: Stop Med (1 or more SSRI,
SSNRI, TCA, MOAI)
-Cyproheptadine
Triptans: Used for MIGRAINES
-These meds increase
serotonin example
SUMATRIPTAN
patient taking Prozac and started on sumatriptan: -call PCP to ask
them to switch the migraine med if patient already on SUMATRIPTAN
do not start antidepressant without talking to PCP
How long do you wait when switching between an SSRI to an MAOI?:
2 weeks
How long do you wait when switching between Prozac and MAOI?: 5-
6 weeks wash out period
What is the first line treatment for depression and why?: SSRI-First
line treatment for depression due to less risk of injury from
OVERDOSE
If a cancer patient has depression what should you consider?:
Treating with a medication with minimal drug/drug side effects like
Lexapro
Patient with depression worries about sexual dysfunction what would
be the medication of choice?: Wellbutrin
Primary symptoms of depression include fatigue and low energy
what med would you chose?: Wellbutrin
Wellbutrin is contraindicated in patients with: Seizures and anorexia
Which medications are best for neuropathic pain?:
, NURS PMHNP EXAM 1 BEST QUESTIONS WITH ANSWERS
2022/2023 UPDATE GRADED A+ ACTUAL EXAM
SNRI Gabapentin
TCA
