Georgette's LMR with complete solution
What should you not do when advocating for a patient? - Answer Judge or confront
What class of medication is contraindicated with tics? - Answer Stimulants
What should you provide for prior to assessing abuse victims? - Answer A safe
environment
What are your actions if a child reports abuse? - Answer First interview separately
from parents then report to CPS
What should you do if a child plays with toys in a way that you suspect abuse? - Answer
Report to CPS
In what setting as an inpatient provider should you interview a patient? - Answer
Use a private room with the door partially open
How should you begin your interview with adolescents? - Answer By building
rapport with them by ensuring confidentiality absent exceptions
Should you interview adolescents with or without parents? - Answer Without
What if an adolescent tells you they are homosexual and they don't want their parents to
know? - Answer This is confidential
The patient is being discharged and would like their labs faxed to the rehab facility.
What is your initial action? - Answer Get informed consent/ROI
What do you do if a medical evaluation is needed? - Answer Refer out - this is out of
scope
What do you do if a patient is takes something and is feeling really funny/unwell in your
office? - Answer Collect UDS and then refer out
Is it considered a mental illness if it is an expected response culturally? What do you
offer as treatment? - Answer No; brief supportive therapy - not medication
A mother states her child is experiencing a cultural illness. What is your initial action? -
Answer Respect the mother's cultural understanding of illness prior to assessment
Native Americans view mental illness and SUDs as? - Answer An imbalance
between the individual and the world
What ethnic group has the highest rate of suicidality in the US? - Answer Native
Americans
,Georgette's LMR with complete solution
If a patient believes they need a healing stick in their room, but the staff nurses removed
it from them - what should you do? - Answer Teach cultural sensitivity and make
accommodations for patient to have healing stick available such as 1:1
Psychoeducation should be based on? - Answer Cultural context
How do you promote health in a location with multiple ethnicities and education levels? -
Answer Multiple cultural education and ethnospecific assessment parameters
What if a patient wants a traditional healer? - Answer Allow this - remember
ROI/informed consent
Normal TSH? - Answer 0.5-5.0
TSH < 0.5 = ? - Answer Hyperthyroidism
TSH > 5.0 = ? - Answer Hypothyroidism
Relationship between TSH & T3/T4? - Answer Inverse
Hyperthyroidism can present as? - Answer Mania
Hypothyroidism can present as? - Answer Depression
Normal depakote level? - Answer 50-125
Toxic depakote level? - Answer 150+
Birth defect caused by depakote? - Answer Spina Bifida
S/S of depakote toxicity? - Answer Disorientation, lethargy, decreased respiratory
rate, and N/V
What to do if there is depakote toxicity? - Answer D/C depakote and check VPA
level, LFTs, and ammonia
S/S of hepatotoxicity? - Answer RUQ pain, reddish brown urine, jaundice, fatigue,
and elevated LFTs
Normal AST? - Answer 5-40
Normal ALT? - Answer 5-35
Kava kava can cause? - Answer Liver damage and heavy sedation
Kava kava is c/i with? - Answer Benzos or sedatives
, Georgette's LMR with complete solution
Mood stabilizer most associated with SJS? - Answer Lamictal
Mood stabilizer with least weight gain? - Answer Lamictal
SGAs with least weight gain? - Answer ziprasidone, abilify, and latuda
Least sedating SGA? - Answer Abilify
Routine labs with SGAs? - Answer BMI, hip to waist ratio, glucose, A1C, and lipid
panel
Management of metabolic syndrome with SGAs? - Answer 1. Nonpharm = exercise
or nutritional counseling
2. Pharm = switch to other SGA with lower chance of metabolic syndrome
Carbamazepine can cause? - Answer Agranulocytosis and aplastic anemia
What should you screen for prior to starting Asians on carbamazepine and why? -
Answer HLAB1502 Allele; risk of SJS
When should you d/c carbamazepine if agranulocytosis is suspected? - Answer If
ANC is < 1000 with or without s/s of infection
Lithium range? - Answer 0.6 - 1.2
What to do if lithium is 1.3 or 1.4? - Answer Monitor
What to do if lithium is 1.5+? - Answer D/C
Benefits of lithium? - Answer Gold standard for mania, neuroprotective, and
antisuicidal effects
S/S of lithium toxicity? - Answer Severe N/V, polydipsia, polyuria, leukocytosis,
palpitations, coarse tremor
What to do if lithium toxicity is suspected? - Answer D/C and check serum levels
prior to checking VS
Kidney disease and drugs that reduce renal clearance can raise lithium levels. What are
these drugs? - Answer NSAIDs, ace inhibitors for heart failure (-pril), and thiazides
(HCTZ)
What demonstrates understanding of education on lithium? - Answer Taking extra
water with patient when they go hiking
What should you not do when advocating for a patient? - Answer Judge or confront
What class of medication is contraindicated with tics? - Answer Stimulants
What should you provide for prior to assessing abuse victims? - Answer A safe
environment
What are your actions if a child reports abuse? - Answer First interview separately
from parents then report to CPS
What should you do if a child plays with toys in a way that you suspect abuse? - Answer
Report to CPS
In what setting as an inpatient provider should you interview a patient? - Answer
Use a private room with the door partially open
How should you begin your interview with adolescents? - Answer By building
rapport with them by ensuring confidentiality absent exceptions
Should you interview adolescents with or without parents? - Answer Without
What if an adolescent tells you they are homosexual and they don't want their parents to
know? - Answer This is confidential
The patient is being discharged and would like their labs faxed to the rehab facility.
What is your initial action? - Answer Get informed consent/ROI
What do you do if a medical evaluation is needed? - Answer Refer out - this is out of
scope
What do you do if a patient is takes something and is feeling really funny/unwell in your
office? - Answer Collect UDS and then refer out
Is it considered a mental illness if it is an expected response culturally? What do you
offer as treatment? - Answer No; brief supportive therapy - not medication
A mother states her child is experiencing a cultural illness. What is your initial action? -
Answer Respect the mother's cultural understanding of illness prior to assessment
Native Americans view mental illness and SUDs as? - Answer An imbalance
between the individual and the world
What ethnic group has the highest rate of suicidality in the US? - Answer Native
Americans
,Georgette's LMR with complete solution
If a patient believes they need a healing stick in their room, but the staff nurses removed
it from them - what should you do? - Answer Teach cultural sensitivity and make
accommodations for patient to have healing stick available such as 1:1
Psychoeducation should be based on? - Answer Cultural context
How do you promote health in a location with multiple ethnicities and education levels? -
Answer Multiple cultural education and ethnospecific assessment parameters
What if a patient wants a traditional healer? - Answer Allow this - remember
ROI/informed consent
Normal TSH? - Answer 0.5-5.0
TSH < 0.5 = ? - Answer Hyperthyroidism
TSH > 5.0 = ? - Answer Hypothyroidism
Relationship between TSH & T3/T4? - Answer Inverse
Hyperthyroidism can present as? - Answer Mania
Hypothyroidism can present as? - Answer Depression
Normal depakote level? - Answer 50-125
Toxic depakote level? - Answer 150+
Birth defect caused by depakote? - Answer Spina Bifida
S/S of depakote toxicity? - Answer Disorientation, lethargy, decreased respiratory
rate, and N/V
What to do if there is depakote toxicity? - Answer D/C depakote and check VPA
level, LFTs, and ammonia
S/S of hepatotoxicity? - Answer RUQ pain, reddish brown urine, jaundice, fatigue,
and elevated LFTs
Normal AST? - Answer 5-40
Normal ALT? - Answer 5-35
Kava kava can cause? - Answer Liver damage and heavy sedation
Kava kava is c/i with? - Answer Benzos or sedatives
, Georgette's LMR with complete solution
Mood stabilizer most associated with SJS? - Answer Lamictal
Mood stabilizer with least weight gain? - Answer Lamictal
SGAs with least weight gain? - Answer ziprasidone, abilify, and latuda
Least sedating SGA? - Answer Abilify
Routine labs with SGAs? - Answer BMI, hip to waist ratio, glucose, A1C, and lipid
panel
Management of metabolic syndrome with SGAs? - Answer 1. Nonpharm = exercise
or nutritional counseling
2. Pharm = switch to other SGA with lower chance of metabolic syndrome
Carbamazepine can cause? - Answer Agranulocytosis and aplastic anemia
What should you screen for prior to starting Asians on carbamazepine and why? -
Answer HLAB1502 Allele; risk of SJS
When should you d/c carbamazepine if agranulocytosis is suspected? - Answer If
ANC is < 1000 with or without s/s of infection
Lithium range? - Answer 0.6 - 1.2
What to do if lithium is 1.3 or 1.4? - Answer Monitor
What to do if lithium is 1.5+? - Answer D/C
Benefits of lithium? - Answer Gold standard for mania, neuroprotective, and
antisuicidal effects
S/S of lithium toxicity? - Answer Severe N/V, polydipsia, polyuria, leukocytosis,
palpitations, coarse tremor
What to do if lithium toxicity is suspected? - Answer D/C and check serum levels
prior to checking VS
Kidney disease and drugs that reduce renal clearance can raise lithium levels. What are
these drugs? - Answer NSAIDs, ace inhibitors for heart failure (-pril), and thiazides
(HCTZ)
What demonstrates understanding of education on lithium? - Answer Taking extra
water with patient when they go hiking
