LMR Georgette’s PMHNP Certification Exam/632
Questions And Answers.
What drugs should be avoided with Kava Kava? - Correct Answer -Alprazolam
CNS depressants (e.g., phenobarbital, zolpidem)
Cultural Formulation Interview perform what 3 functions? - Correct Answer -
Clarify meaning of illness
Empower the patient
Validate symptoms within cultural context
What does a cultural formulation interview do? - Correct Answer -cultural
assessment
What is the normal range for TSH? - Correct Answer -0.5 - 5.0 mu/L
What are lab values in Hyperthyroidism - Correct Answer -Decreased TSH
Increased T4 and T3
What are labs in Hypothyroidism? - Correct Answer -Increased TSH
Decreased T4 and T3
What are 5 primary symptoms of Hyperthyroidism? - Correct Answer -Heat
intolerance
Agitation, Anxiety, Irritability
Tachycardia
Mood swings
Weight loss
What are 4 primary symptoms of Hypothyroidism? - Correct Answer -Cold
intolerance
Lethargy
Weight gain
Decreased libido
Hypothyroidism mimics symptoms of what psychiatric disorder? - Correct
Answer -Depression
Hyperthyroidism mimics symptoms of what psychiatric disorder? - Correct
Answer -Mania
Valproic acid produces what teratogenic effect? - Correct Answer -Spina
bifida (neural tube defect)
,What is the primary organ where valproic acid is toxic? - Correct Answer -
Liver (hepatoxicity)
What are 4 signs of hepatoxicity? - Correct Answer -Abdominal pain in the
URQ
Reddish-brown urine
Yellowing of the skin and sclera
Fatigue
Abdominal pain in the URQ, Reddish-brown urine, Yellowing of the skin and
sclera, and Fatigue are signs of - Correct Answer -Hepatoxicity
What is the therapeutic range for valproic acid? - Correct Answer -50-125
mcg/ml
What is a toxic level of valproic acid? - Correct Answer ->150 mcg/ml
What are 4 signs of valproic acid toxicity? - Correct Answer -Disorientation
Lethargy
Respiratory depression
Nausea/vomiting
Disorientation, Lethargy, Respiratory depression, and Nausea/vomiting are
symptoms of toxicity with what drug? - Correct Answer -Valproic acid
With suspected toxicity with valproic acid, what labs should be drawn? -
Correct Answer -DC drug
Check drug level
Obtain LFTs
Obtain ammonia level
What is the major side effect with Kava Kava? - Correct Answer -Liver
damage
What herbal supplement is sued for anxiety, stress, and insomnia? - Correct
Answer -Kava Kava
What are 5 symptoms of Stephen's Johnson Syndrome? - Correct Answer -
Fever
Body aches
Severe red rash
Peeling skin
Facial and tongue swelling
Severe red rash, Fever, Body aches, Peeling skin, and Facial and tongue
swelling are symptoms of - Correct Answer -Stephen's Johnson Syndrome
,Which mood stabilizer causes the least weight gain? - Correct Answer -
Lamotrigine (Lamictal)
Which 3 SGAs cause the least weight gain? - Correct Answer -Lurasidone
(Latuda)
Aripiprazole (Abilify)
Ziprasidone (Geodon)
Which SGA is the least sedating? - Correct Answer -Aripiprazole (Abilify)
What are 3 hallmark symptoms of delirium? - Correct Answer -Acute
disturbance of LOC
impaired cognition
inattention
Acute disturbance of LOC, cognition, and inattention are hallmark symptoms
of - Correct Answer -Delirium
How are agitation and psychotic symptoms treated in delirium? - Correct
Answer -Low dose Haldol
What 4 drugs can cause mania? - Correct Answer -Steroids
Disulfiram (Antabuse)
Isoniazid (INH)
Antidepressants (in BPD)
Steroids, Disulfiram (Antabuse), and Isoniazid (INH) can induce - Correct
Answer -Mania
What 6 drugs can induce depression? - Correct Answer -Steroids
Beta blockers
Interferon, Isotretinoin (Accutane)
Retroviral drugs, Antineoplastic drugs
Benzodiazepines
Progesterone
Steroids can induce what 3 psychiatric states? - Correct Answer -Mania
Depression
Psychosis
What medication to treat acne cause cause birth defects? - Correct Answer -
Isotretinoin (Accutane)
What is the therapeutic range for lithium? - Correct Answer -0.6-1.2 mEq/L
, What medication has a neuroprotective effect for bipolar disorder? - Correct
Answer -Lithium
What is the gold standard for treating manic episodes - Correct Answer -
Lithium
What mood stabilizer has anti-suicidal effects? - Correct Answer -Lithium
What 5 labs should be drawn with lithium? - Correct Answer -Thyroid panel
(TSH)
Serum creatinine
BUN
Urinalysis
HCG
What is a normal SCr range? - Correct Answer -0.6-1.2 mg/dL
What is the normal range for BUN? - Correct Answer -10-20 mg/dL
When should you suspect kidney disease with a urinalysis? - Correct Answer -
4+ protein
4+ protein in the kidney suggests - Correct Answer -Kidney disease
What are 7 side effects of lithium? - Correct Answer -Hypothyroidism
Fine hand tremors
Maculopapular rash
GI upset (N/V/D, cramps, anorexia)
Polyuria, polydipsia, diabetes insipidus
T-wave inversions
Leucocytosis
What are 7 signs of lithium toxicity? - Correct Answer -Severe nausea,
vomiting, diarrhea
Confusion
Drowsiness
Muscle weakness
Heart palpitations
Coarse hand tremor
Unsteadiness while standing or walking
Which 3 drugs can increase lithium levels by decreasing renal clearance? -
Correct Answer -NSAIDs (ibuprofen, indomethacin)
Thiazides
ACEI
Questions And Answers.
What drugs should be avoided with Kava Kava? - Correct Answer -Alprazolam
CNS depressants (e.g., phenobarbital, zolpidem)
Cultural Formulation Interview perform what 3 functions? - Correct Answer -
Clarify meaning of illness
Empower the patient
Validate symptoms within cultural context
What does a cultural formulation interview do? - Correct Answer -cultural
assessment
What is the normal range for TSH? - Correct Answer -0.5 - 5.0 mu/L
What are lab values in Hyperthyroidism - Correct Answer -Decreased TSH
Increased T4 and T3
What are labs in Hypothyroidism? - Correct Answer -Increased TSH
Decreased T4 and T3
What are 5 primary symptoms of Hyperthyroidism? - Correct Answer -Heat
intolerance
Agitation, Anxiety, Irritability
Tachycardia
Mood swings
Weight loss
What are 4 primary symptoms of Hypothyroidism? - Correct Answer -Cold
intolerance
Lethargy
Weight gain
Decreased libido
Hypothyroidism mimics symptoms of what psychiatric disorder? - Correct
Answer -Depression
Hyperthyroidism mimics symptoms of what psychiatric disorder? - Correct
Answer -Mania
Valproic acid produces what teratogenic effect? - Correct Answer -Spina
bifida (neural tube defect)
,What is the primary organ where valproic acid is toxic? - Correct Answer -
Liver (hepatoxicity)
What are 4 signs of hepatoxicity? - Correct Answer -Abdominal pain in the
URQ
Reddish-brown urine
Yellowing of the skin and sclera
Fatigue
Abdominal pain in the URQ, Reddish-brown urine, Yellowing of the skin and
sclera, and Fatigue are signs of - Correct Answer -Hepatoxicity
What is the therapeutic range for valproic acid? - Correct Answer -50-125
mcg/ml
What is a toxic level of valproic acid? - Correct Answer ->150 mcg/ml
What are 4 signs of valproic acid toxicity? - Correct Answer -Disorientation
Lethargy
Respiratory depression
Nausea/vomiting
Disorientation, Lethargy, Respiratory depression, and Nausea/vomiting are
symptoms of toxicity with what drug? - Correct Answer -Valproic acid
With suspected toxicity with valproic acid, what labs should be drawn? -
Correct Answer -DC drug
Check drug level
Obtain LFTs
Obtain ammonia level
What is the major side effect with Kava Kava? - Correct Answer -Liver
damage
What herbal supplement is sued for anxiety, stress, and insomnia? - Correct
Answer -Kava Kava
What are 5 symptoms of Stephen's Johnson Syndrome? - Correct Answer -
Fever
Body aches
Severe red rash
Peeling skin
Facial and tongue swelling
Severe red rash, Fever, Body aches, Peeling skin, and Facial and tongue
swelling are symptoms of - Correct Answer -Stephen's Johnson Syndrome
,Which mood stabilizer causes the least weight gain? - Correct Answer -
Lamotrigine (Lamictal)
Which 3 SGAs cause the least weight gain? - Correct Answer -Lurasidone
(Latuda)
Aripiprazole (Abilify)
Ziprasidone (Geodon)
Which SGA is the least sedating? - Correct Answer -Aripiprazole (Abilify)
What are 3 hallmark symptoms of delirium? - Correct Answer -Acute
disturbance of LOC
impaired cognition
inattention
Acute disturbance of LOC, cognition, and inattention are hallmark symptoms
of - Correct Answer -Delirium
How are agitation and psychotic symptoms treated in delirium? - Correct
Answer -Low dose Haldol
What 4 drugs can cause mania? - Correct Answer -Steroids
Disulfiram (Antabuse)
Isoniazid (INH)
Antidepressants (in BPD)
Steroids, Disulfiram (Antabuse), and Isoniazid (INH) can induce - Correct
Answer -Mania
What 6 drugs can induce depression? - Correct Answer -Steroids
Beta blockers
Interferon, Isotretinoin (Accutane)
Retroviral drugs, Antineoplastic drugs
Benzodiazepines
Progesterone
Steroids can induce what 3 psychiatric states? - Correct Answer -Mania
Depression
Psychosis
What medication to treat acne cause cause birth defects? - Correct Answer -
Isotretinoin (Accutane)
What is the therapeutic range for lithium? - Correct Answer -0.6-1.2 mEq/L
, What medication has a neuroprotective effect for bipolar disorder? - Correct
Answer -Lithium
What is the gold standard for treating manic episodes - Correct Answer -
Lithium
What mood stabilizer has anti-suicidal effects? - Correct Answer -Lithium
What 5 labs should be drawn with lithium? - Correct Answer -Thyroid panel
(TSH)
Serum creatinine
BUN
Urinalysis
HCG
What is a normal SCr range? - Correct Answer -0.6-1.2 mg/dL
What is the normal range for BUN? - Correct Answer -10-20 mg/dL
When should you suspect kidney disease with a urinalysis? - Correct Answer -
4+ protein
4+ protein in the kidney suggests - Correct Answer -Kidney disease
What are 7 side effects of lithium? - Correct Answer -Hypothyroidism
Fine hand tremors
Maculopapular rash
GI upset (N/V/D, cramps, anorexia)
Polyuria, polydipsia, diabetes insipidus
T-wave inversions
Leucocytosis
What are 7 signs of lithium toxicity? - Correct Answer -Severe nausea,
vomiting, diarrhea
Confusion
Drowsiness
Muscle weakness
Heart palpitations
Coarse hand tremor
Unsteadiness while standing or walking
Which 3 drugs can increase lithium levels by decreasing renal clearance? -
Correct Answer -NSAIDs (ibuprofen, indomethacin)
Thiazides
ACEI
