LMR Georgette’s PMHNP Certification 2024
Questions And Correct Answers(Verified
Answers)AGRADE
A client presents with complains of changes in appetite, feeling fatigued, problems
with sleep-rest cycle, and changes in libido. What is the neuroanatomical area of the
brain that is responsible for the normal regulation of these functions?
A. Thalamus
B. Hypothalamus
C. Limbic System
D. Hippocampus
Hypothalamus
A, B, & D are all part of the limbic system so you can rule that out
When a patient is hesitant to participate in treatment you should encourage? Bring a
support person like a husband
Thyroid-Stimulating hormone normal level 0.5-
5.0 Mu/L
When T4 and T3 are high and TSH is low what is the diagnosis
HYPERTHYROIDISM, TSH secretion decreases: TSH LOW à key symptoms HEAT
INTOLERANCE
Key symptoms of Heat Intolerance
Hyperthyroidism
When T4 and T3 are Low and TSH is high what is the diagnosis
(HYPOTHYROIDISM) TSH secretion increased: TSH HIGH à COLD INTERANCE
Key symptoms of Cold Intolerance
Hypothyroidism
Hyperthyroid can mimic
Mania
Hypothyroid can mimic
,Depression
A patient on depakote complains of RUQ pain and has reddish/brown urine
Hepatoxicity
-Check LFTs
Signs of Depakote toxicity
Disorientation, confusion, lethargy
,You suspect depakote toxicity what do you do?
Check
-LFT
-Ammonia
-Depakote Level
What herbal supplement can cause hepatoxicity? Kava
Kava
When taking Kava Kava in combinations with other medications you should caution about
Risk of Hepatoxicity and Sedation
TCAs carry a risk of Hepatotoxicity
Signs of Stevens-Johnson Syndrome
-fever, mouth pain, swelling, burning eyes, blisters, skin pain two
psychotropics known to cause steven johnson syndrome lamictal and
tegretol
What nationality is most suseptible of getting steven johnson? Asians
When treating asians with tegretal screen for?
HLAB-1502 Allele
What two medications cause agranulocytosis? Clozaril &
Tegretal
Agranulocytosis when to discontinue medication Less
than 1000
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 impairment)à4+ protein in urine=MONITOR FOR
TOXICITY
4+ protein in the urine of a patient on lithium
Questions And Correct Answers(Verified
Answers)AGRADE
A client presents with complains of changes in appetite, feeling fatigued, problems
with sleep-rest cycle, and changes in libido. What is the neuroanatomical area of the
brain that is responsible for the normal regulation of these functions?
A. Thalamus
B. Hypothalamus
C. Limbic System
D. Hippocampus
Hypothalamus
A, B, & D are all part of the limbic system so you can rule that out
When a patient is hesitant to participate in treatment you should encourage? Bring a
support person like a husband
Thyroid-Stimulating hormone normal level 0.5-
5.0 Mu/L
When T4 and T3 are high and TSH is low what is the diagnosis
HYPERTHYROIDISM, TSH secretion decreases: TSH LOW à key symptoms HEAT
INTOLERANCE
Key symptoms of Heat Intolerance
Hyperthyroidism
When T4 and T3 are Low and TSH is high what is the diagnosis
(HYPOTHYROIDISM) TSH secretion increased: TSH HIGH à COLD INTERANCE
Key symptoms of Cold Intolerance
Hypothyroidism
Hyperthyroid can mimic
Mania
Hypothyroid can mimic
,Depression
A patient on depakote complains of RUQ pain and has reddish/brown urine
Hepatoxicity
-Check LFTs
Signs of Depakote toxicity
Disorientation, confusion, lethargy
,You suspect depakote toxicity what do you do?
Check
-LFT
-Ammonia
-Depakote Level
What herbal supplement can cause hepatoxicity? Kava
Kava
When taking Kava Kava in combinations with other medications you should caution about
Risk of Hepatoxicity and Sedation
TCAs carry a risk of Hepatotoxicity
Signs of Stevens-Johnson Syndrome
-fever, mouth pain, swelling, burning eyes, blisters, skin pain two
psychotropics known to cause steven johnson syndrome lamictal and
tegretol
What nationality is most suseptible of getting steven johnson? Asians
When treating asians with tegretal screen for?
HLAB-1502 Allele
What two medications cause agranulocytosis? Clozaril &
Tegretal
Agranulocytosis when to discontinue medication Less
than 1000
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 impairment)à4+ protein in urine=MONITOR FOR
TOXICITY
4+ protein in the urine of a patient on lithium
