Georgette's LMR Exam with complete
solution 2024
What should you not do when advocating for a patient? - correct answerJudge or
confront
What class of medication is contraindicated with tics? - correct answerStimulants
What should you provide for prior to assessing abuse victims? - correct answerA safe
environment
What are your actions if a child reports abuse? - correct answerFirst 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? - correct
answerReport to CPS
In what setting as an inpatient provider should you interview a patient? - correct
answerUse a private room with the door partially open
How should you begin your interview with adolescents? - correct answerBy building
rapport with them by ensuring confidentiality absent exceptions
Should you interview adolescents with or without parents? - correct answerWithout
What if an adolescent tells you they are homosexual and they don't want their parents to
know? - correct answerThis is confidential
The patient is being discharged and would like their labs faxed to the rehab facility.
What is your initial action? - correct answerGet informed consent/ROI
What do you do if a medical evaluation is needed? - correct answerRefer 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? - correct answerCollect UDS and then refer out
Is it considered a mental illness if it is an expected response culturally? What do you
offer as treatment? - correct answerNo; brief supportive therapy - not medication
,A mother states her child is experiencing a cultural illness. What is your initial action? -
correct answerRespect the mother's cultural understanding of illness prior to
assessment
Native Americans view mental illness and SUDs as? - correct answerAn imbalance
between the individual and the world
What ethnic group has the highest rate of suicidality in the US? - correct answerNative
Americans
If a patient believes they need a healing stick in their room, but the staff nurses removed
it from them - what should you do? - correct answerTeach cultural sensitivity and make
accommodations for patient to have healing stick available such as 1:1
Psychoeducation should be based on? - correct answerCultural context
How do you promote health in a location with multiple ethnicities and education levels? -
correct answerMultiple cultural education and ethnospecific assessment parameters
What if a patient wants a traditional healer? - correct answerAllow this - remember
ROI/informed consent
Normal TSH? - correct answer0.5-5.0
TSH < 0.5 = ? - correct answerHyperthyroidism
TSH > 5.0 = ? - correct answerHypothyroidism
Relationship between TSH & T3/T4? - correct answerInverse
Hyperthyroidism can present as? - correct answerMania
Hypothyroidism can present as? - correct answerDepression
Normal depakote level? - correct answer50-125
Toxic depakote level? - correct answer150+
Birth defect caused by depakote? - correct answerSpina Bifida
S/S of depakote toxicity? - correct answerDisorientation, lethargy, decreased respiratory
rate, and N/V
What to do if there is depakote toxicity? - correct answerD/C depakote and check VPA
level, LFTs, and ammonia
, S/S of hepatotoxicity? - correct answerRUQ pain, reddish brown urine, jaundice, fatigue,
and elevated LFTs
Normal AST? - correct answer5-40
Normal ALT? - correct answer5-35
Kava kava can cause? - correct answerLiver damage and heavy sedation
Kava kava is c/i with? - correct answerBenzos or sedatives
Mood stabilizer most associated with SJS? - correct answerLamictal
Mood stabilizer with least weight gain? - correct answerLamictal
SGAs with least weight gain? - correct answerziprasidone, abilify, and latuda
Least sedating SGA? - correct answerAbilify
Routine labs with SGAs? - correct answerBMI, hip to waist ratio, glucose, A1C, and lipid
panel
Management of metabolic syndrome with SGAs? - correct answer1. Nonpharm =
exercise or nutritional counseling
2. Pharm = switch to other SGA with lower chance of metabolic syndrome
Carbamazepine can cause? - correct answerAgranulocytosis and aplastic anemia
What should you screen for prior to starting Asians on carbamazepine and why? -
correct answerHLAB1502 Allele; risk of SJS
When should you d/c carbamazepine if agranulocytosis is suspected? - correct answerIf
ANC is < 1000 with or without s/s of infection
Lithium range? - correct answer0.6 - 1.2
What to do if lithium is 1.3 or 1.4? - correct answerMonitor
What to do if lithium is 1.5+? - correct answerD/C
Benefits of lithium? - correct answerGold standard for mania, neuroprotective, and
antisuicidal effects
S/S of lithium toxicity? - correct answerSevere N/V, polydipsia, polyuria, leukocytosis,
palpitations, coarse tremor
solution 2024
What should you not do when advocating for a patient? - correct answerJudge or
confront
What class of medication is contraindicated with tics? - correct answerStimulants
What should you provide for prior to assessing abuse victims? - correct answerA safe
environment
What are your actions if a child reports abuse? - correct answerFirst 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? - correct
answerReport to CPS
In what setting as an inpatient provider should you interview a patient? - correct
answerUse a private room with the door partially open
How should you begin your interview with adolescents? - correct answerBy building
rapport with them by ensuring confidentiality absent exceptions
Should you interview adolescents with or without parents? - correct answerWithout
What if an adolescent tells you they are homosexual and they don't want their parents to
know? - correct answerThis is confidential
The patient is being discharged and would like their labs faxed to the rehab facility.
What is your initial action? - correct answerGet informed consent/ROI
What do you do if a medical evaluation is needed? - correct answerRefer 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? - correct answerCollect UDS and then refer out
Is it considered a mental illness if it is an expected response culturally? What do you
offer as treatment? - correct answerNo; brief supportive therapy - not medication
,A mother states her child is experiencing a cultural illness. What is your initial action? -
correct answerRespect the mother's cultural understanding of illness prior to
assessment
Native Americans view mental illness and SUDs as? - correct answerAn imbalance
between the individual and the world
What ethnic group has the highest rate of suicidality in the US? - correct answerNative
Americans
If a patient believes they need a healing stick in their room, but the staff nurses removed
it from them - what should you do? - correct answerTeach cultural sensitivity and make
accommodations for patient to have healing stick available such as 1:1
Psychoeducation should be based on? - correct answerCultural context
How do you promote health in a location with multiple ethnicities and education levels? -
correct answerMultiple cultural education and ethnospecific assessment parameters
What if a patient wants a traditional healer? - correct answerAllow this - remember
ROI/informed consent
Normal TSH? - correct answer0.5-5.0
TSH < 0.5 = ? - correct answerHyperthyroidism
TSH > 5.0 = ? - correct answerHypothyroidism
Relationship between TSH & T3/T4? - correct answerInverse
Hyperthyroidism can present as? - correct answerMania
Hypothyroidism can present as? - correct answerDepression
Normal depakote level? - correct answer50-125
Toxic depakote level? - correct answer150+
Birth defect caused by depakote? - correct answerSpina Bifida
S/S of depakote toxicity? - correct answerDisorientation, lethargy, decreased respiratory
rate, and N/V
What to do if there is depakote toxicity? - correct answerD/C depakote and check VPA
level, LFTs, and ammonia
, S/S of hepatotoxicity? - correct answerRUQ pain, reddish brown urine, jaundice, fatigue,
and elevated LFTs
Normal AST? - correct answer5-40
Normal ALT? - correct answer5-35
Kava kava can cause? - correct answerLiver damage and heavy sedation
Kava kava is c/i with? - correct answerBenzos or sedatives
Mood stabilizer most associated with SJS? - correct answerLamictal
Mood stabilizer with least weight gain? - correct answerLamictal
SGAs with least weight gain? - correct answerziprasidone, abilify, and latuda
Least sedating SGA? - correct answerAbilify
Routine labs with SGAs? - correct answerBMI, hip to waist ratio, glucose, A1C, and lipid
panel
Management of metabolic syndrome with SGAs? - correct answer1. Nonpharm =
exercise or nutritional counseling
2. Pharm = switch to other SGA with lower chance of metabolic syndrome
Carbamazepine can cause? - correct answerAgranulocytosis and aplastic anemia
What should you screen for prior to starting Asians on carbamazepine and why? -
correct answerHLAB1502 Allele; risk of SJS
When should you d/c carbamazepine if agranulocytosis is suspected? - correct answerIf
ANC is < 1000 with or without s/s of infection
Lithium range? - correct answer0.6 - 1.2
What to do if lithium is 1.3 or 1.4? - correct answerMonitor
What to do if lithium is 1.5+? - correct answerD/C
Benefits of lithium? - correct answerGold standard for mania, neuroprotective, and
antisuicidal effects
S/S of lithium toxicity? - correct answerSevere N/V, polydipsia, polyuria, leukocytosis,
palpitations, coarse tremor
