LMR Georgette s PMHNP Certification Exams
(Latest 2024/ 2025 Updates STUDY BUNDLE
PACKAGE) Questions and Verified Answers|
Grade A| 100% Correct
Intervention before assessment - ANSWERWhen intervention is safety
e.g. discontinuing lithium when toxic
Suspecting child abuse - ANSWER- Immediate report to CPS
- Do not assess, can tamper with evidence
- If child reports it, interview separate from parent
Requests for Traditional Healer - ANSWERmake accommodations after signed
release of info and clearance of informed consent
EPS not common side effect in... - ANSWERatypical
Least weight gaining atypical - ANSWERAripiprazole....next is ziprazidone and
lurasidone
(Switch to this if metabolic syndrome)
Administration of antipsychotic after first break - ANSWERAdminister IM
Class of meds that causes weight gain - ANSWERmood stabilizers
TSH level - ANSWER0.5-5
Mood stabilizer that can cause hepatic toxicity - ANSWERDepakote
- Look for c/o upper right quad pain and brown/red urine
- Order LFT
Kava - ANSWER- Herbal that treats anxiety and insomnia
- Educate about hepatoxic toxicity potential
- Can cause sedation....do not give with other meds that cause drowsiness (e.g.
xanax)
Antidepressant that can cause hepatic toxicity - ANSWERTCA (Order LFT)
Depakote toxicity - ANSWER- Symptom = confusion and lethargy
- Can cause hepatic toxicity
- Check LFT, ammonia levels and Depakote level
Stevens-Johnson Syndrome - ANSWER- Can occur with Lamotrigine
- S/s: burning, mouth swelling and fever
, Blood test prior to administer mood stabilizer - ANSWERHCG of any female that is of
child bearing age
What increases lithium levels - ANSWER- NSAIDS, ACE Inhibitors, Thiazides
(hydrochlorothiazide)
- Because they all reduce kidney clearance
Lithium heck prior to administration - ANSWER- Thyroid, BUN, Creatinine, urine
analysis (protein in urine 4+ ketones - protein uria)
Lithium side effects - ANSWER- Hypothyroidism, leukocytosis, Twave inversion,
maculopapular rash, Fine and coarse tremors, GI upset (diarrhea, vomit, anorexia),
muscle weakness, drowsy, palpations and coordination impairment
- D/c med and order lithium level
NMS causes and symptoms - ANSWER- Caused by antipsychotics
- Leads to muscle rigidity (mutism), elevated CPK (muscle break down), high LFT, high
WBC, myoglobinuria.
Fluoxetine half life - ANSWERLonger so must wait 5-6 weeks before switching to
MAOI
Triptans - ANSWER- Treats migranes
- Can cause serotonin syndrome
- If on antidepressant contact PCP to discontinue this med.
If depressed and has cancer give... - ANSWERSSRI (Escitalopram) because less drug to
drug interactions with cancer tx
Wellbutrin cotraindication - ANSWERSz d/o and eating d/o
Neuropathic pain tx - ANSWER- First use SNRI
- Then TCA and GABA
Med with bad serotonin d/c syndrome - ANSWERSertraline because short half life
What to ask depressed patients - ANSWERAlcohol use b/c can make depression
worse
Serotonin discontinuation syndrome - ANSWERFlu symptoms (muscle aches,
soreness, lethargy, fatigue, gi upset: nausea and vomiting) and decreased
concentration
Mental illness with highest risk for SI - ANSWERSchizophrenia
(Latest 2024/ 2025 Updates STUDY BUNDLE
PACKAGE) Questions and Verified Answers|
Grade A| 100% Correct
Intervention before assessment - ANSWERWhen intervention is safety
e.g. discontinuing lithium when toxic
Suspecting child abuse - ANSWER- Immediate report to CPS
- Do not assess, can tamper with evidence
- If child reports it, interview separate from parent
Requests for Traditional Healer - ANSWERmake accommodations after signed
release of info and clearance of informed consent
EPS not common side effect in... - ANSWERatypical
Least weight gaining atypical - ANSWERAripiprazole....next is ziprazidone and
lurasidone
(Switch to this if metabolic syndrome)
Administration of antipsychotic after first break - ANSWERAdminister IM
Class of meds that causes weight gain - ANSWERmood stabilizers
TSH level - ANSWER0.5-5
Mood stabilizer that can cause hepatic toxicity - ANSWERDepakote
- Look for c/o upper right quad pain and brown/red urine
- Order LFT
Kava - ANSWER- Herbal that treats anxiety and insomnia
- Educate about hepatoxic toxicity potential
- Can cause sedation....do not give with other meds that cause drowsiness (e.g.
xanax)
Antidepressant that can cause hepatic toxicity - ANSWERTCA (Order LFT)
Depakote toxicity - ANSWER- Symptom = confusion and lethargy
- Can cause hepatic toxicity
- Check LFT, ammonia levels and Depakote level
Stevens-Johnson Syndrome - ANSWER- Can occur with Lamotrigine
- S/s: burning, mouth swelling and fever
, Blood test prior to administer mood stabilizer - ANSWERHCG of any female that is of
child bearing age
What increases lithium levels - ANSWER- NSAIDS, ACE Inhibitors, Thiazides
(hydrochlorothiazide)
- Because they all reduce kidney clearance
Lithium heck prior to administration - ANSWER- Thyroid, BUN, Creatinine, urine
analysis (protein in urine 4+ ketones - protein uria)
Lithium side effects - ANSWER- Hypothyroidism, leukocytosis, Twave inversion,
maculopapular rash, Fine and coarse tremors, GI upset (diarrhea, vomit, anorexia),
muscle weakness, drowsy, palpations and coordination impairment
- D/c med and order lithium level
NMS causes and symptoms - ANSWER- Caused by antipsychotics
- Leads to muscle rigidity (mutism), elevated CPK (muscle break down), high LFT, high
WBC, myoglobinuria.
Fluoxetine half life - ANSWERLonger so must wait 5-6 weeks before switching to
MAOI
Triptans - ANSWER- Treats migranes
- Can cause serotonin syndrome
- If on antidepressant contact PCP to discontinue this med.
If depressed and has cancer give... - ANSWERSSRI (Escitalopram) because less drug to
drug interactions with cancer tx
Wellbutrin cotraindication - ANSWERSz d/o and eating d/o
Neuropathic pain tx - ANSWER- First use SNRI
- Then TCA and GABA
Med with bad serotonin d/c syndrome - ANSWERSertraline because short half life
What to ask depressed patients - ANSWERAlcohol use b/c can make depression
worse
Serotonin discontinuation syndrome - ANSWERFlu symptoms (muscle aches,
soreness, lethargy, fatigue, gi upset: nausea and vomiting) and decreased
concentration
Mental illness with highest risk for SI - ANSWERSchizophrenia
