LMR Georgette s PMHNP Certification Exams
(Latest 2024/ 2025 Updates STUDY BUNDLE
PACKAGE) Questions and Verified Answers|
Grade A| 100% Correct
Someone reports they are raped. Priority action? - ANSWERAssess safety. Safety
before assessment and intervention
Priority when discharging a patient from inpatient? - ANSWERSafety
Child comes into office and reports abuse in presence of parents. Next action? -
ANSWERInterview child separately from parents and then call CPS.
Child comes into office without his/her parents and is playing with a toy in a sexual
way. You suspect sexual abuse. Next action? - ANSWERImmediately call CPS.
Suspicion is enough reason to call. Don't call parents first.
Teen wants you to keep something secret and not tell parents (not related to harm),
parents insist you tell them. What do you do? - ANSWERDon't tell them. Child/teen
as the right to CONFIDENTIALITY (not privacy).
You identify a gap in care that many people who commit suicide postpartum did not
receive a risk assessment by the OBGYN. What do you do? - ANSWERCOLLABORATE
with OBGYN to close gap.
Patient is discharging to a rehab facility. Had labs done while at your clinic. Steps to
sending labs to rehab facility? - ANSWERNeed informed consent and then you can
fax the labs over to the rehab facility.
14 yo comes to office feeling "funny" because they inhaled acetone. What is within
your scope of practice that you could do before referring this patient? -
ANSWERUrine drug screen
Pt has a panic attack after you make eye contact with them. This response was
related to a cultural syndrome. Treatment for cultural syndrome? - ANSWERBrief
supportive therapy.
How should you respond to a patient who complains of somatic pain when PCP
couldn't find any medical causes? - ANSWERVALIDATE their symptoms based on
cultural experience
Key components of cultural interviews: - ANSWERClarify meaning of illness
Contextualize their situation in their local world
Empower the patient
,Educating someone with schizophrenia should include what key component? -
ANSWERCultural competence. Educate based on cultural contexts of schizophrenia.
2 key factors when educating a diverse population - ANSWERMULTICULTURAL
EDUCATION and ETHNOSPECIFIC ASSESSMENT PARAMETERS (aka will use different
parameters for every household in a diverse population)
Which care attribute should you employ?: . Native Americans believe mental
illnesses of substance use can be caused by an imbalance between an individual's
relationship with the world. - ANSWERRESPECT their interpretation
Ethnic group with highest rate of suicide - ANSWERNative americans
Native Americans believe in the healing stick which has healing powers. Working
inpatient, native american comes in with healing stick and insists on having the
healing stick with them. Nurses want to take away the healing stick. What will you
do? - ANSWERTEACH NURSE about CULTURAL COMPETENCY. If you find yourself
being confrontational with a culture, incorrect answer.
Patient wants you to release their info to a traditional healer. What do you need to
do to make this happen? - ANSWERGet informed consent before releasing
information.
TSH normal level - ANSWER0.5-5.0 Mu/L
Hyperthyroidism TSH, T3, and T4 levels - ANSWERTSH low, T3 and 4 high
Symptoms of hyperthyroidism - ANSWERHeat intolerance, agitation, anxiety,
irritability, tachycardia, mood swings, weight loss
Hypothyroidism TSH, T3, and T4 levels - ANSWERTSH high, T3 and 4 low
Symptoms of hypothyroidism - ANSWERcold intolerance, lethargy, weight gain,
decreased libido
Which would you check first, TSH or T3/T4? - ANSWERTSH first, if abnormal, can do
individual T3 and 4
Divalproex Sodium (Depakote) birth defect? - ANSWERSpina bifida (neural tube
defect)
Divalproex Sodium (Depakote) BB warning - ANSWERHepatotoxicity
S/S of hepatotoxicity when taking Divalproex Sodium (Depakote)
, What to do if hepatotoxic? - ANSWERRUQ abdominal pain, reddish brown urine,
yellowing of skin and whites of eye, fatigue
DC Depakote and do LFT checking AST and ALT
Normal AST and ALT - ANSWERAST 5-40 U/land
ALT 5-35 U/land
Therapeutic range for depakote? when does toxicity occur?
S/S of Toxicity?
What to do when toxic? - ANSWER50-125 ug/mL
Toxic when >150 ug/mL
S/S:disorientation, lethargy, resp depression, N/V
DC depakote and check drug levels, LFT and ammonia levels
Besides hepatotoxicity, what other organ system does depakote affect? S/S? -
ANSWERPancreatitis (RUQ abd pain that radiates to back, tender abd, fever, rapid
pulse, vomiting, oily stools)
Side effect of Kava - ANSWERliver damage
If taking Kava and having signs of hepatotoxicity, what should you do? - ANSWERtell
them to STOP taking Kava
Major med interactions with kava? Why? - ANSWERBENZOS, Alprazolam (Xanax):
extreme drowsiness
Also other CNS depressants
SJS symptoms - ANSWERRash, body aches, FEVER, peeling skin, facial/tongue
swelling
Atypical antipsychotics that cause least weight gain? - ANSWERZiprasidone,
aripirazole, lurasidone
Least sedating atypical? - ANSWERAbilify
Routine labs when on an atypical that causes weight gain - ANSWERBMI, hip to waist
ratio, glucose, lipid panel
Atypical induced weight gain management - ANSWERNonpharm first: EXERCISE and
nutrition counseling.
(Latest 2024/ 2025 Updates STUDY BUNDLE
PACKAGE) Questions and Verified Answers|
Grade A| 100% Correct
Someone reports they are raped. Priority action? - ANSWERAssess safety. Safety
before assessment and intervention
Priority when discharging a patient from inpatient? - ANSWERSafety
Child comes into office and reports abuse in presence of parents. Next action? -
ANSWERInterview child separately from parents and then call CPS.
Child comes into office without his/her parents and is playing with a toy in a sexual
way. You suspect sexual abuse. Next action? - ANSWERImmediately call CPS.
Suspicion is enough reason to call. Don't call parents first.
Teen wants you to keep something secret and not tell parents (not related to harm),
parents insist you tell them. What do you do? - ANSWERDon't tell them. Child/teen
as the right to CONFIDENTIALITY (not privacy).
You identify a gap in care that many people who commit suicide postpartum did not
receive a risk assessment by the OBGYN. What do you do? - ANSWERCOLLABORATE
with OBGYN to close gap.
Patient is discharging to a rehab facility. Had labs done while at your clinic. Steps to
sending labs to rehab facility? - ANSWERNeed informed consent and then you can
fax the labs over to the rehab facility.
14 yo comes to office feeling "funny" because they inhaled acetone. What is within
your scope of practice that you could do before referring this patient? -
ANSWERUrine drug screen
Pt has a panic attack after you make eye contact with them. This response was
related to a cultural syndrome. Treatment for cultural syndrome? - ANSWERBrief
supportive therapy.
How should you respond to a patient who complains of somatic pain when PCP
couldn't find any medical causes? - ANSWERVALIDATE their symptoms based on
cultural experience
Key components of cultural interviews: - ANSWERClarify meaning of illness
Contextualize their situation in their local world
Empower the patient
,Educating someone with schizophrenia should include what key component? -
ANSWERCultural competence. Educate based on cultural contexts of schizophrenia.
2 key factors when educating a diverse population - ANSWERMULTICULTURAL
EDUCATION and ETHNOSPECIFIC ASSESSMENT PARAMETERS (aka will use different
parameters for every household in a diverse population)
Which care attribute should you employ?: . Native Americans believe mental
illnesses of substance use can be caused by an imbalance between an individual's
relationship with the world. - ANSWERRESPECT their interpretation
Ethnic group with highest rate of suicide - ANSWERNative americans
Native Americans believe in the healing stick which has healing powers. Working
inpatient, native american comes in with healing stick and insists on having the
healing stick with them. Nurses want to take away the healing stick. What will you
do? - ANSWERTEACH NURSE about CULTURAL COMPETENCY. If you find yourself
being confrontational with a culture, incorrect answer.
Patient wants you to release their info to a traditional healer. What do you need to
do to make this happen? - ANSWERGet informed consent before releasing
information.
TSH normal level - ANSWER0.5-5.0 Mu/L
Hyperthyroidism TSH, T3, and T4 levels - ANSWERTSH low, T3 and 4 high
Symptoms of hyperthyroidism - ANSWERHeat intolerance, agitation, anxiety,
irritability, tachycardia, mood swings, weight loss
Hypothyroidism TSH, T3, and T4 levels - ANSWERTSH high, T3 and 4 low
Symptoms of hypothyroidism - ANSWERcold intolerance, lethargy, weight gain,
decreased libido
Which would you check first, TSH or T3/T4? - ANSWERTSH first, if abnormal, can do
individual T3 and 4
Divalproex Sodium (Depakote) birth defect? - ANSWERSpina bifida (neural tube
defect)
Divalproex Sodium (Depakote) BB warning - ANSWERHepatotoxicity
S/S of hepatotoxicity when taking Divalproex Sodium (Depakote)
, What to do if hepatotoxic? - ANSWERRUQ abdominal pain, reddish brown urine,
yellowing of skin and whites of eye, fatigue
DC Depakote and do LFT checking AST and ALT
Normal AST and ALT - ANSWERAST 5-40 U/land
ALT 5-35 U/land
Therapeutic range for depakote? when does toxicity occur?
S/S of Toxicity?
What to do when toxic? - ANSWER50-125 ug/mL
Toxic when >150 ug/mL
S/S:disorientation, lethargy, resp depression, N/V
DC depakote and check drug levels, LFT and ammonia levels
Besides hepatotoxicity, what other organ system does depakote affect? S/S? -
ANSWERPancreatitis (RUQ abd pain that radiates to back, tender abd, fever, rapid
pulse, vomiting, oily stools)
Side effect of Kava - ANSWERliver damage
If taking Kava and having signs of hepatotoxicity, what should you do? - ANSWERtell
them to STOP taking Kava
Major med interactions with kava? Why? - ANSWERBENZOS, Alprazolam (Xanax):
extreme drowsiness
Also other CNS depressants
SJS symptoms - ANSWERRash, body aches, FEVER, peeling skin, facial/tongue
swelling
Atypical antipsychotics that cause least weight gain? - ANSWERZiprasidone,
aripirazole, lurasidone
Least sedating atypical? - ANSWERAbilify
Routine labs when on an atypical that causes weight gain - ANSWERBMI, hip to waist
ratio, glucose, lipid panel
Atypical induced weight gain management - ANSWERNonpharm first: EXERCISE and
nutrition counseling.
