Georgette Review Exam 717 Questions with Correct Answers,
ANCC Review Manual PMHNP.
When many answers are remarkably similar, they are usually _____________ - Correct
Answer wrong
Interprofessional collaboration is encouraged. - Correct Answer Collaborate is usually
right.
Delegate is usually wrong.
ADPIER - Correct Answer Assessment, diagnosis, Plan, intervention, evaluate, refer out
last.
Lithium - Correct Answer Normal 0.6-1.2
Lithium toxicity occurs at levels - Correct Answer > 1.5
Signs of Lithium toxicity - Correct Answer severe nausea, diarrhea, vomiting, confusion,
drowsiness, muscle weakness, heart palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard for - Correct Answer MANIA
Lithium has evidence shown to - Correct Answer reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester - Correct Answer Ebstein
anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to - Correct Answer rise
Baseline labs before initiation of lithium - Correct Answer TSH
creatinine (0.6-1.2)
BUN (10-20)
HCG (all psychotropics females 12-51)
EKG 50+
Urinalysis (check for proteins, 4+ may indicate kidney disease)
Side Effects of Lithium - Correct Answer hypothyroidism
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Pt education for lithimum - Correct Answer staying hydrated
avoiding NSAIDS
,compliance
Depakote normal level - Correct Answer 50-125
Depakote toxicity level - Correct Answer greater than 150
Teratogenic effects of Depakote - Correct Answer spina bifida
Adverse effects of depakote - Correct Answer alopecia
hepatotoxicity (RUQ pain or brown/red urine--order LFTs) AST 5-40, ALT 5-35,
yellowing of skin or eyes, fatigue
Signs of Depakote toxicity - Correct Answer disorientation, lethargy, respiratory
depression, nausea/vomiting
Intervention for depakote toxicity - Correct Answer DC med
check level
LFT
ammonia
MAOI + tyramine causes - Correct Answer hypertensive crisis
Symptoms of hypertensive crisis - Correct Answer elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI + - Correct Answer MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis - Correct Answer DC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzos - Correct Answer floppy baby, cleft palate
Teratogenic effects of tegratol - Correct Answer neural tube defect
,teratogenic effects of lithium - Correct Answer ebstein anomaly (heart defect) (avoid,
especially 1st trimester)
teratogenic effects of depakote - Correct Answer neural tube defects/spina bifida
Adverse reaction to Lamictal - Correct Answer Steven Johnson's Syndrome
Signs of SJS - Correct Answer FEVER --high yield
sore throat
facial swelling
tongue swelling
red rash
skin sloughing
body aches
prodromal headache
malaise
arthralgia
painful mucus membranes
Lamotrigine is least likely to cause - Correct Answer sedation or weight gain
Carbamazepine (tegretol) black box warning - Correct Answer agranulocytosis
(decrease WBCs)
aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin rash, SOA)
Carbamazepine and asians - Correct Answer Screen for HLAB-1502 allele before
initiating, due to high incidence of SJS if positive for allele.
Child-bearing aged women - Correct Answer check for pregnancy before starting mood
stabilizer
start on folic acid to support neural tube development during the first month that a
woman is pregnant
Clozaril/clozapine can cause - Correct Answer agranulocytosis and neutropenia
For monitoring neutropenia in Clozaril, monitor - Correct Answer ANC
DC clozarli if ANC - Correct Answer less than 1000
DC clozaril if WBC - Correct Answer 2000-3000, risk of agranulocytosis
When on clozaril monitor for - Correct Answer signs and symptoms of infection: sudden
fever, chills, sore throat, weakness
Clozaril only known antipsychotic to - Correct Answer decrease risk of suicide in
patients with schizophrenia.
, Your patient with bipolar disorder is admitted to a medical hospital. The internist
contacts your office and asks whether the lithium you prescribed him is effecting his
ECG. How do you respond? - Correct Answer Answer: Lithium can invert the t waves.
Mary is a 45-year-old African American female who has been treated on Isocarboxazid
(Marplan) for over 6 years. Mary is going in for a surgical procedure. Which medication
is strictly contraindicated with Isocarboxazid? - Correct Answer Answer:
Methylphenidate
You are treating a client with schizophrenia who takes clozapine. What lab values will
indicate the client needs to discontinue treatment? - Correct Answer Answer: ANC less
than 1000
If given during pregnancy, sodium valproate can cause which of the following medical
problems in the baby? - Correct Answer Spina bifida
Which mood stabilizer is associated with potential life-threatening rash in the Asian
population? - Correct Answer Carbamazepine
Bulimia, weight is ___________ - Correct Answer within the normal range.
Pharm treatment for bulimia - Correct Answer Fluoxetine
SSRIs and TCAs effective in reducing binging and purging
Signs of anorexia nervosa - Correct Answer low BMI
Amennorrhea
Emaciation
Bradycardua
Hypotension
Pharm treatment for anorexia - Correct Answer there is none
therapy
Which of the following physical exam findings would help the PMHNP differentiate
anorexia nervosa from bulimia nervosa? - Correct Answer Low BMI
If a patient is depression, low energy, fatigued, you would prescribe - Correct Answer
Wellbutrin
Wellbutrin is contraindicated in patients with - Correct Answer seizure disorder or
conditions that increase risk of seizures such as eating disorder.
Which of the following medications has a unique mechanism that is both a
norepinephrine and dopamine reuptake inhibitor? - Correct Answer bupropion
ANCC Review Manual PMHNP.
When many answers are remarkably similar, they are usually _____________ - Correct
Answer wrong
Interprofessional collaboration is encouraged. - Correct Answer Collaborate is usually
right.
Delegate is usually wrong.
ADPIER - Correct Answer Assessment, diagnosis, Plan, intervention, evaluate, refer out
last.
Lithium - Correct Answer Normal 0.6-1.2
Lithium toxicity occurs at levels - Correct Answer > 1.5
Signs of Lithium toxicity - Correct Answer severe nausea, diarrhea, vomiting, confusion,
drowsiness, muscle weakness, heart palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard for - Correct Answer MANIA
Lithium has evidence shown to - Correct Answer reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester - Correct Answer Ebstein
anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to - Correct Answer rise
Baseline labs before initiation of lithium - Correct Answer TSH
creatinine (0.6-1.2)
BUN (10-20)
HCG (all psychotropics females 12-51)
EKG 50+
Urinalysis (check for proteins, 4+ may indicate kidney disease)
Side Effects of Lithium - Correct Answer hypothyroidism
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Pt education for lithimum - Correct Answer staying hydrated
avoiding NSAIDS
,compliance
Depakote normal level - Correct Answer 50-125
Depakote toxicity level - Correct Answer greater than 150
Teratogenic effects of Depakote - Correct Answer spina bifida
Adverse effects of depakote - Correct Answer alopecia
hepatotoxicity (RUQ pain or brown/red urine--order LFTs) AST 5-40, ALT 5-35,
yellowing of skin or eyes, fatigue
Signs of Depakote toxicity - Correct Answer disorientation, lethargy, respiratory
depression, nausea/vomiting
Intervention for depakote toxicity - Correct Answer DC med
check level
LFT
ammonia
MAOI + tyramine causes - Correct Answer hypertensive crisis
Symptoms of hypertensive crisis - Correct Answer elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI + - Correct Answer MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis - Correct Answer DC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzos - Correct Answer floppy baby, cleft palate
Teratogenic effects of tegratol - Correct Answer neural tube defect
,teratogenic effects of lithium - Correct Answer ebstein anomaly (heart defect) (avoid,
especially 1st trimester)
teratogenic effects of depakote - Correct Answer neural tube defects/spina bifida
Adverse reaction to Lamictal - Correct Answer Steven Johnson's Syndrome
Signs of SJS - Correct Answer FEVER --high yield
sore throat
facial swelling
tongue swelling
red rash
skin sloughing
body aches
prodromal headache
malaise
arthralgia
painful mucus membranes
Lamotrigine is least likely to cause - Correct Answer sedation or weight gain
Carbamazepine (tegretol) black box warning - Correct Answer agranulocytosis
(decrease WBCs)
aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin rash, SOA)
Carbamazepine and asians - Correct Answer Screen for HLAB-1502 allele before
initiating, due to high incidence of SJS if positive for allele.
Child-bearing aged women - Correct Answer check for pregnancy before starting mood
stabilizer
start on folic acid to support neural tube development during the first month that a
woman is pregnant
Clozaril/clozapine can cause - Correct Answer agranulocytosis and neutropenia
For monitoring neutropenia in Clozaril, monitor - Correct Answer ANC
DC clozarli if ANC - Correct Answer less than 1000
DC clozaril if WBC - Correct Answer 2000-3000, risk of agranulocytosis
When on clozaril monitor for - Correct Answer signs and symptoms of infection: sudden
fever, chills, sore throat, weakness
Clozaril only known antipsychotic to - Correct Answer decrease risk of suicide in
patients with schizophrenia.
, Your patient with bipolar disorder is admitted to a medical hospital. The internist
contacts your office and asks whether the lithium you prescribed him is effecting his
ECG. How do you respond? - Correct Answer Answer: Lithium can invert the t waves.
Mary is a 45-year-old African American female who has been treated on Isocarboxazid
(Marplan) for over 6 years. Mary is going in for a surgical procedure. Which medication
is strictly contraindicated with Isocarboxazid? - Correct Answer Answer:
Methylphenidate
You are treating a client with schizophrenia who takes clozapine. What lab values will
indicate the client needs to discontinue treatment? - Correct Answer Answer: ANC less
than 1000
If given during pregnancy, sodium valproate can cause which of the following medical
problems in the baby? - Correct Answer Spina bifida
Which mood stabilizer is associated with potential life-threatening rash in the Asian
population? - Correct Answer Carbamazepine
Bulimia, weight is ___________ - Correct Answer within the normal range.
Pharm treatment for bulimia - Correct Answer Fluoxetine
SSRIs and TCAs effective in reducing binging and purging
Signs of anorexia nervosa - Correct Answer low BMI
Amennorrhea
Emaciation
Bradycardua
Hypotension
Pharm treatment for anorexia - Correct Answer there is none
therapy
Which of the following physical exam findings would help the PMHNP differentiate
anorexia nervosa from bulimia nervosa? - Correct Answer Low BMI
If a patient is depression, low energy, fatigued, you would prescribe - Correct Answer
Wellbutrin
Wellbutrin is contraindicated in patients with - Correct Answer seizure disorder or
conditions that increase risk of seizures such as eating disorder.
Which of the following medications has a unique mechanism that is both a
norepinephrine and dopamine reuptake inhibitor? - Correct Answer bupropion
