LMR Georgette’s PMHNP Certification Exam

LMR GEORGETTE’S PMHNP GG GG




CERTIFICATION EXAM GG GG GG




What drugs should be avoided with Kava Kava?ANS==
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Alprazolam CNS depressants (e.g., phenobarbital, zolpidem)
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What is the normal range for TSH?ANS== 0.5 - 5.0 mu/L
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What are lab values in HyperthyroidismANS== Decreased TSH
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Increased T4 and T3
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What are labs in Hypothyroidism?ANS== Increased TSH
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Decreased T4 and T3
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What are 5 primary symptoms of Hyperthyroidism?ANS==
GG GG GG GG GG GG Heat
intolerance Agitation, Anxiety, Irritability
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Tachycardia
Mood swings
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Weight loss
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What are 4 primary symptoms of Hypothyroidism?ANS==
GG GG GG GG GG GG Cold
intolerance Lethargy
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Weight gain GG



Decreased
GG



libido
GG




Hypothyroidism mimics symptoms of what psychiatric disorder?ANS== Depression
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Hyperthyroidism mimics symptoms of what psychiatric disorder?ANS== Mania
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Valproic acid produces what teratogenic effect?ANS== Spina bifida (neural
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tube defect)
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What is the primary organ where valproic acid is toxic?ANS==
GG GG GG GG GG GG GG GG GG G G Liver (hepatoxicity)
GG




What are 4 signs of hepatoxicity?ANS== Abdominal pain in the URQ GG GG GG GG



Reddish-brown urine
Yellowing of the skin and
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sclera Fatigue
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What is the therapeutic range for valproic acid?ANS==50-125 mcg/ml
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What is a toxic level of valproic acid?ANS==
GG GG GG GG GG GG GG G G >150 mcg/ml GG

,What are 4 signs of valproic acid toxicity?ANS==
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Disorientation
Lethargy
GG



Respiratory depression GG



Nausea/vomiting
GG




A pt on Depakote C/O Abdominal pain in the URQ and Reddish-brown urine.
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What do you suspect? What do you do?ANS== Hepatotoxicity; hold med, draw
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LFT's (priority), DVP level
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With suspected toxicity with valproic acid, what steps/labs should be
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drawn?ANS== D/C drug
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Check drug level GG GG



Obtain LFTs
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Obtain ammonia level GG GG




A pregnant pt is taking accutane, zyprexa and abilify; what med needs
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to be d/c'd?ANS==
GG GG Accutane (used for acne; Causes birth
GG GG GG GG GG GG



Defects!!!)
GG




What herbal supplement is used for anxiety, stress, and insomnia? What is the
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GGmajor side effect with Kava Kava?ANS== Kava Kava
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liver damage GG




What are 5 symptoms of Stephen's Johnson Syndrome?ANS==
GG GG GG GG GG GG GG Fever - GG



Key sx to suspect SJS; high yield (HY)
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burning of mouth/eyes - GG GG GG



HY Body aches
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Severe red rash GG GG



Peeling skin
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Facial and tongue swelling
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Which mood stabilizer causes the least weight gain?ANS==
GG GG GG GG GG GG GG G G Lamotrigine (Lamictal) GG




Which 3 SGAs cause the least weight gain?ANS==
GG GG GG GG GG GG GG Lurasidone
(Latuda) Aripiprazole (Abilify)
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Ziprasidone (Geodon) GG




Which SGA is the least sedating?ANS== Aripiprazole (Abilify)
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Your pt is taking Kava and you need to add an AS to manage their SCZ, which
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do you add?ANS== Aripiprazole (least sedating)
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What are 2 hallmark symptoms of delirium?ANS== Acute onset
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disturbance of LOC
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impaired cognition GG



inattention
GG

,How are agitation and psychotic symptoms treated in delirium?ANS== Low
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dose Haldol (QTc check first)
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16 y/o C/O feeling funny after inhaling Acetone (nail polish remover). What is
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your action?ANS==
GG GG Do UDS; chances are they may be abusing other GG GG GG GG GG GG GG GG



substances
GG




What 4 drugs can cause mania?ANS==
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"SAID" Steroids
GG GG



Antidepressants (in BPD) GG GG



Isoniazid (INH)
GG G G



Disulfiram (Antabuse)
GG GG




What 6 drugs can induce depression?ANS==
GG GG GG GG GG "SIP
BARB" Steroids
GG GG



Interferon,
Progesterone
GG




Beta blockers GG



Accutane,
GG



(Isotretinoin)
GG



Retroviral drugs, Antineoplastic drugs GG GG GG



Benzodiazepines
GG




Steroids can induce what 3 psychiatric states?ANS== Mania
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Depression
GG



Psychosis

REMEMBER SAFETY FIRST; pt s/p assault, 1st thing you do is
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What is the best environment to interview this pt in?ANS== reassure safety,
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provide environment of safety
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private area with door open/partially open
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What is the therapeutic range for lithium?ANS==
GG GG GG GG GG GG G G 0.6-1.2 mEq/L GG




Many postpartum women have SI after delivery, yet they don't have psych evals
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before leaving the hospital, what could a possible solution be?ANS== collaborating
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care between psych and OBGYN to provide the best care for that pt
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If collaborating with a provider who is not in the same clinic or hospital, the
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informed consent [does/does not] apply?ANS== Does not, ie pt will need to
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sign consent for labs/ chart to be sent
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When discharging from inpatient you want [to fax/print off-give to pt.] labs for
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the outpatient provider before pt discharge?ANS== fax; so the new provider has
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them for follow-up appointment
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