PMHNP CERTIFICATION EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS ALREADY A+
GRADED FOR GUARANTEED PASS LATEST UPDATE
What medication INCREASES Lithium serum level up to double - CORRECT
ANSWER Ibuprofen
Why is Lithium used? - CORRECT ANSWER • First-line neuro-protective for bipolar
• Lab Values concerning for patient on Lithium: - CORRECT ANSWER • Leukocytosis
• Creatinine
• BUN
• NA+
• 4 + PORTEIN in Urine
• + Pregnancy Test
• Lithium (Eskalith/Lithobid) Toxicity - CORRECT ANSWER • Normal Range
of LITHIUM LEVEL - 0.5 - 1.2 mEq/L
• MONITOR for TOXICITY: Toxicity = > 1.2 mEq/l
• Slurred speech, confusion, severe GI effect - diarrhea/nausea/vomiting,
metallic taste and SEVERE tremor.
Common side effects of Lithium (Eskalith/Lithobid) - CORRECT ANSWER
Nausea, fine-hand tremors (start monitoring for toxicity), increased urination and
thirst
What pregnancy category is Lithium (Eskalith/Lithobid) - CORRECT ANSWER
CATEGORY D: AVOID in pregnancy, especially 1st trimester - Ebstein anomaly,
cardiac defect
What increases risk of lithium (Eskalith/Lithobid) toxicity? - CORRECT
ANSWER NSAID, dehydration and Thiazides
What is the best action for a 16 y/o with conduct disorder that refuses tx? -
CORRECT ANSWER • Send to psych specialist for acting out kids - Referrals -
Have to see if you are going to refer the same patient to the same provider - Cannot
refer the patient to another provider that is the same as you (ie psych) - you must
refer to a neurologist or another specialist or PCP
What is a priority consideration for a 16-year-old that shows up with mother for
first therapy? - CORRECT ANSWER • Confidentiality (ex. mom sits in lobby)
What is important to know about ACE inhibitors (Meds for Heart failure/HTN) -
CORRECT ANSWER • This medication can cause increased lithium levels to
, PMHNP CERTIFICATION EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS ALREADY A+
GRADED FOR GUARANTEED PASS LATEST UPDATE
toxic levels - must collaborate with PCP to determine whether to change ACE or
change Lithium - Can't use both
, PMHNP CERTIFICATION EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS ALREADY A+
GRADED FOR GUARANTEED PASS LATEST UPDATE
What co-morbid risk in increased with Lithium (Eskalith/Lithobid)? - CORRECT
ANSWER • Risk of Hypothyroidism
What do symptoms of hypothyroidism (decreased T4 & increased TSH) mimic? -
CORRECT ANSWER Unipolar mood disorders:
- confusion
- decreased libido
- impotence
- decreased apetite
- memory loss
- lethargy
- constipation
- headaches
- slow or clumsy movements
- syncope
- weight gain
- fluid retention
- muscle aches and stiffness
- slowed reflexes
- somatic discomfort including aching and joint stiffness
- slowed speech and thinking
- sensory disturbances including hearing
- cerebellar ataxia (may present with symptoms of an inability to coordinate
balance, gait, extremity and eye movements)
- loss of amplitude in ECG
What are assessed in the Thought Content of the MSE - CORRECT ANSWER
SI/HI, Plan, Hallucinations
• PNEUMOIC - Old Age Parents Love Grandchildren - CORRECT ANSWER •
Oral (0-18 months), Anal (18 months - 3 years), Phallic (3 years to 6 years), Latent
(6 to 12), Genital (12 +)
• FREUD's PSYCHOSOCIAL STAGES OF DEVELOPMENT - PHALLIC STAGE -
3-6 years
old - CORRECT ANSWER • 3-year-old masturbates, play with self, says naughty
things
• This is NORMAL for children this age.
What do you do when a patient has an increased prolactin level? - CORRECT
ANSWER • Stop prolactin (stop the agent that cause increase prolactin)
• ACUTE STRESS DISORDER - CORRECT ANSWER • A d/o resulting from
, PMHNP CERTIFICATION EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS ALREADY A+
GRADED FOR GUARANTEED PASS LATEST UPDATE
exposure to a major stressor, with SX of ANX, depression, dissociation,
recurring nightmares, sleep disturbances, problems in concentrations, reliving
the event, dreams, flashbacks - UP to ONE MONTH - Less than 1 month.
• If LONGER than 1 month = PTSD
- Symptoms that occur immediately after the event but resolve in less than 3
days would not meet criteria for acute stress disorder
CORRECT DETAILED ANSWERS ALREADY A+
GRADED FOR GUARANTEED PASS LATEST UPDATE
What medication INCREASES Lithium serum level up to double - CORRECT
ANSWER Ibuprofen
Why is Lithium used? - CORRECT ANSWER • First-line neuro-protective for bipolar
• Lab Values concerning for patient on Lithium: - CORRECT ANSWER • Leukocytosis
• Creatinine
• BUN
• NA+
• 4 + PORTEIN in Urine
• + Pregnancy Test
• Lithium (Eskalith/Lithobid) Toxicity - CORRECT ANSWER • Normal Range
of LITHIUM LEVEL - 0.5 - 1.2 mEq/L
• MONITOR for TOXICITY: Toxicity = > 1.2 mEq/l
• Slurred speech, confusion, severe GI effect - diarrhea/nausea/vomiting,
metallic taste and SEVERE tremor.
Common side effects of Lithium (Eskalith/Lithobid) - CORRECT ANSWER
Nausea, fine-hand tremors (start monitoring for toxicity), increased urination and
thirst
What pregnancy category is Lithium (Eskalith/Lithobid) - CORRECT ANSWER
CATEGORY D: AVOID in pregnancy, especially 1st trimester - Ebstein anomaly,
cardiac defect
What increases risk of lithium (Eskalith/Lithobid) toxicity? - CORRECT
ANSWER NSAID, dehydration and Thiazides
What is the best action for a 16 y/o with conduct disorder that refuses tx? -
CORRECT ANSWER • Send to psych specialist for acting out kids - Referrals -
Have to see if you are going to refer the same patient to the same provider - Cannot
refer the patient to another provider that is the same as you (ie psych) - you must
refer to a neurologist or another specialist or PCP
What is a priority consideration for a 16-year-old that shows up with mother for
first therapy? - CORRECT ANSWER • Confidentiality (ex. mom sits in lobby)
What is important to know about ACE inhibitors (Meds for Heart failure/HTN) -
CORRECT ANSWER • This medication can cause increased lithium levels to
, PMHNP CERTIFICATION EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS ALREADY A+
GRADED FOR GUARANTEED PASS LATEST UPDATE
toxic levels - must collaborate with PCP to determine whether to change ACE or
change Lithium - Can't use both
, PMHNP CERTIFICATION EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS ALREADY A+
GRADED FOR GUARANTEED PASS LATEST UPDATE
What co-morbid risk in increased with Lithium (Eskalith/Lithobid)? - CORRECT
ANSWER • Risk of Hypothyroidism
What do symptoms of hypothyroidism (decreased T4 & increased TSH) mimic? -
CORRECT ANSWER Unipolar mood disorders:
- confusion
- decreased libido
- impotence
- decreased apetite
- memory loss
- lethargy
- constipation
- headaches
- slow or clumsy movements
- syncope
- weight gain
- fluid retention
- muscle aches and stiffness
- slowed reflexes
- somatic discomfort including aching and joint stiffness
- slowed speech and thinking
- sensory disturbances including hearing
- cerebellar ataxia (may present with symptoms of an inability to coordinate
balance, gait, extremity and eye movements)
- loss of amplitude in ECG
What are assessed in the Thought Content of the MSE - CORRECT ANSWER
SI/HI, Plan, Hallucinations
• PNEUMOIC - Old Age Parents Love Grandchildren - CORRECT ANSWER •
Oral (0-18 months), Anal (18 months - 3 years), Phallic (3 years to 6 years), Latent
(6 to 12), Genital (12 +)
• FREUD's PSYCHOSOCIAL STAGES OF DEVELOPMENT - PHALLIC STAGE -
3-6 years
old - CORRECT ANSWER • 3-year-old masturbates, play with self, says naughty
things
• This is NORMAL for children this age.
What do you do when a patient has an increased prolactin level? - CORRECT
ANSWER • Stop prolactin (stop the agent that cause increase prolactin)
• ACUTE STRESS DISORDER - CORRECT ANSWER • A d/o resulting from
, PMHNP CERTIFICATION EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS ALREADY A+
GRADED FOR GUARANTEED PASS LATEST UPDATE
exposure to a major stressor, with SX of ANX, depression, dissociation,
recurring nightmares, sleep disturbances, problems in concentrations, reliving
the event, dreams, flashbacks - UP to ONE MONTH - Less than 1 month.
• If LONGER than 1 month = PTSD
- Symptoms that occur immediately after the event but resolve in less than 3
days would not meet criteria for acute stress disorder
