PMHNP Certification Review 2025 | Psychiatric Nurse Practitioner
Exam Questions, DSM-5, Clinical Concepts, and Treatment
Guidelines | Updated Flashcards, Notes & Study Resources for ANCC
Boards
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?
A. Lithium can prolong the QT interval
B. Lithium has no effect on his ECG
C. Lithium can invert the t waves
D. Lithium can shorten the PR interval
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?
A. Morphine
B. NSAIDS
C. Methylphenidate
D. Acetaminophen
Answer: Methylphenidate
You are treating a client with schizophrenia who takes clozapine. What lab values will indicate the client
needs to discontinue treatment?
A. WBC less than 1800 and ANC less than 1200
B. ANC less than 1,000
C. WBC less than 5,000
D. ANC less than 2000
Answer: ANC less than 1000
If given during pregnancy, socium valproate can cause which of the following medical problems in the
baby?
A. SJS
B. Ebstein's anomaly
C. Spina bifida
,D. Cleft palate
A. Spina bifida
Which mood stabilizer is associated with potential life-threatening rash in the Asian population?
A. Carbamazepine (tegretol)
B. Depakote
C. Lithium
D. Lamictal
A. Carbamazepine
Bulimia, weight is ___________
within the normal range.
Pharm treatment for bulimia
Fluoxetine
SSRIs and TCAs effective in reducing binging and purging
Signs of anorexia nervosa
low BMI
Amennorrhea
Emaciation
Bradycardua
Hypotension
Pharm treatment for anorexia
there is none
therapy
Which of the following physical exam findings would help the PMHNP differentiate anorexia nervosa
from bulimia nervosa?
A. Russell sign
B. Low BMI
C. Erosion of dental enamel
D. Hypertrophy of salivary glands
Low BMI
If a patient is depression, low energy, fatigued, you would prescribe
,Wellbutrin
Wellbutrin is contraindicated in patients with
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?
A. Bupropion (Wellbutrin)
B. Sertraline (Zoloft)
C. Clomipramine (Anafranil)
D. Duloxetine (Cymbalta)
bupropion
CLozaril is metabolized by
cytochrome P450 enzyme CYP1A2
INducers
induce metabolism and therefore decrease serum levels of other drugs that are substrates
Smoking will do what to drug levels
decrease therapeutic levels of the drug
Bull Shit CRAP GPS Induces my rage
Barbituates
St. Johns Wart
Carbamazepine
Rifampicin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulphonylureas
If your patient is a smoker you will need ___________doses of their medication.
higher
Inhibitors
inhibit metabolism and therefore increase levels of the drug.
, SICKFACES.com for Inhibitors
Sodium valproate
Isoniazid
Cimetidine
Ketoconazole
Alcohol
Chloramphenicol
Erythromycin
Sulfonamine
Cipro
Omeprazole
Metronidazole
Which cytochrome enzyme is implicated as a tobacco inducer when an individual is treated with
clozapine
a. 2D6
b. 1A2
c. 2C19
d. 2C9
1A2
(want A 2 cigarette break)
When treating older adults, you should keep in mind that they are more sensitive to issues of drug
toxicity because of which of the following reasons?
A. Decreased body fat
B. Increased liver capacity
C. Decreased protein binding
D. Increased muscle concentration
Decreased protein binding
For 12 years, a 65 year old patient with bipolar affective disorder has been treated with lithium 900 mg
daily. When oral HCTC 12.5 daily is added for hypertension, the patient develops nausea, vomiting,
ataxia, and muscle weakness and the patient's serum lithium level is 2.0. The interaction of the lithium
and the thiazide diuretic has induced:
A. hypokalemia
Exam Questions, DSM-5, Clinical Concepts, and Treatment
Guidelines | Updated Flashcards, Notes & Study Resources for ANCC
Boards
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?
A. Lithium can prolong the QT interval
B. Lithium has no effect on his ECG
C. Lithium can invert the t waves
D. Lithium can shorten the PR interval
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?
A. Morphine
B. NSAIDS
C. Methylphenidate
D. Acetaminophen
Answer: Methylphenidate
You are treating a client with schizophrenia who takes clozapine. What lab values will indicate the client
needs to discontinue treatment?
A. WBC less than 1800 and ANC less than 1200
B. ANC less than 1,000
C. WBC less than 5,000
D. ANC less than 2000
Answer: ANC less than 1000
If given during pregnancy, socium valproate can cause which of the following medical problems in the
baby?
A. SJS
B. Ebstein's anomaly
C. Spina bifida
,D. Cleft palate
A. Spina bifida
Which mood stabilizer is associated with potential life-threatening rash in the Asian population?
A. Carbamazepine (tegretol)
B. Depakote
C. Lithium
D. Lamictal
A. Carbamazepine
Bulimia, weight is ___________
within the normal range.
Pharm treatment for bulimia
Fluoxetine
SSRIs and TCAs effective in reducing binging and purging
Signs of anorexia nervosa
low BMI
Amennorrhea
Emaciation
Bradycardua
Hypotension
Pharm treatment for anorexia
there is none
therapy
Which of the following physical exam findings would help the PMHNP differentiate anorexia nervosa
from bulimia nervosa?
A. Russell sign
B. Low BMI
C. Erosion of dental enamel
D. Hypertrophy of salivary glands
Low BMI
If a patient is depression, low energy, fatigued, you would prescribe
,Wellbutrin
Wellbutrin is contraindicated in patients with
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?
A. Bupropion (Wellbutrin)
B. Sertraline (Zoloft)
C. Clomipramine (Anafranil)
D. Duloxetine (Cymbalta)
bupropion
CLozaril is metabolized by
cytochrome P450 enzyme CYP1A2
INducers
induce metabolism and therefore decrease serum levels of other drugs that are substrates
Smoking will do what to drug levels
decrease therapeutic levels of the drug
Bull Shit CRAP GPS Induces my rage
Barbituates
St. Johns Wart
Carbamazepine
Rifampicin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulphonylureas
If your patient is a smoker you will need ___________doses of their medication.
higher
Inhibitors
inhibit metabolism and therefore increase levels of the drug.
, SICKFACES.com for Inhibitors
Sodium valproate
Isoniazid
Cimetidine
Ketoconazole
Alcohol
Chloramphenicol
Erythromycin
Sulfonamine
Cipro
Omeprazole
Metronidazole
Which cytochrome enzyme is implicated as a tobacco inducer when an individual is treated with
clozapine
a. 2D6
b. 1A2
c. 2C19
d. 2C9
1A2
(want A 2 cigarette break)
When treating older adults, you should keep in mind that they are more sensitive to issues of drug
toxicity because of which of the following reasons?
A. Decreased body fat
B. Increased liver capacity
C. Decreased protein binding
D. Increased muscle concentration
Decreased protein binding
For 12 years, a 65 year old patient with bipolar affective disorder has been treated with lithium 900 mg
daily. When oral HCTC 12.5 daily is added for hypertension, the patient develops nausea, vomiting,
ataxia, and muscle weakness and the patient's serum lithium level is 2.0. The interaction of the lithium
and the thiazide diuretic has induced:
A. hypokalemia
