LMR Exam Study Guide Questions And Answers
Verified 100% Correct
Besides hepatotoxicity, what other organ system does depakote
affect? S/S? -answer -Pancreatitis (RUQ abd pain that radiates to
back, tender abd, fever, rapid pulse, vomiting, oily stools)
Side effect of Kava -answer -liver damage
If taking Kava and having signs of hepatotoxicity, what should you
do? -answer -tell them to STOP taking Kava
Major med interactions with kava? Why? -answer -BENZOS,
Alprazolam (Xanax): extreme drowsiness
Also other CNS depressants
SJS symptoms -answer -Rash, body aches, FEVER, peeling skin,
facial/tongue swelling
Atypical antipsychotics that cause least weight gain? -answer -
Ziprasidone, aripirazole, lurasidone
Least sedating atypical? -answer -Abilify
,Routine labs when on an atypical that causes weight gain -answer
BMI, hip to waist ratio, glucose, lipid panel
Atypical induced weight gain management -answer -Nonpharm first:
EXERCISE and nutrition counseling.
if necessary, switch to atypical with less weight gain
Started pt on seroquel. They don't exercise and gain a lot of weight.
They develop metabolic syndrome. Next action as the PMHNP? -
ANSWER -ENCOURAGE EXERCISE.
If exercise doesn't work, can prescribe a different med with less
weight gain.
BB warning for carbamazepine?
Could also cause another serious condition? -answer -BB:
agranulocytosis and aplastic anemia
SJS
Prescribing carbamazepine to asian. What to do? -answer -Screen for
HLAB 1502 which indicates increased risk of SJS
,S/S of agranulocytosis -answer -pallor, fatigue, HA, fever, nosebleeds,
bleeding gums, skin rash, SOB
Pt taking clozaril has an ANC less than 1000 but isn't showing signs
of fever/infection. What should you do? -answer -DC med and repeat
labs.
You notice signs of infection while pt is taking carbamazepine. What
should you do? -answer -DC med and repeat labs
Lithium normal range? toxic? -answer -0.6-1.2 mEq/L
Toxic >1.5
Only known medication to reduce risk of suicide in patients with
schizophrenia? -answer -Clozaril
Labs for lithium -answer -TSH, Serum Cr, BUN, Urinalysis (large
amount of protein in urine 4+ may indicate kidney disease),
Pregnancy test for childbearing females (12-51 yrs old)
S/S of lithium toxicity -answer -severe nausea, vomiting, diarrhea,
confusion, drowsy, muscle weakness, heart palpitations, coarse hand
tremors, unsteady while standing or walking (ataxia)
Drugs that reduce renal clearance of toxicity thereby INCREASING
risk for toxicity -answer -NSAIDS, thiazides, ACE inhibitors "prils"
What do ACE inhibitors "prils" do to lithium levels? How? -answer -
, Increase toxicity by REDUCING RENAL CLEARANCE
High yield SE of Lithium -answer -Leukocytosis
key symptoms of NMS? key lab findings and reason for finding? -
ANSWER -extreme muscular rigidity and mutism
Increased CPK from muscle contraction/destruction
Myoglobinuria from muscle destruction
Leukocytosis
Elevated LFTs
Treatment for NMS? mechanism of treatments -answer -
Bromocriptine: D2 agonist
Dantrolene: muscle relaxant
Key symptoms of serotonin syndrome
Treatment? -answer -hyperreflexia and myoclonic jerks
Verified 100% Correct
Besides hepatotoxicity, what other organ system does depakote
affect? S/S? -answer -Pancreatitis (RUQ abd pain that radiates to
back, tender abd, fever, rapid pulse, vomiting, oily stools)
Side effect of Kava -answer -liver damage
If taking Kava and having signs of hepatotoxicity, what should you
do? -answer -tell them to STOP taking Kava
Major med interactions with kava? Why? -answer -BENZOS,
Alprazolam (Xanax): extreme drowsiness
Also other CNS depressants
SJS symptoms -answer -Rash, body aches, FEVER, peeling skin,
facial/tongue swelling
Atypical antipsychotics that cause least weight gain? -answer -
Ziprasidone, aripirazole, lurasidone
Least sedating atypical? -answer -Abilify
,Routine labs when on an atypical that causes weight gain -answer
BMI, hip to waist ratio, glucose, lipid panel
Atypical induced weight gain management -answer -Nonpharm first:
EXERCISE and nutrition counseling.
if necessary, switch to atypical with less weight gain
Started pt on seroquel. They don't exercise and gain a lot of weight.
They develop metabolic syndrome. Next action as the PMHNP? -
ANSWER -ENCOURAGE EXERCISE.
If exercise doesn't work, can prescribe a different med with less
weight gain.
BB warning for carbamazepine?
Could also cause another serious condition? -answer -BB:
agranulocytosis and aplastic anemia
SJS
Prescribing carbamazepine to asian. What to do? -answer -Screen for
HLAB 1502 which indicates increased risk of SJS
,S/S of agranulocytosis -answer -pallor, fatigue, HA, fever, nosebleeds,
bleeding gums, skin rash, SOB
Pt taking clozaril has an ANC less than 1000 but isn't showing signs
of fever/infection. What should you do? -answer -DC med and repeat
labs.
You notice signs of infection while pt is taking carbamazepine. What
should you do? -answer -DC med and repeat labs
Lithium normal range? toxic? -answer -0.6-1.2 mEq/L
Toxic >1.5
Only known medication to reduce risk of suicide in patients with
schizophrenia? -answer -Clozaril
Labs for lithium -answer -TSH, Serum Cr, BUN, Urinalysis (large
amount of protein in urine 4+ may indicate kidney disease),
Pregnancy test for childbearing females (12-51 yrs old)
S/S of lithium toxicity -answer -severe nausea, vomiting, diarrhea,
confusion, drowsy, muscle weakness, heart palpitations, coarse hand
tremors, unsteady while standing or walking (ataxia)
Drugs that reduce renal clearance of toxicity thereby INCREASING
risk for toxicity -answer -NSAIDS, thiazides, ACE inhibitors "prils"
What do ACE inhibitors "prils" do to lithium levels? How? -answer -
, Increase toxicity by REDUCING RENAL CLEARANCE
High yield SE of Lithium -answer -Leukocytosis
key symptoms of NMS? key lab findings and reason for finding? -
ANSWER -extreme muscular rigidity and mutism
Increased CPK from muscle contraction/destruction
Myoglobinuria from muscle destruction
Leukocytosis
Elevated LFTs
Treatment for NMS? mechanism of treatments -answer -
Bromocriptine: D2 agonist
Dantrolene: muscle relaxant
Key symptoms of serotonin syndrome
Treatment? -answer -hyperreflexia and myoclonic jerks
