LMR GEORGETTE’S PMHNP CERTIFICATION LATEST 2025 WITH QUESTIONS AND CORRECT
VERIFIED ANSWERS GRADED A+ GUARANTEED 100% PASS
What do you do if a patient on lithium has dark brown urine? - (ANSWER)Check renal function
What do you do if a patient presents with fever while on Clozaril? - (ANSWER)Check ANC level to assess
for agranulocytosis
What can cause serotonin syndrome? - (ANSWER)Antidepressants, St. John's Wort, Same-E, Kava Kava,
and Tryptophan
What labs are indicative of NMS? - (ANSWER)Elevated WBC (over 11,000) and elevated CPK
S/S of NMS - (ANSWER)muscle rigidity, hyperthermia, tachycardia, abnormal bp, sweating, altered
mental status, cherry colored urine
What should you do if a patient presents with cherry colored urine? - (ANSWER)Check for rhabdo with
CPK
s/s of serotonin syndrome - (ANSWER)hyperreflexia, muscle spasms, myoclonus (involuntary muscle
jerk), fever, tachycardia, HTN, shits and shivers
What two medications to give with NMS? - (ANSWER)bromocriptine (Parlodel)- D2 agonist dantrolene-
muscle relaxer
What medication to give during SS? - (ANSWER)cyproheptadine (Periactin)- 5HT-2A receptor antagonist
What is the onset and typical length of NMS? - (ANSWER)Slow onset (1-2 weeks after changing or
starting therapy) and resolves within 9-14 days
What is the onset of SS? - (ANSWER)Within 24 hours of starting/changing medication and resolves
within a few days
, LMR GEORGETTE’S PMHNP CERTIFICATION LATEST 2025 WITH QUESTIONS AND CORRECT
VERIFIED ANSWERS GRADED A+ GUARANTEED 100% PASS
How do you distinguish between NMS and acute dystonia? - (ANSWER)NMS has a slower onset while
acute dystonia occurs within hours
What happens with lithium and NSAIDs? - (ANSWER)Increased risk of lithium toxicity (gout meds,
ibuprophen, naproxen, etc.)
What happens with lithium and ACE inhibitors? - (ANSWER)Increased risk of lithium toxicity related to
the increased urination from the ACE inhibitors
Why should a patient on lithium avoid calcium channel blockers? - (ANSWER)Risk of fatal nephrotoxicity
What is a fetal side effect of lithium? - (ANSWER)Epstein's anomaly
What lab should you check for athletes on lithium? - (ANSWER)Specific gravity to assess for dehydration
(dehydration is >1.015)
What do you do if the lithium level is 1.3? - (ANSWER)Do not give the next dose and assess for s/s
At what level is lithium toxicity a medical emergency? - (ANSWER)>3
S/S of lithium toxicity - (ANSWER)vomiting, diarrhea, slurred speech, hand tremor, dry mouth/thirst,
muscle weakness/twitching
Why check an EKG with lithium? - (ANSWER)Inverted T-waves
What medication should treat hypothyroidism caused by lithium use? - (ANSWER)Synthroid
, LMR GEORGETTE’S PMHNP CERTIFICATION LATEST 2025 WITH QUESTIONS AND CORRECT
VERIFIED ANSWERS GRADED A+ GUARANTEED 100% PASS
What do you do if patient is prescribed both depakote and lamictal? - (ANSWER)Decreased lamictal dose
by 50%
Depakote and pregnancy - (ANSWER)Spina bifida
What emergency may be occuring if patient on depakote reports upper abdominal pain? -
(ANSWER)Pancreatitis
What lab should you check if patient has right upper quadrant pain and dark brown urine? -
(ANSWER)LFTs
What lab means pregnancy? - (ANSWER)HCG
Why is Clozaril used? - (ANSWER)Treatment resistant schizophrenia, improves SI, and improves negative
symptoms of schizophrenia
What two medications have the highest risk of agranulocytosis and aplastic anemia? - (ANSWER)Clozaril
and Tegretol
What symptoms may mean a Clozaril induced infection? - (ANSWER)Sore throats, sores in mouth/gums,
fever
When should you discontinue Clozaril or Tegretol? - (ANSWER)WBC < 2000 or ANC <1000
What should you check in Asian patients taking Tegretol? - (ANSWER)For the HLA-B*1502 allele (higher
risk of SJS)
What two epidermal issues can arise from Tegretol or Lamictal? - (ANSWER)Toxic epidermal necrosis
and SJS
VERIFIED ANSWERS GRADED A+ GUARANTEED 100% PASS
What do you do if a patient on lithium has dark brown urine? - (ANSWER)Check renal function
What do you do if a patient presents with fever while on Clozaril? - (ANSWER)Check ANC level to assess
for agranulocytosis
What can cause serotonin syndrome? - (ANSWER)Antidepressants, St. John's Wort, Same-E, Kava Kava,
and Tryptophan
What labs are indicative of NMS? - (ANSWER)Elevated WBC (over 11,000) and elevated CPK
S/S of NMS - (ANSWER)muscle rigidity, hyperthermia, tachycardia, abnormal bp, sweating, altered
mental status, cherry colored urine
What should you do if a patient presents with cherry colored urine? - (ANSWER)Check for rhabdo with
CPK
s/s of serotonin syndrome - (ANSWER)hyperreflexia, muscle spasms, myoclonus (involuntary muscle
jerk), fever, tachycardia, HTN, shits and shivers
What two medications to give with NMS? - (ANSWER)bromocriptine (Parlodel)- D2 agonist dantrolene-
muscle relaxer
What medication to give during SS? - (ANSWER)cyproheptadine (Periactin)- 5HT-2A receptor antagonist
What is the onset and typical length of NMS? - (ANSWER)Slow onset (1-2 weeks after changing or
starting therapy) and resolves within 9-14 days
What is the onset of SS? - (ANSWER)Within 24 hours of starting/changing medication and resolves
within a few days
, LMR GEORGETTE’S PMHNP CERTIFICATION LATEST 2025 WITH QUESTIONS AND CORRECT
VERIFIED ANSWERS GRADED A+ GUARANTEED 100% PASS
How do you distinguish between NMS and acute dystonia? - (ANSWER)NMS has a slower onset while
acute dystonia occurs within hours
What happens with lithium and NSAIDs? - (ANSWER)Increased risk of lithium toxicity (gout meds,
ibuprophen, naproxen, etc.)
What happens with lithium and ACE inhibitors? - (ANSWER)Increased risk of lithium toxicity related to
the increased urination from the ACE inhibitors
Why should a patient on lithium avoid calcium channel blockers? - (ANSWER)Risk of fatal nephrotoxicity
What is a fetal side effect of lithium? - (ANSWER)Epstein's anomaly
What lab should you check for athletes on lithium? - (ANSWER)Specific gravity to assess for dehydration
(dehydration is >1.015)
What do you do if the lithium level is 1.3? - (ANSWER)Do not give the next dose and assess for s/s
At what level is lithium toxicity a medical emergency? - (ANSWER)>3
S/S of lithium toxicity - (ANSWER)vomiting, diarrhea, slurred speech, hand tremor, dry mouth/thirst,
muscle weakness/twitching
Why check an EKG with lithium? - (ANSWER)Inverted T-waves
What medication should treat hypothyroidism caused by lithium use? - (ANSWER)Synthroid
, LMR GEORGETTE’S PMHNP CERTIFICATION LATEST 2025 WITH QUESTIONS AND CORRECT
VERIFIED ANSWERS GRADED A+ GUARANTEED 100% PASS
What do you do if patient is prescribed both depakote and lamictal? - (ANSWER)Decreased lamictal dose
by 50%
Depakote and pregnancy - (ANSWER)Spina bifida
What emergency may be occuring if patient on depakote reports upper abdominal pain? -
(ANSWER)Pancreatitis
What lab should you check if patient has right upper quadrant pain and dark brown urine? -
(ANSWER)LFTs
What lab means pregnancy? - (ANSWER)HCG
Why is Clozaril used? - (ANSWER)Treatment resistant schizophrenia, improves SI, and improves negative
symptoms of schizophrenia
What two medications have the highest risk of agranulocytosis and aplastic anemia? - (ANSWER)Clozaril
and Tegretol
What symptoms may mean a Clozaril induced infection? - (ANSWER)Sore throats, sores in mouth/gums,
fever
When should you discontinue Clozaril or Tegretol? - (ANSWER)WBC < 2000 or ANC <1000
What should you check in Asian patients taking Tegretol? - (ANSWER)For the HLA-B*1502 allele (higher
risk of SJS)
What two epidermal issues can arise from Tegretol or Lamictal? - (ANSWER)Toxic epidermal necrosis
and SJS
