LMR Georgette’s PMHNP Certification Exam Latest Questions
And Correct Answers (Verified Answers)
What does ADPIE stand for? - ANSWER-Assessment
Diagnosis
Planning
Implementation
Evaluation
What should you do when a mother reports her child woke up screaming in the
middle of the night? - ANSWER-Ask her if it's happened before to assess for
sleep issue patterns
What do you do if a patient comes in with fungus on their toenail? - ANSWER-
Scrape nail and send for testing
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
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
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
And Correct Answers (Verified Answers)
What does ADPIE stand for? - ANSWER-Assessment
Diagnosis
Planning
Implementation
Evaluation
What should you do when a mother reports her child woke up screaming in the
middle of the night? - ANSWER-Ask her if it's happened before to assess for
sleep issue patterns
What do you do if a patient comes in with fungus on their toenail? - ANSWER-
Scrape nail and send for testing
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
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
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
