LMR Georgette’s PMHNP Certification Exam V2 (2025–
2026) – Updated Question Bank with Verified Answers
and Explanations
Introduction:
This updated 2025–2026 version of Georgette’s LMR PMHNP
Certification Exam Review includes over 60 verified questions and
100% accurate answers covering all major psychiatric-mental health
nursing topics. It features detailed explanations on
psychopharmacology (antipsychotics, lithium, anticonvulsants,
SSRIs, MAOIs), neurobiology, neurotransmitter systems, and
endocrine pathways (HPA, HPT, HPG axes). The document also
includes sections on psychiatric assessment, DSM-5 disorders, ethical
practice, therapeutic communication, and advanced PMHNP roles.
Ideal for students and practitioners preparing for the PMHNP
certification, this guide combines up-to-date exam content with
precise, evidence-based answers.
Exam Questions and Answers
What drugs induce CYP 450 34A? --- correct precise answer ---
carbamazepine (effects oral contraceptives)
34A induction affects methadone, so certain HIV meds will induce
methadone requiring adjustment of dose.
34A is induced by St. Johns Wart, which decreases cyclosporin
levels
,Discuss the relationship between oral contraceptives and
lamotrigine. --- correct precise answer ---exogenous estrogen in
the form of oral contraceptives in combo with lamotrigine will
induce the production of 1A4, increasing the metabolism of
lamotrigine up to 50%
Discuss the relationship between lithium and Ibuprofen. --- correct
precise answer ---lithium levels increase with inhibitions
prostaglandins, she common nsaids such as ibuprofen will effect
levels. expeptions are ASA, sulindac and tylenol
How do atypical antipsychotics work? --- correct precise answer ---
By blocking D2 receptors in the mesolithic and mesocortical tract
What are the side effects of typical antipsychotics and the d2
receptor blockade? --- correct precise answer ---- sedation/wt gain
from Histamine (H1) blockade
- orthostatic hypotension and drowsiness from alpha 1 adrenergic
receptor blockade
- increased prolactin from the d2 blockade tubinfundivular tract
- anticholinergic effects from M1 blockade
-EPS form d2 blockade in the nigrostriatal tract
what are some tx for EPS? --- correct precise answer ---- change in
med
,- lower dose
- benztropine
What are long term s/e of typical antipsychotics? --- correct precise
answer ---permanent effects on movement
- tardive dyskinesia
- potential NMS
List some examples typical antipsychotics. --- correct precise
answer ---Thorazine (chlorpromazine)
mellaril (thioridazine)
Stelazine (Trifluoperazine)
Trilafon (perphenazine)
Haldol (haloperidol)
Navene (thiothexene)
Taractan (chlorprothixene)
What is the MOA of atypical antipsychotics? --- correct precise
answer ---blocks d2 and 5ht (specifically 5ht2a) receptors in the
brain
, 5HT2A blockade helps decrease eps and get relief of negative
symptoms of psychosis which is not seen with typical
antispsychotics
What are some side effects of atypical antipsychotics? --- correct
precise answer ---orthostatic hypotension
dizziness
wt gain
tachycardia
sleep disturbances
constipation
NMS
What is unique to clozapine? --- correct precise answer ---may
cause agranulocytosis
at increased risk for sz
rigorous monitoring of ANC, weekly for 6 months, biweekly for 6
months, then monthly for year
if WBC less than 2, or ANC les than 1, stop and monitor daily
if WBC less than 3 or ANC 1.0 to 1.5, hold and get daily levels until
ANC rises
IF WBC less than 3.5 or ANC 1.5 to 2, repeat CBC and get biweekly
until levels rise
2026) – Updated Question Bank with Verified Answers
and Explanations
Introduction:
This updated 2025–2026 version of Georgette’s LMR PMHNP
Certification Exam Review includes over 60 verified questions and
100% accurate answers covering all major psychiatric-mental health
nursing topics. It features detailed explanations on
psychopharmacology (antipsychotics, lithium, anticonvulsants,
SSRIs, MAOIs), neurobiology, neurotransmitter systems, and
endocrine pathways (HPA, HPT, HPG axes). The document also
includes sections on psychiatric assessment, DSM-5 disorders, ethical
practice, therapeutic communication, and advanced PMHNP roles.
Ideal for students and practitioners preparing for the PMHNP
certification, this guide combines up-to-date exam content with
precise, evidence-based answers.
Exam Questions and Answers
What drugs induce CYP 450 34A? --- correct precise answer ---
carbamazepine (effects oral contraceptives)
34A induction affects methadone, so certain HIV meds will induce
methadone requiring adjustment of dose.
34A is induced by St. Johns Wart, which decreases cyclosporin
levels
,Discuss the relationship between oral contraceptives and
lamotrigine. --- correct precise answer ---exogenous estrogen in
the form of oral contraceptives in combo with lamotrigine will
induce the production of 1A4, increasing the metabolism of
lamotrigine up to 50%
Discuss the relationship between lithium and Ibuprofen. --- correct
precise answer ---lithium levels increase with inhibitions
prostaglandins, she common nsaids such as ibuprofen will effect
levels. expeptions are ASA, sulindac and tylenol
How do atypical antipsychotics work? --- correct precise answer ---
By blocking D2 receptors in the mesolithic and mesocortical tract
What are the side effects of typical antipsychotics and the d2
receptor blockade? --- correct precise answer ---- sedation/wt gain
from Histamine (H1) blockade
- orthostatic hypotension and drowsiness from alpha 1 adrenergic
receptor blockade
- increased prolactin from the d2 blockade tubinfundivular tract
- anticholinergic effects from M1 blockade
-EPS form d2 blockade in the nigrostriatal tract
what are some tx for EPS? --- correct precise answer ---- change in
med
,- lower dose
- benztropine
What are long term s/e of typical antipsychotics? --- correct precise
answer ---permanent effects on movement
- tardive dyskinesia
- potential NMS
List some examples typical antipsychotics. --- correct precise
answer ---Thorazine (chlorpromazine)
mellaril (thioridazine)
Stelazine (Trifluoperazine)
Trilafon (perphenazine)
Haldol (haloperidol)
Navene (thiothexene)
Taractan (chlorprothixene)
What is the MOA of atypical antipsychotics? --- correct precise
answer ---blocks d2 and 5ht (specifically 5ht2a) receptors in the
brain
, 5HT2A blockade helps decrease eps and get relief of negative
symptoms of psychosis which is not seen with typical
antispsychotics
What are some side effects of atypical antipsychotics? --- correct
precise answer ---orthostatic hypotension
dizziness
wt gain
tachycardia
sleep disturbances
constipation
NMS
What is unique to clozapine? --- correct precise answer ---may
cause agranulocytosis
at increased risk for sz
rigorous monitoring of ANC, weekly for 6 months, biweekly for 6
months, then monthly for year
if WBC less than 2, or ANC les than 1, stop and monitor daily
if WBC less than 3 or ANC 1.0 to 1.5, hold and get daily levels until
ANC rises
IF WBC less than 3.5 or ANC 1.5 to 2, repeat CBC and get biweekly
until levels rise
