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GEORGETTE REVIEW PMHNP EXAM LATEST UPDATE -
2025/2026- 100+ QUESTIONS AND VERIFIED ANSWERS ALL
THE BEST
Pt education for lithimum
staying hydrated
avoiding NSAIDS
compliance
Depakote normal level
50-125
Depakote toxicity level
greater than 150
Teratogenic effects of Depakote
spina bifida
Adverse effects of depakote
alopecia
hepatotoxicity (RUQ pain or brown/red urine--order LFTs) AST 5-40, ALT 5-35,
yellowing of skin or eyes, fatigue
Signs of Depakote toxicity
disorientation, lethargy, respiratory depression, nausea/vomiting
Intervention for depakote toxicity
DC med
, 2
check level
LFT
ammonia
MAOI + tyramine causes
hypertensive crisis
Symptoms of hypertensive crisis
elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI +
MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis
, 3
DC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzos
floppy baby, cleft palate
Teratogenic effects of tegratol
neural tube defect
teratogenic effects of lithium
ebstein anomaly (heart defect) (avoid, especially 1st trimester)
teratogenic effects of depakote
neural tube defects/spina bifida
dehydration and hyponatremia cause lithium levels to
rise
Baseline labs before initiation of lithium
TSH
creatinine (0.6-1.2)
BUN (10-20)
HCG (all psychotropics females 12-51)
EKG 50+
Urinalysis (check for proteins, 4+ may indicate kidney disease)
Side Effects of Lithium
hypothyroidism
coase hand tremors with toxicity
maculopapular rash
, 4
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Adverse reaction to Lamictal
Steven Johnson's Syndrome
Signs of SJS
FEVER --high yield
sore throat
facial swelling
tongue swelling
red rash
skin sloughing
body aches
prodromal headache
malaise
arthralgia
painful mucus membranes
Lamotrigine is least likely to cause
sedation or weight gain
Carbamazepine (tegretol) black box warning
agranulocytosis (decrease WBCs)
GEORGETTE REVIEW PMHNP EXAM LATEST UPDATE -
2025/2026- 100+ QUESTIONS AND VERIFIED ANSWERS ALL
THE BEST
Pt education for lithimum
staying hydrated
avoiding NSAIDS
compliance
Depakote normal level
50-125
Depakote toxicity level
greater than 150
Teratogenic effects of Depakote
spina bifida
Adverse effects of depakote
alopecia
hepatotoxicity (RUQ pain or brown/red urine--order LFTs) AST 5-40, ALT 5-35,
yellowing of skin or eyes, fatigue
Signs of Depakote toxicity
disorientation, lethargy, respiratory depression, nausea/vomiting
Intervention for depakote toxicity
DC med
, 2
check level
LFT
ammonia
MAOI + tyramine causes
hypertensive crisis
Symptoms of hypertensive crisis
elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI +
MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis
, 3
DC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzos
floppy baby, cleft palate
Teratogenic effects of tegratol
neural tube defect
teratogenic effects of lithium
ebstein anomaly (heart defect) (avoid, especially 1st trimester)
teratogenic effects of depakote
neural tube defects/spina bifida
dehydration and hyponatremia cause lithium levels to
rise
Baseline labs before initiation of lithium
TSH
creatinine (0.6-1.2)
BUN (10-20)
HCG (all psychotropics females 12-51)
EKG 50+
Urinalysis (check for proteins, 4+ may indicate kidney disease)
Side Effects of Lithium
hypothyroidism
coase hand tremors with toxicity
maculopapular rash
, 4
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Adverse reaction to Lamictal
Steven Johnson's Syndrome
Signs of SJS
FEVER --high yield
sore throat
facial swelling
tongue swelling
red rash
skin sloughing
body aches
prodromal headache
malaise
arthralgia
painful mucus membranes
Lamotrigine is least likely to cause
sedation or weight gain
Carbamazepine (tegretol) black box warning
agranulocytosis (decrease WBCs)
