GEORGETTE REVIEW PMHNP EXAM PREPARATION NEWEST
WITH COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS| BRAND NEW VERSION!
When many answers are remarkably similar, they are usually _____________ - CORRECT
ANSWERS-wrong
Interprofessional collaboration is encouraged. - CORRECT ANSWERS-Collaborate is usually
right.
Delegate is usually wrong.
ADPIER - CORRECT ANSWERS-Assessment, diagnosis, Plan, intervention, evaluate, refer out
last.
Lithium - CORRECT ANSWERS-Normal 0.6-1.2
Lithium toxicity occurs at levels - CORRECT ANSWERS-> 1.5
Signs of Lithium toxicity - CORRECT ANSWERS-severe nausea, diarrhea, vomiting, confusion,
drowsiness, muscle weakness, heart palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard for - CORRECT ANSWERS-MANIA
Lithium has evidence shown to - CORRECT ANSWERS-reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester - CORRECT ANSWERS-Ebstein
anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to - CORRECT ANSWERS-rise
,Baseline labs before initiation of lithium - CORRECT ANSWERS-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 - CORRECT ANSWERS-hypothyroidism
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Pt education for lithimum - CORRECT ANSWERS-staying hydrated
avoiding NSAIDS
compliance
Depakote normal level - CORRECT ANSWERS-50-125
Depakote toxicity level - CORRECT ANSWERS-greater than 150
Teratogenic effects of Depakote - CORRECT ANSWERS-spina bifida
Adverse effects of depakote - CORRECT ANSWERS-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 - CORRECT ANSWERS-disorientation, lethargy, respiratory
depression, nausea/vomiting
Intervention for depakote toxicity - CORRECT ANSWERS-DC med
check level
LFT
ammonia
MAOI + tyramine causes - CORRECT ANSWERS-hypertensive crisis
Symptoms of hypertensive crisis - CORRECT ANSWERS-elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI + - CORRECT ANSWERS-MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis - CORRECT ANSWERS-DC offending agent
Administer PHENTOLAMINE
, Teratogenic effects of benzos - CORRECT ANSWERS-floppy baby, cleft palate
Teratogenic effects of tegratol - CORRECT ANSWERS-neural tube defect
teratogenic effects of lithium - CORRECT ANSWERS-ebstein anomaly (heart defect) (avoid,
especially 1st trimester)
teratogenic effects of depakote - CORRECT ANSWERS-neural tube defects/spina bifida
Adverse reaction to Lamictal - CORRECT ANSWERS-Steven Johnson's Syndrome
Signs of SJS - CORRECT ANSWERS-FEVER --high yield
sore throat
facial swelling
tongue swelling
red rash
skin sloughing
body aches
prodromal headache
malaise
arthralgia
painful mucus membranes
You are treating a client with schizophrenia who takes clozapine. What lab values will indicate the client
needs to discontinue treatment?
A. WBC less than 1800 and ANC less than 1200
B. ANC less than 1,000
C. WBC less than 5,000
WITH COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS| BRAND NEW VERSION!
When many answers are remarkably similar, they are usually _____________ - CORRECT
ANSWERS-wrong
Interprofessional collaboration is encouraged. - CORRECT ANSWERS-Collaborate is usually
right.
Delegate is usually wrong.
ADPIER - CORRECT ANSWERS-Assessment, diagnosis, Plan, intervention, evaluate, refer out
last.
Lithium - CORRECT ANSWERS-Normal 0.6-1.2
Lithium toxicity occurs at levels - CORRECT ANSWERS-> 1.5
Signs of Lithium toxicity - CORRECT ANSWERS-severe nausea, diarrhea, vomiting, confusion,
drowsiness, muscle weakness, heart palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard for - CORRECT ANSWERS-MANIA
Lithium has evidence shown to - CORRECT ANSWERS-reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester - CORRECT ANSWERS-Ebstein
anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to - CORRECT ANSWERS-rise
,Baseline labs before initiation of lithium - CORRECT ANSWERS-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 - CORRECT ANSWERS-hypothyroidism
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Pt education for lithimum - CORRECT ANSWERS-staying hydrated
avoiding NSAIDS
compliance
Depakote normal level - CORRECT ANSWERS-50-125
Depakote toxicity level - CORRECT ANSWERS-greater than 150
Teratogenic effects of Depakote - CORRECT ANSWERS-spina bifida
Adverse effects of depakote - CORRECT ANSWERS-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 - CORRECT ANSWERS-disorientation, lethargy, respiratory
depression, nausea/vomiting
Intervention for depakote toxicity - CORRECT ANSWERS-DC med
check level
LFT
ammonia
MAOI + tyramine causes - CORRECT ANSWERS-hypertensive crisis
Symptoms of hypertensive crisis - CORRECT ANSWERS-elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI + - CORRECT ANSWERS-MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis - CORRECT ANSWERS-DC offending agent
Administer PHENTOLAMINE
, Teratogenic effects of benzos - CORRECT ANSWERS-floppy baby, cleft palate
Teratogenic effects of tegratol - CORRECT ANSWERS-neural tube defect
teratogenic effects of lithium - CORRECT ANSWERS-ebstein anomaly (heart defect) (avoid,
especially 1st trimester)
teratogenic effects of depakote - CORRECT ANSWERS-neural tube defects/spina bifida
Adverse reaction to Lamictal - CORRECT ANSWERS-Steven Johnson's Syndrome
Signs of SJS - CORRECT ANSWERS-FEVER --high yield
sore throat
facial swelling
tongue swelling
red rash
skin sloughing
body aches
prodromal headache
malaise
arthralgia
painful mucus membranes
You are treating a client with schizophrenia who takes clozapine. What lab values will indicate the client
needs to discontinue treatment?
A. WBC less than 1800 and ANC less than 1200
B. ANC less than 1,000
C. WBC less than 5,000
