Georgette's LMR; Georgette's PMHNP Certification Exam
Review Questions With Correct Answers
What should you not do when advocating for a patient? {{Ans- Judge or confront
What class of medication is contraindicated with tics? {{Ans- Stimulants
What should you provide for prior to assessing abuse victims? {{Ans- A safe environment
What are your actions if a child reports abuse?
{{Ans- First interview separately from parents then report to CPS
What should you do if a child plays with toys in a way that you suspect abuse? {{Ans- Report to CPS
In what setting as an inpatient provider should you interview a patient?
{{Ans- Use a private room with the door partially open
How should you begin your interview with adolescents?
{{Ans- By building rapport with them by ensuring confidentiality absent exceptions
Should you interview adolescents with or without parents? {{Ans- Without
What if an adolescent tells you they are homosexual and they don't want their parents to know?
{{Ans- This is confidential
The patient is being discharged and would like their labs faxed to the rehab facility. What is your
initial action? {{Ans- Get informed consent/ROI
What do you do if a medical evaluation is needed? {{Ans- Refer out - this is out of scope
What do you do if a patient is takes something and is feeling really funny/unwell in your office?
{{Ans-
Collect UDS and then refer out
Is it considered a mental illness if it is an expected response culturally? What do you offer as
treatment? {{Ans- No; brief supportive therapy - not medication
, A mother states her child is experiencing a cultural illness. What is your initial action?
{{Ans- Respect the mother's cultural understanding of illness prior to assessment
What ethnic group has the highest rate of suicidality in the US?
{{Ans- Native Americans
If a patient believes they need a healing stick in their room, but the staff nurses removed it from them
- what should you do?
{{Ans- Teach cultural sensitivity and make accommodations for patient to have healing stick available
such as 1:1
Psychoeducation should be based on? {{Ans- Cultural context
How do you promote health in a location with multiple ethnicities and education levels?
{{Ans- Multiple cultural education and ethnospecific assessment parameters
What if a patient wants a traditional healer? {{Ans- Allow this - remember ROI/informed consent
Normal TSH? {{Ans- 0.5-5.0
TSH < 0.5 = ? {{Ans- Hyperthyroidism
TSH > 5.0 = ? {{Ans- Hypothyroidism
Relationship between TSH & T3/T4? {{Ans- Inverse
Hyperthyroidism can present as? {{Ans- Mania
Hypothyroidism can present as? {{Ans- Depression
Normal depakote level? {{Ans- 50-125
Toxic depakote level? {{Ans- 150+
Birth defect caused by depakote? {{Ans- Spina Bifida
S/S of depakote toxicity? {{Ans- Disorientation, lethargy, decreased respiratory rate, and N/V
What to do if there is depakote toxicity? {{Ans- D/C depakote and check VPA level, LFTs, and ammonia
S/S of hepatotoxicity? {{Ans- RUQ pain, reddish brown urine, jaundice, fatigue, and elevated LFTs
, Normal AST? {{Ans- 5-40
Normal ALT? {{Ans- 5-35
Kava kava can cause? {{Ans- Liver damage and heavy sedation
Kava kava is c/i with? {{Ans- Benzos or sedatives
Mood stabilizer most associated with SJS? {{Ans- Lamictal
Mood stabilizer with least weight gain? {{Ans- Lamictal
SGAs with least weight gain? {{Ans- ziprasidone, abilify, and latuda
Least sedating SGA? {{Ans- Abilify
Routine labs with SGAs? {{Ans- BMI, hip to waist ratio, glucose, A1C, and lipid panel
Management of metabolic syndrome with SGAs?
{{Ans- 1. Nonpharm = exercise or nutritional counseling
2. Pharm = switch to other SGA with lower chance of metabolic syndrome
Carbamazepine can cause? {{Ans- Agranulocytosis and aplastic anemia
What should you screen for prior to starting Asians on carbamazepine and why?
{{Ans- HLAB1502 Allele; risk of SJS
When should you d/c carbamazepine if agranulocytosis is suspected?
{{Ans- If ANC is < 1000 with or without s/s of infection
Lithium range? {{Ans- 0.6 - 1.2
What to do if lithium is 1.3 or 1.4? {{Ans- Monitor
What to do if lithium is 1.5+? {{Ans- D/C
Benefits of lithium? {{Ans- Gold standard for mania, neuroprotective, and antisuicidal effects
S/S of lithium toxicity? {{Ans- Severe N/V, polydipsia, polyuria, leukocytosis, palpitations, coarse tremor
Review Questions With Correct Answers
What should you not do when advocating for a patient? {{Ans- Judge or confront
What class of medication is contraindicated with tics? {{Ans- Stimulants
What should you provide for prior to assessing abuse victims? {{Ans- A safe environment
What are your actions if a child reports abuse?
{{Ans- First interview separately from parents then report to CPS
What should you do if a child plays with toys in a way that you suspect abuse? {{Ans- Report to CPS
In what setting as an inpatient provider should you interview a patient?
{{Ans- Use a private room with the door partially open
How should you begin your interview with adolescents?
{{Ans- By building rapport with them by ensuring confidentiality absent exceptions
Should you interview adolescents with or without parents? {{Ans- Without
What if an adolescent tells you they are homosexual and they don't want their parents to know?
{{Ans- This is confidential
The patient is being discharged and would like their labs faxed to the rehab facility. What is your
initial action? {{Ans- Get informed consent/ROI
What do you do if a medical evaluation is needed? {{Ans- Refer out - this is out of scope
What do you do if a patient is takes something and is feeling really funny/unwell in your office?
{{Ans-
Collect UDS and then refer out
Is it considered a mental illness if it is an expected response culturally? What do you offer as
treatment? {{Ans- No; brief supportive therapy - not medication
, A mother states her child is experiencing a cultural illness. What is your initial action?
{{Ans- Respect the mother's cultural understanding of illness prior to assessment
What ethnic group has the highest rate of suicidality in the US?
{{Ans- Native Americans
If a patient believes they need a healing stick in their room, but the staff nurses removed it from them
- what should you do?
{{Ans- Teach cultural sensitivity and make accommodations for patient to have healing stick available
such as 1:1
Psychoeducation should be based on? {{Ans- Cultural context
How do you promote health in a location with multiple ethnicities and education levels?
{{Ans- Multiple cultural education and ethnospecific assessment parameters
What if a patient wants a traditional healer? {{Ans- Allow this - remember ROI/informed consent
Normal TSH? {{Ans- 0.5-5.0
TSH < 0.5 = ? {{Ans- Hyperthyroidism
TSH > 5.0 = ? {{Ans- Hypothyroidism
Relationship between TSH & T3/T4? {{Ans- Inverse
Hyperthyroidism can present as? {{Ans- Mania
Hypothyroidism can present as? {{Ans- Depression
Normal depakote level? {{Ans- 50-125
Toxic depakote level? {{Ans- 150+
Birth defect caused by depakote? {{Ans- Spina Bifida
S/S of depakote toxicity? {{Ans- Disorientation, lethargy, decreased respiratory rate, and N/V
What to do if there is depakote toxicity? {{Ans- D/C depakote and check VPA level, LFTs, and ammonia
S/S of hepatotoxicity? {{Ans- RUQ pain, reddish brown urine, jaundice, fatigue, and elevated LFTs
, Normal AST? {{Ans- 5-40
Normal ALT? {{Ans- 5-35
Kava kava can cause? {{Ans- Liver damage and heavy sedation
Kava kava is c/i with? {{Ans- Benzos or sedatives
Mood stabilizer most associated with SJS? {{Ans- Lamictal
Mood stabilizer with least weight gain? {{Ans- Lamictal
SGAs with least weight gain? {{Ans- ziprasidone, abilify, and latuda
Least sedating SGA? {{Ans- Abilify
Routine labs with SGAs? {{Ans- BMI, hip to waist ratio, glucose, A1C, and lipid panel
Management of metabolic syndrome with SGAs?
{{Ans- 1. Nonpharm = exercise or nutritional counseling
2. Pharm = switch to other SGA with lower chance of metabolic syndrome
Carbamazepine can cause? {{Ans- Agranulocytosis and aplastic anemia
What should you screen for prior to starting Asians on carbamazepine and why?
{{Ans- HLAB1502 Allele; risk of SJS
When should you d/c carbamazepine if agranulocytosis is suspected?
{{Ans- If ANC is < 1000 with or without s/s of infection
Lithium range? {{Ans- 0.6 - 1.2
What to do if lithium is 1.3 or 1.4? {{Ans- Monitor
What to do if lithium is 1.5+? {{Ans- D/C
Benefits of lithium? {{Ans- Gold standard for mania, neuroprotective, and antisuicidal effects
S/S of lithium toxicity? {{Ans- Severe N/V, polydipsia, polyuria, leukocytosis, palpitations, coarse tremor
