PMHNP EXAM 2025–2026 Acl Exam Questions and
Verified Correct Answers
When many answers are remarkably similar, they are usually - answer>>>wrong
Interprofessional collaboration is encouraged. - answer>>>Collaborate is usually right.
Delegate is usually wrong.
ADPIER - answer>>>Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
Lithium - answer>>>Normal 0.6-1.2
Lithium toxicity occurs at levels - answer>>>> 1.5
Signs of Lithium toxicity - answer>>>severe nausea, diarrhea, vomiting, confusion, drowsiness, muscle
weakness, heart palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard for - answer>>>MANIA
Lithium has evidence shown to - answer>>>reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester - answer>>>Ebstein anomaly (congenital
heart defect)
dehydration and hyponatremia cause lithium levels to - answer>>>rise
Baseline labs before initiation of lithium - answer>>>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 - answer>>>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 - answer>>>staying hydrated
avoiding NSAIDS
compliance
Depakote normal level - answer>>>50-125
Depakote toxicity level - answer>>>greater than 150
Teratogenic effects of Depakote - answer>>>spina bifida
Adverse effects of depakote - answer>>>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 - answer>>>disorientation, lethargy, respiratory depression, nausea/vomiting
Intervention for depakote toxicity - answer>>>DC med
check level
,LFT
ammonia
MAOI + tyramine causes - answer>>>hypertensive crisis
Symptoms of hypertensive crisis - answer>>>elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI + - answer>>>MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis - answer>>>DC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzos - answer>>>floppy baby, cleft palate
Teratogenic effects of tegratol - answer>>>neural tube defect
, Teratogenic Effects Of Lithium - Answer>>>Ebstein Anomaly (Heart Defect) (Avoid, Especially 1st Trimester)
Teratogenic Effects Of Depakote - Answer>>>Neural Tube Defects/Spina Bifida
Adverse Reaction To Lamictal - Answer>>>Steven Johnson's Syndrome
Signs Of Sjs - Answer>>>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 - Answer>>>Sedation Or Weight Gain
Carbamazepine (Tegretol) Black Box Warning - Answer>>>Agranulocytosis (Decrease
Wbcs) Aplastic Anemia (Pallor, Fatigue, Ha, Fever, Nosebleeds, Bleeding Gums, Skin Rash,
Soa)
Carbamazepine And Asians - Answer>>>Screen For Hlab-1502 Allele Before Initiating, Due To High
Incidence Of Sjs If Positive For Allele.
Child-Bearing Aged Women - Answer>>>Check For Pregnancy Before Starting Mood Stabilizer
Start On Folic Acid To Support Neural Tube Development During The First Month That A Woman Is Pregnant
Verified Correct Answers
When many answers are remarkably similar, they are usually - answer>>>wrong
Interprofessional collaboration is encouraged. - answer>>>Collaborate is usually right.
Delegate is usually wrong.
ADPIER - answer>>>Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
Lithium - answer>>>Normal 0.6-1.2
Lithium toxicity occurs at levels - answer>>>> 1.5
Signs of Lithium toxicity - answer>>>severe nausea, diarrhea, vomiting, confusion, drowsiness, muscle
weakness, heart palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard for - answer>>>MANIA
Lithium has evidence shown to - answer>>>reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester - answer>>>Ebstein anomaly (congenital
heart defect)
dehydration and hyponatremia cause lithium levels to - answer>>>rise
Baseline labs before initiation of lithium - answer>>>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 - answer>>>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 - answer>>>staying hydrated
avoiding NSAIDS
compliance
Depakote normal level - answer>>>50-125
Depakote toxicity level - answer>>>greater than 150
Teratogenic effects of Depakote - answer>>>spina bifida
Adverse effects of depakote - answer>>>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 - answer>>>disorientation, lethargy, respiratory depression, nausea/vomiting
Intervention for depakote toxicity - answer>>>DC med
check level
,LFT
ammonia
MAOI + tyramine causes - answer>>>hypertensive crisis
Symptoms of hypertensive crisis - answer>>>elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI + - answer>>>MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis - answer>>>DC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzos - answer>>>floppy baby, cleft palate
Teratogenic effects of tegratol - answer>>>neural tube defect
, Teratogenic Effects Of Lithium - Answer>>>Ebstein Anomaly (Heart Defect) (Avoid, Especially 1st Trimester)
Teratogenic Effects Of Depakote - Answer>>>Neural Tube Defects/Spina Bifida
Adverse Reaction To Lamictal - Answer>>>Steven Johnson's Syndrome
Signs Of Sjs - Answer>>>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 - Answer>>>Sedation Or Weight Gain
Carbamazepine (Tegretol) Black Box Warning - Answer>>>Agranulocytosis (Decrease
Wbcs) Aplastic Anemia (Pallor, Fatigue, Ha, Fever, Nosebleeds, Bleeding Gums, Skin Rash,
Soa)
Carbamazepine And Asians - Answer>>>Screen For Hlab-1502 Allele Before Initiating, Due To High
Incidence Of Sjs If Positive For Allele.
Child-Bearing Aged Women - Answer>>>Check For Pregnancy Before Starting Mood Stabilizer
Start On Folic Acid To Support Neural Tube Development During The First Month That A Woman Is Pregnant
