GEORGETTE REVIEW PMHNP
COMPREHENSIVE STUDY GUIDE 2026 388
QUESTIONS WITH DETAILED COMPLETE
SOLUTIONS GRADED A+
⩥ Test Taking Strategies. Answer: *Narrow down options to 2 possible
right answers
*The right answer option might have the same word(s) as the test
question; it can be the same word or a synonym of the word
4* Be wary of absolutes; all, only, everything, nothing, etc. → usually
wrong
*If undecided (or more than correct answer), the umbrella is usually the
right answer (for non-priority questions)
⩥ Interprofessional collaboration is encouraged. Answer: Collaborate is
usually right.
Delegate is usually wrong.
⩥ test strategies. Answer: Safety for the patient and others is usually the
right answer and Priority is usually concerning safety
⩥ ADPIER. Answer: Assessment, diagnosis, Plan, intervention,
evaluate, refer out last.
,⩥ Lithium. Answer: Normal 0.6-1.2
A narrow range is why we monitor toxicity
⩥ 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
central nervous system
fine hand tremors
coarse hand tremors with toxicity
maculopapular rash
t wave inversions
leukocytosis
⩥ GI side effects of Lithium. Answer: Diarrhea, vomiting, cramps,
anorexia, can increase dehydration- Monitor closely --signs of toxicity.
⩥ side effects of lithium. Answer: maculopapular rash
leukocytosis
⩥ side effect of lithium. Answer: t wave inversions, why you screen
before starting w/ECG
⩥ 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
(aged cheese, cured meats, some wines). Answer: causes hypertensive
crisis
COMPREHENSIVE STUDY GUIDE 2026 388
QUESTIONS WITH DETAILED COMPLETE
SOLUTIONS GRADED A+
⩥ Test Taking Strategies. Answer: *Narrow down options to 2 possible
right answers
*The right answer option might have the same word(s) as the test
question; it can be the same word or a synonym of the word
4* Be wary of absolutes; all, only, everything, nothing, etc. → usually
wrong
*If undecided (or more than correct answer), the umbrella is usually the
right answer (for non-priority questions)
⩥ Interprofessional collaboration is encouraged. Answer: Collaborate is
usually right.
Delegate is usually wrong.
⩥ test strategies. Answer: Safety for the patient and others is usually the
right answer and Priority is usually concerning safety
⩥ ADPIER. Answer: Assessment, diagnosis, Plan, intervention,
evaluate, refer out last.
,⩥ Lithium. Answer: Normal 0.6-1.2
A narrow range is why we monitor toxicity
⩥ 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
central nervous system
fine hand tremors
coarse hand tremors with toxicity
maculopapular rash
t wave inversions
leukocytosis
⩥ GI side effects of Lithium. Answer: Diarrhea, vomiting, cramps,
anorexia, can increase dehydration- Monitor closely --signs of toxicity.
⩥ side effects of lithium. Answer: maculopapular rash
leukocytosis
⩥ side effect of lithium. Answer: t wave inversions, why you screen
before starting w/ECG
⩥ 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
(aged cheese, cured meats, some wines). Answer: causes hypertensive
crisis
