PMHNP Board Exam Review
Pass the PMHNP Board Exam
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2026 Georgette’s LMR PMHNP Board
Exam Review is a high-yield digital study
guide designed to help you feel
confident for the PMHNP board exam.
, GEORGETTE’S REVIEW
KNOW FOR THE TEST HIGH YIELD CONTENT KEYWORDS ON BOARDS
HOW THE TEST IS SCORED
SCIENTIFIC FOUNDATION: 30 QUESTIONS (20%)
ADV. PRACTICE SKILLS: 38 QUESTIONS (25%
DIAGNOSIS/TREATMENT: 37 QUESTIONS (25%)
PSYCHOTHERAPY/THEORIES: 22 QUESTIONS (15%)
ETHICAL/LEGAL PRINCIPLES: 23 QUESTIONS (15%)
175 Qs – 25 SAMPLE/THROW AWAY Qs = 150 Qs
150 = 500 PTs
105/150 Qs or 350/500 PTs = PASS
MODULES 1 & 2 - SCIENTIFIC FOUNDATION AND ADVANCED PRACTICE
SKILLS
TEST TAKING STRATEGIES
1. Read the entire question fully before answering and identify what the question is
seeking., Do not skim over the words or read them too quickly.
a. When reading the question, pay attention to keywords.
b. Pay attention to final phrase in question. What are they asking for?
2. Do not read into the question. Only use the information provided by the examiner
to answer the question without making any assumptions or adding more
information in the question.
3. Read all the answer choices.
a. Partially correct answers are not the correct answer
b. Narrow down options to 2 possible right answers.
c. When 2 answer choices are the opposite of one another, one is usually the
correct answer.
d. The right answer option might have the same word as the test question—it
can be same word or a synonym of the word.
e. Choose client focused answers.
f. When many response choices are remarkably similar, they are usually
wrong.
g. Safety is usually the right answer
h. Culture is important to be included in all nursing care
i. Critical thinking is important
j. Interprofessional collab is encouraged
i. If collaborate is an option, it is usually the right answer.
ii. All other options are likely out of your scope of practice.
k. Best answer/choice: Answers that acknowledge a patient’s feelings and
makes the patient feel heard.
, l. Be wary of absolutes: All, only, always, every, must, never, none,
everything, nothing, etc. are usually wrong.
m. May give a few sx of d/o – not full criteria, but the most likely dx
4. Questions that use adjectives like priority, initial action test your ability to
prioritize.
a. PRIORITIZE IN ORDER:
i. Airway, breathing, and circulation
ii. Maslow's Hierarchy of Needs (physiological needs: food, water,
warmth, rest, safety, security, etc.)
iii. The nursing process: Assessment before intervention. (ADPIE)
1. You will know it’s an assessment because you’ll be collecting
data
PB 180 – LITHIUM
LITHIUM: 0.6 – 1.2 m Eq/L > 1.5 = toxicity GOLD STD. FOR MANIC
EPISODE/SUICIDALITY
o BASELINE LABS:
Thyroid panel
Serum Creatinine (0.6 – 1.2) (bc metabolizes in kidneys)
BUN 10-20
Pregnancy Test (HCG) if 12-51y/o
ECG > 50y/o
PB 181 – SIDE EFFECTS OF LITHIUM
ENDOCRINE
o Hypothyroidism
o Weight gain
CNS
o Find hand tremors ○ Fatigue ○ Nystagmus
o Mental cloudiness ○ Headaches
o Coarse hand tremors occur with toxicity
DERMATOLOGICAL
o Maculopapular Rash ○ Pruritis ○ Acne
GASTROINTESTINAL
o Diarrhea ○ Vomiting ○ Cramps ○ Anorexia
RENAL
o Polyuria ○ Polydipsia ○ Diabetes Insipidus ○ Edema
o Microscopic tubular changes
CARDIAC
o T-Wave inversions ○ Dysrhythmia
PB 157 – HYPERTENSIVE CRISIS
, Occurs when MAOIs are taken in conjunction with foods containing tyramine, a
dietary precursor to norepinephrine
o Hypertensive crisis is life-threatening and cannot be reversed unless more
MAO is produced by the body.
o Hypertensive crisis and death also occur when MAOIs are taken in
conjunction with certain medications:
Meperidine ◼ Stimulants and other sympathomimetics
Decongestants TCAs
Atypical APs St John’s Wort
L-tryptophan
TREATMENT: D/C offending agent, administer phentolamine
PB 118 – TERATOGENIC RISKS OF COMMON PSYCH MEDS
BENZOS: Floppy baby syndrome, cleft palate
CARBAMAZEPINE (Tegretol): Neural tube defect
LITHIUM (Eskalith): Ebstein anomaly (avoid in pregnancy, especially 1st
trimester)
DIVALPROEX SODIUM (Depakote): Neural tube defects, specifically spina bifida
PB 181 – SIDE EFFECTS OF MOOD STABILIZERS
LAMICTAL: SJS (severe rash)
o S/S OF SJS:
Fever *
Sore throat
Facial swelling
Tongue swelling
Rash
Skin sloughing
Prodromal headache, malaise, arthralgia, painful mucous membranes
may occur before rash occurs.
PB 182 – CARBAMAZEPINE
o Black box warning: Agranulocytosis (decreased WBCs) and aplastic
anemia (pallor, fatigue, headache, fever, nosebleeds, bleeding gums,
skin rash, SOB)
o SJS, particularly in Asians (screen for HLAB-1502 allele before initiating)
HLAB-1502 allele is highly associated with outcome of
carbamazepine-induced SJS
Check HCG before starting in patient of child-bearing age (12-51y/o)
on mood stabilizer
FOLIC ACID – supports neural tube development during the first month that a
woman is pregnant
o It is recommended that all women planning or capable of becoming
pregnant take 0.4 - 0.8mg of folic acid daily