2026 Georgette’s LMR
PMHNP Board Exam Review
Pass the PMHNP Board Exam
excellent board exam review materials
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.
, LAST-MINUTE
LAST MINUTE REVIEW &REVIEW
MORE, SO MUCH MORE!
Nurse Practitioner - Core Values for Culturally
Competent Care:
Respect / Knowledge of cultural belief and practices
Advocacy for the development of culturally
appropriate pt care services.
Partnership with the pt to develop the TP.
o Cultural expected response to stressor doesn’t mean there is a mental illness.
o Understand Cultural Context of the symptoms.
o Cultural Assessment / Cultural Formulation Interview:
Helps clarify meaning of the pt illness
Helps empower the pt.
Help contextualize pt’s symptoms in their local world
The pt may present with Cultural Syndrome = Offer Brief Supportive Therapy.
o Respect pt’ understanding of what cause the illness. (e.g., Native Americans think that mental illness can be
caused by Imbalance btw Individual Relationships with the World)
o Native Americans:
Ethnic group in the US with the highest suicide rate / suicide attempts - Also High level of Domestic Violence
They believe in the healing stick – if in the hospital, let the pt have his healing stick.
Make accommodations for them to have the healing stick / educate other members of the team on Cultural
Sensitivity.
Make accommodations for the traditional healer to be part of the Plan of Care – First obtain clearance for
Inform Consent.
o Health Promotion in the Community / Nursing Conference (if attendees are from different cultures):
provide multicultural teaching/education.
Use Ethnospecific Assessment Parameters.
D – Respect mother’s understanding of the Child’s illness.
Build rapport with the mother.
1
,o Least
Lest Weight Gain Antipsychotics:
Latuda (Lurasidone)
Abilify (Aripiprazole) – also least sedating
Geodon (Ziprasidone)
If pt presented with a 1st psychotic episode – use atypical antipsychotic (less EPS), especially IMs:
Invega (Paliperidone)
Olanzapine (Zyprexa)
Abilify (Aripiprazole)
Geodon (Ziprasidone)
Interprofessional collaboration is Encouraged.
Staff cases
Address discrepancy
Identify problems (e.g., woman getting discharged after they deliver without proper psy screening – post-
partum depression / psychosis afterwards – now collaboration with OB to address this issue.
Medical evaluations are out of scope – these answers is to refer pts.
If mood disorders – check THS
Hypothyroidism (cold intolerance) mimics Depression
Hyperthyroidism (heat intolerance) mimics Mania
1st check TSH (0.5 – 5.0)
2nd check T4
If T4 high – THS is low.
If T4 low – THS is high
HEPATOTOXIC DRUGS:
(Hypotonia)
Depakote (50 – 125) Toxic > 150
Spina Bifida / Neural Tubes Defects (TERATOGENIC)
Hepatotoxicity
RUQ Pain
Reddish brown urine
Complete LFT
When toxic (Confusion, Lethargy, Resp Depression, Disorientation)
If Toxicity:
o D/C;
o Check Valproic Acid Levels.
o Check Ammonia Levels.
o LFT
KAVA – Herbal Supplement
Use for insomnia, anxiety
Is also hepatotoxic
Complete LFT (priority labs)
No BNZs + KAVA
TCA
Hepatotoxic.
2
, Lamotrigine (Lamictal)
Can cause Steven Johnson Syndrome (SJS)
Cause the less weight gain among the Mood stabilizers.
Carbamazepine (Tegretol) “A.A.A” (Anemia, Agranulocytosis, Asians)
Can cause SJS in the Asian population – always screen for the
theHLA-B
ALAB-1502 allele
Can cause Agranulocytosis (A serious condition that occurs when there is an extremely low number of
Clozapine (Clozaril)
Can cause Agranulocytosis
If ANC < 1000 = D/C even if the pt is no showing S/S of infections.
Monitor for S/S of Infections (sore throat, fever, fatigue, chills)
Decrease Suicide Ideations in pts with schizophrenia
Always check HCG in females (12 – 51 years) before starting Mood Stabilizers.
LITHIUM (0.6 – 1.2) - Toxicity ≥ 1.5
Check TSH
Creatinine (0.6 – 1.2)
BUN (10-20)
Urinalysis (check for proteins, 4+)
Neuroprotective treatment for Bipolar Disorder (protect nerve cells from damage)
Gold Standard for treatment in Bipolar
Decrease Suicide Ideations in BD
Can cause Epstein Anomaly – especially during the 1st trimester.
Meds that can increase Lithium Levels (by reducing renal clearance):
NSAIDs (ibuprofen; naproxen; diclofenac; celecoxib; indomethacin; high-dose aspirin)
Thiazides (Chlorothiazide; Chlorthalidone; Hydrochlorothiazide).
ACE-Is (Captopril; Enalapril; Lisinopril)
Dehydration
Side Effects:
Leukocytosis (High white blood cell count)
Hypothyroidism
Maculopapular rash
T-Wave Inversion. - Do EKG if > 50 y/o.
Fine hand tremors
If Coarse hand tremors = Toxicity.
GI upset (Nausea, Vomiting, Diarrhea, Anorexia) – monitor pt closely for toxicity.
Signs and Symptoms of Lithium Toxicity:
Severe GI symptoms / Metallic taste
Muscle weakness
Confusion
Palpitation
Coarse Hand tremor
3
PMHNP Board Exam Review
Pass the PMHNP Board Exam
excellent board exam review materials
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.
, LAST-MINUTE
LAST MINUTE REVIEW &REVIEW
MORE, SO MUCH MORE!
Nurse Practitioner - Core Values for Culturally
Competent Care:
Respect / Knowledge of cultural belief and practices
Advocacy for the development of culturally
appropriate pt care services.
Partnership with the pt to develop the TP.
o Cultural expected response to stressor doesn’t mean there is a mental illness.
o Understand Cultural Context of the symptoms.
o Cultural Assessment / Cultural Formulation Interview:
Helps clarify meaning of the pt illness
Helps empower the pt.
Help contextualize pt’s symptoms in their local world
The pt may present with Cultural Syndrome = Offer Brief Supportive Therapy.
o Respect pt’ understanding of what cause the illness. (e.g., Native Americans think that mental illness can be
caused by Imbalance btw Individual Relationships with the World)
o Native Americans:
Ethnic group in the US with the highest suicide rate / suicide attempts - Also High level of Domestic Violence
They believe in the healing stick – if in the hospital, let the pt have his healing stick.
Make accommodations for them to have the healing stick / educate other members of the team on Cultural
Sensitivity.
Make accommodations for the traditional healer to be part of the Plan of Care – First obtain clearance for
Inform Consent.
o Health Promotion in the Community / Nursing Conference (if attendees are from different cultures):
provide multicultural teaching/education.
Use Ethnospecific Assessment Parameters.
D – Respect mother’s understanding of the Child’s illness.
Build rapport with the mother.
1
,o Least
Lest Weight Gain Antipsychotics:
Latuda (Lurasidone)
Abilify (Aripiprazole) – also least sedating
Geodon (Ziprasidone)
If pt presented with a 1st psychotic episode – use atypical antipsychotic (less EPS), especially IMs:
Invega (Paliperidone)
Olanzapine (Zyprexa)
Abilify (Aripiprazole)
Geodon (Ziprasidone)
Interprofessional collaboration is Encouraged.
Staff cases
Address discrepancy
Identify problems (e.g., woman getting discharged after they deliver without proper psy screening – post-
partum depression / psychosis afterwards – now collaboration with OB to address this issue.
Medical evaluations are out of scope – these answers is to refer pts.
If mood disorders – check THS
Hypothyroidism (cold intolerance) mimics Depression
Hyperthyroidism (heat intolerance) mimics Mania
1st check TSH (0.5 – 5.0)
2nd check T4
If T4 high – THS is low.
If T4 low – THS is high
HEPATOTOXIC DRUGS:
(Hypotonia)
Depakote (50 – 125) Toxic > 150
Spina Bifida / Neural Tubes Defects (TERATOGENIC)
Hepatotoxicity
RUQ Pain
Reddish brown urine
Complete LFT
When toxic (Confusion, Lethargy, Resp Depression, Disorientation)
If Toxicity:
o D/C;
o Check Valproic Acid Levels.
o Check Ammonia Levels.
o LFT
KAVA – Herbal Supplement
Use for insomnia, anxiety
Is also hepatotoxic
Complete LFT (priority labs)
No BNZs + KAVA
TCA
Hepatotoxic.
2
, Lamotrigine (Lamictal)
Can cause Steven Johnson Syndrome (SJS)
Cause the less weight gain among the Mood stabilizers.
Carbamazepine (Tegretol) “A.A.A” (Anemia, Agranulocytosis, Asians)
Can cause SJS in the Asian population – always screen for the
theHLA-B
ALAB-1502 allele
Can cause Agranulocytosis (A serious condition that occurs when there is an extremely low number of
Clozapine (Clozaril)
Can cause Agranulocytosis
If ANC < 1000 = D/C even if the pt is no showing S/S of infections.
Monitor for S/S of Infections (sore throat, fever, fatigue, chills)
Decrease Suicide Ideations in pts with schizophrenia
Always check HCG in females (12 – 51 years) before starting Mood Stabilizers.
LITHIUM (0.6 – 1.2) - Toxicity ≥ 1.5
Check TSH
Creatinine (0.6 – 1.2)
BUN (10-20)
Urinalysis (check for proteins, 4+)
Neuroprotective treatment for Bipolar Disorder (protect nerve cells from damage)
Gold Standard for treatment in Bipolar
Decrease Suicide Ideations in BD
Can cause Epstein Anomaly – especially during the 1st trimester.
Meds that can increase Lithium Levels (by reducing renal clearance):
NSAIDs (ibuprofen; naproxen; diclofenac; celecoxib; indomethacin; high-dose aspirin)
Thiazides (Chlorothiazide; Chlorthalidone; Hydrochlorothiazide).
ACE-Is (Captopril; Enalapril; Lisinopril)
Dehydration
Side Effects:
Leukocytosis (High white blood cell count)
Hypothyroidism
Maculopapular rash
T-Wave Inversion. - Do EKG if > 50 y/o.
Fine hand tremors
If Coarse hand tremors = Toxicity.
GI upset (Nausea, Vomiting, Diarrhea, Anorexia) – monitor pt closely for toxicity.
Signs and Symptoms of Lithium Toxicity:
Severe GI symptoms / Metallic taste
Muscle weakness
Confusion
Palpitation
Coarse Hand tremor
3
