LMR Georgette’s PMHNP Certification
Exam Latest 2025 Questions And
Correct Answers(Verified Answers)
What does ADPIE stand for? - ---correct answer ---Assessment
Diagnosis
Planning
Implementation
Evaluation
What should you do when a mother reports her child woke up screaming in the
middle of the night? - ---correct answer ---Ask her if it's happened before
to assess for sleep issue patterns
What do you do if a patient comes in with fungus on their toenail? - ---correct
answer ---Scrape nail and send for testing
What do you do if a patient on lithium has dark brown urine? - ---correct
answer ---Check renal function
What do you do if a patient presents with fever while on Clozaril? - ---correct
answer ---Check ANC level to assess for agranulocytosis
,What can cause serotonin syndrome? - ---correct answer ---
Antidepressants, St. John's Wort, Same-E, Kava Kava, and Tryptophan
What labs are indicative of NMS? - ---correct answer ---Elevated WBC
(over 11,000) and elevated CPK
S/S of NMS - ---correct answer ---muscle rigidity, hyperthermia,
tachycardia, abnormal bp, sweating, altered mental status, cherry colored urine
What should you do if a patient presents with cherry colored urine? - ---
correct answer ---Check for rhabdo with CPK
s/s of serotonin syndrome - ---correct answer ---hyperreflexia, muscle
spasms, myoclonus (involuntary muscle jerk), fever, tachycardia, HTN, shits and
shivers
What two medications to give with NMS? - ---correct answer ---
bromocriptine (Parlodel)- D2 agonist dantrolene- muscle relaxer
What medication to give during SS? - ---correct answer ---cyproheptadine
(Periactin)- 5HT-2A receptor antagonist
What is the onset and typical length of NMS? - ---correct answer ---Slow
onset (1-2 weeks after changing or starting therapy) and resolves within 9-14 days
What is the onset of SS? - ---correct answer ---Within 24 hours of
starting/changing medication and resolves within a few days
,How do you distinguish between NMS and acute dystonia? - ---correct
answer ---NMS has a slower onset while acute dystonia occurs within hours
What happens with lithium and NSAIDs? - ---correct answer ---Increased
risk of lithium toxicity (gout meds, ibuprophen, naproxen, etc.)
What happens with lithium and ACE inhibitors? - ---correct answer ---
Increased risk of lithium toxicity related to the increased urination from the ACE
inhibitors
Why should a patient on lithium avoid calcium channel blockers? - ---correct
answer ---Risk of fatal nephrotoxicity
What is a fetal side effect of lithium? - ---correct answer ---Epstein's
anomaly
What lab should you check for athletes on lithium? - ---correct answer ---
Specific gravity to assess for dehydration (dehydration is >1.015)
What do you do if the lithium level is 1.3? - ---correct answer ---Do not
give the next dose and assess for s/s
At what level is lithium toxicity a medical emergency? - ---correct answer
--->3
, S/S of lithium toxicity - ---correct answer ---vomiting, diarrhea, slurred
speech, hand tremor, dry mouth/thirst, muscle weakness/twitching
Why check an EKG with lithium? - ---correct answer ---Inverted T-waves
What medication should treat hypothyroidism caused by lithium use? - ---
correct answer ---Synthroid
What do you do if patient is prescribed both depakote and lamictal? - ---
correct answer ---Decreased lamictal dose by 50%
Depakote and pregnancy - ---correct answer ---Spina bifida
What emergency may be occuring if patient on depakote reports upper abdominal
pain? - ---correct answer ---Pancreatitis
What lab should you check if patient has right upper quadrant pain and dark brown
urine? - ---correct answer ---LFTs
What lab means pregnancy? - ---correct answer ---HCG
Why is Clozaril used? - ---correct answer ---Treatment resistant
schizophrenia, improves SI, and improves negative symptoms of schizophrenia
Exam Latest 2025 Questions And
Correct Answers(Verified Answers)
What does ADPIE stand for? - ---correct answer ---Assessment
Diagnosis
Planning
Implementation
Evaluation
What should you do when a mother reports her child woke up screaming in the
middle of the night? - ---correct answer ---Ask her if it's happened before
to assess for sleep issue patterns
What do you do if a patient comes in with fungus on their toenail? - ---correct
answer ---Scrape nail and send for testing
What do you do if a patient on lithium has dark brown urine? - ---correct
answer ---Check renal function
What do you do if a patient presents with fever while on Clozaril? - ---correct
answer ---Check ANC level to assess for agranulocytosis
,What can cause serotonin syndrome? - ---correct answer ---
Antidepressants, St. John's Wort, Same-E, Kava Kava, and Tryptophan
What labs are indicative of NMS? - ---correct answer ---Elevated WBC
(over 11,000) and elevated CPK
S/S of NMS - ---correct answer ---muscle rigidity, hyperthermia,
tachycardia, abnormal bp, sweating, altered mental status, cherry colored urine
What should you do if a patient presents with cherry colored urine? - ---
correct answer ---Check for rhabdo with CPK
s/s of serotonin syndrome - ---correct answer ---hyperreflexia, muscle
spasms, myoclonus (involuntary muscle jerk), fever, tachycardia, HTN, shits and
shivers
What two medications to give with NMS? - ---correct answer ---
bromocriptine (Parlodel)- D2 agonist dantrolene- muscle relaxer
What medication to give during SS? - ---correct answer ---cyproheptadine
(Periactin)- 5HT-2A receptor antagonist
What is the onset and typical length of NMS? - ---correct answer ---Slow
onset (1-2 weeks after changing or starting therapy) and resolves within 9-14 days
What is the onset of SS? - ---correct answer ---Within 24 hours of
starting/changing medication and resolves within a few days
,How do you distinguish between NMS and acute dystonia? - ---correct
answer ---NMS has a slower onset while acute dystonia occurs within hours
What happens with lithium and NSAIDs? - ---correct answer ---Increased
risk of lithium toxicity (gout meds, ibuprophen, naproxen, etc.)
What happens with lithium and ACE inhibitors? - ---correct answer ---
Increased risk of lithium toxicity related to the increased urination from the ACE
inhibitors
Why should a patient on lithium avoid calcium channel blockers? - ---correct
answer ---Risk of fatal nephrotoxicity
What is a fetal side effect of lithium? - ---correct answer ---Epstein's
anomaly
What lab should you check for athletes on lithium? - ---correct answer ---
Specific gravity to assess for dehydration (dehydration is >1.015)
What do you do if the lithium level is 1.3? - ---correct answer ---Do not
give the next dose and assess for s/s
At what level is lithium toxicity a medical emergency? - ---correct answer
--->3
, S/S of lithium toxicity - ---correct answer ---vomiting, diarrhea, slurred
speech, hand tremor, dry mouth/thirst, muscle weakness/twitching
Why check an EKG with lithium? - ---correct answer ---Inverted T-waves
What medication should treat hypothyroidism caused by lithium use? - ---
correct answer ---Synthroid
What do you do if patient is prescribed both depakote and lamictal? - ---
correct answer ---Decreased lamictal dose by 50%
Depakote and pregnancy - ---correct answer ---Spina bifida
What emergency may be occuring if patient on depakote reports upper abdominal
pain? - ---correct answer ---Pancreatitis
What lab should you check if patient has right upper quadrant pain and dark brown
urine? - ---correct answer ---LFTs
What lab means pregnancy? - ---correct answer ---HCG
Why is Clozaril used? - ---correct answer ---Treatment resistant
schizophrenia, improves SI, and improves negative symptoms of schizophrenia
