GEORGETTE REVIEW PMHNP QUESTIONS AND
ANSWERS
1. W
hen many answers are remarkably similar, they are usually :-
wrong
2. Interprofessional collaboration is encouraged.: Collaborate is
usually right. Delegate is usually wrong.
3. ADPIER: Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
4. Lithium: Normal 0.6-1.2
5. Lithium toxicity occurs at levels: > 1.5
6. Signs of Lithium toxicity: severe nausea, diarrhea, vomiting, confusion, drowsiness,
muscle weakness, heart palpitation, coarse hand tremors, unsteady gait
7. Lithium is gold standard for: MANIA
8. Lithium has evidence shown to: reduce suicidal ideation
9. What does lithium cause in neonate, especially 1st trimester:
Ebstein anomaly (congenital heart defect)
10. dehydration and hyponatremia cause lithium levels to: rise
11. Baseline labs before initiation of
lithium: 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)
12. Side Effects of Lithium:
hypothyroidism coase hand tremors with
toxicity
,GEORGETTE REVIEW PMHNP QUESTIONS AND
ANSWERS
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor
closely. anorexia
t wave
inversions
leukocytosis
13. Pt education for lithimum:
staying hydrated avoiding NSAIDS
compliance
14. Depakote normal level: 50-125
15. Depakote toxicity level: greater than 150
,GEORGETTE REVIEW PMHNP QUESTIONS AND
ANSWERS
16. Teratogenic effects of Depakote: spina bifida
17. Adverse effects of depakote: alopecia
hepatotoxicity (RUQ pain or brown/red urine--order LFTs) AST 5-40, ALT 5-35, yellowing of skin or eyes,
fatigue
18. Signs of Depakote toxicity: disorientation, lethargy, respiratory depression,
nausea/vomiting
19. Intervention for depakote
toxicity: DC med check level
LFT
ammonia
20. MAOI + tyramine causes: hypertensive crisis
21. Symptoms of hypertensive crisis:
elevated BP sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
22. Hypertensive crisis occurs with MAOI +:
MEPERIDINE STIMULANTS
decongestants
TCAs
atypicals
St. John's
, GEORGETTE REVIEW PMHNP QUESTIONS AND
ANSWERS
wart L-
tryptophan
asthma
meds
23. Treatment for hypertensive crisis: DC
ottending agent Administer PHENTOLAMINE
24. Teratogenic effects of benzos: floppy baby, cleft palate
25. Teratogenic effects of tegratol: neural tube defect
26. teratogenic effects of lithium: ebstein anomaly (heart defect) (avoid,
especially 1st trimester)
27. teratogenic effects of depakote: neural tube defects/spina bifida
28. Adverse reaction to Lamictal: Steven Johnson's Syndrome
ANSWERS
1. W
hen many answers are remarkably similar, they are usually :-
wrong
2. Interprofessional collaboration is encouraged.: Collaborate is
usually right. Delegate is usually wrong.
3. ADPIER: Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
4. Lithium: Normal 0.6-1.2
5. Lithium toxicity occurs at levels: > 1.5
6. Signs of Lithium toxicity: severe nausea, diarrhea, vomiting, confusion, drowsiness,
muscle weakness, heart palpitation, coarse hand tremors, unsteady gait
7. Lithium is gold standard for: MANIA
8. Lithium has evidence shown to: reduce suicidal ideation
9. What does lithium cause in neonate, especially 1st trimester:
Ebstein anomaly (congenital heart defect)
10. dehydration and hyponatremia cause lithium levels to: rise
11. Baseline labs before initiation of
lithium: 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)
12. Side Effects of Lithium:
hypothyroidism coase hand tremors with
toxicity
,GEORGETTE REVIEW PMHNP QUESTIONS AND
ANSWERS
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor
closely. anorexia
t wave
inversions
leukocytosis
13. Pt education for lithimum:
staying hydrated avoiding NSAIDS
compliance
14. Depakote normal level: 50-125
15. Depakote toxicity level: greater than 150
,GEORGETTE REVIEW PMHNP QUESTIONS AND
ANSWERS
16. Teratogenic effects of Depakote: spina bifida
17. Adverse effects of depakote: alopecia
hepatotoxicity (RUQ pain or brown/red urine--order LFTs) AST 5-40, ALT 5-35, yellowing of skin or eyes,
fatigue
18. Signs of Depakote toxicity: disorientation, lethargy, respiratory depression,
nausea/vomiting
19. Intervention for depakote
toxicity: DC med check level
LFT
ammonia
20. MAOI + tyramine causes: hypertensive crisis
21. Symptoms of hypertensive crisis:
elevated BP sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
22. Hypertensive crisis occurs with MAOI +:
MEPERIDINE STIMULANTS
decongestants
TCAs
atypicals
St. John's
, GEORGETTE REVIEW PMHNP QUESTIONS AND
ANSWERS
wart L-
tryptophan
asthma
meds
23. Treatment for hypertensive crisis: DC
ottending agent Administer PHENTOLAMINE
24. Teratogenic effects of benzos: floppy baby, cleft palate
25. Teratogenic effects of tegratol: neural tube defect
26. teratogenic effects of lithium: ebstein anomaly (heart defect) (avoid,
especially 1st trimester)
27. teratogenic effects of depakote: neural tube defects/spina bifida
28. Adverse reaction to Lamictal: Steven Johnson's Syndrome
