C
Georgette Review PMHNP. (2026/2027) ACCURATE EXPERT
VERIFIED ACTUAL QUESTIONS & ANSWERS FOR
GUARANTEED PASS | NEWEST UPDATE,
Students also studied
C
Terms in this set (388)
When many answers are remarkably similar, ANSWERS wrong
they are usually _____________
Interprofessional collaboration is Collaborate is usually right.
encouraged. Delegate is usually
wrong.
ADPIER Assessment, diagnosis, Plan, intervention, evaluate, refer out
last.
Lithium Normal 0.6-1.2
Lithium toxicity occurs at levels > 1.5
Signs of Lithium toxicity severe nausea, diarrhea, vomiting, confusion, drowsiness,
muscle weakness, heart palpitation, coarse hand tremors,
unsteady gait
Lithium is gold standard for MANIA
Lithium has evidence shown to reduce suicidal ideation
What does lithium cause in neonate, Ebstein anomaly (congenital heart defect)
especially 1st trimester
dehydration and hyponatremia cause lithium rise
levels to
,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)
Side Effects of Lithium hypothyroidism
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Pt education for lithimum staying
hydrated
avoiding NSAIDS
compliance
Depakote normal level 50-125
Depakote toxicity level greater than 150
Teratogenic effects of Depakote spina bifida
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
Signs of Depakote toxicity disorientation, lethargy, respiratory depression,
nausea/vomiting
Intervention for depakote toxicity DC med
check
level LFT
ammonia
MAOI + tyramine causes hypertensive crisis
Symptoms of hypertensive crisis elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
,Hypertensive crisis occurs with MAOI + MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis DC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzos floppy baby, cleft palate
Teratogenic effects of tegratol neural tube defect
teratogenic effects of lithium ebstein anomaly (heart defect) (avoid, especially 1st trimester)
teratogenic effects of depakote neural tube defects/spina bifida
Adverse reaction to Lamictal Steven Johnson's Syndrome
Signs of SJS FEVER --high yield
sore throat
facial swelling
tongue swelling
red rash
skin sloughing
body aches
prodromal headache
malaise
arthralgia
painful mucus membranes
Lamotrigine is least likely to cause sedation or weight gain
Carbamazepine (tegretol) black box agranulocytosis (decrease WBCs)
warning aplastic anemia (pallor, fatigue, HA, fever, nosebleeds,
bleeding gums, skin rash, SOA)
Carbamazepine and asians Screen for HLAB-1502 allele before initiating, due to high
incidence of SJS if positive for allele.
Child-bearing aged women check for pregnancy before starting mood stabilizer
start on folic acid to support neural tube development during
the first month that a woman is pregnant
Clozaril/clozapine can cause agranulocytosis and neutropenia
For monitoring neutropenia in Clozaril, ANC
monitor
, DC clozarli if ANC less than 1000
DC clozaril if WBC 2000-3000, risk of agranulocytosis
When on clozaril monitor for signs and symptoms of infection: sudden fever, chills, sore
throat, weakness
Clozaril only known antipsychotic to decrease risk of suicide in patients with schizophrenia.
Your patient with bipolar disorder is Answer: Lithium can invert the t waves.
admitted to a medical hospital. The
internist contacts your office and asks
whether the lithium you prescribed him is
effecting his ECG. How do you respond?
A. Lithium can prolong the QT interval
B. Lithium has no effect on his ECG
C. Lithium can invert the t waves
D. Lithium can shorten the PR interval
Mary is a 45-year-old African American Answer: Methylphenidate
female who has been treated on
Isocarboxazid (Marplan) for over 6 years.
Mary is going in for a surgical procedure.
Which medication is strictly contraindicated
with Isocarboxazid?
A. Morphine
B. NSAIDS
C. Methylphenidate
D. Acetaminophen
You are treating a client with schizophrenia Answer: ANC less than 1000
who takes clozapine. What lab values will
indicate the client needs to discontinue
treatment?
A. WBC less than 1800 and ANC less than
1200
B. ANC less than 1,000
C. WBC less than 5,000
D. ANC less than 2000
If given during pregnancy, socium valproate A. Spina bifida
can cause which of the following medical
problems in the baby?
A. SJS
B. Ebstein's anomaly
C. Spina bifida
D. Cleft palate
Georgette Review PMHNP. (2026/2027) ACCURATE EXPERT
VERIFIED ACTUAL QUESTIONS & ANSWERS FOR
GUARANTEED PASS | NEWEST UPDATE,
Students also studied
C
Terms in this set (388)
When many answers are remarkably similar, ANSWERS wrong
they are usually _____________
Interprofessional collaboration is Collaborate is usually right.
encouraged. Delegate is usually
wrong.
ADPIER Assessment, diagnosis, Plan, intervention, evaluate, refer out
last.
Lithium Normal 0.6-1.2
Lithium toxicity occurs at levels > 1.5
Signs of Lithium toxicity severe nausea, diarrhea, vomiting, confusion, drowsiness,
muscle weakness, heart palpitation, coarse hand tremors,
unsteady gait
Lithium is gold standard for MANIA
Lithium has evidence shown to reduce suicidal ideation
What does lithium cause in neonate, Ebstein anomaly (congenital heart defect)
especially 1st trimester
dehydration and hyponatremia cause lithium rise
levels to
,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)
Side Effects of Lithium hypothyroidism
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Pt education for lithimum staying
hydrated
avoiding NSAIDS
compliance
Depakote normal level 50-125
Depakote toxicity level greater than 150
Teratogenic effects of Depakote spina bifida
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
Signs of Depakote toxicity disorientation, lethargy, respiratory depression,
nausea/vomiting
Intervention for depakote toxicity DC med
check
level LFT
ammonia
MAOI + tyramine causes hypertensive crisis
Symptoms of hypertensive crisis elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
,Hypertensive crisis occurs with MAOI + MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis DC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzos floppy baby, cleft palate
Teratogenic effects of tegratol neural tube defect
teratogenic effects of lithium ebstein anomaly (heart defect) (avoid, especially 1st trimester)
teratogenic effects of depakote neural tube defects/spina bifida
Adverse reaction to Lamictal Steven Johnson's Syndrome
Signs of SJS FEVER --high yield
sore throat
facial swelling
tongue swelling
red rash
skin sloughing
body aches
prodromal headache
malaise
arthralgia
painful mucus membranes
Lamotrigine is least likely to cause sedation or weight gain
Carbamazepine (tegretol) black box agranulocytosis (decrease WBCs)
warning aplastic anemia (pallor, fatigue, HA, fever, nosebleeds,
bleeding gums, skin rash, SOA)
Carbamazepine and asians Screen for HLAB-1502 allele before initiating, due to high
incidence of SJS if positive for allele.
Child-bearing aged women check for pregnancy before starting mood stabilizer
start on folic acid to support neural tube development during
the first month that a woman is pregnant
Clozaril/clozapine can cause agranulocytosis and neutropenia
For monitoring neutropenia in Clozaril, ANC
monitor
, DC clozarli if ANC less than 1000
DC clozaril if WBC 2000-3000, risk of agranulocytosis
When on clozaril monitor for signs and symptoms of infection: sudden fever, chills, sore
throat, weakness
Clozaril only known antipsychotic to decrease risk of suicide in patients with schizophrenia.
Your patient with bipolar disorder is Answer: Lithium can invert the t waves.
admitted to a medical hospital. The
internist contacts your office and asks
whether the lithium you prescribed him is
effecting his ECG. How do you respond?
A. Lithium can prolong the QT interval
B. Lithium has no effect on his ECG
C. Lithium can invert the t waves
D. Lithium can shorten the PR interval
Mary is a 45-year-old African American Answer: Methylphenidate
female who has been treated on
Isocarboxazid (Marplan) for over 6 years.
Mary is going in for a surgical procedure.
Which medication is strictly contraindicated
with Isocarboxazid?
A. Morphine
B. NSAIDS
C. Methylphenidate
D. Acetaminophen
You are treating a client with schizophrenia Answer: ANC less than 1000
who takes clozapine. What lab values will
indicate the client needs to discontinue
treatment?
A. WBC less than 1800 and ANC less than
1200
B. ANC less than 1,000
C. WBC less than 5,000
D. ANC less than 2000
If given during pregnancy, socium valproate A. Spina bifida
can cause which of the following medical
problems in the baby?
A. SJS
B. Ebstein's anomaly
C. Spina bifida
D. Cleft palate
