Georgette Review PMHNP questions with verified answers
A+ Grade
When many answers are remarkably similar, they are usually _____________
- correct answer wrong
Interprofessional collaboration is encouraged.
- correct answer Collaborate is usually right.
Delegate is usually wrong.
ADPIER
- correct answer Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
Lithium
- correct answer Normal 0.6-1.2
Lithium toxicity occurs at levels
- correct answer > 1.5
Signs of Lithium toxicity
- correct answer severe nausea, diarrhea, vomiting, confusion, drowsiness, muscle weakness, heart
palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard for
- correct answer MANIA
Lithium has evidence shown to
- correct answer reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester
- correct answer Ebstein anomaly (congenital heart defect)
,dehydration and hyponatremia cause lithium levels to
- correct answer rise
Baseline labs before initiation of lithium
- correct answer 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
- correct answer 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
- correct answer staying hydrated
avoiding NSAIDS
compliance
Depakote normal level
- correct answer 50-125
Depakote toxicity level
- correct answer greater than 150
,Teratogenic effects of Depakote
- correct answer spina bifida
Adverse effects of depakote
- correct answer 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
- correct answer disorientation, lethargy, respiratory depression, nausea/vomiting
Intervention for depakote toxicity
- correct answer DC med
check level
LFT
ammonia
MAOI + tyramine causes
- correct answer hypertensive crisis
Symptoms of hypertensive crisis
- correct answer elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI +
- correct answer MEPERIDINE
, STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis
- correct answer DC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzos
- correct answer floppy baby, cleft palate
Teratogenic effects of tegratol
- correct answer neural tube defect
teratogenic effects of lithium
- correct answer ebstein anomaly (heart defect) (avoid, especially 1st trimester)
teratogenic effects of depakote
- correct answer neural tube defects/spina bifida
Adverse reaction to Lamictal
- correct answer Steven Johnson's Syndrome
Signs of SJS
- correct answer FEVER --high yield
sore throat
facial swelling
A+ Grade
When many answers are remarkably similar, they are usually _____________
- correct answer wrong
Interprofessional collaboration is encouraged.
- correct answer Collaborate is usually right.
Delegate is usually wrong.
ADPIER
- correct answer Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
Lithium
- correct answer Normal 0.6-1.2
Lithium toxicity occurs at levels
- correct answer > 1.5
Signs of Lithium toxicity
- correct answer severe nausea, diarrhea, vomiting, confusion, drowsiness, muscle weakness, heart
palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard for
- correct answer MANIA
Lithium has evidence shown to
- correct answer reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester
- correct answer Ebstein anomaly (congenital heart defect)
,dehydration and hyponatremia cause lithium levels to
- correct answer rise
Baseline labs before initiation of lithium
- correct answer 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
- correct answer 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
- correct answer staying hydrated
avoiding NSAIDS
compliance
Depakote normal level
- correct answer 50-125
Depakote toxicity level
- correct answer greater than 150
,Teratogenic effects of Depakote
- correct answer spina bifida
Adverse effects of depakote
- correct answer 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
- correct answer disorientation, lethargy, respiratory depression, nausea/vomiting
Intervention for depakote toxicity
- correct answer DC med
check level
LFT
ammonia
MAOI + tyramine causes
- correct answer hypertensive crisis
Symptoms of hypertensive crisis
- correct answer elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI +
- correct answer MEPERIDINE
, STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis
- correct answer DC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzos
- correct answer floppy baby, cleft palate
Teratogenic effects of tegratol
- correct answer neural tube defect
teratogenic effects of lithium
- correct answer ebstein anomaly (heart defect) (avoid, especially 1st trimester)
teratogenic effects of depakote
- correct answer neural tube defects/spina bifida
Adverse reaction to Lamictal
- correct answer Steven Johnson's Syndrome
Signs of SJS
- correct answer FEVER --high yield
sore throat
facial swelling
