LMR Georgette’s PMHNP Certification Exam [2026] |
UPDATED ACTUAL QUESTIONS AND CORRECT ANSWERS
| VERIFIED EXAM PREP
• What does ADPIE stand for? -✓✓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? -✓✓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? -
✓✓ANSWER: Scrape nail and send for testing
• What do you do if a patient on lithium has dark brown urine? -✓✓ANSWER:
Check renal function
• What do you do if a patient presents with fever while on Clozaril? -✓✓ANSWER:
Check ANC level to assess for agranulocytosis
• What can cause serotonin syndrome? -✓✓ANSWER: Antidepressants, St. John's
Wort, Same-E, Kava Kava, and Tryptophan
,• What labs are indicative of NMS? -✓✓ANSWER: Elevated WBC (over 11,000)
and elevated CPK
• S/S of NMS -✓✓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? -
✓✓ANSWER: Check for rhabdo with CPK
• s/s of serotonin syndrome -✓✓ANSWER: hyperreflexia, muscle spasms,
myoclonus (involuntary muscle jerk), fever, tachycardia, HTN, shits and shivers
• What two medications to give with NMS? -✓✓ANSWER: bromocriptine
(Parlodel)- D2 agonist dantrolene- muscle relaxer
• What medication to give during SS? -✓✓ANSWER: cyproheptadine (Periactin)-
5HT-2A receptor antagonist
• What is the onset and typical length of NMS? -✓✓ANSWER: Slow onset (1-2
weeks after changing or starting therapy) and resolves within 9-14 days
• What is the onset of SS? -✓✓ANSWER: Within 24 hours of starting/changing
medication and resolves within a few days
• How do you distinguish between NMS and acute dystonia? -✓✓ANSWER: NMS
has a slower onset while acute dystonia occurs within hours
, • What happens with lithium and NSAIDs? -✓✓ANSWER: Increased risk of lithium
toxicity (gout meds, ibuprophen, naproxen, etc.)
• What happens with lithium and ACE inhibitors? -✓✓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? -✓✓ANSWER:
Risk of fatal nephrotoxicity
• What is a fetal side effect of lithium? -✓✓ANSWER: Epstein's anomaly
• What lab should you check for athletes on lithium? -✓✓ANSWER: Specific
gravity to assess for dehydration (dehydration is >1.015)
• What do you do if the lithium level is 1.3? -✓✓ANSWER: Do not give the next
dose and assess for s/s
• At what level is lithium toxicity a medical emergency? -✓✓ANSWER: >3
• S/S of lithium toxicity -✓✓ANSWER: vomiting, diarrhea, slurred speech, hand
tremor, dry mouth/thirst, muscle weakness/twitching
• Why check an EKG with lithium? -✓✓ANSWER: Inverted T-waves
UPDATED ACTUAL QUESTIONS AND CORRECT ANSWERS
| VERIFIED EXAM PREP
• What does ADPIE stand for? -✓✓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? -✓✓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? -
✓✓ANSWER: Scrape nail and send for testing
• What do you do if a patient on lithium has dark brown urine? -✓✓ANSWER:
Check renal function
• What do you do if a patient presents with fever while on Clozaril? -✓✓ANSWER:
Check ANC level to assess for agranulocytosis
• What can cause serotonin syndrome? -✓✓ANSWER: Antidepressants, St. John's
Wort, Same-E, Kava Kava, and Tryptophan
,• What labs are indicative of NMS? -✓✓ANSWER: Elevated WBC (over 11,000)
and elevated CPK
• S/S of NMS -✓✓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? -
✓✓ANSWER: Check for rhabdo with CPK
• s/s of serotonin syndrome -✓✓ANSWER: hyperreflexia, muscle spasms,
myoclonus (involuntary muscle jerk), fever, tachycardia, HTN, shits and shivers
• What two medications to give with NMS? -✓✓ANSWER: bromocriptine
(Parlodel)- D2 agonist dantrolene- muscle relaxer
• What medication to give during SS? -✓✓ANSWER: cyproheptadine (Periactin)-
5HT-2A receptor antagonist
• What is the onset and typical length of NMS? -✓✓ANSWER: Slow onset (1-2
weeks after changing or starting therapy) and resolves within 9-14 days
• What is the onset of SS? -✓✓ANSWER: Within 24 hours of starting/changing
medication and resolves within a few days
• How do you distinguish between NMS and acute dystonia? -✓✓ANSWER: NMS
has a slower onset while acute dystonia occurs within hours
, • What happens with lithium and NSAIDs? -✓✓ANSWER: Increased risk of lithium
toxicity (gout meds, ibuprophen, naproxen, etc.)
• What happens with lithium and ACE inhibitors? -✓✓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? -✓✓ANSWER:
Risk of fatal nephrotoxicity
• What is a fetal side effect of lithium? -✓✓ANSWER: Epstein's anomaly
• What lab should you check for athletes on lithium? -✓✓ANSWER: Specific
gravity to assess for dehydration (dehydration is >1.015)
• What do you do if the lithium level is 1.3? -✓✓ANSWER: Do not give the next
dose and assess for s/s
• At what level is lithium toxicity a medical emergency? -✓✓ANSWER: >3
• S/S of lithium toxicity -✓✓ANSWER: vomiting, diarrhea, slurred speech, hand
tremor, dry mouth/thirst, muscle weakness/twitching
• Why check an EKG with lithium? -✓✓ANSWER: Inverted T-waves
