LMR GEORGETTE’S PMHNP CERTIFICATION EXAM LATEST 2026
COMPLETE QUESTIONS AND VERIFIED CORRECT ANSWERS
GRADED A+ GUARANTEED 100% PASS
Endocrine findings suggestive of alcohol dependency - ANSWER-testicular atrophy,
gynecomastia, and sexual dysfunction
Kava Kava - ANSWER-used for anxiety, causes sedation, metabolized in liver-
monitor LFTs
Kava kava and levodopa - ANSWER-causes decreased absorption of levodopa
Autism Spectrum Disorder - ANSWER-a disorder that appears in childhood and is
marked by significant deficiencies in communication and social interaction, and by
rigidly fixated interests and repetitive behaviors
Reactive Attachment Disorder - ANSWER-no emotions, eating without interest;
caused by negligent care and lack of primary caregiver
What percentage of children have learning disorders? - ANSWER-4-6%
osteoporosis prevention - ANSWER-encourage the women to participate in weight-
bearing activities, take vitamin D, avoid caffeine/smoking/alcohol, estrogen supplement
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
What medication should treat hypothyroidism caused by lithium use? - ANSWER-
Synthroid
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
What do you do if patient is prescribed both depakote and lamictal? - ANSWER-
Decreased lamictal dose by 50%
Depakote and pregnancy - ANSWER-Spina bifida
What emergency may be occuring if patient on depakote reports upper abdominal pain?
- ANSWER-Pancreatitis
What lab should you check if patient has right upper quadrant pain and dark brown
urine? - ANSWER-LFTs
What lab means pregnancy? - ANSWER-HCG
Why is Clozaril used? - ANSWER-Treatment resistant schizophrenia, improves SI,
and improves negative symptoms of schizophrenia
What two medications have the highest risk of agranulocytosis and aplastic anemia? -
ANSWER-Clozaril and Tegretol
What symptoms may mean a Clozaril induced infection? - ANSWER-Sore throats,
sores in mouth/gums, fever
When should you discontinue Clozaril or Tegretol? - ANSWER-WBC < 2000 or ANC
<1000
COMPLETE QUESTIONS AND VERIFIED CORRECT ANSWERS
GRADED A+ GUARANTEED 100% PASS
Endocrine findings suggestive of alcohol dependency - ANSWER-testicular atrophy,
gynecomastia, and sexual dysfunction
Kava Kava - ANSWER-used for anxiety, causes sedation, metabolized in liver-
monitor LFTs
Kava kava and levodopa - ANSWER-causes decreased absorption of levodopa
Autism Spectrum Disorder - ANSWER-a disorder that appears in childhood and is
marked by significant deficiencies in communication and social interaction, and by
rigidly fixated interests and repetitive behaviors
Reactive Attachment Disorder - ANSWER-no emotions, eating without interest;
caused by negligent care and lack of primary caregiver
What percentage of children have learning disorders? - ANSWER-4-6%
osteoporosis prevention - ANSWER-encourage the women to participate in weight-
bearing activities, take vitamin D, avoid caffeine/smoking/alcohol, estrogen supplement
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
What medication should treat hypothyroidism caused by lithium use? - ANSWER-
Synthroid
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
What do you do if patient is prescribed both depakote and lamictal? - ANSWER-
Decreased lamictal dose by 50%
Depakote and pregnancy - ANSWER-Spina bifida
What emergency may be occuring if patient on depakote reports upper abdominal pain?
- ANSWER-Pancreatitis
What lab should you check if patient has right upper quadrant pain and dark brown
urine? - ANSWER-LFTs
What lab means pregnancy? - ANSWER-HCG
Why is Clozaril used? - ANSWER-Treatment resistant schizophrenia, improves SI,
and improves negative symptoms of schizophrenia
What two medications have the highest risk of agranulocytosis and aplastic anemia? -
ANSWER-Clozaril and Tegretol
What symptoms may mean a Clozaril induced infection? - ANSWER-Sore throats,
sores in mouth/gums, fever
When should you discontinue Clozaril or Tegretol? - ANSWER-WBC < 2000 or ANC
<1000
