LMR GEORGETTE’S PMHNP CERTIFICATION EXAM LATEST 2025
QUESTIONS AND CORRECT ANSWERS(VERIFIED ANSWERS)
What does ADPIE stand for? - CORRECT 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? - CORRECT 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? -
CORRECT ANSWER-Scrape nail and send for testing
What do you do if a patient on lithium has dark brown urine? - CORRECT
ANSWER-Check renal function
What do you do if a patient presents with fever while on Clozaril? -
CORRECT ANSWER-Check ANC level to assess for agranulocytosis
What can cause serotonin syndrome? - CORRECT ANSWER-
Antidepressants, St. John's Wort, Same-E, Kava Kava, and Tryptophan
What labs are indicative of NMS? - CORRECT ANSWER-Elevated WBC
(over 11,000) and elevated CPK
,S/S of NMS - CORRECT 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? -
CORRECT ANSWER-Check for rhabdo with CPK
s/s of serotonin syndrome - CORRECT ANSWER-hyperreflexia, muscle
spasms, myoclonus (involuntary muscle jerk), fever, tachycardia, HTN,
shits and shivers
What two medications to give with NMS? - CORRECT ANSWER-
bromocriptine (Parlodel)- D2 agonist dantrolene- muscle relaxer
What medication to give during SS? - CORRECT ANSWER-cyproheptadine
(Periactin)- 5HT-2A receptor antagonist
What is the onset and typical length of NMS? - CORRECT ANSWER-Slow
onset (1-2 weeks after changing or starting therapy) and resolves within 9-
14 days
What is the onset of SS? - CORRECT ANSWER-Within 24 hours of
starting/changing medication and resolves within a few days
How do you distinguish between NMS and acute dystonia? - CORRECT
ANSWER-NMS has a slower onset while acute dystonia occurs within
hours
What happens with lithium and NSAIDs? - CORRECT ANSWER-Increased
risk of lithium toxicity (gout meds, ibuprophen, naproxen, etc.)
, What happens with lithium and ACE inhibitors? - CORRECT 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? -
CORRECT ANSWER-Risk of fatal nephrotoxicity
What is a fetal side effect of lithium? - CORRECT ANSWER-Epstein's
anomaly
What lab should you check for athletes on lithium? - CORRECT ANSWER-
Specific gravity to assess for dehydration (dehydration is >1.015)
What do you do if the lithium level is 1.3? - CORRECT ANSWER-Do not
give the next dose and assess for s/s
At what level is lithium toxicity a medical emergency? - CORRECT
ANSWER->3
S/S of lithium toxicity - CORRECT ANSWER-vomiting, diarrhea, slurred
speech, hand tremor, dry mouth/thirst, muscle weakness/twitching
Why check an EKG with lithium? - CORRECT ANSWER-Inverted T-waves
What medication should treat hypothyroidism caused by lithium use? -
CORRECT ANSWER-Synthroid
QUESTIONS AND CORRECT ANSWERS(VERIFIED ANSWERS)
What does ADPIE stand for? - CORRECT 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? - CORRECT 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? -
CORRECT ANSWER-Scrape nail and send for testing
What do you do if a patient on lithium has dark brown urine? - CORRECT
ANSWER-Check renal function
What do you do if a patient presents with fever while on Clozaril? -
CORRECT ANSWER-Check ANC level to assess for agranulocytosis
What can cause serotonin syndrome? - CORRECT ANSWER-
Antidepressants, St. John's Wort, Same-E, Kava Kava, and Tryptophan
What labs are indicative of NMS? - CORRECT ANSWER-Elevated WBC
(over 11,000) and elevated CPK
,S/S of NMS - CORRECT 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? -
CORRECT ANSWER-Check for rhabdo with CPK
s/s of serotonin syndrome - CORRECT ANSWER-hyperreflexia, muscle
spasms, myoclonus (involuntary muscle jerk), fever, tachycardia, HTN,
shits and shivers
What two medications to give with NMS? - CORRECT ANSWER-
bromocriptine (Parlodel)- D2 agonist dantrolene- muscle relaxer
What medication to give during SS? - CORRECT ANSWER-cyproheptadine
(Periactin)- 5HT-2A receptor antagonist
What is the onset and typical length of NMS? - CORRECT ANSWER-Slow
onset (1-2 weeks after changing or starting therapy) and resolves within 9-
14 days
What is the onset of SS? - CORRECT ANSWER-Within 24 hours of
starting/changing medication and resolves within a few days
How do you distinguish between NMS and acute dystonia? - CORRECT
ANSWER-NMS has a slower onset while acute dystonia occurs within
hours
What happens with lithium and NSAIDs? - CORRECT ANSWER-Increased
risk of lithium toxicity (gout meds, ibuprophen, naproxen, etc.)
, What happens with lithium and ACE inhibitors? - CORRECT 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? -
CORRECT ANSWER-Risk of fatal nephrotoxicity
What is a fetal side effect of lithium? - CORRECT ANSWER-Epstein's
anomaly
What lab should you check for athletes on lithium? - CORRECT ANSWER-
Specific gravity to assess for dehydration (dehydration is >1.015)
What do you do if the lithium level is 1.3? - CORRECT ANSWER-Do not
give the next dose and assess for s/s
At what level is lithium toxicity a medical emergency? - CORRECT
ANSWER->3
S/S of lithium toxicity - CORRECT ANSWER-vomiting, diarrhea, slurred
speech, hand tremor, dry mouth/thirst, muscle weakness/twitching
Why check an EKG with lithium? - CORRECT ANSWER-Inverted T-waves
What medication should treat hypothyroidism caused by lithium use? -
CORRECT ANSWER-Synthroid
