GEORGETTE REVIEW PMHNP EXAM LATEST
2024/2025 UPDATED QUESTIONS AND CORRECT
DETAILED ANSWERS GRADED A+
When many answers are remarkably similar, they are usually _____________ -
ANSWER-wrong
Interprofessional collaboration is encouraged. - ANSWER-Collaborate is usually
right.
Delegate is usually wrong.
ADPIER - ANSWER-Assessment, diagnosis, Plan, intervention, evaluate, refer
out last.
Lithium - ANSWER-Normal 0.6-1.2
Lithium toxicity occurs at levels - ANSWER-> 1.5
,Signs of Lithium toxicity - ANSWER-severe nausea, diarrhea, vomiting,
confusion, drowsiness, muscle weakness, heart palpitation, coarse hand
tremors, unsteady gait
Lithium is gold standard for - ANSWER-MANIA
Lithium has evidence shown to - ANSWER-reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester - ANSWER-Ebstein
anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to - ANSWER-rise
Lamotrigine is least likely to cause - ANSWER-sedation or weight gain
Carbamazepine (tegretol) black box warning - ANSWER-agranulocytosis
(decrease WBCs)
aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin
rash, SOA)
Carbamazepine and asians - ANSWER-Screen for HLAB-1502 allele before
initiating, due to high incidence of SJS if positive for allele.
Child-bearing aged women - ANSWER-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
Baseline labs before initiation of lithium - 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 - 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 - ANSWER-staying hydrated
avoiding NSAIDS
compliance
Depakote normal level - ANSWER-50-125
Depakote toxicity level - ANSWER-greater than 150
Teratogenic effects of Depakote - ANSWER-spina bifida
Adverse effects of depakote - 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 - ANSWER-disorientation, lethargy, respiratory
depression, nausea/vomiting
Intervention for depakote toxicity - ANSWER-DC med
check level
LFT
ammonia
MAOI + tyramine causes - ANSWER-hypertensive crisis
Symptoms of hypertensive crisis - ANSWER-elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI + - ANSWER-MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
2024/2025 UPDATED QUESTIONS AND CORRECT
DETAILED ANSWERS GRADED A+
When many answers are remarkably similar, they are usually _____________ -
ANSWER-wrong
Interprofessional collaboration is encouraged. - ANSWER-Collaborate is usually
right.
Delegate is usually wrong.
ADPIER - ANSWER-Assessment, diagnosis, Plan, intervention, evaluate, refer
out last.
Lithium - ANSWER-Normal 0.6-1.2
Lithium toxicity occurs at levels - ANSWER-> 1.5
,Signs of Lithium toxicity - ANSWER-severe nausea, diarrhea, vomiting,
confusion, drowsiness, muscle weakness, heart palpitation, coarse hand
tremors, unsteady gait
Lithium is gold standard for - ANSWER-MANIA
Lithium has evidence shown to - ANSWER-reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester - ANSWER-Ebstein
anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to - ANSWER-rise
Lamotrigine is least likely to cause - ANSWER-sedation or weight gain
Carbamazepine (tegretol) black box warning - ANSWER-agranulocytosis
(decrease WBCs)
aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin
rash, SOA)
Carbamazepine and asians - ANSWER-Screen for HLAB-1502 allele before
initiating, due to high incidence of SJS if positive for allele.
Child-bearing aged women - ANSWER-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
Baseline labs before initiation of lithium - 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 - 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 - ANSWER-staying hydrated
avoiding NSAIDS
compliance
Depakote normal level - ANSWER-50-125
Depakote toxicity level - ANSWER-greater than 150
Teratogenic effects of Depakote - ANSWER-spina bifida
Adverse effects of depakote - 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 - ANSWER-disorientation, lethargy, respiratory
depression, nausea/vomiting
Intervention for depakote toxicity - ANSWER-DC med
check level
LFT
ammonia
MAOI + tyramine causes - ANSWER-hypertensive crisis
Symptoms of hypertensive crisis - ANSWER-elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI + - ANSWER-MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
