PMHNP Boards - Georgette's Study Guide
Exam Test Questions with Correct Answers.
When many answers are remarkably similar, they are usually _____________ - Correct
Answer-wrong
When two answers are opposites, usually... - Correct Answer-one of those two is the
correct answer
When looking at questions about intraprofessional communication: ________ don't
_________. - Correct Answer-collaborate, dont delegate
If asked to differentiate #1 from #2; think what is unique about _______. - Correct Answer-
#1
If a question and an answer use the same words or synonyms, then that answer is usually
______. - Correct Answer-correct
If an answer has absolutes (only, always) it is usually _________. - Correct Answer-wrong
Levels of prioritization to use when answering questions: three levels. - Correct Answer-1.
Airway, breathing, circulation
2. Maslowes - physiological needs (food, water, warmth, rest), safey and security
3. Nursing process: Assessment, diagnosis, plan, intervention, evaluate, refer out last
Lithium levels - Normal and Toxicity - Correct Answer-Normal 0.6-1.2
Toxicity > 1.5
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 (2) - Correct Answer-1. reduce suicidal ideation
2. Neuroprotective tx of choice for bipolar
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+
Side Effects of Lithium and lithium toxicity - Correct Answer-SIde Effects: hypothyroidism,
coarse hand tremors with toxicity, diarrhea, leukocytosis
Toxicity: N/V, confusion, convulsions, drawsiness, blurred vision, slurred speech, mm
weakness, heart palpitations, course hand tremors, and unsteadiness when walking
(STOP and check levels)
Why are elderly more sensitive to lithium (5) - Correct Answer-Decreased intercellular
water, protein binding, mm mass, and metabolism
Increased body fat
MAOI + tyramine causes - Correct Answer-hypertensive crisis - life threatening and
emergency
Symptoms of hypertensive crisis - Correct Answer-elevated BP
sudden explosive occipital headache
facial flushing
palpitations
pupillary dilation
diaphoresis
,fever
Hypertensive crisis occurs with MAOI + - Correct Answer-MEPERIDINE
STIMULANTS
TCAs
asthma meds
antipsychotics
Treatment for hypertensive crisis - Correct Answer-DC offending agent
Administer PHENTOLAMINE
teratogenic effects of depakote - Correct Answer-neural tube defects/spina bifida
Severe side effect of mood stabilizers __ __ __ - Correct Answer-Steven Johnson's
Syndrome
Signs of Stevens johnson syndrome (SJS) - Correct Answer-FEVER --high yield
facial swelling
tongue swelling
burning papule rashe
skin sloughing
prodromal headache
painful mucus membranes
Side effects of valproic acid/divalproex sodium - Correct Answer-hepatotoxicity and
pancreatitis
Carbamazepine (tegretol) black box warning - Correct Answer-agranulocytosis (decrease
WBCs)
aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin rash, SOB)
Carbamazepine and asians - Correct Answer-FDA REQUIRED ccreen for HLAB-1502
allele before initiating, due to high incidence of SJS if positive for allele
, Child-bearing aged women (Tegretol) - Correct 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 (0.4-0.5 mg daily)
Clozaril/clozapine can cause - Correct Answer-agranulocytosis and neutropenia
For monitoring neutropenia in Clozaril, monitor what lab - Correct Answer-ANC only (not
in conjunction with WBCs)
DC clozaril if ANC - Correct Answer-less than 1000, risk of neuropenia
Normal 2500-6000
DC clozaril if WBC - Correct Answer-2000-3000, risk of agranulocytosis
Normal: 4500-11000
Frequency of clozaril labs - Correct Answer-First six months - weekly
Next six months - every two weeks
Then monthly if ANC normal
When on clozaril monitor for - Correct Answer-signs and symptoms of infection: sudden
fever, chills, sore throat, weakness
Your patient with bipolar disorder is admitted to a medical hospital. The internist contacts
your office and asks whether the lithium you prescribed him is effecting his ECG. How do
you respond?
A. Lithium can prolong the QT interval
B. Lithium has no effect on his ECG
C. Lithium can invert the t waves
D. Lithium can shorten the PR interval - Correct Answer-Answer: Lithium can invert the t
waves.
Mary is a 45-year-old African American female who has been treated on Isocarboxazid
(Marplan) for over 6 years. Mary is going in for a surgical procedure. Which medication is
strictly contraindicated with Isocarboxazid?
Exam Test Questions with Correct Answers.
When many answers are remarkably similar, they are usually _____________ - Correct
Answer-wrong
When two answers are opposites, usually... - Correct Answer-one of those two is the
correct answer
When looking at questions about intraprofessional communication: ________ don't
_________. - Correct Answer-collaborate, dont delegate
If asked to differentiate #1 from #2; think what is unique about _______. - Correct Answer-
#1
If a question and an answer use the same words or synonyms, then that answer is usually
______. - Correct Answer-correct
If an answer has absolutes (only, always) it is usually _________. - Correct Answer-wrong
Levels of prioritization to use when answering questions: three levels. - Correct Answer-1.
Airway, breathing, circulation
2. Maslowes - physiological needs (food, water, warmth, rest), safey and security
3. Nursing process: Assessment, diagnosis, plan, intervention, evaluate, refer out last
Lithium levels - Normal and Toxicity - Correct Answer-Normal 0.6-1.2
Toxicity > 1.5
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 (2) - Correct Answer-1. reduce suicidal ideation
2. Neuroprotective tx of choice for bipolar
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+
Side Effects of Lithium and lithium toxicity - Correct Answer-SIde Effects: hypothyroidism,
coarse hand tremors with toxicity, diarrhea, leukocytosis
Toxicity: N/V, confusion, convulsions, drawsiness, blurred vision, slurred speech, mm
weakness, heart palpitations, course hand tremors, and unsteadiness when walking
(STOP and check levels)
Why are elderly more sensitive to lithium (5) - Correct Answer-Decreased intercellular
water, protein binding, mm mass, and metabolism
Increased body fat
MAOI + tyramine causes - Correct Answer-hypertensive crisis - life threatening and
emergency
Symptoms of hypertensive crisis - Correct Answer-elevated BP
sudden explosive occipital headache
facial flushing
palpitations
pupillary dilation
diaphoresis
,fever
Hypertensive crisis occurs with MAOI + - Correct Answer-MEPERIDINE
STIMULANTS
TCAs
asthma meds
antipsychotics
Treatment for hypertensive crisis - Correct Answer-DC offending agent
Administer PHENTOLAMINE
teratogenic effects of depakote - Correct Answer-neural tube defects/spina bifida
Severe side effect of mood stabilizers __ __ __ - Correct Answer-Steven Johnson's
Syndrome
Signs of Stevens johnson syndrome (SJS) - Correct Answer-FEVER --high yield
facial swelling
tongue swelling
burning papule rashe
skin sloughing
prodromal headache
painful mucus membranes
Side effects of valproic acid/divalproex sodium - Correct Answer-hepatotoxicity and
pancreatitis
Carbamazepine (tegretol) black box warning - Correct Answer-agranulocytosis (decrease
WBCs)
aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin rash, SOB)
Carbamazepine and asians - Correct Answer-FDA REQUIRED ccreen for HLAB-1502
allele before initiating, due to high incidence of SJS if positive for allele
, Child-bearing aged women (Tegretol) - Correct 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 (0.4-0.5 mg daily)
Clozaril/clozapine can cause - Correct Answer-agranulocytosis and neutropenia
For monitoring neutropenia in Clozaril, monitor what lab - Correct Answer-ANC only (not
in conjunction with WBCs)
DC clozaril if ANC - Correct Answer-less than 1000, risk of neuropenia
Normal 2500-6000
DC clozaril if WBC - Correct Answer-2000-3000, risk of agranulocytosis
Normal: 4500-11000
Frequency of clozaril labs - Correct Answer-First six months - weekly
Next six months - every two weeks
Then monthly if ANC normal
When on clozaril monitor for - Correct Answer-signs and symptoms of infection: sudden
fever, chills, sore throat, weakness
Your patient with bipolar disorder is admitted to a medical hospital. The internist contacts
your office and asks whether the lithium you prescribed him is effecting his ECG. How do
you respond?
A. Lithium can prolong the QT interval
B. Lithium has no effect on his ECG
C. Lithium can invert the t waves
D. Lithium can shorten the PR interval - Correct Answer-Answer: Lithium can invert the t
waves.
Mary is a 45-year-old African American female who has been treated on Isocarboxazid
(Marplan) for over 6 years. Mary is going in for a surgical procedure. Which medication is
strictly contraindicated with Isocarboxazid?
