LMR Georgette’s PMHNP Certification Exam V2 | Latest 2025/ 2026 Update | Questions and Verified Answers | 100% Correct | GRADED A.

LMR Georgette’s PMHNP Certification Exam V2 | Latest 2025/ 2026 Update | Questions and Verified Answers | 100% Correct | GRADED A. Question: Side effects of atypical antipsychotics Answer: Risk of metabolic syndrome: increased weight, blood glucose, triglycerides, and insulin resistance Question: Zyprexa (Olanzapine) side effect Answer: Excessive weight gain Question: Seroquel side effects Answer: weight gain and sedation; cataracts (assess with slit lamp) Question: Thorazine (chlorpromazine) Answer: corneal deposits Question: Geodon (ziprasidone) Answer: weight neutral, take with food, monitor for QT prolongation Question: Latuda (lurasidone) Answer: eat with med 360 calories Question: Risperdal and Reglan Answer: Reglan is a D2 dopamine antagonist and should be avoided with Risperdal for 2 hours. It decreases the absorption of the Risperdal. Question: First line antipsychotic in children Answer: Risperdal (max 3 mg/day) Question: arcus senilis Answer: gray-white arc or circle around the limbus of the iris that is common with aging; hyperlipidemia Question: Protection of ischemic injuries Answer: atypical antipsychotics Question: Ages of Schizophrenia Answer: 18-25 males 25-35 females Question: Why dose cimetidine, zantac, and omeprazole 2 hours apart from Risperdal? Answer: They are inhibitors and will decrease the absorption of Risperdal in liver Question: What alpha 2 delta ligands are approved for neuropathic pain tx? Answer: Lyrica and gabapentin Question: Celexa and Lexapro side effect Answer: Prolonged QT interval Question: Effexor side effect Answer: elevated bp Question: false positives Answer: benzos- zoloft Question: what to avoid with MAOIs Answer: Tyramine (aged cheese, wine, pickled herring) Question: What can happen when TCAs and MAOIs are combined? Answer: Increased norepinephrine causing a hypertensive crisis (flushing, explosive headache in the back of head) Question: How to treat hypertensive crisis from MAOI and TCA combo Answer: Phentolamine Question: What is 1st line antidepressant for children? Answer: Prozac Question: Tx OCD in kids Answer: Zoloft Question: How long to wait between MAOI and SSRI Answer: 14 days Question: How long is the wash-out period between MAOI and Prozac? Answer: 5 weeks Question: Pseudodementia Answer: A condition with clinical symptoms of dementia but due to depression Question: Remeron (mirtazapine) Answer: helps with weight gain Question: Risk with zoloft and cipro Answer: tendon rupture Question: Risk with celexa and cipro Answer: QTC prolongation Question: Imitrex (sumatriptan) and Celexa Answer: Serotonin syndrome Question: Trazodone (Desyrel) Answer: Priapism Question: Tamoxifen (Nolvadex) and BFP Answer: bupropion, fluoxetine, and paxil can cause reoccurence of cancer when given with tamoxifen Question: Acute disseminated encephalomyelitis (ADEM) action Answer: check cytokines (will be increased), neuro exam, assess asymmetry of extremities, send to ER Question: alcohol dehydrogenase Answer: an enzyme in the stomach that breaks down alcohol; women have less than men Question: Endocrine findings suggestive of alcohol dependency Answer: testicular atrophy, gynecomastia, and sexual dysfunction Question: Kava Kava Answer: used for anxiety, causes sedation, metabolized in liver- monitor LFTs Question: Kava kava and levodopa Answer: causes decreased absorption of levodopa Question: 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 Question: Reactive Attachment Disorder Answer: no emotions, eating without interest; caused by negligent care and lack of primary caregiver Question: What percentage of children have learning disorders? Answer: 4-6% Question: osteoporosis prevention Answer: encourage the women to participate in weight-bearing activities, take vitamin D, avoid caffeine/smoking/alcohol, estrogen supplement Question: decreased testosterone in women Answer: less blood to vagina causes dryness, mood changes, decreased libido Question: Rett Syndrome Answer: progressive neurological developmental disorder, more in females, seizure/scoliosis risk, decelerated head growth Question: Tx for menopausal women Answer: tai chi, flaxseed, soy Question: CAT for PTSD Answer: Guided imagery Question: imagery rehearsal therapy Answer: a treatment involving rewriting a nightmare by visualizing positive images while awake Question: EMDR Answer: eye movement desensitization and reprocessing (desensitization, installation, body scan) Question: critical incident stress management (CISM) Answer: introduction fact thought reaction symptoms teaching re-entry Question: adjustment disorder Answer: reaction to a specific life event; less than 6 months Question: acute stress disorder vs PTSD Answer: PTSD >1 month Acute stress disorder < 1 mont Question: MDD diagnosis Answer: 5 or more symptoms of MSIGECAPS for at least 2 weeks Question: SIGECAPS Answer: Sleep Interest Guilt Energy Concentration Appetite Psychomotor Suicide Question: ODD vs. Conduct Disorder Answer: ODD is persistent, hostile, defiant behavior without serious violations of basic rights of other, conduct disorder is with violations of basic right of others (often legal violations) Question: factitious disorder Answer: Condition in which a person acts as if he or she has a physical or mental illness when he or she is not really sick. Question: Malingering Answer: secondary gain is present Question: conversion disorder Answer: neurological symptoms that cannot be explained by medical disease or culturally sanctioned behavior Question: Somatic Disorders Answer: no medical explanation Question: brief psychotic disorder Answer: Psychotic disturbance involving delusions, hallucinations, or disorganized speech or behavior but lasting less than 1 month; often occurs in reaction to a stressor. Question: schizophreniform disorder Answer: Psychotic disorder involving the symptoms of schizophrenia but lasting less than 6 months. Question: Schizophrenia Answer: a psychological disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished, inappropriate emotional expression Question: schizoaffective disorder Answer: a psychological disorder characterized by the combination of mood and psychotic symptoms; schizophrenia present for more than 2 weeks without mood disorder symptoms Question: delusional disorder Answer: a psychotic disorder in which the primary symptom is one or more delusions; no other symptom, at least 1 month Question: DIGFAST for mania Answer: Distractibility Indiscretion Grandiosity Flight of ideas Activity increase Sleep deficit Talking increase Question: Mania vs Hypomania Answer: mania: > 1 week of symptoms -distress -hospitalization required Question: hypomania: Answer: < 1 week of symptoms -no hospitalization required Question: Bipolar I vs Bipolar II Answer: Bipolar I: All that is required for Dx is 1 Manic Episode (No depressive episode needed). Bipolar II: Requires at least one depressive episode and a Hypomanic Episode Question: Tics are found in what percentage of children Answer: 1-2% Question: Tourette's Neurotransmitters Answer: increased dopamine Question: Non-stimulants for ADHD Answer: atomoxetine (Strattera) clonidine (Catapres) guanfacine (Tenex) Question: signs of amphetamine abuse Answer: irritable, weight loss Question: Stimulant intoxication symptoms Answer: high feeling pupillary dilation euphoria gregariousness grandiosity repetitive behavior anger impaired judgement weakness Question: Methadone Answer: long acting oral opiate used for heroin detoxification or long term maintenance Question: opioid intoxication symptoms Answer: decreased respiratory rate, hypotension, hypothermia, dec bowel sounds, miosis Question: SBIRT Answer: Screening, Brief Intervention, and Referral to Treatment Question: motivational interviewing Answer: a collaborative, person-centered form of guiding to elicit and strengthen motivation for change Question: Beck inventory severe score Answer: Over 30 is severe Question: Hamilton Anxiety Rating Scale Answer: a. 14 items scored on a scale of 0 (not present) to 4 (severe) b. total score range 0-56 c. Mild severity- <17 d. mild-mod 18-24 e. mod -severe 25-30 Question: PHQ-9 scoring Answer: 0-4 none 5-9 mild depression 10-14 moderate 15-19 mod. severe 20-27 severe depression Question: Zung Self-Rating Depression Scale Answer: Self-rated- Over 70 high risk for suicide. Question: GAD-7 scale Answer: More than 15 severe Question: Vanderbilt Scales Answer: Screening for ADHD and common comorbidities: oppositional-defiant, conduct, anxiety and depression Question: Detox with hepatic dysfunction Answer: Ativan or Serax Question: Avoid cymbalta with alcohol patients why? Answer: Liver damage- check LFTs Question: Opiate detox for pregnant women Answer: Methadone Question: Ativan in pregnancy Answer: floppy baby and cleft palate Question: Naltrexone (ReVia) contraindication in who? Answer: Pts with liver disease Question: Acmprosate contraindicated with who? Answer: Pts with kidney problems Question: Disulfiram (Antabuse) Answer: Must be alcohol free 12 hours; avoid substances for 2 weeks after stopping or flushing, HA, SOB, fainting, tachycardia, blurred vision Question: Lewy body dementia Answer: A form of dementia characterized by an increase in Lewy body cells in the brain. Symptoms include visual hallucinations, momentary loss of attention, falling, and fainting. Question: Pick's disease Answer: rare condition that results in early onset; personality changes; frontotemporal dementia Question: Namenda (memantine) Answer: moderate to severe Alzheimer's disease Question: Cholinesterase inhibitors Answer: Donepezil Rivastigmine Galantamine Question: Side effects of cholinesterase inhibitors Answer: Nausea, vomiting, dyspepsia, diarrhea, dizziness, headache, bradycardia, weight loss Question: macrocytic anemia Answer: check folic acid and vitamin B12 levels Question: Huntington's disease Answer: Genetic disorder that causes progressive deterioration of brain cells. caused by a dominant allele before age 30 Question: Symptoms of Huntington's Disease Answer: Tremors, clumsiness, memory loss, inability to concentrate, mood changes, involuntary movements, difficulty swallowing or speaking Question: Anorexia vs. Bulimia Answer: Major difference between two conditions is control. Anorexic is usually already below healthy weight, ,still perceives own weight is unacceptable, attempts to lower weight further by limiting food intake. Bulimic has no sense of control over eating habits. Eat excessively and then attempt to overcompensate for excessive food intake. Question: Wellbutrin in anorexic patients Answer: low seizure threshold Question: Refeeding syndrome Answer: metabolic alterations that may occur during nutritional repletion of starved patients; pain with eating Question: Russel sign Answer: Calluses on knuckles from inducing vomiting Question: Criteria for admitting anorexic patient Answer: weight less than 75% of ideal body weight, low temp, low pulse, low bp Question: Who is at a higher risk of fibromyalgia? Answer: sex abuse victims Question: Inducers of Cytochrome P450 (CYP450) Answer: worry about subtherapeutic levels; tobacco, phenytoin, carbamazepine, and rifampin Question: Inhibitors of CYP450 Answer: worry about toxicity; Cimetidine, ketoconazole, erythromycin, isoniazid and grapefruit Question: flonase and depakote Answer: Patient can become manic- d/c flonase Question: Medications that cause depression Answer: Sedatives (etoh, benzos, antihistamines), flonase, interferon, accutane, abx, progesterone, beta-blockers Question: Medications that cause mania Answer: flonase, steroids, disulfram, isoniazid, SSRIs Question: Piaget's stages of cognitive development Answer: sensorimotor infancy (object consistency), pre operational 2-5 (egocentrism), concrete operational 6-11 (conservation, reversibility), formal operational Question: psychosexual stages Answer: the childhood stages of development (oral, anal, phallic, latency, genital) during which, according to Freud, the id's pleasure-seeking energies focus on distinct erogenous zones Question: Recovery Model Answer: A model that is patient/consumer-centered, is hopeful and empowering, and emphasizes the person and the future rather than the illness and the present. Question: client readiness to learn Answer: emotional, physical, experiential, and knowledge readiness Question: Appreciate Inquiry Answer: an approach that seeks to identify the unique qualities and special strengths of an organization, which can then be built on to improve performance Question: Just Culture Model Answer: Type of culture model in which the focus is on identifying and addressing systems issues that lead individuals to engage in unsafe behaviors, while maintaining individual accountability by establishing zero tolerance for unsafe behavior. Question: Root Cause Analysis Answer: An analytical technique used to determine the basic underlying reason that causes a variance or a defect or a risk. A root cause may underlie more than one variance or defect or risk. Question: parity law Answer: directs insurance companies to provide equal coverage for mental and medical problems Question: Stark Law Answer: Prohibits physicians or their family members who own health care facilities from referring patients to those entities if the federal government, under Medicare or Medicaid, will pay for treatment. Question: kickback Answer: the return of a portion of the money received in a sale or contract, often secretly or illegally, in exchange for favors Question: Habeous Corpus Answer: the right to hearing in front of a judge to determine guilt or innocence Question: Tarasoff Answer: duty to warn Question: Desmopressin (DDAVP) Answer: used for bedwetting, decreases urine Question: Lead poisoning symptoms Answer: worry about neuro (seizures), irritability, lethargy, anorexia, vomiting, diarrhea, anemia Question: fetal alcohol syndrome (FAS) s/s Answer: small head, short eye opening, flat face, smooth philtrum, underdeveloped jaw, thin upper lip, short nose Question: Iatrogenic Medicine Answer: benzo- can lead to dependence Question: paradoxical effect Answer: opposite of the intended drug effect Question: change agent Answer: the person formally in charge of guiding a change effort Question: criteria for involuntary admission Answer: - Presence of mental illness - Poses a danger to self or others - Demonstrates severe disability or inability to meet basic necessities including food, clothing, and shelter - Requires treatment but unable to seek it voluntarily related to the impact of the mental illness Question: O'Connor v. Donaldson Answer: Established that mental illness alone is not enough for involuntary hospitalization -- mentally ill cannot be confined against their will if they can survive on their own Question: dusky vs united states Answer: competence to stand trial Question: Durham vs. United States Answer: insanity defense Question: Rogers vs. Okin Answer: right to refuse medication unless guardian consents Question: Rennie v. Klein Answer: patients have the right to refuse any treatment and attempt to appeal Question: Ford vs. Wainwright Answer: Prohibits the execution of the insane Question: defense mechanisms Answer: the ego's protective methods of reducing anxiety by unconsciously distorting reality Question: Healthy defense mechanisms Answer: Altruism- kill them with kindness Sublimation- channel emotions into something else Suppression- repress conciously Humor Question: Crisis Intervention Steps Answer: 1. Identify the problem 2. List alternatives 3. Choose from alternatives 4. Implement the plan 5. Evaluate the outcome Question: Maslow's Hierarchy of Needs Answer: (level 1) Physiological Needs, (level 2) Safety and Security, (level 3) Relationships, Love and Affection, (level 4) Self Esteem, (level 5) Self Actualization Question: high level of evidence Answer: random control trials Question: lowest level of evidence Answer: Expert opinion; narrative reviews; studies of single cases; personal experiences in practice Question: cornerstone of evidence-based practice Answer: systematic reviews Question: erectile dysfunction (ED) medication Answer: PDE5 inhibitors (rapid absorption) Question: Temporal arteritis Answer: ESR elevation Question: TIGER (Technology Informatics Guiding Education Reform) Answer: toward compter literacy Question: HITECH Act Answer: Health Info Technology for Economic & Clinical Health Act. Part of ARRA. Question: Telelogical Answer: ethical theory concerned with outcome, whether an action produces greater good in the world Question: Deontological Answer: good or bad right now Question: Depolarization Answer: initial phase, excitatory, influx of sodium and calcium ions Question: Repolarization Answer: restoration phase, inhibitor response, potassium leaving cell and chloride entering cell Question: advanced sleep phase type Answer: Falling asleep and waking earlier than desired Question: delayed sleep phase type Answer: Falling asleep and waking later than desired Question: classical conditioning Answer: a type of learning in which one learns to link two or more stimuli and anticipate events Question: operant conditioning Answer: a type of learning in which behavior is strengthened if followed by a reinforcer or diminished if followed by a punisher Question: respondent behavior Answer: behavior that occurs as an automatic response to some stimulus