ANCC PMHNP Final Exam Review – Georgette’s Comprehensive Question and Answer Guide |
Psychiatric-Mental Health Certification Prep (2024)
Description:
This is an in-depth review guide for the ANCC PMHNP final exam, curated by Georgette. It includes
hundreds of high-yield multiple-choice questions with correct answers and clinical rationales. Covered
topics include psychopharmacology, mood disorders, personality disorders, brain anatomy, DSM-5
diagnostic criteria, ethical and legal principles, developmental theories, and specific medication side
effects and interactions. Designed for nurse practitioners preparing for board certification and needing a
reliable and accurate final prep resource.
When many answers are remarkably similar, they are usually _____________
wrong
Interprofessional collaboration is encouraged.
Collaborate is usually right.
Delegate is usually wrong.
ADPIER
Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
Lithium
Normal 0.6-1.2
Lithium toxicity occurs at levels
> 1.5
Signs of Lithium toxicity
severe nausea, diarrhea, vomiting, confusion, drowsiness, muscle weakness, heart palpitation, coarse
hand tremors, unsteady gait
Lithium is gold standard for
MANIA
Lithium has evidence shown to
reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester
Ebstein anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to
rise
,Baseline labs before initiation of lithium
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
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
staying hydrated
avoiding NSAIDS
compliance
Depakote normal level
50-125
Depakote toxicity level
greater than 150
Teratogenic effects of Depakote
spina bifida
Adverse effects of depakote
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
disorientation, lethargy, respiratory depression, nausea/vomiting
Intervention for depakote toxicity
DC med
check level
,LFT
ammonia
MAOI + tyramine causes
hypertensive crisis
Symptoms of hypertensive crisis
elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI +
MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis
DC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzos
floppy baby, cleft palate
Teratogenic effects of tegratol
neural tube defect
teratogenic effects of lithium
ebstein anomaly (heart defect) (avoid, especially 1st trimester)
teratogenic effects of depakote
neural tube defects/spina bifida
Adverse reaction to Lamictal
Steven Johnson's Syndrome
, Signs of SJS
FEVER --high yield
sore throat
facial swelling
tongue swelling
red rash
skin sloughing
body aches
prodromal headache
malaise
arthralgia
painful mucus membranes
Lamotrigine is least likely to cause
sedation or weight gain
Carbamazepine (tegretol) black box warning
agranulocytosis (decrease WBCs)
aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin rash, SOA)
Carbamazepine and asians
Screen for HLAB-1502 allele before initiating, due to high incidence of SJS if positive for allele.
Child-bearing aged women
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
Clozaril/clozapine can cause
agranulocytosis and neutropenia
For monitoring neutropenia in Clozaril, monitor
ANC
DC clozarli if ANC
less than 1000
DC clozaril if WBC
2000-3000, risk of agranulocytosis
When on clozaril monitor for
signs and symptoms of infection: sudden fever, chills, sore throat, weakness
Clozaril only known antipsychotic to
Psychiatric-Mental Health Certification Prep (2024)
Description:
This is an in-depth review guide for the ANCC PMHNP final exam, curated by Georgette. It includes
hundreds of high-yield multiple-choice questions with correct answers and clinical rationales. Covered
topics include psychopharmacology, mood disorders, personality disorders, brain anatomy, DSM-5
diagnostic criteria, ethical and legal principles, developmental theories, and specific medication side
effects and interactions. Designed for nurse practitioners preparing for board certification and needing a
reliable and accurate final prep resource.
When many answers are remarkably similar, they are usually _____________
wrong
Interprofessional collaboration is encouraged.
Collaborate is usually right.
Delegate is usually wrong.
ADPIER
Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
Lithium
Normal 0.6-1.2
Lithium toxicity occurs at levels
> 1.5
Signs of Lithium toxicity
severe nausea, diarrhea, vomiting, confusion, drowsiness, muscle weakness, heart palpitation, coarse
hand tremors, unsteady gait
Lithium is gold standard for
MANIA
Lithium has evidence shown to
reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester
Ebstein anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to
rise
,Baseline labs before initiation of lithium
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
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
staying hydrated
avoiding NSAIDS
compliance
Depakote normal level
50-125
Depakote toxicity level
greater than 150
Teratogenic effects of Depakote
spina bifida
Adverse effects of depakote
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
disorientation, lethargy, respiratory depression, nausea/vomiting
Intervention for depakote toxicity
DC med
check level
,LFT
ammonia
MAOI + tyramine causes
hypertensive crisis
Symptoms of hypertensive crisis
elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI +
MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis
DC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzos
floppy baby, cleft palate
Teratogenic effects of tegratol
neural tube defect
teratogenic effects of lithium
ebstein anomaly (heart defect) (avoid, especially 1st trimester)
teratogenic effects of depakote
neural tube defects/spina bifida
Adverse reaction to Lamictal
Steven Johnson's Syndrome
, Signs of SJS
FEVER --high yield
sore throat
facial swelling
tongue swelling
red rash
skin sloughing
body aches
prodromal headache
malaise
arthralgia
painful mucus membranes
Lamotrigine is least likely to cause
sedation or weight gain
Carbamazepine (tegretol) black box warning
agranulocytosis (decrease WBCs)
aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin rash, SOA)
Carbamazepine and asians
Screen for HLAB-1502 allele before initiating, due to high incidence of SJS if positive for allele.
Child-bearing aged women
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
Clozaril/clozapine can cause
agranulocytosis and neutropenia
For monitoring neutropenia in Clozaril, monitor
ANC
DC clozarli if ANC
less than 1000
DC clozaril if WBC
2000-3000, risk of agranulocytosis
When on clozaril monitor for
signs and symptoms of infection: sudden fever, chills, sore throat, weakness
Clozaril only known antipsychotic to
