LMR Georgette’s PMHNP Certification Exam Latest
Questions And Correct Answers(Verified Answers)
What does ADPIE stand for? - ...(ANSWERS)....Assessment
Diagnosis
Planning
Implementation
Evaluation
What should you do when a mother reports her child woke up screaming in the
middle of the night? - ...(ANSWERS)....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? -
...(ANSWERS)....Scrape nail and send for testing
What do you do if a patient on lithium has dark brown urine? -
...(ANSWERS)....Check renal function
What do you do if a patient presents with fever while on Clozaril? -
...(ANSWERS)....Check ANC level to assess for agranulocytosis
What can cause serotonin syndrome? - ...(ANSWERS)....Antidepressants, St.
John's Wort, Same-E, Kava Kava, and Tryptophan
,What labs are indicative of NMS? - ...(ANSWERS)....Elevated WBC (over 11,000)
and elevated CPK
S/S of NMS - ...(ANSWERS)....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? -
...(ANSWERS)....Check for rhabdo with CPK
s/s of serotonin syndrome - ...(ANSWERS)....hyperreflexia, muscle spasms,
myoclonus (involuntary muscle jerk), fever, tachycardia, HTN, shits and shivers
What two medications to give with NMS? - ...(ANSWERS)....bromocriptine
(Parlodel)- D2 agonist dantrolene- muscle relaxer
What medication to give during SS? - ...(ANSWERS)....cyproheptadine (Periactin)-
5HT-2A receptor antagonist
What is the onset and typical length of NMS? - ...(ANSWERS)....Slow onset (1-2
weeks after changing or starting therapy) and resolves within 9-14 days
What is the onset of SS? - ...(ANSWERS)....Within 24 hours of starting/changing
medication and resolves within a few days
,How do you distinguish between NMS and acute dystonia? - ...(ANSWERS)....NMS
has a slower onset while acute dystonia occurs within hours
What happens with lithium and NSAIDs? - ...(ANSWERS)....Increased risk of
lithium toxicity (gout meds, ibuprophen, naproxen, etc.)
What happens with lithium and ACE inhibitors? - ...(ANSWERS)....Increased risk of
lithium toxicity related to the increased urination from the ACE inhibitors
Why should a patient on lithium avoid calcium channel blockers? -
...(ANSWERS)....Risk of fatal nephrotoxicity
What is a fetal side effect of lithium? - ...(ANSWERS)....Epstein's anomaly
What lab should you check for athletes on lithium? - ...(ANSWERS)....Specific
gravity to assess for dehydration (dehydration is >1.015)
What do you do if the lithium level is 1.3? - ...(ANSWERS)....Do not give the next
dose and assess for s/s
At what level is lithium toxicity a medical emergency? - ...(ANSWERS)....>3
S/S of lithium toxicity - ...(ANSWERS)....vomiting, diarrhea, slurred speech, hand
tremor, dry mouth/thirst, muscle weakness/twitching
, Why check an EKG with lithium? - ...(ANSWERS)....Inverted T-waves
What medication should treat hypothyroidism caused by lithium use? -
...(ANSWERS)....Synthroid
What do you do if patient is prescribed both depakote and lamictal? -
...(ANSWERS)....Decreased lamictal dose by 50%
Depakote and pregnancy - ...(ANSWERS)....Spina bifida
What emergency may be occuring if patient on depakote reports upper
abdominal pain? - ...(ANSWERS)....Pancreatitis
What lab should you check if patient has right upper quadrant pain and dark
brown urine? - ...(ANSWERS)....LFTs
What lab means pregnancy? - ...(ANSWERS)....HCG
Why is Clozaril used? - ...(ANSWERS)....Treatment resistant schizophrenia,
improves SI, and improves negative symptoms of schizophrenia
What two medications have the highest risk of agranulocytosis and aplastic
anemia? - ...(ANSWERS)....Clozaril and Tegretol
Questions And Correct Answers(Verified Answers)
What does ADPIE stand for? - ...(ANSWERS)....Assessment
Diagnosis
Planning
Implementation
Evaluation
What should you do when a mother reports her child woke up screaming in the
middle of the night? - ...(ANSWERS)....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? -
...(ANSWERS)....Scrape nail and send for testing
What do you do if a patient on lithium has dark brown urine? -
...(ANSWERS)....Check renal function
What do you do if a patient presents with fever while on Clozaril? -
...(ANSWERS)....Check ANC level to assess for agranulocytosis
What can cause serotonin syndrome? - ...(ANSWERS)....Antidepressants, St.
John's Wort, Same-E, Kava Kava, and Tryptophan
,What labs are indicative of NMS? - ...(ANSWERS)....Elevated WBC (over 11,000)
and elevated CPK
S/S of NMS - ...(ANSWERS)....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? -
...(ANSWERS)....Check for rhabdo with CPK
s/s of serotonin syndrome - ...(ANSWERS)....hyperreflexia, muscle spasms,
myoclonus (involuntary muscle jerk), fever, tachycardia, HTN, shits and shivers
What two medications to give with NMS? - ...(ANSWERS)....bromocriptine
(Parlodel)- D2 agonist dantrolene- muscle relaxer
What medication to give during SS? - ...(ANSWERS)....cyproheptadine (Periactin)-
5HT-2A receptor antagonist
What is the onset and typical length of NMS? - ...(ANSWERS)....Slow onset (1-2
weeks after changing or starting therapy) and resolves within 9-14 days
What is the onset of SS? - ...(ANSWERS)....Within 24 hours of starting/changing
medication and resolves within a few days
,How do you distinguish between NMS and acute dystonia? - ...(ANSWERS)....NMS
has a slower onset while acute dystonia occurs within hours
What happens with lithium and NSAIDs? - ...(ANSWERS)....Increased risk of
lithium toxicity (gout meds, ibuprophen, naproxen, etc.)
What happens with lithium and ACE inhibitors? - ...(ANSWERS)....Increased risk of
lithium toxicity related to the increased urination from the ACE inhibitors
Why should a patient on lithium avoid calcium channel blockers? -
...(ANSWERS)....Risk of fatal nephrotoxicity
What is a fetal side effect of lithium? - ...(ANSWERS)....Epstein's anomaly
What lab should you check for athletes on lithium? - ...(ANSWERS)....Specific
gravity to assess for dehydration (dehydration is >1.015)
What do you do if the lithium level is 1.3? - ...(ANSWERS)....Do not give the next
dose and assess for s/s
At what level is lithium toxicity a medical emergency? - ...(ANSWERS)....>3
S/S of lithium toxicity - ...(ANSWERS)....vomiting, diarrhea, slurred speech, hand
tremor, dry mouth/thirst, muscle weakness/twitching
, Why check an EKG with lithium? - ...(ANSWERS)....Inverted T-waves
What medication should treat hypothyroidism caused by lithium use? -
...(ANSWERS)....Synthroid
What do you do if patient is prescribed both depakote and lamictal? -
...(ANSWERS)....Decreased lamictal dose by 50%
Depakote and pregnancy - ...(ANSWERS)....Spina bifida
What emergency may be occuring if patient on depakote reports upper
abdominal pain? - ...(ANSWERS)....Pancreatitis
What lab should you check if patient has right upper quadrant pain and dark
brown urine? - ...(ANSWERS)....LFTs
What lab means pregnancy? - ...(ANSWERS)....HCG
Why is Clozaril used? - ...(ANSWERS)....Treatment resistant schizophrenia,
improves SI, and improves negative symptoms of schizophrenia
What two medications have the highest risk of agranulocytosis and aplastic
anemia? - ...(ANSWERS)....Clozaril and Tegretol
