GEORGETTE REVIEW EXAM
QUESTIONS WITH CORRECT
ANSWERS, ANCC REVIEW MANUAL
PMHNP 2025
,When many answers are remarkably similar, they are usually _____________ -
ANSWERwrong
Interprofessional collaboration is encouraged. - ANSWERCollaborate is usually right.
Delegate is usually wrong.
ADPIER - ANSWERAssessment, diagnosis, Plan, intervention, evaluate, refer out last.
Lithium - ANSWERNormal 0.6-1.2
Lithium toxicity occurs at levels - ANSWER> 1.5
Signs of Lithium toxicity - ANSWERsevere nausea, diarrhea, vomiting, confusion,
drowsiness, muscle weakness, heart palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard for - ANSWERMANIA
Lithium has evidence shown to - ANSWERreduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester - ANSWEREbstein
anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to - ANSWERrise
Baseline labs before initiation of lithium - ANSWERTSH
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 - ANSWERhypothyroidism
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Pt education for lithimum - ANSWERstaying hydrated
avoiding NSAIDS
compliance
,Depakote normal level - ANSWER50-125
Depakote toxicity level - ANSWERgreater than 150
Teratogenic effects of Depakote - ANSWERspina bifida
Adverse effects of depakote - ANSWERalopecia
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 - ANSWERdisorientation, lethargy, respiratory depression,
nausea/vomiting
Intervention for depakote toxicity - ANSWERDC med
check level
LFT
ammonia
MAOI + tyramine causes - ANSWERhypertensive crisis
Symptoms of hypertensive crisis - ANSWERelevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI + - ANSWERMEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis - ANSWERDC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzos - ANSWERfloppy baby, cleft palate
Teratogenic effects of tegratol - ANSWERneural tube defect
, teratogenic effects of lithium - ANSWERebstein anomaly (heart defect) (avoid,
especially 1st trimester)
teratogenic effects of depakote - ANSWERneural tube defects/spina bifida
Adverse reaction to Lamictal - ANSWERSteven Johnson's Syndrome
Signs of SJS - ANSWERFEVER --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 - ANSWERsedation or weight gain
Carbamazepine (tegretol) black box warning - ANSWERagranulocytosis (decrease
WBCs)
aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin rash, SOA)
Carbamazepine and asians - ANSWERScreen for HLAB-1502 allele before initiating,
due to high incidence of SJS if positive for allele.
Child-bearing aged women - ANSWERcheck 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 - ANSWERagranulocytosis and neutropenia
For monitoring neutropenia in Clozaril, monitor - ANSWERANC
DC clozarli if ANC - ANSWERless than 1000
DC clozaril if WBC - ANSWER2000-3000, risk of agranulocytosis
When on clozaril monitor for - ANSWERsigns and symptoms of infection: sudden fever,
chills, sore throat, weakness
Clozaril only known antipsychotic to - ANSWERdecrease risk of suicide in patients with
schizophrenia.
QUESTIONS WITH CORRECT
ANSWERS, ANCC REVIEW MANUAL
PMHNP 2025
,When many answers are remarkably similar, they are usually _____________ -
ANSWERwrong
Interprofessional collaboration is encouraged. - ANSWERCollaborate is usually right.
Delegate is usually wrong.
ADPIER - ANSWERAssessment, diagnosis, Plan, intervention, evaluate, refer out last.
Lithium - ANSWERNormal 0.6-1.2
Lithium toxicity occurs at levels - ANSWER> 1.5
Signs of Lithium toxicity - ANSWERsevere nausea, diarrhea, vomiting, confusion,
drowsiness, muscle weakness, heart palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard for - ANSWERMANIA
Lithium has evidence shown to - ANSWERreduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester - ANSWEREbstein
anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to - ANSWERrise
Baseline labs before initiation of lithium - ANSWERTSH
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 - ANSWERhypothyroidism
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Pt education for lithimum - ANSWERstaying hydrated
avoiding NSAIDS
compliance
,Depakote normal level - ANSWER50-125
Depakote toxicity level - ANSWERgreater than 150
Teratogenic effects of Depakote - ANSWERspina bifida
Adverse effects of depakote - ANSWERalopecia
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 - ANSWERdisorientation, lethargy, respiratory depression,
nausea/vomiting
Intervention for depakote toxicity - ANSWERDC med
check level
LFT
ammonia
MAOI + tyramine causes - ANSWERhypertensive crisis
Symptoms of hypertensive crisis - ANSWERelevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI + - ANSWERMEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis - ANSWERDC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzos - ANSWERfloppy baby, cleft palate
Teratogenic effects of tegratol - ANSWERneural tube defect
, teratogenic effects of lithium - ANSWERebstein anomaly (heart defect) (avoid,
especially 1st trimester)
teratogenic effects of depakote - ANSWERneural tube defects/spina bifida
Adverse reaction to Lamictal - ANSWERSteven Johnson's Syndrome
Signs of SJS - ANSWERFEVER --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 - ANSWERsedation or weight gain
Carbamazepine (tegretol) black box warning - ANSWERagranulocytosis (decrease
WBCs)
aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin rash, SOA)
Carbamazepine and asians - ANSWERScreen for HLAB-1502 allele before initiating,
due to high incidence of SJS if positive for allele.
Child-bearing aged women - ANSWERcheck 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 - ANSWERagranulocytosis and neutropenia
For monitoring neutropenia in Clozaril, monitor - ANSWERANC
DC clozarli if ANC - ANSWERless than 1000
DC clozaril if WBC - ANSWER2000-3000, risk of agranulocytosis
When on clozaril monitor for - ANSWERsigns and symptoms of infection: sudden fever,
chills, sore throat, weakness
Clozaril only known antipsychotic to - ANSWERdecrease risk of suicide in patients with
schizophrenia.
