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📄 DOWNLOAD PDF
eorgette’s LMR PMHNP Actual Certification Review
G
2025 – Psychiatric-Mental Health NP Questions &
Answers with Rationales | 100% Verified | Graded A+
tudent Name:_________________________
S
Date:_______________
Time Limit: 90 minutes
Total Questions: 90
Instructions
● T his exam contains 90 questions, including multiple-choice (MCQs), select-all-that-apply
(SATA), and case studies, aligned with Next Generation NCLEX (NGN) standards and the 2025
PMHNP Certification Exam.
● Read each question carefully and select the best answer(s). For SATA questions, choose all
options that apply.
● Complete the exam within the 90-minute time limit.
● This exam tests PMHNP knowledge in lithium monitoring, interdisciplinary collaboration,
diagnosis differentiation, therapeutic communication, prescribing guidelines, and PMHNP scope
and ethics, aligned with current psychopharmacology standards.
Lithium Monitoring (Questions 1–20)
1. A
client on lithium for bipolar disorder reports nausea and tremor. What is the PMHNP’s
priority action?
A. Increase the lithium dose
B. Check serum lithium levels
C. Discontinue lithium immediately
D. Administer an antiemetic
Answer:B. Check serum lithium levels
Rationale:Nausea and tremor suggest lithium toxicity;checking serum levels (therapeutic range:
0.6–1.2 mEq/L) is critical. Increasing the dose worsens toxicity, discontinuing without assessment
, 2
is premature, and antiemetics treat symptoms, not the cause.
2. W
hat is the therapeutic serum lithium level for a client with bipolar I disorder?
A. 0.2–0.4 mEq/L
B. 0.6–1.2 mEq/L
C. 1.5–2.0 mEq/L
D. 2.5–3.0 mEq/L
Answer:B. 0.6–1.2 mEq/L
Rationale:The therapeutic lithium range for bipolardisorder is 0.6–1.2 mEq/L. Levels below are
subtherapeutic, and levels above risk toxicity.
3. S
elect All That Apply: Which laboratory tests should the PMHNP monitor for a client on
lithium?
A. Thyroid function
B. Renal function
C. Complete blood count
D. Liver function
E. Serum lithium levels
Answer:A, B, E
Rationale:Lithium requires monitoring of thyroidfunction (risk of hypothyroidism), renal
function (risk of nephrotoxicity), and serum lithium levels (toxicity risk). CBC and liver function
are not routinely required for lithium.
4. A
client on lithium has a serum level of 1.8 mEq/L. What is the PMHNP’s priority action?
A. Continue the current dose
B. Notify the provider and hold the dose
C. Increase the dose
D. Administer a diuretic
Answer:B. Notify the provider and hold the dose
Rationale:A lithium level of 1.8 mEq/L indicatestoxicity (>1.5 mEq/L); holding the dose and
notifying the provider is critical. Continuing or increasing the dose worsens toxicity, and diuretics
increase lithium levels.
5. A
client on lithium reports polyuria and polydipsia. What should the PMHNP assess?
A. Blood glucose
B. Renal function
C. INR
D. Liver enzymes
Answer:B. Renal function
Rationale:Polyuria and polydipsia may indicate lithium-inducednephrogenic diabetes insipidus;
renal function assessment is critical. Glucose, INR, or liver enzymes are not directly related.
6. C
ase Study: A 32-year-old client on lithium for bipolar disorder reports confusion and
ataxia. What is the PMHNP’s priority action?
, 3
. Administer an antipsychotic
A
B. Check serum lithium levels
C. Increase the lithium dose
D. Encourage fluid restriction
Answer:B. Check serum lithium levels
Rationale:Confusion and ataxia suggest lithium toxicity;checking serum levels is critical.
Antipsychotics, increasing the dose, or fluid restriction are inappropriate and may worsen toxicity.
7. W
hat medication should be avoided in a client on lithium due to increased toxicity risk?
A. Sertraline
B. Ibuprofen
C. Lorazepam
D. Trazodone
Answer:B. Ibuprofen
Rationale:NSAIDs like ibuprofen reduce renal clearance,increasing lithium toxicity risk.
Sertraline, lorazepam, and trazodone do not significantly affect lithium levels.
8. A
client on lithium has a thyroid-stimulating hormone (TSH) level of 6.2 mIU/L. What is the
PMHNP’s priority action?
A. Ignore the result
B. Refer to endocrinology
C. Increase the lithium dose
D. Administer a thyroid supplement
Answer:B. Refer to endocrinology
Rationale:Elevated TSH (normal: 0.4–4.5 mIU/L) suggestslithium-induced hypothyroidism;
endocrinology referral is needed. Ignoring, increasing lithium, or supplementing without
consultation is inappropriate.
9. A
client on lithium reports diarrhea and vomiting. What should the PMHNP assess first?
A. Blood glucose
B. Serum lithium levels
C. Liver function
D. Platelet count
Answer:B. Serum lithium levels
Rationale:Diarrhea and vomiting increase lithiumtoxicity risk due to dehydration; checking
levels is critical. Glucose, liver function, or platelets are not primary concerns.
10. What is the recommended frequency for monitoring serum lithium levels during
maintenance therapy?
A. Every 1–2 weeks
B. Every 3–6 months
C. Every 12 months
D. Only at initiation
Answer:B. Every 3–6 months
📄 DOWNLOAD PDF
eorgette’s LMR PMHNP Actual Certification Review
G
2025 – Psychiatric-Mental Health NP Questions &
Answers with Rationales | 100% Verified | Graded A+
tudent Name:_________________________
S
Date:_______________
Time Limit: 90 minutes
Total Questions: 90
Instructions
● T his exam contains 90 questions, including multiple-choice (MCQs), select-all-that-apply
(SATA), and case studies, aligned with Next Generation NCLEX (NGN) standards and the 2025
PMHNP Certification Exam.
● Read each question carefully and select the best answer(s). For SATA questions, choose all
options that apply.
● Complete the exam within the 90-minute time limit.
● This exam tests PMHNP knowledge in lithium monitoring, interdisciplinary collaboration,
diagnosis differentiation, therapeutic communication, prescribing guidelines, and PMHNP scope
and ethics, aligned with current psychopharmacology standards.
Lithium Monitoring (Questions 1–20)
1. A
client on lithium for bipolar disorder reports nausea and tremor. What is the PMHNP’s
priority action?
A. Increase the lithium dose
B. Check serum lithium levels
C. Discontinue lithium immediately
D. Administer an antiemetic
Answer:B. Check serum lithium levels
Rationale:Nausea and tremor suggest lithium toxicity;checking serum levels (therapeutic range:
0.6–1.2 mEq/L) is critical. Increasing the dose worsens toxicity, discontinuing without assessment
, 2
is premature, and antiemetics treat symptoms, not the cause.
2. W
hat is the therapeutic serum lithium level for a client with bipolar I disorder?
A. 0.2–0.4 mEq/L
B. 0.6–1.2 mEq/L
C. 1.5–2.0 mEq/L
D. 2.5–3.0 mEq/L
Answer:B. 0.6–1.2 mEq/L
Rationale:The therapeutic lithium range for bipolardisorder is 0.6–1.2 mEq/L. Levels below are
subtherapeutic, and levels above risk toxicity.
3. S
elect All That Apply: Which laboratory tests should the PMHNP monitor for a client on
lithium?
A. Thyroid function
B. Renal function
C. Complete blood count
D. Liver function
E. Serum lithium levels
Answer:A, B, E
Rationale:Lithium requires monitoring of thyroidfunction (risk of hypothyroidism), renal
function (risk of nephrotoxicity), and serum lithium levels (toxicity risk). CBC and liver function
are not routinely required for lithium.
4. A
client on lithium has a serum level of 1.8 mEq/L. What is the PMHNP’s priority action?
A. Continue the current dose
B. Notify the provider and hold the dose
C. Increase the dose
D. Administer a diuretic
Answer:B. Notify the provider and hold the dose
Rationale:A lithium level of 1.8 mEq/L indicatestoxicity (>1.5 mEq/L); holding the dose and
notifying the provider is critical. Continuing or increasing the dose worsens toxicity, and diuretics
increase lithium levels.
5. A
client on lithium reports polyuria and polydipsia. What should the PMHNP assess?
A. Blood glucose
B. Renal function
C. INR
D. Liver enzymes
Answer:B. Renal function
Rationale:Polyuria and polydipsia may indicate lithium-inducednephrogenic diabetes insipidus;
renal function assessment is critical. Glucose, INR, or liver enzymes are not directly related.
6. C
ase Study: A 32-year-old client on lithium for bipolar disorder reports confusion and
ataxia. What is the PMHNP’s priority action?
, 3
. Administer an antipsychotic
A
B. Check serum lithium levels
C. Increase the lithium dose
D. Encourage fluid restriction
Answer:B. Check serum lithium levels
Rationale:Confusion and ataxia suggest lithium toxicity;checking serum levels is critical.
Antipsychotics, increasing the dose, or fluid restriction are inappropriate and may worsen toxicity.
7. W
hat medication should be avoided in a client on lithium due to increased toxicity risk?
A. Sertraline
B. Ibuprofen
C. Lorazepam
D. Trazodone
Answer:B. Ibuprofen
Rationale:NSAIDs like ibuprofen reduce renal clearance,increasing lithium toxicity risk.
Sertraline, lorazepam, and trazodone do not significantly affect lithium levels.
8. A
client on lithium has a thyroid-stimulating hormone (TSH) level of 6.2 mIU/L. What is the
PMHNP’s priority action?
A. Ignore the result
B. Refer to endocrinology
C. Increase the lithium dose
D. Administer a thyroid supplement
Answer:B. Refer to endocrinology
Rationale:Elevated TSH (normal: 0.4–4.5 mIU/L) suggestslithium-induced hypothyroidism;
endocrinology referral is needed. Ignoring, increasing lithium, or supplementing without
consultation is inappropriate.
9. A
client on lithium reports diarrhea and vomiting. What should the PMHNP assess first?
A. Blood glucose
B. Serum lithium levels
C. Liver function
D. Platelet count
Answer:B. Serum lithium levels
Rationale:Diarrhea and vomiting increase lithiumtoxicity risk due to dehydration; checking
levels is critical. Glucose, liver function, or platelets are not primary concerns.
10. What is the recommended frequency for monitoring serum lithium levels during
maintenance therapy?
A. Every 1–2 weeks
B. Every 3–6 months
C. Every 12 months
D. Only at initiation
Answer:B. Every 3–6 months
