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GEORGETTE REVIEW PMHNP 2025 UPDATED
ACTUAL EXAM WITH CORRECT SOLUTIONS.
When many answers are remarkably similar, they are usually
_____________ - correct answer- wrong
Interprofessional collaboration is encouraged. - correct answer-
Collaborate is usually right.
Delegate is usually wrong.
ADPIER - correct answer- Assessment, diagnosis, Plan,
intervention, evaluate, refer out last.
Lithium - correct answer- Normal 0.6-1.2
Lithium toxicity occurs at levels - correct answer- > 1.5
Signs of Lithium toxicity - correct answer- severe nausea,
diarrhea, vomiting, confusion, drowsiness, muscle weakness,
heart palpitation, coarse hand tremors, unsteady gait
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Lithium is gold standard for - correct answer- MANIA
Lithium has evidence shown to - correct answer- reduce
suicidal ideation
What does lithium cause in neonate, especially 1st trimester -
correct answer- Ebstein anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to - correct
answer- rise
Baseline labs before initiation of lithium - correct answer- 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 - correct answer- hypothyroidism
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coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Pt education for lithimum - correct answer- staying hydrated
avoiding NSAIDS
compliance
Depakote normal level - correct answer- 50-125
Depakote toxicity level - correct answer- greater than 150
Teratogenic effects of Depakote - correct answer- spina bifida
Adverse effects of depakote - correct answer- alopecia
hepatotoxicity (RUQ pain or brown/red urine--order LFTs) AST
5-40, ALT 5-35, yellowing of skin or eyes, fatigue
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Signs of Depakote toxicity - correct answer- disorientation,
lethargy, respiratory depression, nausea/vomiting
Intervention for depakote toxicity - correct answer- DC med
check level
LFT
ammonia
MAOI + tyramine causes - correct answer- hypertensive crisis
Symptoms of hypertensive crisis - correct answer- elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
GEORGETTE REVIEW PMHNP 2025 UPDATED
ACTUAL EXAM WITH CORRECT SOLUTIONS.
When many answers are remarkably similar, they are usually
_____________ - correct answer- wrong
Interprofessional collaboration is encouraged. - correct answer-
Collaborate is usually right.
Delegate is usually wrong.
ADPIER - correct answer- Assessment, diagnosis, Plan,
intervention, evaluate, refer out last.
Lithium - correct answer- Normal 0.6-1.2
Lithium toxicity occurs at levels - correct answer- > 1.5
Signs of Lithium toxicity - correct answer- severe nausea,
diarrhea, vomiting, confusion, drowsiness, muscle weakness,
heart palpitation, coarse hand tremors, unsteady gait
,2 | Page
Lithium is gold standard for - correct answer- MANIA
Lithium has evidence shown to - correct answer- reduce
suicidal ideation
What does lithium cause in neonate, especially 1st trimester -
correct answer- Ebstein anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to - correct
answer- rise
Baseline labs before initiation of lithium - correct answer- 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 - correct answer- hypothyroidism
,3 | Page
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Pt education for lithimum - correct answer- staying hydrated
avoiding NSAIDS
compliance
Depakote normal level - correct answer- 50-125
Depakote toxicity level - correct answer- greater than 150
Teratogenic effects of Depakote - correct answer- spina bifida
Adverse effects of depakote - correct answer- alopecia
hepatotoxicity (RUQ pain or brown/red urine--order LFTs) AST
5-40, ALT 5-35, yellowing of skin or eyes, fatigue
, 4 | Page
Signs of Depakote toxicity - correct answer- disorientation,
lethargy, respiratory depression, nausea/vomiting
Intervention for depakote toxicity - correct answer- DC med
check level
LFT
ammonia
MAOI + tyramine causes - correct answer- hypertensive crisis
Symptoms of hypertensive crisis - correct answer- elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
