LMR GEORGETTE’S PMHNP CERTIFICATION EXAM
LATEST 2026 /2027 QUESTIONS AND CORRECT
ANSWERS(VERIFIED 100% & GRADED A+)
What does ADPIE stand for? - CORRECT ANSWER
Assessment
Diagnosis
Planning
Implementation
Evaluation
What should you do when a mother reports her child woke up
screaming in the middle of the night? - CORRECT ANSWER - 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? -
CORRECT ANSWER - Scrape nail and send for testing
1|Page
,What do you do if a patient on lithium has dark brown urine? -
CORRECT ANSWER - Check renal function
What do you do if a patient presents with fever while on Clozaril? -
CORRECT ANSWER - Check ANC level to assess for agranulocytosis
What can cause serotonin syndrome? - CORRECT ANSWER -
Antidepressants, St. John's Wort, Same-E, Kava Kava, and Tryptophan
What labs are indicative of NMS? - CORRECT ANSWER - Elevated WBC
(over 11,000) and elevated CPK
S/S of NMS - CORRECT ANSWER - 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? -
CORRECT ANSWER - Check for rhabdo with CPK
2|Page
,s/s of serotonin syndrome - CORRECT ANSWER - hyperreflexia,
muscle spasms, myoclonus (involuntary muscle jerk), fever,
tachycardia, HTN, shits and shivers
What two medications to give with NMS? - CORRECT ANSWER -
bromocriptine (Parlodel)- D2 agonist dantrolene- muscle relaxer
What medication to give during SS? - CORRECT ANSWER -
cyproheptadine (Periactin)- 5HT-2A receptor antagonist
What is the onset and typical length of NMS? - CORRECT ANSWER -
Slow onset (1-2 weeks after changing or starting therapy) and resolves
within 9-14 days
What is the onset of SS? - CORRECT ANSWER - Within 24 hours of
starting/changing medication and resolves within a few days
3|Page
, How do you distinguish between NMS and acute dystonia? - CORRECT
ANSWER - NMS has a slower onset while acute dystonia occurs
within hours
What happens with lithium and NSAIDs? - CORRECT ANSWER -
Increased risk of lithium toxicity (gout meds, ibuprophen, naproxen,
etc.)
What happens with lithium and ACE inhibitors? - CORRECT ANSWER -
Increased risk of lithium toxicity related to the increased urination
from the ACE inhibitors
Why should a patient on lithium avoid calcium channel blockers? -
CORRECT ANSWER - Risk of fatal nephrotoxicity
What is a fetal side effect of lithium? - CORRECT ANSWER - Epstein's
anomaly
4|Page
LATEST 2026 /2027 QUESTIONS AND CORRECT
ANSWERS(VERIFIED 100% & GRADED A+)
What does ADPIE stand for? - CORRECT ANSWER
Assessment
Diagnosis
Planning
Implementation
Evaluation
What should you do when a mother reports her child woke up
screaming in the middle of the night? - CORRECT ANSWER - 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? -
CORRECT ANSWER - Scrape nail and send for testing
1|Page
,What do you do if a patient on lithium has dark brown urine? -
CORRECT ANSWER - Check renal function
What do you do if a patient presents with fever while on Clozaril? -
CORRECT ANSWER - Check ANC level to assess for agranulocytosis
What can cause serotonin syndrome? - CORRECT ANSWER -
Antidepressants, St. John's Wort, Same-E, Kava Kava, and Tryptophan
What labs are indicative of NMS? - CORRECT ANSWER - Elevated WBC
(over 11,000) and elevated CPK
S/S of NMS - CORRECT ANSWER - 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? -
CORRECT ANSWER - Check for rhabdo with CPK
2|Page
,s/s of serotonin syndrome - CORRECT ANSWER - hyperreflexia,
muscle spasms, myoclonus (involuntary muscle jerk), fever,
tachycardia, HTN, shits and shivers
What two medications to give with NMS? - CORRECT ANSWER -
bromocriptine (Parlodel)- D2 agonist dantrolene- muscle relaxer
What medication to give during SS? - CORRECT ANSWER -
cyproheptadine (Periactin)- 5HT-2A receptor antagonist
What is the onset and typical length of NMS? - CORRECT ANSWER -
Slow onset (1-2 weeks after changing or starting therapy) and resolves
within 9-14 days
What is the onset of SS? - CORRECT ANSWER - Within 24 hours of
starting/changing medication and resolves within a few days
3|Page
, How do you distinguish between NMS and acute dystonia? - CORRECT
ANSWER - NMS has a slower onset while acute dystonia occurs
within hours
What happens with lithium and NSAIDs? - CORRECT ANSWER -
Increased risk of lithium toxicity (gout meds, ibuprophen, naproxen,
etc.)
What happens with lithium and ACE inhibitors? - CORRECT ANSWER -
Increased risk of lithium toxicity related to the increased urination
from the ACE inhibitors
Why should a patient on lithium avoid calcium channel blockers? -
CORRECT ANSWER - Risk of fatal nephrotoxicity
What is a fetal side effect of lithium? - CORRECT ANSWER - Epstein's
anomaly
4|Page
