GEORGETTE'S DOMAIN 1: SCIENCTIFIC pmhnp board FOUNDATION
Study online at https://quizlet.com/_gn1tb0
1. Which neurotransmitters are most likely implicated in the patho of a mood
disorder that consists of depression and anxiety?: Serotonin and Norepinephrine
Low levels of Serotonin--> depressive symptoms
imbalances of norepi--> anxiety symptoms
2. Lithium of 1.6: Initial action:: D/C lithium and start on an different mood stabilizer
3. Which neurotransmitters are most likely implicated in the patho of a mood
disorder that consists of recurrent depressive episodes and elevated mood, like
Bipolar Disorder?: Serotonin and Dopamine
Low levels of Serotonin--> depressive symptoms
High levels of Dopamine--> linked to manic or hypomanic symptoms
4. How can alcohol affect lithium levels?: lithium levels may be higher due to decreased renal
clearance
Alcohol can lead to impaired renal function
5. Lithium modulates what neurotransmitter which makes it an appropriate
choice for a pt with bipolar disorder who has a hx of suicide attempts and is
currently in the depressive state?: Modules Glutamate receptor--> reducing impulsivity
6. If a pt who is one lithium presents with excessive thirst and increased urina-
tion, what would be the first step for the PMHNP?: Order a serum lithium level
7. If a pt who is on Olanzapine, has been sedentary and eating unhealthy food,
starts to develop metabolic syndrome, what is the initial action?: Educate on a healthy
lifestyle including diet and exercise
Decreasing the dose may lead to inadequate symptom control
8. If a pt who is stabilized on lithium, states that they are worried about their
weight gain and increased thirst, what is the initial step?: Educate on common side effects
and importance of regular monitoring
, GEORGETTE'S DOMAIN 1: SCIENCTIFIC pmhnp board FOUNDATION
Study online at https://quizlet.com/_gn1tb0
9. If a pt who is on lithium presents with persistent hand tremors and elevated
WBC count, what should the PMHNP do?: Assess for other signs of lithium toxicity and adjust the
dose
10. How can dehydration affect lithium levels?: It may cause lithium levels to increase due to
decrease renal excretion
11. How do NSAIDs affect lithium levels?: They can increase lithium levels by reducing renal excretion
12. How does hyponatremia affect lithium levels?: It can increase lithium levels by reducing
renal excretion
13. How does hypokalemia affect lithium levels?: It can decrease lithium levels by enhancing
renal excretion
14. Lithium education:: -Stay hydrated
-maintain consistent levels of sodium
-have regular blood tests done to monitor levels
-Do not abruptly stop it
15. Timing of blood tests for lithium levels:: It should be done at the same time each day that the
blood work is drawn preferably in the morning before taking the dose
16. Can you take lithium with water?: Take a with full glass of water to ensure proper absorption and
prevent irritation
17. Relationship between lithium and cognition?: Lithium ahs been shown to improve cognitive
function and reduce cognitive decline in bipolar disorder
-lithium has neuroprotective effects
18. If a pt is on an antidepressant and a mood stabilizer and they start to
experience symptoms of a hypertensive crisis, what is the initial step of the
PMHNP?: D/C both the antidepressant and mood stabilizer
-both can contribute to hypertensive events
19. If a pt who is on lithium wants to get pregnant, what is the most appropriate
action?: gradually taper off the lithium and explore alternative mood stabilizers
-lithium is associated with congenital malformation particularly in the 1st trimester
Study online at https://quizlet.com/_gn1tb0
1. Which neurotransmitters are most likely implicated in the patho of a mood
disorder that consists of depression and anxiety?: Serotonin and Norepinephrine
Low levels of Serotonin--> depressive symptoms
imbalances of norepi--> anxiety symptoms
2. Lithium of 1.6: Initial action:: D/C lithium and start on an different mood stabilizer
3. Which neurotransmitters are most likely implicated in the patho of a mood
disorder that consists of recurrent depressive episodes and elevated mood, like
Bipolar Disorder?: Serotonin and Dopamine
Low levels of Serotonin--> depressive symptoms
High levels of Dopamine--> linked to manic or hypomanic symptoms
4. How can alcohol affect lithium levels?: lithium levels may be higher due to decreased renal
clearance
Alcohol can lead to impaired renal function
5. Lithium modulates what neurotransmitter which makes it an appropriate
choice for a pt with bipolar disorder who has a hx of suicide attempts and is
currently in the depressive state?: Modules Glutamate receptor--> reducing impulsivity
6. If a pt who is one lithium presents with excessive thirst and increased urina-
tion, what would be the first step for the PMHNP?: Order a serum lithium level
7. If a pt who is on Olanzapine, has been sedentary and eating unhealthy food,
starts to develop metabolic syndrome, what is the initial action?: Educate on a healthy
lifestyle including diet and exercise
Decreasing the dose may lead to inadequate symptom control
8. If a pt who is stabilized on lithium, states that they are worried about their
weight gain and increased thirst, what is the initial step?: Educate on common side effects
and importance of regular monitoring
, GEORGETTE'S DOMAIN 1: SCIENCTIFIC pmhnp board FOUNDATION
Study online at https://quizlet.com/_gn1tb0
9. If a pt who is on lithium presents with persistent hand tremors and elevated
WBC count, what should the PMHNP do?: Assess for other signs of lithium toxicity and adjust the
dose
10. How can dehydration affect lithium levels?: It may cause lithium levels to increase due to
decrease renal excretion
11. How do NSAIDs affect lithium levels?: They can increase lithium levels by reducing renal excretion
12. How does hyponatremia affect lithium levels?: It can increase lithium levels by reducing
renal excretion
13. How does hypokalemia affect lithium levels?: It can decrease lithium levels by enhancing
renal excretion
14. Lithium education:: -Stay hydrated
-maintain consistent levels of sodium
-have regular blood tests done to monitor levels
-Do not abruptly stop it
15. Timing of blood tests for lithium levels:: It should be done at the same time each day that the
blood work is drawn preferably in the morning before taking the dose
16. Can you take lithium with water?: Take a with full glass of water to ensure proper absorption and
prevent irritation
17. Relationship between lithium and cognition?: Lithium ahs been shown to improve cognitive
function and reduce cognitive decline in bipolar disorder
-lithium has neuroprotective effects
18. If a pt is on an antidepressant and a mood stabilizer and they start to
experience symptoms of a hypertensive crisis, what is the initial step of the
PMHNP?: D/C both the antidepressant and mood stabilizer
-both can contribute to hypertensive events
19. If a pt who is on lithium wants to get pregnant, what is the most appropriate
action?: gradually taper off the lithium and explore alternative mood stabilizers
-lithium is associated with congenital malformation particularly in the 1st trimester
