FITZGERALD PMHNP PSYCHIATRIC
MENTAL HEALTH NURSE PRACTITIONER
FINAL TESTBANK PRACTICE GUIDE
UPDATED 2026 TESTED SOLUTIONS
⫸ Clinical Decision Making Process Answer: • ADPIE
-Assessment: 1st step, subjective and objective data
• Diagnosis: analysis, formulation of nursing diagnosis
• Planning: prioritizing problems, determining goals, plan of care
• Implementation: nursing action (rather than medical action)
• Evaluating: comparing outcomes, communicate and document findings
⫸ Aspartate aminotransferase (AST)
Alanine aminotransferase (ALT)
Range?
Measures? Answer: 0-40 units/L
0-40 units/L
,Hepatocellular damage
Potentially elevated in valproate therapy, hepatitis, cirrhosis
⫸ Glutamyltransferase (GGT)
Alkaline phospatase (ALP)
Range?
Measures?
Examples? Answer: 0-30 units/L
30-120 international units/L
Cholestasis: bike flow, either extrahepatic or intrahepatic
Elevated in alcohol abuse.
Elevated in gallbladder disease, liver disease. Elevated with bone injury
⫸ Creatine Kinase (CK)
Range?
Measures?
,Examples? Answer: 0-139 units/L
Muscle Injury. muscle enzyme found in skeletal and cardiac muscle;
elevated blood levels associated with heart attack, muscular dystrophy,
and other skeletal muscle pathologies
⫸ Urea Nitrogen (BUN)
Creatinine Answer: 8-20 mg/dL
0.6-1.2 mg/dl
Kidney Function
Increased in impaired kidney function
Measured with lithium therapy
Creatinine is more sensitive and specific indicator of kidney disease than
BUN.
Measured with lithium therapy.
⫸ Glomerular Filtration Rate (GFR)
, Range?
Measures?
Examples? Answer: >90mL/min.
The best measurement of kidney function.
the amount of filtrate formed per minute by the two kidneys combined
Elderly pts have 30% reduced because of decreased muscle mass
Generally no dose adjustments or contraindications with psychotropics
when GFR >60mL/min
⫸ Valproate and select epileptic drugs ex. Carbamazepine.
Lab testing?
Level?
Comment?
Discontinue when? Answer: Liver pane (ALT, AST, ALP, bilirubin,
albumin, total protein), CBC, WBC, platelet count, serum hCG,
valproate level.
Level 50-120mcg/ml
MENTAL HEALTH NURSE PRACTITIONER
FINAL TESTBANK PRACTICE GUIDE
UPDATED 2026 TESTED SOLUTIONS
⫸ Clinical Decision Making Process Answer: • ADPIE
-Assessment: 1st step, subjective and objective data
• Diagnosis: analysis, formulation of nursing diagnosis
• Planning: prioritizing problems, determining goals, plan of care
• Implementation: nursing action (rather than medical action)
• Evaluating: comparing outcomes, communicate and document findings
⫸ Aspartate aminotransferase (AST)
Alanine aminotransferase (ALT)
Range?
Measures? Answer: 0-40 units/L
0-40 units/L
,Hepatocellular damage
Potentially elevated in valproate therapy, hepatitis, cirrhosis
⫸ Glutamyltransferase (GGT)
Alkaline phospatase (ALP)
Range?
Measures?
Examples? Answer: 0-30 units/L
30-120 international units/L
Cholestasis: bike flow, either extrahepatic or intrahepatic
Elevated in alcohol abuse.
Elevated in gallbladder disease, liver disease. Elevated with bone injury
⫸ Creatine Kinase (CK)
Range?
Measures?
,Examples? Answer: 0-139 units/L
Muscle Injury. muscle enzyme found in skeletal and cardiac muscle;
elevated blood levels associated with heart attack, muscular dystrophy,
and other skeletal muscle pathologies
⫸ Urea Nitrogen (BUN)
Creatinine Answer: 8-20 mg/dL
0.6-1.2 mg/dl
Kidney Function
Increased in impaired kidney function
Measured with lithium therapy
Creatinine is more sensitive and specific indicator of kidney disease than
BUN.
Measured with lithium therapy.
⫸ Glomerular Filtration Rate (GFR)
, Range?
Measures?
Examples? Answer: >90mL/min.
The best measurement of kidney function.
the amount of filtrate formed per minute by the two kidneys combined
Elderly pts have 30% reduced because of decreased muscle mass
Generally no dose adjustments or contraindications with psychotropics
when GFR >60mL/min
⫸ Valproate and select epileptic drugs ex. Carbamazepine.
Lab testing?
Level?
Comment?
Discontinue when? Answer: Liver pane (ALT, AST, ALP, bilirubin,
albumin, total protein), CBC, WBC, platelet count, serum hCG,
valproate level.
Level 50-120mcg/ml
