GEORGETTE REVIEW PMHNP FINAL
STUDY SHEET 2026 SOLVED QUESTIONS
FULLY CORRECT
⫸ Interprofessional collaboration is encouraged. Answer: Collaborate is
usually right.
Delegate is usually wrong.
⫸ ADPIER Answer: Assessment, diagnosis, Plan, intervention,
evaluate, refer out last.
⫸ Lithium Answer: Normal 0.6-1.2
⫸ Lithium toxicity occurs at levels Answer: > 1.5
⫸ Signs of Lithium toxicity Answer: severe nausea, diarrhea, vomiting,
confusion, drowsiness, muscle weakness, heart palpitation, coarse hand
tremors, unsteady gait
⫸ Lithium is gold standard for Answer: MANIA
⫸ Lithium has evidence shown to Answer: reduce suicidal ideation
,⫸ What does lithium cause in neonate, especially 1st trimester Answer:
Ebstein anomaly (congenital heart defect)
⫸ dehydration and hyponatremia cause lithium levels to Answer: rise
⫸ Baseline labs before initiation of lithium 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 Answer: hypothyroidism
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
⫸ Pt education for lithimum Answer: staying hydrated
avoiding NSAIDS
compliance
,⫸ Depakote normal level Answer: 50-125
⫸ Depakote toxicity level Answer: greater than 150
⫸ Teratogenic effects of Depakote Answer: spina bifida
⫸ Adverse effects of depakote Answer: alopecia
hepatotoxicity (RUQ pain or brown/red urine--order LFTs) AST 5-40,
ALT 5-35, yellowing of skin or eyes, fatigue
⫸ Signs of Depakote toxicity Answer: disorientation, lethargy,
respiratory depression, nausea/vomiting
⫸ Intervention for depakote toxicity Answer: DC med
check level
LFT
ammonia
⫸ MAOI + tyramine causes Answer: hypertensive crisis
⫸ Symptoms of hypertensive crisis Answer: elevated BP
sudden explosive like headache
facial flushing
, palpitations
pupillary dilation
diaphoresis
fever
⫸ Hypertensive crisis occurs with MAOI + Answer: MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
⫸ Treatment for hypertensive crisis Answer: DC offending agent
Administer PHENTOLAMINE
⫸ Teratogenic effects of benzos Answer: floppy baby, cleft palate
⫸ Teratogenic effects of tegratol Answer: neural tube defect
⫸ teratogenic effects of lithium Answer: ebstein anomaly (heart defect)
(avoid, especially 1st trimester)
STUDY SHEET 2026 SOLVED QUESTIONS
FULLY CORRECT
⫸ Interprofessional collaboration is encouraged. Answer: Collaborate is
usually right.
Delegate is usually wrong.
⫸ ADPIER Answer: Assessment, diagnosis, Plan, intervention,
evaluate, refer out last.
⫸ Lithium Answer: Normal 0.6-1.2
⫸ Lithium toxicity occurs at levels Answer: > 1.5
⫸ Signs of Lithium toxicity Answer: severe nausea, diarrhea, vomiting,
confusion, drowsiness, muscle weakness, heart palpitation, coarse hand
tremors, unsteady gait
⫸ Lithium is gold standard for Answer: MANIA
⫸ Lithium has evidence shown to Answer: reduce suicidal ideation
,⫸ What does lithium cause in neonate, especially 1st trimester Answer:
Ebstein anomaly (congenital heart defect)
⫸ dehydration and hyponatremia cause lithium levels to Answer: rise
⫸ Baseline labs before initiation of lithium 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 Answer: hypothyroidism
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
⫸ Pt education for lithimum Answer: staying hydrated
avoiding NSAIDS
compliance
,⫸ Depakote normal level Answer: 50-125
⫸ Depakote toxicity level Answer: greater than 150
⫸ Teratogenic effects of Depakote Answer: spina bifida
⫸ Adverse effects of depakote Answer: alopecia
hepatotoxicity (RUQ pain or brown/red urine--order LFTs) AST 5-40,
ALT 5-35, yellowing of skin or eyes, fatigue
⫸ Signs of Depakote toxicity Answer: disorientation, lethargy,
respiratory depression, nausea/vomiting
⫸ Intervention for depakote toxicity Answer: DC med
check level
LFT
ammonia
⫸ MAOI + tyramine causes Answer: hypertensive crisis
⫸ Symptoms of hypertensive crisis Answer: elevated BP
sudden explosive like headache
facial flushing
, palpitations
pupillary dilation
diaphoresis
fever
⫸ Hypertensive crisis occurs with MAOI + Answer: MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
⫸ Treatment for hypertensive crisis Answer: DC offending agent
Administer PHENTOLAMINE
⫸ Teratogenic effects of benzos Answer: floppy baby, cleft palate
⫸ Teratogenic effects of tegratol Answer: neural tube defect
⫸ teratogenic effects of lithium Answer: ebstein anomaly (heart defect)
(avoid, especially 1st trimester)
