PMHNP REVIEW LATEST 2026 REVISED
EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS
When many Answers are remarkably similar, they are usually _____________ -
ANSWER-wrong
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
EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS
When many Answers are remarkably similar, they are usually _____________ -
ANSWER-wrong
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
