This comprehensive PMHNP certification exam study guide features LMR Georgette's latest actual questions with correct verified answers—already graded A+ for the cycle. Covering all essential psychiatric-mental health nurse practitioner domains including psychopharmacology (Tegretol and Lamictal—SJS and toxic epidermal necrosis, HLA-B*1502 allele in Asian patients; Lamictal aseptic meningitis; low weight-gain antipsychotics—Geodon, Abilify, Latuda; Clozaril—treatment-resistant schizophrenia, agranulocytosis monitoring with ANC; lithium toxicity—NSAIDs, ACE inhibitors, CCB interactions, Ebstein's anomaly, dark brown urine indicates renal issue, EKG for inverted T-waves; Depakote—spina bifida, pancreatitis, LFT monitoring; serotonin syndrome causes—antidepressants, St. John's Wort, SAMe, kava kava, tryptophan; NMS—elevated WBC and CPK, cherry colored urine, treatment with bromocriptine and dantrolene), neurobiology and brain anatomy (prefrontal cortex—pain perception and TMS; dorsolateral prefrontal cortex—executive function; orbitalfrontal cortex—impulse control and ADHD; temporal lobe—visual/auditory hallucinations; basal ganglia—intentional movement; hippocampus—memory; amygdala—stress response; mesolimbic, mesocortical, nigrostriatal, tuberoinfundibular pathways; neurotransmitter function in disorders—autism, schizophrenia, depression, bipolar, anxiety, OCD, ADHD, Parkinson's, Tourette's, substance abuse), psychiatric disorders and diagnosis (MDD—SIGECAPS; mania—DIGFAST; bipolar I vs II; schizophrenia vs schizoaffective vs brief psychotic vs delusional disorder; ODD vs conduct disorder; acute stress disorder vs PTSD; adjustment disorder; somatic disorders—conversion, factitious, malingering; anorexia vs bulimia—refeeding syndrome, Russell sign; autism spectrum disorder; Rett syndrome; reactive attachment disorder; Lewy body dementia vs Pick's disease vs Alzheimer's—cholinesterase inhibitors, Namenda), adverse effects and emergencies (acute dystonia, akathisia, parkinsonism, tardive dyskinesia—AIMS scale; NMS vs serotonin syndrome onset differentiation; agranulocytosis from Clozaril/Tegretol—WBC 2000 or ANC 1000), developmental and lifespan considerations (Piaget's stages—sensorimotor, preoperational, concrete operational, formal operational; psychosexual stages—Freud; pruning—autism under-pruning vs schizophrenia over-pruning; fetal alcohol syndrome; lead poisoning symptoms; first-line antipsychotic in children—Risperdal max 3 mg/day; first-line antidepressant in children—Prozac; OCD in kids—Zoloft), substance use disorders (alcohol—alcohol dehydrogenase gender differences, endocrine findings—testicular atrophy, gynecomastia, sexual dysfunction; opioid intoxication—miosis, decreased RR; methadone for heroin detox or pregnancy; naltrexone contraindicated in liver disease; acamprosate contraindicated in kidney disease; disulfiram—alcohol-free 12 hours, reaction lasts 2 weeks; SBIRT; motivational interviewing), rating scales and assessment (PHQ-9 scoring—0-4 none, 20-27 severe; GAD-7—15 severe; Beck Inventory severe 30; Hamilton Anxiety—17 mild, 25-30 moderate-severe; Zung Self-Rating—70 high suicide risk; Vanderbilt for ADHD; Mini-Cog—3-word recall and clock drawing; MMSE scoring—24-30 no impairment, 18-23 mild, 17 severe), legal and ethical issues (Tarasoff—duty to warn; O'Connor v. Donaldson—mental illness alone not enough for involuntary commitment; Dusky v. United States—competence to stand trial; Durham v. United States—insanity defense; Rogers v. Okin—right to refuse medication; Rennie v. Klein—right to appeal treatment; Ford v. Wainwright—prohibits execution of insane; parity law—equal mental health coverage; Stark Law—no self-referral; habeas corpus; criteria for involuntary admission), and pharmacogenomics (CYP450 inducers—tobacco, phenytoin, carbamazepine, rifampin—subtherapeutic levels; CYP450 inhibitors—cimetidine, ketoconazole, erythromycin, isoniazid, grapefruit—toxicity risk). Ideal for PMHNP certification exam, ANCC psychiatric-mental health nurse practitioner board review, psychopharmacology, and mental health advanced practice.
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LMR GEORGETTE’S PMHNP CERTIFICATION EXAM
LATEST 2026-2027 QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+
What should you check in Asian patients taking Tegretol? - ANS... -For
the HLA-B*1502 allele (higher risk of SJS)
What two epidermal issues can arise from Tegretol or Lamictal? -
ANS... -Toxic epidermal necrosis and SJS
What may be the issue if a patient on Lamictal presents with a fever and
severe headache? - ANS... -Aspetic meningitis
What three antipsychotics have very low weight gaining effects? -
ANS... -Geodon, Abilify, and Latuda
Mini-Cog - ANS... -3 word recall and
clock drawing
MMSE scoring - ANS... -24-30 severe impairment
18-23 mild impairment
17 and less no impairment
What happens during pruning? - ANS... -Brain eliminates extra synapses
during infancy
autism and pruning - ANS... -Excess synapses caused by under-pruning
(patient oversensitive to light/sounds and seizures)
schizophrenia and pruning - ANS... -Fewer synapses caused by over-
pruning
,grey matter vs white matter - ANS... -Grey matter- synapses, working
area of brain, dendrites
White matter- myelinated axons
axons and dendrites - ANS... -axon away from cell and dendrites to
neuron's cell body
CNS is made up of - ANS... -brain and spinal cord
PNS consists of - ANS... -cranial nerves and spinal nerves- responsible
for voluntary movement
somatic nervous system - ANS... -the division of the peripheral nervous
system that controls the body's skeletal muscles
autonomic nervous system - ANS... -the part of the peripheral nervous
system that controls the glands and the muscles of the internal organs
parasympathetic nervous system - ANS... -the division of the autonomic
nervous system that calms the body, conserving its energy
sympathetic nervous system - ANS... -the division of the autonomic
nervous system that arouses the body, mobilizing its energy in stressful
situations
What does ADPIE stand for? - ANS... -Assessment
Diagnosis
Planning
Implementation
Evaluation
What should you do when a mother reports her child woke up screaming
in the middle of the night? - ANS... -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? -
ANS... -Scrape nail and send for testing
What do you do if a patient on lithium has dark brown urine? - ANS... -
Check renal function
What do you do if a patient presents with fever while on Clozaril? -
ANS... -Check ANC level to assess for agranulocytosis
What can cause serotonin syndrome? - ANS... -Antidepressants, St.
John's Wort, Same-E, Kava Kava, and Tryptophan
What labs are indicative of NMS? - ANS... -Elevated WBC (over
11,000) and elevated CPK
S/S of NMS - ANS... -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? -
ANS... -Check for rhabdo with CPK
s/s of serotonin syndrome - ANS... -hyperreflexia, muscle spasms,
myoclonus (involuntary muscle jerk), fever, tachycardia, HTN, shits and
shivers
What two medications to give with NMS? - ANS... -bromocriptine
(Parlodel)- D2 agonist dantrolene- muscle relaxer
What medication to give during SS? - ANS... -cyproheptadine
(Periactin)- 5HT-2A receptor antagonist
What is the onset and typical length of NMS? - ANS... -Slow onset (1-2
weeks after changing or starting therapy) and resolves within 9-14 days