GEORGETTE REVIEW PMHNP ACCURATE EXPERT VERIFIED
ACTUAL QUESTIONS & ANSWERS FOR GUARANTEED PASS
NEWEST UPDATE 2026
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
teratogenic effects of lithium -ANSWER-ebstein anomaly (heart defect) (avoid, especially 1st
trimester)
teratogenic effects of depakote -ANSWER-neural tube defects/spina bifida
Adverse reaction to Lamictal -ANSWER-Steven Johnson's Syndrome
Signs of SJS -ANSWER-FEVER --high yield
sore throat
facial swelling
tongue swelling
red rash
skin sloughing
body aches
prodromal headache
malaise
arthralgia
painful mucus membranes
Lamotrigine is least likely to cause -ANSWER-sedation or weight gain
ACTUAL QUESTIONS & ANSWERS FOR GUARANTEED PASS
NEWEST UPDATE 2026
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
teratogenic effects of lithium -ANSWER-ebstein anomaly (heart defect) (avoid, especially 1st
trimester)
teratogenic effects of depakote -ANSWER-neural tube defects/spina bifida
Adverse reaction to Lamictal -ANSWER-Steven Johnson's Syndrome
Signs of SJS -ANSWER-FEVER --high yield
sore throat
facial swelling
tongue swelling
red rash
skin sloughing
body aches
prodromal headache
malaise
arthralgia
painful mucus membranes
Lamotrigine is least likely to cause -ANSWER-sedation or weight gain
