LMR GEORGETTE'S PMHNP CERTIFICATION
EXAM 2025 | COMPREHENSIVE BOARD
REVIEW, PRACTICE QUESTIONS &
ANSWERS
| GRADED A+ |GUARANTEED SUCCESS
Updated 2026 Questions and Answers
100% Verified Exam Prep and Comprehensive
Rationales Included
, What do you do if a patient presents with fever while on Check ANC level to assess for agranulocytosis
Clozaril?
What can cause serotonin syndrome? Antidepressants, St. John's Wort, Same-E, Kava Kava, and Tryptophan
What labs are indicative of NMS? Elevated WBC (over 11,000) and elevated CPK
S/S of NMS muscle rigidity, hyperthermia, tachycardia, abnormal bp, sweating, altered mental
status, cherry colored urine
What should you do if a patient presents with cherry Check for rhabdo with CPK
colored urine?
s/s of serotonin syndrome hyperreflexia, muscle spasms, myoclonus (involuntary muscle jerk), fever,
tachycardia, HTN, shits and shivers
What two medications to give with NMS? bromocriptine (Parlodel)- D2 agonist dantrolene- muscle relaxer
What medication to give during SS? cyproheptadine (Periactin)- 5HT-2A receptor antagonist
What is the onset and typical length of NMS? Slow onset (1-2 weeks after changing or starting therapy) and resolves within 9-14
days
What is the onset of SS? Within 24 hours of starting/changing medication and resolves within a few days
How do you distinguish between NMS and acute NMS has a slower onset while acute dystonia occurs within hours
dystonia?
What happens with lithium and NSAIDs? Increased risk of lithium toxicity (gout meds, ibuprophen, naproxen, etc.)
What happens with lithium and ACE inhibitors? Increased risk of lithium toxicity related to the increased urination from the ACE
inhibitors
Why should a patient on lithium avoid calcium channel Risk of fatal nephrotoxicity
blockers?
What is a fetal side effect of lithium? Epstein's anomaly
What lab should you check for athletes on lithium? Specific gravity to assess for dehydration (dehydration is >1.015)
EXAM 2025 | COMPREHENSIVE BOARD
REVIEW, PRACTICE QUESTIONS &
ANSWERS
| GRADED A+ |GUARANTEED SUCCESS
Updated 2026 Questions and Answers
100% Verified Exam Prep and Comprehensive
Rationales Included
, What do you do if a patient presents with fever while on Check ANC level to assess for agranulocytosis
Clozaril?
What can cause serotonin syndrome? Antidepressants, St. John's Wort, Same-E, Kava Kava, and Tryptophan
What labs are indicative of NMS? Elevated WBC (over 11,000) and elevated CPK
S/S of NMS muscle rigidity, hyperthermia, tachycardia, abnormal bp, sweating, altered mental
status, cherry colored urine
What should you do if a patient presents with cherry Check for rhabdo with CPK
colored urine?
s/s of serotonin syndrome hyperreflexia, muscle spasms, myoclonus (involuntary muscle jerk), fever,
tachycardia, HTN, shits and shivers
What two medications to give with NMS? bromocriptine (Parlodel)- D2 agonist dantrolene- muscle relaxer
What medication to give during SS? cyproheptadine (Periactin)- 5HT-2A receptor antagonist
What is the onset and typical length of NMS? Slow onset (1-2 weeks after changing or starting therapy) and resolves within 9-14
days
What is the onset of SS? Within 24 hours of starting/changing medication and resolves within a few days
How do you distinguish between NMS and acute NMS has a slower onset while acute dystonia occurs within hours
dystonia?
What happens with lithium and NSAIDs? Increased risk of lithium toxicity (gout meds, ibuprophen, naproxen, etc.)
What happens with lithium and ACE inhibitors? Increased risk of lithium toxicity related to the increased urination from the ACE
inhibitors
Why should a patient on lithium avoid calcium channel Risk of fatal nephrotoxicity
blockers?
What is a fetal side effect of lithium? Epstein's anomaly
What lab should you check for athletes on lithium? Specific gravity to assess for dehydration (dehydration is >1.015)
