GEORGETTE'S LMR (GEORGETTE'S PMHNP CERTIFICATION) EXAM 300
QUESTIONS AND CORRECT DETAILED ANSWERS WITH EXPERT
VERIFICATION ALREADY A GRADED|BRAND NEW!!
How should you begin your interview with adolescents?- correct answer>>>By building
rapport with them by ensuring confidentiality absent exceptions
Should you interview adolescents with or without parents?- correct answer>>>Without
What if an adolescent tells you they are homosexual and they don't want their parents to
know?- correct answer>>>This is confidential
The patient is being discharged and would like their labs faxed to the rehab facility.
What is your initial action?- correct answer>>>Get informed consent/ROI
What do you do if a medical evaluation is needed?- correct answer>>>Refer out - this is
out of scope
What do you do if a patient is takes something and is feeling really funny/unwell in your
office?- correct answer>>>Collect UDS and then refer out
Is it considered a mental illness if it is an expected response culturally? What do you
offer as treatment?- correct answer>>>No; brief supportive therapy - not medication
A mother states her child is experiencing a cultural illness. What is your initial action?-
correct answer>>>Respect the mother's cultural understanding of illness prior to
assessment
Native Americans view mental illness and SUDs as?- correct answer>>>An imbalance
between the individual and the world
What ethnic group has the highest rate of suicidality in the US?- correct
answer>>>Native Americans
If a patient believes they need a healing stick in their room, but the staff nurses removed
it from them - what should you do?- correct answer>>>Teach cultural sensitivity and
make accommodations for patient to have healing stick available such as 1:1
Psychoeducation should be based on?- correct answer>>>Cultural context
How do you promote health in a location with multiple ethnicities and education levels?-
correct answer>>>Multiple cultural education and ethnospecific assessment parameters
What if a patient wants a traditional healer?- correct answer>>>Allow this - remember
ROI/informed consent
,Normal TSH?- correct answer>>>0.5-5.0
TSH < 0.5 = ?- correct answer>>>Hyperthyroidism
TSH > 5.0 = ?- correct answer>>>Hypothyroidism
Relationship between TSH & T3/T4?- correct answer>>>Inverse
Hyperthyroidism can present as?- correct answer>>>Mania
Hypothyroidism can present as?- correct answer>>>Depression
Normal depakote level?- correct answer>>>50-125
Toxic depakote level?- correct answer>>>150+
Birth defect caused by depakote?- correct answer>>>Spina Bifida
S/S of depakote toxicity?- correct answer>>>Disorientation, lethargy, decreased
respiratory rate, and N/V
What to do if there is depakote toxicity?- correct answer>>>D/C depakote and check
VPA level, LFTs, and ammonia
S/S of hepatotoxicity?- correct answer>>>RUQ pain, reddish brown urine, jaundice,
fatigue, and elevated LFTs
Normal AST?- correct answer>>>5-40
Normal ALT?- correct answer>>>5-35
Kava kava can cause?- correct answer>>>Liver damage and heavy sedation
Kava kava is c/i with?- correct answer>>>Benzos or sedatives
Mood stabilizer most associated with SJS?- correct answer>>>Lamictal
Mood stabilizer with least weight gain?- correct answer>>>Lamictal
SGAs with least weight gain?- correct answer>>>ziprasidone, abilify, and latuda
Least sedating SGA?- correct answer>>>Abilify
Routine labs with SGAs?- correct answer>>>BMI, hip to waist ratio, glucose, A1C, and
lipid panel
, Management of metabolic syndrome with SGAs?- correct answer>>>1. Nonpharm =
exercise or nutritional counseling
2. Pharm = switch to other SGA with lower chance of metabolic syndrome
Carbamazepine can cause?- correct answer>>>Agranulocytosis and aplastic anemia
What should you screen for prior to starting Asians on carbamazepine and why?-
correct answer>>>HLAB1502 Allele; risk of SJS
When should you d/c carbamazepine if agranulocytosis is suspected?- correct
answer>>>If ANC is < 1000 with or without s/s of infection
Lithium range?- correct answer>>>0.6 - 1.2
What to do if lithium is 1.3 or 1.4?- correct answer>>>Monitor
What to do if lithium is 1.5+?- correct answer>>>D/C
Benefits of lithium?- correct answer>>>Gold standard for mania, neuroprotective, and
antisuicidal effects
S/S of lithium toxicity?- correct answer>>>Severe N/V, polydipsia, polyuria,
leukocytosis, palpitations, coarse tremor
What to do if lithium toxicity is suspected?- correct answer>>>D/C and check serum
levels prior to checking VS
What should you not do when advocating for a patient?- correct answer>>>Judge or
confront
What class of medication is contraindicated with tics?- correct answer>>>Stimulants
What should you provide for prior to assessing abuse victims?- correct answer>>>A
safe environment
What are your actions if a child reports abuse?- correct answer>>>First interview
separately from parents then report to CPS
What should you do if a child plays with toys in a way that you suspect abuse?- correct
answer>>>Report to CPS
In what setting as an inpatient provider should you interview a patient?- correct
answer>>>Use a private room with the door partially open
QUESTIONS AND CORRECT DETAILED ANSWERS WITH EXPERT
VERIFICATION ALREADY A GRADED|BRAND NEW!!
How should you begin your interview with adolescents?- correct answer>>>By building
rapport with them by ensuring confidentiality absent exceptions
Should you interview adolescents with or without parents?- correct answer>>>Without
What if an adolescent tells you they are homosexual and they don't want their parents to
know?- correct answer>>>This is confidential
The patient is being discharged and would like their labs faxed to the rehab facility.
What is your initial action?- correct answer>>>Get informed consent/ROI
What do you do if a medical evaluation is needed?- correct answer>>>Refer out - this is
out of scope
What do you do if a patient is takes something and is feeling really funny/unwell in your
office?- correct answer>>>Collect UDS and then refer out
Is it considered a mental illness if it is an expected response culturally? What do you
offer as treatment?- correct answer>>>No; brief supportive therapy - not medication
A mother states her child is experiencing a cultural illness. What is your initial action?-
correct answer>>>Respect the mother's cultural understanding of illness prior to
assessment
Native Americans view mental illness and SUDs as?- correct answer>>>An imbalance
between the individual and the world
What ethnic group has the highest rate of suicidality in the US?- correct
answer>>>Native Americans
If a patient believes they need a healing stick in their room, but the staff nurses removed
it from them - what should you do?- correct answer>>>Teach cultural sensitivity and
make accommodations for patient to have healing stick available such as 1:1
Psychoeducation should be based on?- correct answer>>>Cultural context
How do you promote health in a location with multiple ethnicities and education levels?-
correct answer>>>Multiple cultural education and ethnospecific assessment parameters
What if a patient wants a traditional healer?- correct answer>>>Allow this - remember
ROI/informed consent
,Normal TSH?- correct answer>>>0.5-5.0
TSH < 0.5 = ?- correct answer>>>Hyperthyroidism
TSH > 5.0 = ?- correct answer>>>Hypothyroidism
Relationship between TSH & T3/T4?- correct answer>>>Inverse
Hyperthyroidism can present as?- correct answer>>>Mania
Hypothyroidism can present as?- correct answer>>>Depression
Normal depakote level?- correct answer>>>50-125
Toxic depakote level?- correct answer>>>150+
Birth defect caused by depakote?- correct answer>>>Spina Bifida
S/S of depakote toxicity?- correct answer>>>Disorientation, lethargy, decreased
respiratory rate, and N/V
What to do if there is depakote toxicity?- correct answer>>>D/C depakote and check
VPA level, LFTs, and ammonia
S/S of hepatotoxicity?- correct answer>>>RUQ pain, reddish brown urine, jaundice,
fatigue, and elevated LFTs
Normal AST?- correct answer>>>5-40
Normal ALT?- correct answer>>>5-35
Kava kava can cause?- correct answer>>>Liver damage and heavy sedation
Kava kava is c/i with?- correct answer>>>Benzos or sedatives
Mood stabilizer most associated with SJS?- correct answer>>>Lamictal
Mood stabilizer with least weight gain?- correct answer>>>Lamictal
SGAs with least weight gain?- correct answer>>>ziprasidone, abilify, and latuda
Least sedating SGA?- correct answer>>>Abilify
Routine labs with SGAs?- correct answer>>>BMI, hip to waist ratio, glucose, A1C, and
lipid panel
, Management of metabolic syndrome with SGAs?- correct answer>>>1. Nonpharm =
exercise or nutritional counseling
2. Pharm = switch to other SGA with lower chance of metabolic syndrome
Carbamazepine can cause?- correct answer>>>Agranulocytosis and aplastic anemia
What should you screen for prior to starting Asians on carbamazepine and why?-
correct answer>>>HLAB1502 Allele; risk of SJS
When should you d/c carbamazepine if agranulocytosis is suspected?- correct
answer>>>If ANC is < 1000 with or without s/s of infection
Lithium range?- correct answer>>>0.6 - 1.2
What to do if lithium is 1.3 or 1.4?- correct answer>>>Monitor
What to do if lithium is 1.5+?- correct answer>>>D/C
Benefits of lithium?- correct answer>>>Gold standard for mania, neuroprotective, and
antisuicidal effects
S/S of lithium toxicity?- correct answer>>>Severe N/V, polydipsia, polyuria,
leukocytosis, palpitations, coarse tremor
What to do if lithium toxicity is suspected?- correct answer>>>D/C and check serum
levels prior to checking VS
What should you not do when advocating for a patient?- correct answer>>>Judge or
confront
What class of medication is contraindicated with tics?- correct answer>>>Stimulants
What should you provide for prior to assessing abuse victims?- correct answer>>>A
safe environment
What are your actions if a child reports abuse?- correct answer>>>First interview
separately from parents then report to CPS
What should you do if a child plays with toys in a way that you suspect abuse?- correct
answer>>>Report to CPS
In what setting as an inpatient provider should you interview a patient?- correct
answer>>>Use a private room with the door partially open
