Georgette PMHNP Review With Correct
Answers
When vmany vanswers vare vremarkably vsimilar, vthey vare vusually v_____________ v- v
vcorrect v v vanswer--wrong
Interprofessional vcollaboration vis vencouraged. v- v vcorrect v v vanswer--Collaborate vis
vusually vright. v
Delegate vis vusually vwrong.
ADPIER v- v vcorrect v v vanswer--Assessment, vdiagnosis, vPlan, vintervention, vevaluate,
vrefer vout vlast.
Lithium v- v vcorrect v v vanswer--Normal v0.6-1.2
Lithium vtoxicity voccurs vat vlevels v- v vcorrect v v vanswer--> v1.5
Signs vof vLithium vtoxicity v- v vcorrect v v vanswer--severe vnausea, vdiarrhea, vvomiting,
vconfusion, vdrowsiness, vmuscle vweakness, vheart vpalpitation, vcoarse vhand vtremors,
vunsteady vgait
Lithium vis vgold vstandard vfor v- v vcorrect v v vanswer--MANIA
Lithium vhas vevidence vshown vto v- v vcorrect v v vanswer--reduce vsuicidal videation
What vdoes vlithium vcause vin vneonate, vespecially v1st vtrimester v- v vcorrect v v vanswer--
Ebstein vanomaly v(congenital vheart vdefect)
dehydration vand vhyponatremia vcause vlithium vlevels vto v- v vcorrect v v vanswer--rise
Baseline vlabs vbefore vinitiation vof vlithium v- v vcorrect v v vanswer--TSH
creatinine v(0.6-1.2)
BUN v(10-20)
HCG v(all vpsychotropics vfemales v12-51)
EKG v50+
Urinalysis v(check vfor vproteins, v4+ vmay vindicate vkidney vdisease)
Side vEffects vof vLithium v- v vcorrect v v vanswer--hypothyroidism
amurimi
,coase vhand vtremors vwith vtoxicity
maculopapular vrash
diarrhea, vvomiting, vcramps--signs vof vtoxicity. vMonitor vclosely. v
anorexia
t vwave vinversions
leukocytosis
Pt veducation vfor vlithimum v- v vcorrect v v vanswer--staying vhydrated
avoiding vNSAIDS
compliance
Depakote vnormal vlevel v- v vcorrect v v vanswer--50-125
Depakote vtoxicity vlevel v- v vcorrect v v vanswer--greater vthan v150
Teratogenic veffects vof vDepakote v- v vcorrect v v vanswer--spina vbifida
Adverse veffects vof vdepakote v- v vcorrect v v vanswer--alopecia
hepatotoxicity v(RUQ vpain vor vbrown/red vurine--order vLFTs) vAST v5-40, vALT v5-35,
vyellowing vof vskin vor veyes, vfatigue
Signs vof vDepakote vtoxicity v- v vcorrect v v vanswer--disorientation, vlethargy, vrespiratory
vdepression, vnausea/vomiting
Intervention vfor vdepakote vtoxicity v- v vcorrect v v vanswer--DC vmed
check vlevel
LFT
ammonia
MAOI v+ vtyramine vcauses v- v vcorrect v v vanswer--hypertensive vcrisis
Symptoms vof vhypertensive vcrisis v- v vcorrect v v vanswer--elevated vBP
sudden vexplosive vlike vheadache
facial vflushing
palpitations
pupillary vdilation
diaphoresis
fever
Hypertensive vcrisis voccurs vwith vMAOI v+ v- v vcorrect v v vanswer--MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. vJohn's vwart
L-tryptophan
amurimi
,asthma vmeds
Treatment vfor vhypertensive vcrisis v- v vcorrect v v vanswer--DC voffending vagent
Administer vPHENTOLAMINE
Teratogenic veffects vof vbenzos v- v vcorrect v v vanswer--floppy vbaby, vcleft vpalate
Teratogenic veffects vof vtegratol v- v vcorrect v v vanswer--neural vtube vdefect
teratogenic veffects vof vlithium v- v vcorrect v v vanswer--ebstein vanomaly v(heart vdefect)
v(avoid, vespecially v1st vtrimester)
teratogenic veffects vof vdepakote v- v vcorrect v v vanswer--neural vtube vdefects/spina
vbifida
Adverse vreaction vto vLamictal v- v vcorrect v v vanswer--Steven vJohnson's vSyndrome
Signs vof vSJS v- v vcorrect v v vanswer--FEVER v--high vyield
sore vthroat
facial vswelling
tongue vswelling
red vrash
skin vsloughing
body vaches
prodromal vheadache
malaise
arthralgia
painful vmucus vmembranes
Lamotrigine vis vleast vlikely vto vcause v- v vcorrect v v vanswer--sedation vor vweight vgain
Carbamazepine v(tegretol) vblack vbox vwarning v- v vcorrect v v vanswer--agranulocytosis
v(decrease vWBCs)
aplastic vanemia v(pallor, vfatigue, vHA, vfever, vnosebleeds, vbleeding vgums, vskin vrash,
vSOA)
Carbamazepine vand vasians v- v vcorrect v v vanswer--Screen vfor vHLAB-1502 vallele
vbefore vinitiating, vdue vto vhigh vincidence vof vSJS vif vpositive vfor vallele.
Child-bearing vaged vwomen v- v vcorrect v v vanswer--check vfor vpregnancy vbefore
vstarting vmood vstabilizer
start von vfolic vacid vto vsupport vneural vtube vdevelopment vduring vthe vfirst vmonth vthat
va vwoman vis vpregnant
Clozaril/clozapine vcan vcause v- v vcorrect v v vanswer--agranulocytosis vand vneutropenia
amurimi
, For vmonitoring vneutropenia vin vClozaril, vmonitor v- v vcorrect v v vanswer--ANC
DC vclozarli vif vANC v- v vcorrect v v vanswer--less vthan v1000
DC vclozaril vif vWBC v- v vcorrect v v vanswer--2000-3000, vrisk vof vagranulocytosis
When von vclozaril vmonitor vfor v- v vcorrect v v vanswer--signs vand vsymptoms vof
vinfection: vsudden vfever, vchills, vsore vthroat, vweakness
Clozaril vonly vknown vantipsychotic vto v- v vcorrect v v vanswer--decrease vrisk vof vsuicide
vin vpatients vwith vschizophrenia.
Your vpatient vwith vbipolar vdisorder vis vadmitted vto va vmedical vhospital. vThe vinternist
vcontacts vyour voffice vand vasks vwhether vthe vlithium vyou vprescribed vhim vis veffecting
vhis vECG. vHow vdo vyou vrespond?
A. vLithium vcan vprolong vthe vQT vinterval
B. vLithium vhas vno veffect von vhis vECG
C. vLithium vcan vinvert vthe vt vwaves
D. vLithium vcan vshorten vthe vPR vinterval v- v vcorrect v v vanswer--Answer: vLithium vcan
vinvert vthe vt vwaves.
Mary vis va v45-year-old vAfrican vAmerican vfemale vwho vhas vbeen vtreated von
vIsocarboxazid v(Marplan) vfor vover v6 vyears. vMary vis vgoing vin vfor va vsurgical
vprocedure. vWhich vmedication vis vstrictly vcontraindicated vwith vIsocarboxazid?
A. vMorphine
B. vNSAIDS
C. vMethylphenidate
D. vAcetaminophen v- v vcorrect v v vanswer--Answer: vMethylphenidate
You vare vtreating va vclient vwith vschizophrenia vwho vtakes vclozapine. vWhat vlab vvalues
vwill vindicate vthe vclient vneeds vto vdiscontinue vtreatment?
A. vWBC vless vthan v1800 vand vANC vless vthan v1200
B. vANC vless vthan v1,000
C. vWBC vless vthan v5,000
D. vANC vless vthan v2000 v- v vcorrect v v vanswer--Answer: vANC vless vthan v1000
If vgiven vduring vpregnancy, vsocium vvalproate vcan vcause vwhich vof vthe vfollowing
vmedical vproblems vin vthe vbaby?
A. vSJS
B. vEbstein's vanomaly
C. vSpina vbifida
D. vCleft vpalate v- v vcorrect v v vanswer--A. vSpina vbifida
Which vmood vstabilizer vis vassociated vwith vpotential vlife-threatening vrash vin vthe
vAsian vpopulation?
A. vCarbamazepine v(tegretol)
amurimi
Answers
When vmany vanswers vare vremarkably vsimilar, vthey vare vusually v_____________ v- v
vcorrect v v vanswer--wrong
Interprofessional vcollaboration vis vencouraged. v- v vcorrect v v vanswer--Collaborate vis
vusually vright. v
Delegate vis vusually vwrong.
ADPIER v- v vcorrect v v vanswer--Assessment, vdiagnosis, vPlan, vintervention, vevaluate,
vrefer vout vlast.
Lithium v- v vcorrect v v vanswer--Normal v0.6-1.2
Lithium vtoxicity voccurs vat vlevels v- v vcorrect v v vanswer--> v1.5
Signs vof vLithium vtoxicity v- v vcorrect v v vanswer--severe vnausea, vdiarrhea, vvomiting,
vconfusion, vdrowsiness, vmuscle vweakness, vheart vpalpitation, vcoarse vhand vtremors,
vunsteady vgait
Lithium vis vgold vstandard vfor v- v vcorrect v v vanswer--MANIA
Lithium vhas vevidence vshown vto v- v vcorrect v v vanswer--reduce vsuicidal videation
What vdoes vlithium vcause vin vneonate, vespecially v1st vtrimester v- v vcorrect v v vanswer--
Ebstein vanomaly v(congenital vheart vdefect)
dehydration vand vhyponatremia vcause vlithium vlevels vto v- v vcorrect v v vanswer--rise
Baseline vlabs vbefore vinitiation vof vlithium v- v vcorrect v v vanswer--TSH
creatinine v(0.6-1.2)
BUN v(10-20)
HCG v(all vpsychotropics vfemales v12-51)
EKG v50+
Urinalysis v(check vfor vproteins, v4+ vmay vindicate vkidney vdisease)
Side vEffects vof vLithium v- v vcorrect v v vanswer--hypothyroidism
amurimi
,coase vhand vtremors vwith vtoxicity
maculopapular vrash
diarrhea, vvomiting, vcramps--signs vof vtoxicity. vMonitor vclosely. v
anorexia
t vwave vinversions
leukocytosis
Pt veducation vfor vlithimum v- v vcorrect v v vanswer--staying vhydrated
avoiding vNSAIDS
compliance
Depakote vnormal vlevel v- v vcorrect v v vanswer--50-125
Depakote vtoxicity vlevel v- v vcorrect v v vanswer--greater vthan v150
Teratogenic veffects vof vDepakote v- v vcorrect v v vanswer--spina vbifida
Adverse veffects vof vdepakote v- v vcorrect v v vanswer--alopecia
hepatotoxicity v(RUQ vpain vor vbrown/red vurine--order vLFTs) vAST v5-40, vALT v5-35,
vyellowing vof vskin vor veyes, vfatigue
Signs vof vDepakote vtoxicity v- v vcorrect v v vanswer--disorientation, vlethargy, vrespiratory
vdepression, vnausea/vomiting
Intervention vfor vdepakote vtoxicity v- v vcorrect v v vanswer--DC vmed
check vlevel
LFT
ammonia
MAOI v+ vtyramine vcauses v- v vcorrect v v vanswer--hypertensive vcrisis
Symptoms vof vhypertensive vcrisis v- v vcorrect v v vanswer--elevated vBP
sudden vexplosive vlike vheadache
facial vflushing
palpitations
pupillary vdilation
diaphoresis
fever
Hypertensive vcrisis voccurs vwith vMAOI v+ v- v vcorrect v v vanswer--MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. vJohn's vwart
L-tryptophan
amurimi
,asthma vmeds
Treatment vfor vhypertensive vcrisis v- v vcorrect v v vanswer--DC voffending vagent
Administer vPHENTOLAMINE
Teratogenic veffects vof vbenzos v- v vcorrect v v vanswer--floppy vbaby, vcleft vpalate
Teratogenic veffects vof vtegratol v- v vcorrect v v vanswer--neural vtube vdefect
teratogenic veffects vof vlithium v- v vcorrect v v vanswer--ebstein vanomaly v(heart vdefect)
v(avoid, vespecially v1st vtrimester)
teratogenic veffects vof vdepakote v- v vcorrect v v vanswer--neural vtube vdefects/spina
vbifida
Adverse vreaction vto vLamictal v- v vcorrect v v vanswer--Steven vJohnson's vSyndrome
Signs vof vSJS v- v vcorrect v v vanswer--FEVER v--high vyield
sore vthroat
facial vswelling
tongue vswelling
red vrash
skin vsloughing
body vaches
prodromal vheadache
malaise
arthralgia
painful vmucus vmembranes
Lamotrigine vis vleast vlikely vto vcause v- v vcorrect v v vanswer--sedation vor vweight vgain
Carbamazepine v(tegretol) vblack vbox vwarning v- v vcorrect v v vanswer--agranulocytosis
v(decrease vWBCs)
aplastic vanemia v(pallor, vfatigue, vHA, vfever, vnosebleeds, vbleeding vgums, vskin vrash,
vSOA)
Carbamazepine vand vasians v- v vcorrect v v vanswer--Screen vfor vHLAB-1502 vallele
vbefore vinitiating, vdue vto vhigh vincidence vof vSJS vif vpositive vfor vallele.
Child-bearing vaged vwomen v- v vcorrect v v vanswer--check vfor vpregnancy vbefore
vstarting vmood vstabilizer
start von vfolic vacid vto vsupport vneural vtube vdevelopment vduring vthe vfirst vmonth vthat
va vwoman vis vpregnant
Clozaril/clozapine vcan vcause v- v vcorrect v v vanswer--agranulocytosis vand vneutropenia
amurimi
, For vmonitoring vneutropenia vin vClozaril, vmonitor v- v vcorrect v v vanswer--ANC
DC vclozarli vif vANC v- v vcorrect v v vanswer--less vthan v1000
DC vclozaril vif vWBC v- v vcorrect v v vanswer--2000-3000, vrisk vof vagranulocytosis
When von vclozaril vmonitor vfor v- v vcorrect v v vanswer--signs vand vsymptoms vof
vinfection: vsudden vfever, vchills, vsore vthroat, vweakness
Clozaril vonly vknown vantipsychotic vto v- v vcorrect v v vanswer--decrease vrisk vof vsuicide
vin vpatients vwith vschizophrenia.
Your vpatient vwith vbipolar vdisorder vis vadmitted vto va vmedical vhospital. vThe vinternist
vcontacts vyour voffice vand vasks vwhether vthe vlithium vyou vprescribed vhim vis veffecting
vhis vECG. vHow vdo vyou vrespond?
A. vLithium vcan vprolong vthe vQT vinterval
B. vLithium vhas vno veffect von vhis vECG
C. vLithium vcan vinvert vthe vt vwaves
D. vLithium vcan vshorten vthe vPR vinterval v- v vcorrect v v vanswer--Answer: vLithium vcan
vinvert vthe vt vwaves.
Mary vis va v45-year-old vAfrican vAmerican vfemale vwho vhas vbeen vtreated von
vIsocarboxazid v(Marplan) vfor vover v6 vyears. vMary vis vgoing vin vfor va vsurgical
vprocedure. vWhich vmedication vis vstrictly vcontraindicated vwith vIsocarboxazid?
A. vMorphine
B. vNSAIDS
C. vMethylphenidate
D. vAcetaminophen v- v vcorrect v v vanswer--Answer: vMethylphenidate
You vare vtreating va vclient vwith vschizophrenia vwho vtakes vclozapine. vWhat vlab vvalues
vwill vindicate vthe vclient vneeds vto vdiscontinue vtreatment?
A. vWBC vless vthan v1800 vand vANC vless vthan v1200
B. vANC vless vthan v1,000
C. vWBC vless vthan v5,000
D. vANC vless vthan v2000 v- v vcorrect v v vanswer--Answer: vANC vless vthan v1000
If vgiven vduring vpregnancy, vsocium vvalproate vcan vcause vwhich vof vthe vfollowing
vmedical vproblems vin vthe vbaby?
A. vSJS
B. vEbstein's vanomaly
C. vSpina vbifida
D. vCleft vpalate v- v vcorrect v v vanswer--A. vSpina vbifida
Which vmood vstabilizer vis vassociated vwith vpotential vlife-threatening vrash vin vthe
vAsian vpopulation?
A. vCarbamazepine v(tegretol)
amurimi
