LMR Georgette’s PMHNP Certification Exam V1 | Latest 2025/ 2026 Update | Questions and Verified Answers | 100% Correct | GRADED A.

LMR Georgette’s PMHNP Certification Exam V1 | Latest 2025/ 2026 Update | Questions and Verified Answers | 100% Correct | GRADED A. Question: What does ADPIE stand for? Answer: Assessment Diagnosis Planning Implementation Evaluation Question: What should you do when a mother reports her child woke up screaming in the middle of the night? Answer: Ask her if it's happened before to assess for sleep issue patterns Question: What do you do if a patient comes in with fungus on their toenail? Answer: Scrape nail and send for testing Question: What do you do if a patient on lithium has dark brown urine? Answer: Check renal function Question: What do you do if a patient presents with fever while on Clozaril? Answer: Check ANC level to assess for agranulocytosis Question: What can cause serotonin syndrome? Answer: Antidepressants, St. John's Wort, Same-E, Kava Kava, and Tryptophan Question: What labs are indicative of NMS? Answer: Elevated WBC (over 11,000) and elevated CPK Question: S/S of NMS Answer: muscle rigidity, hyperthermia, tachycardia, abnormal bp, sweating, altered mental status, cherry colored urine Question: What should you do if a patient presents with cherry colored urine? Answer: Check for rhabdo with CPK Question: s/s of serotonin syndrome Answer: hyperreflexia, muscle spasms, myoclonus (involuntary muscle jerk), fever, tachycardia, HTN, shits and shivers Question: What two medications to give with NMS? Answer: bromocriptine (Parlodel)- D2 agonist dantrolene- muscle relaxer Question: What medication to give during SS? Answer: cyproheptadine (Periactin)- 5HT-2A receptor antagonist Question: What is the onset and typical length of NMS? Answer: Slow onset (1-2 weeks after changing or starting therapy) and resolves within 9-14 days Question: What is the onset of SS? Answer: Within 24 hours of starting/changing medication and resolves within a few days Question: How do you distinguish between NMS and acute dystonia? Answer: NMS has a slower onset while acute dystonia occurs within hours Question: What happens with lithium and NSAIDs? Answer: Increased risk of lithium toxicity (gout meds, ibuprophen, naproxen, etc.) Question: What happens with lithium and ACE inhibitors? Answer: Increased risk of lithium toxicity related to the increased urination from the ACE inhibitors Question: Why should a patient on lithium avoid calcium channel blockers? Answer: Risk of fatal nephrotoxicity Question: What is a fetal side effect of lithium? Answer: Epstein's anomaly Question: What lab should you check for athletes on lithium? Answer: Specific gravity to assess for dehydration (dehydration is 1.015) Question: What do you do if the lithium level is 1.3? Answer: Do not give the next dose and assess for s/s Question: At what level is lithium toxicity a medical emergency? Answer: 3 Question: S/S of lithium toxicity Answer: vomiting, diarrhea, slurred speech, hand tremor, dry mouth/thirst, muscle weakness/twitching Question: Why check an EKG with lithium? Answer: Inverted T-waves Question: What medication should treat hypothyroidism caused by lithium use? Answer: Synthroid Question: What do you do if patient is prescribed both depakote and lamictal? Answer: Decreased lamictal dose by 50% Question: Depakote and pregnancy Answer: Spina bifida Question: What emergency may be occuring if patient on depakote reports upper abdominal pain? Answer: Pancreatitis Question: What lab should you check if patient has right upper quadrant pain and dark brown urine? Answer: LFTs Question: What lab means pregnancy? Answer: HCG Question: Why is Clozaril used? Answer: Treatment resistant schizophrenia, improves SI, and improves negative symptoms of schizophrenia Question: What two medications have the highest risk of agranulocytosis and aplastic anemia? Answer: Clozaril and Tegretol Question: What symptoms may mean a Clozaril induced infection? Answer: Sore throats, sores in mouth/gums, fever Question: When should you discontinue Clozaril or Tegretol? Answer: WBC 2000 or ANC 1000 Question: What should you check in Asian patients taking Tegretol? Answer: For the HLA-B*1502 allele (higher risk of SJS) Question: What two epidermal issues can arise from Tegretol or Lamictal? Answer: Toxic epidermal necrosis and SJS Question: What may be the issue if a patient on Lamictal presents with a fever and severe headache? Answer: Aspetic meningitis Question: What three antipsychotics have very low weight gaining effects? Answer: Geodon, Abilify, and Latuda Question: Mini-Cog Answer: 3 word recall and clock drawing Question: MMSE scoring Answer: 24-30 severe impairment 18-23 mild impairment 17 and less no impairment Question: What happens during pruning? Answer: Brain eliminates extra synapses during infancy Question: autism and pruning Answer: Excess synapses caused by under-pruning (patient oversensitive to light/sounds and seizures) Question: schizophrenia and pruning Answer: Fewer synapses caused by over-pruning Question: grey matter vs white matter Answer: Grey matter- synapses, working area of brain, dendrites White matter- myelinated axons Question: axons and dendrites Answer: axon away from cell and dendrites to neuron's cell body Question: CNS is made up of Answer: brain and spinal cord Question: PNS consists of Answer: cranial nerves and spinal nerves- responsible for voluntary movement Question: somatic nervous system Answer: the division of the peripheral nervous system that controls the body's skeletal muscles Question: autonomic nervous system Answer: the part of the peripheral nervous system that controls the glands and the muscles of the internal organs Question: parasympathetic nervous system Answer: the division of the autonomic nervous system that calms the body, conserving its energy Question: sympathetic nervous system Answer: the division of the autonomic nervous system that arouses the body, mobilizing its energy in stressful situations Question: prefrontal cortex Answer: part of frontal lobe responsible for thinking, planning, and language Question: What part of the brain is responsible for perception of pain? Answer: Prefrontal cortex- Explains TMS Question: What is the dorsolateral prefrontal cortex responsible for? Answer: Executive functioning- undergoes maturation until adulthood Question: orbitofrontal cortex Answer: a region of the brain that controls impulses and attention (ADHD explained) Question: frontal lobe Answer: associated with reasoning, planning, parts of speech (Broca-forming), movement, emotions, and problem solving Question: parietal lobe Answer: A region of the cerebral cortex whose functions include memory, attention, perception, cognition, taste, and reading/writing Question: occipital lobe Answer: A region of the cerebral cortex that processes visual information Question: temporal lobe Answer: A region of the cerebral cortex responsible for hearing, agnosia, and language (Wernicke's area-receptive speech) Question: Issues with what lobe can lead to visual/auditory hallucinations? Answer: Temporal Question: How does the amygdala work? Answer: Sends signal to hypothalamus when in distress, which then communicates to the rest of the body through the nervous system Question: anterior cingulate cortex Answer: critical for stress; implicated in childhood trauma Question: basal ganglia Answer: directs intentional movements and is also called the corpus striatum Question: Hypothalamus Answer: brain region controlling appetite, sleep, libido, heart rate Question: Hippocampus Answer: A neural center located in the limbic system that helps process explicit memories for storage. Question: mesolimbic pathway Answer: positive symptoms of schizophrenia due to increased dopamine Question: mesocortical pathway Answer: negative symptoms of schizophrenia due to decreased dopamine Question: Nigrostriatal pathway Answer: EPS with increased acetylcholine and decreased dopamine Question: Tuberoinfundibular pathway Answer: decreased dopamine causes increased prolactin levels Question: Monoamines Answer: dopamine, norepinephrine, serotonin, epinephrine Question: amino acids Answer: Glutamate and GABA Question: Cholinergic Answer: acetylcholine and neuropeptides Question: Brain Changes in Alzheimer's Disease Answer: amyloid plaques and neurofibrillary tangles Question: Increased and decreased acetylcholine Answer: Increased- parkinson's Decreased-alzheimers Question: Where is Norepinephrine produced? Answer: locus coeruleus Question: Where is serotonin produced? Answer: raphe nuclei Question: Where is epinephrine produced? Answer: adrenal glands Question: Where is dopamine produced? Answer: substantia nigra and ventral tegmental area Question: Where is GABA synthesized? Answer: limbic system Question: s/s of acute dystonia Answer: Severe spasm of the tongue, neck, eyes, face and back; laryngeal spasms (mutism) Question: Akathisia Answer: motor restlessness Question: Parkinonism s/s Answer: slouched posture, shuffling gait, rigid, bradykinesia, tremors at rest, pin-rolling Question: tardive dyskinesia Answer: involuntary movements of the facial muscles, tongue, and limbs, protrusion of tongue, smacking lips Question: Aims Answer: abnormal involuntary movement scale Question: Neurotransmitters autism Answer: gaba, serotonin, glutamate Question: mood disorder neurotransmitters Answer: norepinephrine and serotonin Question: bipolar neurotransmitters Answer: increased glutamate Question: Anxiety neurotransmitters Answer: increased norepinephrine and decreased GABA Question: OCD neurotransmitters Answer: decreased serotonin Question: Parkinson's neurotransmitters Answer: increased acetylcholine and decreased dopamine Question: ADHD neurotransmitters Answer: decrease in dopamine and norepinephrine Question: Tourette's Neurotransmitters Answer: dopamine, serotonin, GABA, and glutamate Question: What to prescribe for Tourette's Answer: Risperdal Question: Substance abuse neurotransmitters Answer: decrease in opioid neuropeptides Question: Alcohol abuse neurotransmitters Answer: increase in GABA and dopamine and decrease in serotonin Question: Depression neurotransmitters Answer: decrease in serotonin, dopamine, and norepinephrine Question: sleep neurotransmitters Answer: low serotonin causes insomnia (Melatonin is pre-cursor) Question: Schizophrenia neurotransmitters Answer: increased dopamine and decreased serotonin Question: negative symptoms of schizophrenia Answer: disturbance of affect, blunting (severe reduction in the intensity of affect expression), flat affect, inappropriate affect (might laugh hysterically while describing someones death) Question: positive symptoms of schizophrenia Answer: Delusions of reference, delusions of persecution, delusions of grandeur, thought broadcasting, though insertion, hallucinations, disorganized thought, disorganized behavior, catatonia