LMR Georgette’s PMHNP Certification Exam Latest Questions And Correct
Answers(Verified Answers)
What does ADPIE stand for? - (ANSWERS)Assessment
Diagnosis
Planning
Implementation
Evaluation
What should you do when a mother reports her child woke up screaming in the middle of the
night? - (ANSWERS)Ask her if it's happened before to assess for sleep issue patterns
What do you do if a patient comes in with fungus on their toenail? - (ANSWERS)Scrape nail and
send for testing
What do you do if a patient on lithium has dark brown urine? - (ANSWERS)Check renal function
What do you do if a patient presents with fever while on Clozaril? - (ANSWERS)Check ANC level
to assess for agranulocytosis
What can cause serotonin syndrome? - (ANSWERS)Antidepressants, St. John's Wort, Same-E,
Kava Kava, and Tryptophan
What labs are indicative of NMS? - (ANSWERS)Elevated WBC (over 11,000) and elevated CPK
S/S of NMS - (ANSWERS)muscle rigidity, hyperthermia, tachycardia, abnormal bp, sweating,
altered mental status, cherry colored urine
What should you do if a patient presents with cherry colored urine? - (ANSWERS)Check for
rhabdo with CPK
s/s of serotonin syndrome - (ANSWERS)hyperreflexia, muscle spasms, myoclonus (involuntary
muscle jerk), fever, tachycardia, HTN, shits and shivers
What two medications to give with NMS? - (ANSWERS)bromocriptine (Parlodel)- D2 agonist
dantrolene- muscle relaxer
What medication to give during SS? - (ANSWERS)cyproheptadine (Periactin)- 5HT-2A receptor
antagonist
What is the onset and typical length of NMS? - (ANSWERS)Slow onset (1-2 weeks after changing
or starting therapy) and resolves within 9-14 days
What is the onset of SS? - (ANSWERS)Within 24 hours of starting/changing medication and
resolves within a few days
,LMR Georgette’s PMHNP Certification Exam Latest Questions And Correct
Answers(Verified Answers)
How do you distinguish between NMS and acute dystonia? - (ANSWERS)NMS has a slower
onset while acute dystonia occurs within hours
What happens with lithium and NSAIDs? - (ANSWERS)Increased risk of lithium toxicity (gout
meds, ibuprophen, naproxen, etc.)
What happens with lithium and ACE inhibitors? - (ANSWERS)Increased risk of lithium toxicity
related to the increased urination from the ACE inhibitors
Why should a patient on lithium avoid calcium channel blockers? - (ANSWERS)Risk of fatal
nephrotoxicity
What is a fetal side effect of lithium? - (ANSWERS)Epstein's anomaly
What lab should you check for athletes on lithium? - (ANSWERS)Specific gravity to assess for
dehydration (dehydration is >1.015)
What do you do if the lithium level is 1.3? - (ANSWERS)Do not give the next dose and assess for
s/s
At what level is lithium toxicity a medical emergency? - (ANSWERS)>3
S/S of lithium toxicity - (ANSWERS)vomiting, diarrhea, slurred speech, hand tremor, dry
mouth/thirst, muscle weakness/twitching
Why check an EKG with lithium? - (ANSWERS)Inverted T-waves
What medication should treat hypothyroidism caused by lithium use? - (ANSWERS)Synthroid
What do you do if patient is prescribed both depakote and lamictal? - (ANSWERS)Decreased
lamictal dose by 50%
Depakote and pregnancy - (ANSWERS)Spina bifida
What emergency may be occuring if patient on depakote reports upper abdominal pain? -
(ANSWERS)Pancreatitis
What lab should you check if patient has right upper quadrant pain and dark brown urine? -
(ANSWERS)LFTs
What lab means pregnancy? - (ANSWERS)HCG
Why is Clozaril used? - (ANSWERS)Treatment resistant schizophrenia, improves SI, and
improves negative symptoms of schizophrenia
, LMR Georgette’s PMHNP Certification Exam Latest Questions And Correct
Answers(Verified Answers)
What two medications have the highest risk of agranulocytosis and aplastic anemia? -
(ANSWERS)Clozaril and Tegretol
What symptoms may mean a Clozaril induced infection? - (ANSWERS)Sore throats, sores in
mouth/gums, fever
When should you discontinue Clozaril or Tegretol? - (ANSWERS)WBC < 2000 or ANC <1000
What should you check in Asian patients taking Tegretol? - (ANSWERS)For the HLA-B*1502
allele (higher risk of SJS)
What two epidermal issues can arise from Tegretol or Lamictal? - (ANSWERS)Toxic epidermal
necrosis and SJS
What may be the issue if a patient on Lamictal presents with a fever and severe headache? -
(ANSWERS)Aspetic meningitis
What three antipsychotics have very low weight gaining effects? - (ANSWERS)Geodon, Abilify,
and Latuda
Mini-Cog - (ANSWERS)3 word recall and
clock drawing
MMSE scoring - (ANSWERS)24-30 severe impairment
18-23 mild impairment
17 and less no impairment
What happens during pruning? - (ANSWERS)Brain eliminates extra synapses during infancy
autism and pruning - (ANSWERS)Excess synapses caused by under-pruning (patient
oversensitive to light/sounds and seizures)
schizophrenia and pruning - (ANSWERS)Fewer synapses caused by over-pruning
grey matter vs white matter - (ANSWERS)Grey matter- synapses, working area of brain,
dendrites
White matter- myelinated axons
axons and dendrites - (ANSWERS)axon away from cell and dendrites to neuron's cell body
CNS is made up of - (ANSWERS)brain and spinal cord
Answers(Verified Answers)
What does ADPIE stand for? - (ANSWERS)Assessment
Diagnosis
Planning
Implementation
Evaluation
What should you do when a mother reports her child woke up screaming in the middle of the
night? - (ANSWERS)Ask her if it's happened before to assess for sleep issue patterns
What do you do if a patient comes in with fungus on their toenail? - (ANSWERS)Scrape nail and
send for testing
What do you do if a patient on lithium has dark brown urine? - (ANSWERS)Check renal function
What do you do if a patient presents with fever while on Clozaril? - (ANSWERS)Check ANC level
to assess for agranulocytosis
What can cause serotonin syndrome? - (ANSWERS)Antidepressants, St. John's Wort, Same-E,
Kava Kava, and Tryptophan
What labs are indicative of NMS? - (ANSWERS)Elevated WBC (over 11,000) and elevated CPK
S/S of NMS - (ANSWERS)muscle rigidity, hyperthermia, tachycardia, abnormal bp, sweating,
altered mental status, cherry colored urine
What should you do if a patient presents with cherry colored urine? - (ANSWERS)Check for
rhabdo with CPK
s/s of serotonin syndrome - (ANSWERS)hyperreflexia, muscle spasms, myoclonus (involuntary
muscle jerk), fever, tachycardia, HTN, shits and shivers
What two medications to give with NMS? - (ANSWERS)bromocriptine (Parlodel)- D2 agonist
dantrolene- muscle relaxer
What medication to give during SS? - (ANSWERS)cyproheptadine (Periactin)- 5HT-2A receptor
antagonist
What is the onset and typical length of NMS? - (ANSWERS)Slow onset (1-2 weeks after changing
or starting therapy) and resolves within 9-14 days
What is the onset of SS? - (ANSWERS)Within 24 hours of starting/changing medication and
resolves within a few days
,LMR Georgette’s PMHNP Certification Exam Latest Questions And Correct
Answers(Verified Answers)
How do you distinguish between NMS and acute dystonia? - (ANSWERS)NMS has a slower
onset while acute dystonia occurs within hours
What happens with lithium and NSAIDs? - (ANSWERS)Increased risk of lithium toxicity (gout
meds, ibuprophen, naproxen, etc.)
What happens with lithium and ACE inhibitors? - (ANSWERS)Increased risk of lithium toxicity
related to the increased urination from the ACE inhibitors
Why should a patient on lithium avoid calcium channel blockers? - (ANSWERS)Risk of fatal
nephrotoxicity
What is a fetal side effect of lithium? - (ANSWERS)Epstein's anomaly
What lab should you check for athletes on lithium? - (ANSWERS)Specific gravity to assess for
dehydration (dehydration is >1.015)
What do you do if the lithium level is 1.3? - (ANSWERS)Do not give the next dose and assess for
s/s
At what level is lithium toxicity a medical emergency? - (ANSWERS)>3
S/S of lithium toxicity - (ANSWERS)vomiting, diarrhea, slurred speech, hand tremor, dry
mouth/thirst, muscle weakness/twitching
Why check an EKG with lithium? - (ANSWERS)Inverted T-waves
What medication should treat hypothyroidism caused by lithium use? - (ANSWERS)Synthroid
What do you do if patient is prescribed both depakote and lamictal? - (ANSWERS)Decreased
lamictal dose by 50%
Depakote and pregnancy - (ANSWERS)Spina bifida
What emergency may be occuring if patient on depakote reports upper abdominal pain? -
(ANSWERS)Pancreatitis
What lab should you check if patient has right upper quadrant pain and dark brown urine? -
(ANSWERS)LFTs
What lab means pregnancy? - (ANSWERS)HCG
Why is Clozaril used? - (ANSWERS)Treatment resistant schizophrenia, improves SI, and
improves negative symptoms of schizophrenia
, LMR Georgette’s PMHNP Certification Exam Latest Questions And Correct
Answers(Verified Answers)
What two medications have the highest risk of agranulocytosis and aplastic anemia? -
(ANSWERS)Clozaril and Tegretol
What symptoms may mean a Clozaril induced infection? - (ANSWERS)Sore throats, sores in
mouth/gums, fever
When should you discontinue Clozaril or Tegretol? - (ANSWERS)WBC < 2000 or ANC <1000
What should you check in Asian patients taking Tegretol? - (ANSWERS)For the HLA-B*1502
allele (higher risk of SJS)
What two epidermal issues can arise from Tegretol or Lamictal? - (ANSWERS)Toxic epidermal
necrosis and SJS
What may be the issue if a patient on Lamictal presents with a fever and severe headache? -
(ANSWERS)Aspetic meningitis
What three antipsychotics have very low weight gaining effects? - (ANSWERS)Geodon, Abilify,
and Latuda
Mini-Cog - (ANSWERS)3 word recall and
clock drawing
MMSE scoring - (ANSWERS)24-30 severe impairment
18-23 mild impairment
17 and less no impairment
What happens during pruning? - (ANSWERS)Brain eliminates extra synapses during infancy
autism and pruning - (ANSWERS)Excess synapses caused by under-pruning (patient
oversensitive to light/sounds and seizures)
schizophrenia and pruning - (ANSWERS)Fewer synapses caused by over-pruning
grey matter vs white matter - (ANSWERS)Grey matter- synapses, working area of brain,
dendrites
White matter- myelinated axons
axons and dendrites - (ANSWERS)axon away from cell and dendrites to neuron's cell body
CNS is made up of - (ANSWERS)brain and spinal cord
