LMR Georgette’s PMHNP Certification Exam Latest 2024-
2025 Questions and Correct Answers (Verified Answers)
Exam 2025/2026
What do you do if a patient on lithium has dark brown urine?
Ans: Check renal function
Quiz What do you do if a patient presents with fever while on Clozaril?
Ans: Check ANC level to assess for agranulocytosis
Quiz What can cause serotonin syndrome?
Ans: Antidepressants, St. John's Wort, Same-E, Kava Kava, and Tryptophan
Quiz What labs are indicative of NMS?
Ans: Elevated WBC (over 11,000) and elevated CPK
,Quiz S/S of NMS
Ans: muscle rigidity, hyperthermia, tachycardia, abnormal bp, sweating, altered mental status,
cherry colored urine
Quiz What should you do if a patient presents with cherry colored urine?
Ans: Check for rhabdo with CPK
Quiz s/s of serotonin syndrome
Ans: hyperreflexia, muscle spasms, myoclonus (involuntary muscle jerk), fever, tachycardia,
HTN, shits and shivers
Quiz What two medications to give with NMS?
Ans: bromocriptine (Parlodel)- D2 agonist dantrolene- muscle relaxer
Quiz What medication to give during SS?
Ans: cyproheptadine (Periactin)- 5HT-2A receptor antagonist
Quiz What is the onset and typical length of NMS?
,Ans: Slow onset (1-2 weeks after changing or starting therapy) and resolves within 9-14 days
Quiz What is the onset of SS?
Ans: Within 24 hours of starting/changing medication and resolves within a few days
Quiz How do you distinguish between NMS and acute dystonia?
Ans: NMS has a slower onset while acute dystonia occurs within hours
Quiz What happens with lithium and NSAIDs?
Ans: Increased risk of lithium toxicity (gout meds, ibuprophen, naproxen, etc.)
Quiz What happens with lithium and ACE inhibitors?
Ans: Increased risk of lithium toxicity related to the increased urination from the ACE inhibitors
Quiz Why should a patient on lithium avoid calcium channel blockers?
Ans: Risk of fatal nephrotoxicity
Quiz What is a fetal side effect of lithium?
, Ans: Epstein's anomaly
Quiz What lab should you check for athletes on lithium?
Ans: Specific gravity to assess for dehydration (dehydration is >1.015)
Quiz What do you do if the lithium level is 1.3?
Ans: Do not give the next dose and assess for s/s
Quiz At what level is lithium toxicity a medical emergency?
Ans: >3
Quiz S/S of lithium toxicity
Ans: vomiting, diarrhea, slurred speech, hand tremor, dry mouth/thirst, muscle
weakness/twitching
Quiz Why check an EKG with lithium?
Ans: Inverted T-waves
Quiz What medication should treat hypothyroidism caused by lithium use?
2025 Questions and Correct Answers (Verified Answers)
Exam 2025/2026
What do you do if a patient on lithium has dark brown urine?
Ans: Check renal function
Quiz What do you do if a patient presents with fever while on Clozaril?
Ans: Check ANC level to assess for agranulocytosis
Quiz What can cause serotonin syndrome?
Ans: Antidepressants, St. John's Wort, Same-E, Kava Kava, and Tryptophan
Quiz What labs are indicative of NMS?
Ans: Elevated WBC (over 11,000) and elevated CPK
,Quiz S/S of NMS
Ans: muscle rigidity, hyperthermia, tachycardia, abnormal bp, sweating, altered mental status,
cherry colored urine
Quiz What should you do if a patient presents with cherry colored urine?
Ans: Check for rhabdo with CPK
Quiz s/s of serotonin syndrome
Ans: hyperreflexia, muscle spasms, myoclonus (involuntary muscle jerk), fever, tachycardia,
HTN, shits and shivers
Quiz What two medications to give with NMS?
Ans: bromocriptine (Parlodel)- D2 agonist dantrolene- muscle relaxer
Quiz What medication to give during SS?
Ans: cyproheptadine (Periactin)- 5HT-2A receptor antagonist
Quiz What is the onset and typical length of NMS?
,Ans: Slow onset (1-2 weeks after changing or starting therapy) and resolves within 9-14 days
Quiz What is the onset of SS?
Ans: Within 24 hours of starting/changing medication and resolves within a few days
Quiz How do you distinguish between NMS and acute dystonia?
Ans: NMS has a slower onset while acute dystonia occurs within hours
Quiz What happens with lithium and NSAIDs?
Ans: Increased risk of lithium toxicity (gout meds, ibuprophen, naproxen, etc.)
Quiz What happens with lithium and ACE inhibitors?
Ans: Increased risk of lithium toxicity related to the increased urination from the ACE inhibitors
Quiz Why should a patient on lithium avoid calcium channel blockers?
Ans: Risk of fatal nephrotoxicity
Quiz What is a fetal side effect of lithium?
, Ans: Epstein's anomaly
Quiz What lab should you check for athletes on lithium?
Ans: Specific gravity to assess for dehydration (dehydration is >1.015)
Quiz What do you do if the lithium level is 1.3?
Ans: Do not give the next dose and assess for s/s
Quiz At what level is lithium toxicity a medical emergency?
Ans: >3
Quiz S/S of lithium toxicity
Ans: vomiting, diarrhea, slurred speech, hand tremor, dry mouth/thirst, muscle
weakness/twitching
Quiz Why check an EKG with lithium?
Ans: Inverted T-waves
Quiz What medication should treat hypothyroidism caused by lithium use?
