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LMR Georgette’s PMHNP
Certification Exam Latest 2025 | 2026
Questions And Correct Answers (Verified
Answers)
What does ADPIE stand for? - ANSWER Assessment
Diagnosis
Planning
Implementation
Evaluation
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
What do you do if a patient comes in with fungus on their toenail? -
ANSWER Scrape nail and send for testing
What do you do if a patient on lithium has dark brown urine? - ANSWER
Check renal function
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What do you do if a patient presents with fever while on Clozaril? -
ANSWER Check ANC level to assess for agranulocytosis
What can cause serotonin syndrome? - ANSWER Antidepressants, St.
John's Wort, Same-E, Kava Kava, and Tryptophan
What labs are indicative of NMS? - ANSWER Elevated WBC (over
11,000) and elevated CPK
S/S of NMS - ANSWER 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? -
ANSWER Check for rhabdo with CPK
s/s of serotonin syndrome - ANSWER hyperreflexia, muscle spasms,
myoclonus (involuntary muscle jerk), fever, tachycardia, HTN, shits and
shivers
What two medications to give with NMS? - ANSWER bromocriptine
(Parlodel)- D2 agonist dantrolene- muscle relaxer
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What medication to give during SS? - ANSWER cyproheptadine
(Periactin)- 5HT-2A receptor antagonist
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
What is the onset of SS? - ANSWER Within 24 hours of
starting/changing medication and resolves within a few days
How do you distinguish between NMS and acute dystonia? - ANSWER
NMS has a slower onset while acute dystonia occurs within hours
What happens with lithium and NSAIDs? - ANSWER Increased risk of
lithium toxicity (gout meds, ibuprophen, naproxen, etc.)
What happens with lithium and ACE inhibitors? - ANSWER Increased
risk of lithium toxicity related to the increased urination from the ACE
inhibitors
Why should a patient on lithium avoid calcium channel blockers? -
ANSWER Risk of fatal nephrotoxicity
What is a fetal side effect of lithium? - ANSWER Epstein's anomaly
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What lab should you check for athletes on lithium? - ANSWER Specific
gravity to assess for dehydration (dehydration is >1.015)
What do you do if the lithium level is 1.3? - ANSWER Do not give the
next dose and assess for s/s
At what level is lithium toxicity a medical emergency? - ANSWER >3
S/S of lithium toxicity - ANSWER vomiting, diarrhea, slurred speech,
hand tremor, dry mouth/thirst, muscle weakness/twitching
Why check an EKG with lithium? - ANSWER Inverted T-waves
What medication should treat hypothyroidism caused by lithium use? -
ANSWER Synthroid
What do you do if patient is prescribed both depakote and lamictal? -
ANSWER Decreased lamictal dose by 50%
Depakote and pregnancy - ANSWER Spina bifida
LMR Georgette’s PMHNP
Certification Exam Latest 2025 | 2026
Questions And Correct Answers (Verified
Answers)
What does ADPIE stand for? - ANSWER Assessment
Diagnosis
Planning
Implementation
Evaluation
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
What do you do if a patient comes in with fungus on their toenail? -
ANSWER Scrape nail and send for testing
What do you do if a patient on lithium has dark brown urine? - ANSWER
Check renal function
,2|Page
What do you do if a patient presents with fever while on Clozaril? -
ANSWER Check ANC level to assess for agranulocytosis
What can cause serotonin syndrome? - ANSWER Antidepressants, St.
John's Wort, Same-E, Kava Kava, and Tryptophan
What labs are indicative of NMS? - ANSWER Elevated WBC (over
11,000) and elevated CPK
S/S of NMS - ANSWER 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? -
ANSWER Check for rhabdo with CPK
s/s of serotonin syndrome - ANSWER hyperreflexia, muscle spasms,
myoclonus (involuntary muscle jerk), fever, tachycardia, HTN, shits and
shivers
What two medications to give with NMS? - ANSWER bromocriptine
(Parlodel)- D2 agonist dantrolene- muscle relaxer
,3|Page
What medication to give during SS? - ANSWER cyproheptadine
(Periactin)- 5HT-2A receptor antagonist
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
What is the onset of SS? - ANSWER Within 24 hours of
starting/changing medication and resolves within a few days
How do you distinguish between NMS and acute dystonia? - ANSWER
NMS has a slower onset while acute dystonia occurs within hours
What happens with lithium and NSAIDs? - ANSWER Increased risk of
lithium toxicity (gout meds, ibuprophen, naproxen, etc.)
What happens with lithium and ACE inhibitors? - ANSWER Increased
risk of lithium toxicity related to the increased urination from the ACE
inhibitors
Why should a patient on lithium avoid calcium channel blockers? -
ANSWER Risk of fatal nephrotoxicity
What is a fetal side effect of lithium? - ANSWER Epstein's anomaly
, 4|Page
What lab should you check for athletes on lithium? - ANSWER Specific
gravity to assess for dehydration (dehydration is >1.015)
What do you do if the lithium level is 1.3? - ANSWER Do not give the
next dose and assess for s/s
At what level is lithium toxicity a medical emergency? - ANSWER >3
S/S of lithium toxicity - ANSWER vomiting, diarrhea, slurred speech,
hand tremor, dry mouth/thirst, muscle weakness/twitching
Why check an EKG with lithium? - ANSWER Inverted T-waves
What medication should treat hypothyroidism caused by lithium use? -
ANSWER Synthroid
What do you do if patient is prescribed both depakote and lamictal? -
ANSWER Decreased lamictal dose by 50%
Depakote and pregnancy - ANSWER Spina bifida
