Georgette Review PMHNP. Questions
and correct answers
WhenKmanyKanswersKareKremarkablyKsimilar,KtheyKareKusuallyK_____________K-
KCORRECTKANSWER-wrong
InterprofessionalKcollaborationKisKencouraged.K-KCORRECTKANSWER-CollaborateKisKusuallyKright.K
DelegateKisKusuallyKwrong.
ADPIERK-KCORRECTKANSWER-Assessment,Kdiagnosis,KPlan,Kintervention,Kevaluate,KreferKoutKlast.
LithiumK-KCORRECTKANSWER-NormalK0.6-1.2
LithiumKtoxicityKoccursKatKlevelsK-KCORRECTKANSWER->K1.5
SignsKofKLithiumKtoxicityK-KCORRECTKANSWER-
severeKnausea,Kdiarrhea,Kvomiting,Kconfusion,Kdrowsiness,KmuscleKweakness,KheartKpalpitation,Kc
oarseKhandKtremors,KunsteadyKgait
LithiumKisKgoldKstandardKforK-KCORRECTKANSWER-MANIA
LithiumKhasKevidenceKshownKtoK-KCORRECTKANSWER-reduceKsuicidalKideation
WhatKdoesKlithiumKcauseKinKneonate,KespeciallyK1stKtrimesterK-KCORRECTKANSWER-
EbsteinKanomalyK(congenitalKheartKdefect)
dehydrationKandKhyponatremiaKcauseKlithiumKlevelsKtoK-KCORRECTKANSWER-rise
BaselineKlabsKbeforeKinitiationKofKlithiumK-KCORRECTKANSWER-TSH
creatinineK(0.6-1.2)
BUNK(10-20)
HCGK(allKpsychotropicsKfemalesK12-51)
EKGK50+
UrinalysisK(checkKforKproteins,K4+KmayKindicateKkidneyKdisease)
SideKEffectsKofKLithiumK-KCORRECTKANSWER-hypothyroidism
coaseKhandKtremorsKwithKtoxicity
maculopapularKrash
,diarrhea,Kvomiting,Kcramps--signsKofKtoxicity.KMonitorKclosely.K
anorexia
tKwaveKinversions
leukocytosis
PtKeducationKforKlithimumK-KCORRECTKANSWER-stayingKhydrated
avoidingKNSAIDS
compliance
DepakoteKnormalKlevelK-KCORRECTKANSWER-50-125
DepakoteKtoxicityKlevelK-KCORRECTKANSWER-greaterKthanK150
TeratogenicKeffectsKofKDepakoteK-KCORRECTKANSWER-spinaKbifida
AdverseKeffectsKofKdepakoteK-KCORRECTKANSWER-alopecia
hepatotoxicityK(RUQKpainKorKbrown/redKurine--orderKLFTs)KASTK5-40,KALTK5-
35,KyellowingKofKskinKorKeyes,Kfatigue
SignsKofKDepakoteKtoxicityK-KCORRECTKANSWER-
disorientation,Klethargy,KrespiratoryKdepression,Knausea/vomiting
InterventionKforKdepakoteKtoxicityK-KCORRECTKANSWER-DCKmed
checkKlevel
LFT
ammonia
MAOIK+KtyramineKcausesK-KCORRECTKANSWER-hypertensiveKcrisis
SymptomsKofKhypertensiveKcrisisK-KCORRECTKANSWER-elevatedKBP
suddenKexplosiveKlikeKheadache
facialKflushing
palpitations
pupillaryKdilation
diaphoresis
fever
,HypertensiveKcrisisKoccursKwithKMAOIK+K-KCORRECTKANSWER-MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St.KJohn'sKwart
L-tryptophan
asthmaKmeds
TreatmentKforKhypertensiveKcrisisK-KCORRECTKANSWER-DCKoffendingKagent
AdministerKPHENTOLAMINE
TeratogenicKeffectsKofKbenzosK-KCORRECTKANSWER-floppyKbaby,KcleftKpalate
TeratogenicKeffectsKofKtegratolK-KCORRECTKANSWER-neuralKtubeKdefect
teratogenicKeffectsKofKlithiumK-KCORRECTKANSWER-
ebsteinKanomalyK(heartKdefect)K(avoid,KespeciallyK1stKtrimester)
teratogenicKeffectsKofKdepakoteK-KCORRECTKANSWER-neuralKtubeKdefects/spinaKbifida
AdverseKreactionKtoKLamictalK-KCORRECTKANSWER-StevenKJohnson'sKSyndrome
SignsKofKSJSK-KCORRECTKANSWER-FEVERK--highKyield
soreKthroat
facialKswelling
tongueKswelling
redKrash
skinKsloughing
bodyKaches
prodromalKheadache
malaise
arthralgia
, painfulKmucusKmembranes
LamotrigineKisKleastKlikelyKtoKcauseK-KCORRECTKANSWER-sedationKorKweightKgain
CarbamazepineK(tegretol)KblackKboxKwarningK-KCORRECTKANSWER-
agranulocytosisK(decreaseKWBCs)
aplasticKanemiaK(pallor,Kfatigue,KHA,Kfever,Knosebleeds,KbleedingKgums,KskinKrash,KSOA)
CarbamazepineKandKasiansK-KCORRECTKANSWER-ScreenKforKHLAB-
1502KalleleKbeforeKinitiating,KdueKtoKhighKincidenceKofKSJSKifKpositiveKforKallele.
Child-bearingKagedKwomenK-KCORRECTKANSWER-
checkKforKpregnancyKbeforeKstartingKmoodKstabilizer
startKonKfolicKacidKtoKsupportKneuralKtubeKdevelopmentKduringKtheKfirstKmonthKthatKaKwomanKisKpr
egnant
Clozaril/clozapineKcanKcauseK-KCORRECTKANSWER-agranulocytosisKandKneutropenia
ForKmonitoringKneutropeniaKinKClozaril,KmonitorK-KCORRECTKANSWER-ANC
DCKclozarliKifKANCK-KCORRECTKANSWER-lessKthanK1000
DCKclozarilKifKWBCK-KCORRECTKANSWER-2000-3000,KriskKofKagranulocytosis
WhenKonKclozarilKmonitorKforK-KCORRECTKANSWER-
signsKandKsymptomsKofKinfection:KsuddenKfever,Kchills,KsoreKthroat,Kweakness
ClozarilKonlyKknownKantipsychoticKtoK-KCORRECTKANSWER-
decreaseKriskKofKsuicideKinKpatientsKwithKschizophrenia.
YourKpatientKwithKbipolarKdisorderKisKadmittedKtoKaKmedicalKhospital.KTheKinternistKcontactsKyourKo
fficeKandKasksKwhetherKtheKlithiumKyouKprescribedKhimKisKeffectingKhisKECG.KHowKdoKyouKrespond?
A.KLithiumKcanKprolongKtheKQTKinterval
B.KLithiumKhasKnoKeffectKonKhisKECG
C.KLithiumKcanKinvertKtheKtKwaves
D.KLithiumKcanKshortenKtheKPRKintervalK-KCORRECTKANSWER-
Answer:KLithiumKcanKinvertKtheKtKwaves.
MaryKisKaK45-year-
oldKAfricanKAmericanKfemaleKwhoKhasKbeenKtreatedKonKIsocarboxazidK(Marplan)KforKoverK6Kyears.K
and correct answers
WhenKmanyKanswersKareKremarkablyKsimilar,KtheyKareKusuallyK_____________K-
KCORRECTKANSWER-wrong
InterprofessionalKcollaborationKisKencouraged.K-KCORRECTKANSWER-CollaborateKisKusuallyKright.K
DelegateKisKusuallyKwrong.
ADPIERK-KCORRECTKANSWER-Assessment,Kdiagnosis,KPlan,Kintervention,Kevaluate,KreferKoutKlast.
LithiumK-KCORRECTKANSWER-NormalK0.6-1.2
LithiumKtoxicityKoccursKatKlevelsK-KCORRECTKANSWER->K1.5
SignsKofKLithiumKtoxicityK-KCORRECTKANSWER-
severeKnausea,Kdiarrhea,Kvomiting,Kconfusion,Kdrowsiness,KmuscleKweakness,KheartKpalpitation,Kc
oarseKhandKtremors,KunsteadyKgait
LithiumKisKgoldKstandardKforK-KCORRECTKANSWER-MANIA
LithiumKhasKevidenceKshownKtoK-KCORRECTKANSWER-reduceKsuicidalKideation
WhatKdoesKlithiumKcauseKinKneonate,KespeciallyK1stKtrimesterK-KCORRECTKANSWER-
EbsteinKanomalyK(congenitalKheartKdefect)
dehydrationKandKhyponatremiaKcauseKlithiumKlevelsKtoK-KCORRECTKANSWER-rise
BaselineKlabsKbeforeKinitiationKofKlithiumK-KCORRECTKANSWER-TSH
creatinineK(0.6-1.2)
BUNK(10-20)
HCGK(allKpsychotropicsKfemalesK12-51)
EKGK50+
UrinalysisK(checkKforKproteins,K4+KmayKindicateKkidneyKdisease)
SideKEffectsKofKLithiumK-KCORRECTKANSWER-hypothyroidism
coaseKhandKtremorsKwithKtoxicity
maculopapularKrash
,diarrhea,Kvomiting,Kcramps--signsKofKtoxicity.KMonitorKclosely.K
anorexia
tKwaveKinversions
leukocytosis
PtKeducationKforKlithimumK-KCORRECTKANSWER-stayingKhydrated
avoidingKNSAIDS
compliance
DepakoteKnormalKlevelK-KCORRECTKANSWER-50-125
DepakoteKtoxicityKlevelK-KCORRECTKANSWER-greaterKthanK150
TeratogenicKeffectsKofKDepakoteK-KCORRECTKANSWER-spinaKbifida
AdverseKeffectsKofKdepakoteK-KCORRECTKANSWER-alopecia
hepatotoxicityK(RUQKpainKorKbrown/redKurine--orderKLFTs)KASTK5-40,KALTK5-
35,KyellowingKofKskinKorKeyes,Kfatigue
SignsKofKDepakoteKtoxicityK-KCORRECTKANSWER-
disorientation,Klethargy,KrespiratoryKdepression,Knausea/vomiting
InterventionKforKdepakoteKtoxicityK-KCORRECTKANSWER-DCKmed
checkKlevel
LFT
ammonia
MAOIK+KtyramineKcausesK-KCORRECTKANSWER-hypertensiveKcrisis
SymptomsKofKhypertensiveKcrisisK-KCORRECTKANSWER-elevatedKBP
suddenKexplosiveKlikeKheadache
facialKflushing
palpitations
pupillaryKdilation
diaphoresis
fever
,HypertensiveKcrisisKoccursKwithKMAOIK+K-KCORRECTKANSWER-MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St.KJohn'sKwart
L-tryptophan
asthmaKmeds
TreatmentKforKhypertensiveKcrisisK-KCORRECTKANSWER-DCKoffendingKagent
AdministerKPHENTOLAMINE
TeratogenicKeffectsKofKbenzosK-KCORRECTKANSWER-floppyKbaby,KcleftKpalate
TeratogenicKeffectsKofKtegratolK-KCORRECTKANSWER-neuralKtubeKdefect
teratogenicKeffectsKofKlithiumK-KCORRECTKANSWER-
ebsteinKanomalyK(heartKdefect)K(avoid,KespeciallyK1stKtrimester)
teratogenicKeffectsKofKdepakoteK-KCORRECTKANSWER-neuralKtubeKdefects/spinaKbifida
AdverseKreactionKtoKLamictalK-KCORRECTKANSWER-StevenKJohnson'sKSyndrome
SignsKofKSJSK-KCORRECTKANSWER-FEVERK--highKyield
soreKthroat
facialKswelling
tongueKswelling
redKrash
skinKsloughing
bodyKaches
prodromalKheadache
malaise
arthralgia
, painfulKmucusKmembranes
LamotrigineKisKleastKlikelyKtoKcauseK-KCORRECTKANSWER-sedationKorKweightKgain
CarbamazepineK(tegretol)KblackKboxKwarningK-KCORRECTKANSWER-
agranulocytosisK(decreaseKWBCs)
aplasticKanemiaK(pallor,Kfatigue,KHA,Kfever,Knosebleeds,KbleedingKgums,KskinKrash,KSOA)
CarbamazepineKandKasiansK-KCORRECTKANSWER-ScreenKforKHLAB-
1502KalleleKbeforeKinitiating,KdueKtoKhighKincidenceKofKSJSKifKpositiveKforKallele.
Child-bearingKagedKwomenK-KCORRECTKANSWER-
checkKforKpregnancyKbeforeKstartingKmoodKstabilizer
startKonKfolicKacidKtoKsupportKneuralKtubeKdevelopmentKduringKtheKfirstKmonthKthatKaKwomanKisKpr
egnant
Clozaril/clozapineKcanKcauseK-KCORRECTKANSWER-agranulocytosisKandKneutropenia
ForKmonitoringKneutropeniaKinKClozaril,KmonitorK-KCORRECTKANSWER-ANC
DCKclozarliKifKANCK-KCORRECTKANSWER-lessKthanK1000
DCKclozarilKifKWBCK-KCORRECTKANSWER-2000-3000,KriskKofKagranulocytosis
WhenKonKclozarilKmonitorKforK-KCORRECTKANSWER-
signsKandKsymptomsKofKinfection:KsuddenKfever,Kchills,KsoreKthroat,Kweakness
ClozarilKonlyKknownKantipsychoticKtoK-KCORRECTKANSWER-
decreaseKriskKofKsuicideKinKpatientsKwithKschizophrenia.
YourKpatientKwithKbipolarKdisorderKisKadmittedKtoKaKmedicalKhospital.KTheKinternistKcontactsKyourKo
fficeKandKasksKwhetherKtheKlithiumKyouKprescribedKhimKisKeffectingKhisKECG.KHowKdoKyouKrespond?
A.KLithiumKcanKprolongKtheKQTKinterval
B.KLithiumKhasKnoKeffectKonKhisKECG
C.KLithiumKcanKinvertKtheKtKwaves
D.KLithiumKcanKshortenKtheKPRKintervalK-KCORRECTKANSWER-
Answer:KLithiumKcanKinvertKtheKtKwaves.
MaryKisKaK45-year-
oldKAfricanKAmericanKfemaleKwhoKhasKbeenKtreatedKonKIsocarboxazidK(Marplan)KforKoverK6Kyears.K