LMR GEORGETTE’S PMHNP CERTIFICATION
ACTUAL EXAM 2026/2027 – COMPLETE LATEST
QUESTIONS, ANSWERS, AND STUDY GUIDE FOR
SUCCESS
What drugs should be avoided with Kava Kava?
Alprazolam
CNS depressants (e.g., phenobarbital, zolpidem)
What is the normal range for TSH?
0.5 - 5.0 mu/L
What are lab values in Hyperthyroidism
Decreased TSH
Increased T4 and T3
What are labs in Hypothyroidism?
Increased TSH
Decreased T4 and T3
What are 5 primary symptoms of Hyperthyroidism?
Heat intolerance
Agitation, Anxiety, Irritability
Tachycardia
Mood swings
Weight loss
What are 4 primary symptoms of Hypothyroidism?
,Cold intolerance
Lethargy
Weight gain
Decreased libido
Hypothyroidism mimics symptoms of what psychiatric disorder?
Depression
Hyperthyroidism mimics symptoms of what psychiatric disorder?
Mania
Valproic acid produces what teratogenic effect?
Spina bifida (neural tube defect)
What is the primary organ where valproic acid is toxic?
Liver (hepatoxicity)
Which 3 drugs can increase lithium levels by decreasing renal
clearance?
NSAIDs (ibuprofen, indomethacin)
Thiazides
ACE-I
What is a toxic level of lithium?
1.5 mEq/L or higher
At what level do you monitor lithium closely
(but not discontinue)?
1.3 -1.4 mEq/L or higher
With suspected lithium toxicity, what do you do first?
D/C Li and draw Lithium level (not VS)
,What is the appropriate action if lithium level is 1.5 mEq/L?
D/C lithium
Check lithium level
What 2 conditions can increase lithium levels?
If this pt is going on a hike, what would you recommend ?
Dehydration
Hyponatremia
Take extra water to avoid dehydration
What birth defect can lithium cause?
Ebstein anomaly (congenital heart defect)
When working with adolescents, parents often feel they have a right
to know what is going on with their child, but the teen has a right to
confidentiality. This can create an
Ethical dilemma
When building a therapeutic alliance w/ adolescents, it is important
to stress
confidentiality;
what they say remains confidential unless they are wanting to harm
self/ someone else,
[or they are in a relationship with someone much older (like 14 y/o
seeing a 30 y/o)]
if an adolescent C/O abuse, even if they make the claim in the
presence of the parents, what should you do?
interview the teen w/o the parents; call CPS
What 3 neurotransmitters are associated with ADHD?
, DA, NE, 5HT aka serotonin -->(DNS)
The Frontal cortex, Basal ganglia, Reticular Activating System are
associated with which psychiatric disorder?
ADHD
Inattentive Type ADHD demonstrates abnormalities in which part of
the brain?
Prefrontal cortex
What should be done before placing a patient on stimulants for ADHD
(priority)?
Cardiac history
Excessive worry, apprehension, or anxiety about events or activities
that occurs more days than not for a period of at least 6 months is
GAD
if ADHD and tic both present, what is contraindicated?
Stimulants
if a stimulant was tried and provided some but not enough benefit
(helped, but not long enough) what can this mean?
the medication has been cleared from the body
What are the lower age limits for stimulants for ADHD?
AMPH = 3yrs MPH = 6yrs
When considering Clonidine or Guanfacine for a pt, the PMHNP
knows?
Clonidine is more sedating than Guanfacine;
Guanfacine lasts longer than Clonidine
ACTUAL EXAM 2026/2027 – COMPLETE LATEST
QUESTIONS, ANSWERS, AND STUDY GUIDE FOR
SUCCESS
What drugs should be avoided with Kava Kava?
Alprazolam
CNS depressants (e.g., phenobarbital, zolpidem)
What is the normal range for TSH?
0.5 - 5.0 mu/L
What are lab values in Hyperthyroidism
Decreased TSH
Increased T4 and T3
What are labs in Hypothyroidism?
Increased TSH
Decreased T4 and T3
What are 5 primary symptoms of Hyperthyroidism?
Heat intolerance
Agitation, Anxiety, Irritability
Tachycardia
Mood swings
Weight loss
What are 4 primary symptoms of Hypothyroidism?
,Cold intolerance
Lethargy
Weight gain
Decreased libido
Hypothyroidism mimics symptoms of what psychiatric disorder?
Depression
Hyperthyroidism mimics symptoms of what psychiatric disorder?
Mania
Valproic acid produces what teratogenic effect?
Spina bifida (neural tube defect)
What is the primary organ where valproic acid is toxic?
Liver (hepatoxicity)
Which 3 drugs can increase lithium levels by decreasing renal
clearance?
NSAIDs (ibuprofen, indomethacin)
Thiazides
ACE-I
What is a toxic level of lithium?
1.5 mEq/L or higher
At what level do you monitor lithium closely
(but not discontinue)?
1.3 -1.4 mEq/L or higher
With suspected lithium toxicity, what do you do first?
D/C Li and draw Lithium level (not VS)
,What is the appropriate action if lithium level is 1.5 mEq/L?
D/C lithium
Check lithium level
What 2 conditions can increase lithium levels?
If this pt is going on a hike, what would you recommend ?
Dehydration
Hyponatremia
Take extra water to avoid dehydration
What birth defect can lithium cause?
Ebstein anomaly (congenital heart defect)
When working with adolescents, parents often feel they have a right
to know what is going on with their child, but the teen has a right to
confidentiality. This can create an
Ethical dilemma
When building a therapeutic alliance w/ adolescents, it is important
to stress
confidentiality;
what they say remains confidential unless they are wanting to harm
self/ someone else,
[or they are in a relationship with someone much older (like 14 y/o
seeing a 30 y/o)]
if an adolescent C/O abuse, even if they make the claim in the
presence of the parents, what should you do?
interview the teen w/o the parents; call CPS
What 3 neurotransmitters are associated with ADHD?
, DA, NE, 5HT aka serotonin -->(DNS)
The Frontal cortex, Basal ganglia, Reticular Activating System are
associated with which psychiatric disorder?
ADHD
Inattentive Type ADHD demonstrates abnormalities in which part of
the brain?
Prefrontal cortex
What should be done before placing a patient on stimulants for ADHD
(priority)?
Cardiac history
Excessive worry, apprehension, or anxiety about events or activities
that occurs more days than not for a period of at least 6 months is
GAD
if ADHD and tic both present, what is contraindicated?
Stimulants
if a stimulant was tried and provided some but not enough benefit
(helped, but not long enough) what can this mean?
the medication has been cleared from the body
What are the lower age limits for stimulants for ADHD?
AMPH = 3yrs MPH = 6yrs
When considering Clonidine or Guanfacine for a pt, the PMHNP
knows?
Clonidine is more sedating than Guanfacine;
Guanfacine lasts longer than Clonidine
