LMR Georgette’s PMHNP Certification
Exam Newest 2025/2026 Questions and
Correct Answers Graded A+|Assured
Success
Why is Clozaril used? - CORRECT ANSWERTreatment resistant schizophrenia,
improves SI, and improves negative symptoms of schizophrenia
What two medications have the highest risk of agranulocytosis and aplastic
anemia? - CORRECT ANSWERClozaril and Tegretol
,What symptoms may mean a Clozaril induced infection? - CORRECT
ANSWERSore throats, sores in mouth/gums, fever
When should you discontinue Clozaril or Tegretol? - CORRECT ANSWERWBC <
2000 or ANC <1000
What do you do if a patient on lithium has dark brown urine? - CORRECT
ANSWERCheck renal function
What do you do if a patient presents with fever while on Clozaril? - CORRECT
ANSWERCheck ANC level to assess for agranulocytosis
What can cause serotonin syndrome? - CORRECT ANSWERAntidepressants, St.
John's Wort, Same-E, Kava Kava, and Tryptophan
What labs are indicative of NMS? - CORRECT ANSWERElevated WBC (over
11,000) and elevated CPK
S/S of NMS - CORRECT ANSWERmuscle rigidity, hyperthermia, tachycardia,
abnormal bp, sweating, altered mental status, cherry colored urine
,What should you do if a patient presents with cherry colored urine? - CORRECT
ANSWERCheck for rhabdo with CPK
s/s of serotonin syndrome - CORRECT ANSWERhyperreflexia, muscle spasms,
myoclonus (involuntary muscle jerk), fever, tachycardia, HTN, shits and shivers
What two medications to give with NMS? - CORRECT ANSWERbromocriptine
(Parlodel)- D2 agonist dantrolene- muscle relaxer
What medication to give during SS? - CORRECT ANSWERcyproheptadine
(Periactin)- 5HT-2A receptor antagonist
What is the onset and typical length of NMS? - CORRECT ANSWERSlow onset
(1-2 weeks after changing or starting therapy) and resolves within 9-14 days
What is the onset of SS? - CORRECT ANSWERWithin 24 hours of
starting/changing medication and resolves within a few days
How do you distinguish between NMS and acute dystonia? - CORRECT
ANSWERNMS has a slower onset while acute dystonia occurs within hours
, What happens with lithium and NSAIDs? - CORRECT ANSWERIncreased risk of
lithium toxicity (gout meds, ibuprophen, naproxen, etc.)
What happens with lithium and ACE inhibitors? - CORRECT ANSWERIncreased
risk of lithium toxicity related to the increased urination from the ACE inhibitors
Why should a patient on lithium avoid calcium channel blockers? - CORRECT
ANSWERRisk of fatal nephrotoxicity
What is a fetal side effect of lithium? - CORRECT ANSWEREpstein's anomaly
What lab should you check for athletes on lithium? - CORRECT
ANSWERSpecific gravity to assess for dehydration (dehydration is >1.015)
What do you do if the lithium level is 1.3? - CORRECT ANSWERDo not give the
next dose and assess for s/s
At what level is lithium toxicity a medical emergency? - CORRECT ANSWER>3
Exam Newest 2025/2026 Questions and
Correct Answers Graded A+|Assured
Success
Why is Clozaril used? - CORRECT ANSWERTreatment resistant schizophrenia,
improves SI, and improves negative symptoms of schizophrenia
What two medications have the highest risk of agranulocytosis and aplastic
anemia? - CORRECT ANSWERClozaril and Tegretol
,What symptoms may mean a Clozaril induced infection? - CORRECT
ANSWERSore throats, sores in mouth/gums, fever
When should you discontinue Clozaril or Tegretol? - CORRECT ANSWERWBC <
2000 or ANC <1000
What do you do if a patient on lithium has dark brown urine? - CORRECT
ANSWERCheck renal function
What do you do if a patient presents with fever while on Clozaril? - CORRECT
ANSWERCheck ANC level to assess for agranulocytosis
What can cause serotonin syndrome? - CORRECT ANSWERAntidepressants, St.
John's Wort, Same-E, Kava Kava, and Tryptophan
What labs are indicative of NMS? - CORRECT ANSWERElevated WBC (over
11,000) and elevated CPK
S/S of NMS - CORRECT ANSWERmuscle rigidity, hyperthermia, tachycardia,
abnormal bp, sweating, altered mental status, cherry colored urine
,What should you do if a patient presents with cherry colored urine? - CORRECT
ANSWERCheck for rhabdo with CPK
s/s of serotonin syndrome - CORRECT ANSWERhyperreflexia, muscle spasms,
myoclonus (involuntary muscle jerk), fever, tachycardia, HTN, shits and shivers
What two medications to give with NMS? - CORRECT ANSWERbromocriptine
(Parlodel)- D2 agonist dantrolene- muscle relaxer
What medication to give during SS? - CORRECT ANSWERcyproheptadine
(Periactin)- 5HT-2A receptor antagonist
What is the onset and typical length of NMS? - CORRECT ANSWERSlow onset
(1-2 weeks after changing or starting therapy) and resolves within 9-14 days
What is the onset of SS? - CORRECT ANSWERWithin 24 hours of
starting/changing medication and resolves within a few days
How do you distinguish between NMS and acute dystonia? - CORRECT
ANSWERNMS has a slower onset while acute dystonia occurs within hours
, What happens with lithium and NSAIDs? - CORRECT ANSWERIncreased risk of
lithium toxicity (gout meds, ibuprophen, naproxen, etc.)
What happens with lithium and ACE inhibitors? - CORRECT ANSWERIncreased
risk of lithium toxicity related to the increased urination from the ACE inhibitors
Why should a patient on lithium avoid calcium channel blockers? - CORRECT
ANSWERRisk of fatal nephrotoxicity
What is a fetal side effect of lithium? - CORRECT ANSWEREpstein's anomaly
What lab should you check for athletes on lithium? - CORRECT
ANSWERSpecific gravity to assess for dehydration (dehydration is >1.015)
What do you do if the lithium level is 1.3? - CORRECT ANSWERDo not give the
next dose and assess for s/s
At what level is lithium toxicity a medical emergency? - CORRECT ANSWER>3
