GEORGETTE
GEORGETTE REVIEW PMHNP
PSYCHIATRICMENTAL
HEALTH NURSE PRACTITIONER 2025-2026
EXAM
QUESTIONS AND ANSWERS
Lithium toxicity occurs - at levels> 1.5
ANSWER
Signs of Lithium - - toxicitysevere nausea, diarrhea, vomiting,
confusion, ANSWER drowsiness, muscle weakness, heart palpitation,
coarse hand - tremors, unsteady gait
Lithium is gold - standard forMANIA
ANSWER
Lithium has evidence - - shown toreduce suicidal ideation
ANSWER
What does lithium - cause in - neonate, especially 1st
trimesterEbstein anomaly ANSWER
(congenital heart defect) -
dehydration and hyponatremia cause - lithium levels torise
ANSWER
Baseline labs before initiation - of -
lithiumTSH creatinine (0.6-1.2) ANSWER
BUN (10-20) -
HCG (all psychotropics females 12-51)
EKG 50+
Urinalysis (check for proteins, 4+ may indicate kidney disease)
Side Effects of Lithium -
hypothyroidism courses hand ANSWER
tremors with toxicity -
maculopapular rash diarrhea,
vomiting, cramps--signs of
toxicity. Monitor closely.
anorexia t wave
inversions
leukocytosis
Pt education for - lithimumstaying
hydrated avoiding ANSWER NSAIDS compliance
-
Depakote normal - level50-125
ANSWER
Depakote toxicity - levelgreater than 150
ANSWER
Teratogenic - - effects of Depakotespina bifida
Adverse effects of ANSWER -
depakotealopecia - ANSWER
-
GEORGETTE REVIEW PMHNP PSYCHIATRICMENTAL HEALTH NURSE PRACTITIONER 2025-2026 EXAM
QUESTIONS AND ANSWERS
,hepatotoxicity (RUQ pain or brown/red urine--order LFTs) AST 5-40, ALT 5-35,
yellowing of skin or
eyes, fatigue
Signs of Depakote - toxicitydisorientation, lethargy, respiratory
depression, nausea/ ANSWER vomiting
-
Intervention for - depakote
toxicityDC med ANSWER check level
LFT -
ammonia
MAOI + tyramine - causeshypertensive crisis
ANSWER
Symptoms of - - hypertensive
crisiselevated BP ANSWER sudden explosive
like headache -
facial flushing
palpitations
pupillary
dilation
diaphoresis
fever
Hypertensive crisis occurs with - MAOI +MEPERIDINE
STIMULANTS ANSWER
decongestants -
TCAs atypicals
St. John's wart
Ltryptophan
asthma meds
Treatment for - hypertensive crisisDC offending agent
Administer ANSWER PHENTOLAMINE
-
Teratogenic effects of - benzosfloppy baby, cleft palate
Teratogenic effects of ANSWER tegratolneural tube
defect -
teratogenic effects of - - lithiumebstein anomaly (heart defect)
(avoid, especially 1st ANSWER
ANSWER trimester)
- -
teratogenic effects of - depakoteneural tube defects/spina
bifida ANSWER
-
Adverse reaction to - LamictalSteven Johnson's Syndrome
ANSWER
Signs of - -
ANSWER
-
SJSFEVER --high
yield sore throat facial
swelling tongue swelling red rash
skin sloughing body aches
prodromal headache
malaise
arthralgia
painful mucus membranes
Lamotrigine is least likely - to causesedation or weight gain
ANSWER
-
GEORGETTE REVIEW PMHNP PSYCHIATRICMENTAL HEALTH NURSE PRACTITIONER 2025-2026 EXAM
QUESTIONS AND ANSWERS
, GEORGETTE
Carbamazepine (tegretol) black - box warningagranulocytosis
(decrease ANSWER
WBCs) aplastic anemia (pallor, - fatigue, HA, fever, nosebleeds,
bleeding gums, skin rash, SOA)
Carbamazepine and - asiansScreen for HLAB-1502 allele before initiating,
due to high ANSWER incidence of SJS if positive for allele.
-
Child-bearing aged - womencheck for pregnancy before starting mood
stabilizer start on ANSWER folic acid to support neural tube development
during the first - month that a woman is pregnant
Clozaril/clozapine - can causeagranulocytosis and neutropenia
ANSWER
For monitoring - -
neutropenia in ANSWER Clozaril,
monitorANC DC - clozarli if
ANCless than
1000 -
DC clozaril if ANSWER - WBC2000-3000, risk of agranulocytosis
- ANSWER
When on -- clozaril monitor forsigns and symptoms of
infection: ANSWER sudden fever, chills, sore throat, weakness
-
Clozaril only known - antipsychotic todecrease risk of suicide in
patients with ANSWER schizophrenia.
-
Your patient with bipolar disorder is admitted to a medical hospital.
The internist contacts your office and asks whether the lithium you
prescribed him is effecting his ECG. How do you respond?
A. Lithium can prolong the QT interval
B.Lithium has no effect on his ECG
C.Lithium can invert the t waves
D. Lithium can shorten - the PR intervalAnswer: Lithium can invert
the t waves. ANSWER
-
Mary is a 45-year-old African American female who has been treated on
Isocarboxazid (Marplan) for over 6 years. Mary is going in for a surgical
procedure. Which medication is strictly contraindicated with Isocarboxazid?
A. Morphine
B. NSAIDS
C. Methylphenidate
D. - AcetaminophenAnswer: Methylphenidate
ANSWER
You are - treating a client with schizophrenia who takes
clozapine. What lab values will indicate the client needs to
discontinue treatment? A. WBC less than 1800 and ANC less than
1200
B.ANC less than 1,000
C.WBC less than 5,000
D. ANC less - than 2000Answer: ANC less than 1000
ANSWER
If given during - pregnancy, socium valproate can cause which of the
following medical problems in the baby?
A. SJS
B.Ebstein's anomaly
C.Spina bifida
GEORGETTE REVIEW PMHNP PSYCHIATRICMENTAL HEALTH NURSE PRACTITIONER 2025-2026 EXAM
QUESTIONS AND ANSWERS
GEORGETTE REVIEW PMHNP
PSYCHIATRICMENTAL
HEALTH NURSE PRACTITIONER 2025-2026
EXAM
QUESTIONS AND ANSWERS
Lithium toxicity occurs - at levels> 1.5
ANSWER
Signs of Lithium - - toxicitysevere nausea, diarrhea, vomiting,
confusion, ANSWER drowsiness, muscle weakness, heart palpitation,
coarse hand - tremors, unsteady gait
Lithium is gold - standard forMANIA
ANSWER
Lithium has evidence - - shown toreduce suicidal ideation
ANSWER
What does lithium - cause in - neonate, especially 1st
trimesterEbstein anomaly ANSWER
(congenital heart defect) -
dehydration and hyponatremia cause - lithium levels torise
ANSWER
Baseline labs before initiation - of -
lithiumTSH creatinine (0.6-1.2) ANSWER
BUN (10-20) -
HCG (all psychotropics females 12-51)
EKG 50+
Urinalysis (check for proteins, 4+ may indicate kidney disease)
Side Effects of Lithium -
hypothyroidism courses hand ANSWER
tremors with toxicity -
maculopapular rash diarrhea,
vomiting, cramps--signs of
toxicity. Monitor closely.
anorexia t wave
inversions
leukocytosis
Pt education for - lithimumstaying
hydrated avoiding ANSWER NSAIDS compliance
-
Depakote normal - level50-125
ANSWER
Depakote toxicity - levelgreater than 150
ANSWER
Teratogenic - - effects of Depakotespina bifida
Adverse effects of ANSWER -
depakotealopecia - ANSWER
-
GEORGETTE REVIEW PMHNP PSYCHIATRICMENTAL HEALTH NURSE PRACTITIONER 2025-2026 EXAM
QUESTIONS AND ANSWERS
,hepatotoxicity (RUQ pain or brown/red urine--order LFTs) AST 5-40, ALT 5-35,
yellowing of skin or
eyes, fatigue
Signs of Depakote - toxicitydisorientation, lethargy, respiratory
depression, nausea/ ANSWER vomiting
-
Intervention for - depakote
toxicityDC med ANSWER check level
LFT -
ammonia
MAOI + tyramine - causeshypertensive crisis
ANSWER
Symptoms of - - hypertensive
crisiselevated BP ANSWER sudden explosive
like headache -
facial flushing
palpitations
pupillary
dilation
diaphoresis
fever
Hypertensive crisis occurs with - MAOI +MEPERIDINE
STIMULANTS ANSWER
decongestants -
TCAs atypicals
St. John's wart
Ltryptophan
asthma meds
Treatment for - hypertensive crisisDC offending agent
Administer ANSWER PHENTOLAMINE
-
Teratogenic effects of - benzosfloppy baby, cleft palate
Teratogenic effects of ANSWER tegratolneural tube
defect -
teratogenic effects of - - lithiumebstein anomaly (heart defect)
(avoid, especially 1st ANSWER
ANSWER trimester)
- -
teratogenic effects of - depakoteneural tube defects/spina
bifida ANSWER
-
Adverse reaction to - LamictalSteven Johnson's Syndrome
ANSWER
Signs of - -
ANSWER
-
SJSFEVER --high
yield sore throat facial
swelling tongue swelling red rash
skin sloughing body aches
prodromal headache
malaise
arthralgia
painful mucus membranes
Lamotrigine is least likely - to causesedation or weight gain
ANSWER
-
GEORGETTE REVIEW PMHNP PSYCHIATRICMENTAL HEALTH NURSE PRACTITIONER 2025-2026 EXAM
QUESTIONS AND ANSWERS
, GEORGETTE
Carbamazepine (tegretol) black - box warningagranulocytosis
(decrease ANSWER
WBCs) aplastic anemia (pallor, - fatigue, HA, fever, nosebleeds,
bleeding gums, skin rash, SOA)
Carbamazepine and - asiansScreen for HLAB-1502 allele before initiating,
due to high ANSWER incidence of SJS if positive for allele.
-
Child-bearing aged - womencheck for pregnancy before starting mood
stabilizer start on ANSWER folic acid to support neural tube development
during the first - month that a woman is pregnant
Clozaril/clozapine - can causeagranulocytosis and neutropenia
ANSWER
For monitoring - -
neutropenia in ANSWER Clozaril,
monitorANC DC - clozarli if
ANCless than
1000 -
DC clozaril if ANSWER - WBC2000-3000, risk of agranulocytosis
- ANSWER
When on -- clozaril monitor forsigns and symptoms of
infection: ANSWER sudden fever, chills, sore throat, weakness
-
Clozaril only known - antipsychotic todecrease risk of suicide in
patients with ANSWER schizophrenia.
-
Your patient with bipolar disorder is admitted to a medical hospital.
The internist contacts your office and asks whether the lithium you
prescribed him is effecting his ECG. How do you respond?
A. Lithium can prolong the QT interval
B.Lithium has no effect on his ECG
C.Lithium can invert the t waves
D. Lithium can shorten - the PR intervalAnswer: Lithium can invert
the t waves. ANSWER
-
Mary is a 45-year-old African American female who has been treated on
Isocarboxazid (Marplan) for over 6 years. Mary is going in for a surgical
procedure. Which medication is strictly contraindicated with Isocarboxazid?
A. Morphine
B. NSAIDS
C. Methylphenidate
D. - AcetaminophenAnswer: Methylphenidate
ANSWER
You are - treating a client with schizophrenia who takes
clozapine. What lab values will indicate the client needs to
discontinue treatment? A. WBC less than 1800 and ANC less than
1200
B.ANC less than 1,000
C.WBC less than 5,000
D. ANC less - than 2000Answer: ANC less than 1000
ANSWER
If given during - pregnancy, socium valproate can cause which of the
following medical problems in the baby?
A. SJS
B.Ebstein's anomaly
C.Spina bifida
GEORGETTE REVIEW PMHNP PSYCHIATRICMENTAL HEALTH NURSE PRACTITIONER 2025-2026 EXAM
QUESTIONS AND ANSWERS
