LMR GEORGETTE’S PMHNP CERTIFICATION
EXAM LATEST 2025 EXAM QUESTIONS AND
CORRECT ANSWERS(VERIFIED ANSWERS)
What does ADPIE stand for? - correct Answers -Assessment
Diagnosis
Planning
Implementation
Evaluation
What should you do when a mother reports her child woke up screaming in the middle of the
night? - correct Answers -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? - correct Answers -Scrape nail
and send for testing
What do you do if a patient on lithium has dark brown urine? - correct Answers -Check renal
function
What do you do if a patient presents with fever while on Clozaril? - correct Answers -Check
ANC level to assess for agranulocytosis
What can cause serotonin syndrome? - correct Answers -Antidepressants, St. John's Wort, Same-
E, Kava Kava, and Tryptophan
What labs are indicative of NMS? - correct Answers -Elevated WBC (over 11,000) and elevated
CPK
,S/S of NMS - correct Answers -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? - correct Answers -Check for
rhabdo with CPK
s/s of serotonin syndrome - correct Answers -hyperreflexia, muscle spasms, myoclonus
(involuntary muscle jerk), fever, tachycardia, HTN, shits and shivers
What two medications to give with NMS? - correct Answers -bromocriptine (Parlodel)- D2
agonist dantrolene- muscle relaxer
What medication to give during SS? - correct Answers -cyproheptadine (Periactin)- 5HT-2A
receptor antagonist
What is the onset and typical length of NMS? - correct Answers -Slow onset (1-2 weeks after
changing or starting therapy) and resolves within 9-14 days
What is the onset of SS? - correct Answers -Within 24 hours of starting/changing medication and
resolves within a few days
How do you distinguish between NMS and acute dystonia? - correct Answers -NMS has a
slower onset while acute dystonia occurs within hours
What happens with lithium and NSAIDs? - correct Answers -Increased risk of lithium toxicity
(gout meds, ibuprophen, naproxen, etc.)
What happens with lithium and ACE inhibitors? - correct Answers -Increased risk of lithium
toxicity related to the increased urination from the ACE inhibitors
Why should a patient on lithium avoid calcium channel blockers? - correct Answers -Risk of
fatal nephrotoxicity
, What is a fetal side effect of lithium? - correct Answers -Epstein's anomaly
What lab should you check for athletes on lithium? - correct Answers -Specific gravity to assess
for dehydration (dehydration is >1.015)
What do you do if the lithium level is 1.3? - correct Answers -Do not give the next dose and
assess for s/s
At what level is lithium toxicity a medical emergency? - correct Answers ->3
S/S of lithium toxicity - correct Answers -vomiting, diarrhea, slurred speech, hand tremor, dry
mouth/thirst, muscle weakness/twitching
Why check an EKG with lithium? - correct Answers -Inverted T-waves
What medication should treat hypothyroidism caused by lithium use? - correct Answers -
Synthroid
What do you do if patient is prescribed both depakote and lamictal? - correct Answers -
Decreased lamictal dose by 50%
Depakote and pregnancy - correct Answers -Spina bifida
What emergency may be occuring if patient on depakote reports upper abdominal pain? - correct
Answers -Pancreatitis
What lab should you check if patient has right upper quadrant pain and dark brown urine? -
correct Answers -LFTs
What lab means pregnancy? - correct Answers -HCG
EXAM LATEST 2025 EXAM QUESTIONS AND
CORRECT ANSWERS(VERIFIED ANSWERS)
What does ADPIE stand for? - correct Answers -Assessment
Diagnosis
Planning
Implementation
Evaluation
What should you do when a mother reports her child woke up screaming in the middle of the
night? - correct Answers -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? - correct Answers -Scrape nail
and send for testing
What do you do if a patient on lithium has dark brown urine? - correct Answers -Check renal
function
What do you do if a patient presents with fever while on Clozaril? - correct Answers -Check
ANC level to assess for agranulocytosis
What can cause serotonin syndrome? - correct Answers -Antidepressants, St. John's Wort, Same-
E, Kava Kava, and Tryptophan
What labs are indicative of NMS? - correct Answers -Elevated WBC (over 11,000) and elevated
CPK
,S/S of NMS - correct Answers -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? - correct Answers -Check for
rhabdo with CPK
s/s of serotonin syndrome - correct Answers -hyperreflexia, muscle spasms, myoclonus
(involuntary muscle jerk), fever, tachycardia, HTN, shits and shivers
What two medications to give with NMS? - correct Answers -bromocriptine (Parlodel)- D2
agonist dantrolene- muscle relaxer
What medication to give during SS? - correct Answers -cyproheptadine (Periactin)- 5HT-2A
receptor antagonist
What is the onset and typical length of NMS? - correct Answers -Slow onset (1-2 weeks after
changing or starting therapy) and resolves within 9-14 days
What is the onset of SS? - correct Answers -Within 24 hours of starting/changing medication and
resolves within a few days
How do you distinguish between NMS and acute dystonia? - correct Answers -NMS has a
slower onset while acute dystonia occurs within hours
What happens with lithium and NSAIDs? - correct Answers -Increased risk of lithium toxicity
(gout meds, ibuprophen, naproxen, etc.)
What happens with lithium and ACE inhibitors? - correct Answers -Increased risk of lithium
toxicity related to the increased urination from the ACE inhibitors
Why should a patient on lithium avoid calcium channel blockers? - correct Answers -Risk of
fatal nephrotoxicity
, What is a fetal side effect of lithium? - correct Answers -Epstein's anomaly
What lab should you check for athletes on lithium? - correct Answers -Specific gravity to assess
for dehydration (dehydration is >1.015)
What do you do if the lithium level is 1.3? - correct Answers -Do not give the next dose and
assess for s/s
At what level is lithium toxicity a medical emergency? - correct Answers ->3
S/S of lithium toxicity - correct Answers -vomiting, diarrhea, slurred speech, hand tremor, dry
mouth/thirst, muscle weakness/twitching
Why check an EKG with lithium? - correct Answers -Inverted T-waves
What medication should treat hypothyroidism caused by lithium use? - correct Answers -
Synthroid
What do you do if patient is prescribed both depakote and lamictal? - correct Answers -
Decreased lamictal dose by 50%
Depakote and pregnancy - correct Answers -Spina bifida
What emergency may be occuring if patient on depakote reports upper abdominal pain? - correct
Answers -Pancreatitis
What lab should you check if patient has right upper quadrant pain and dark brown urine? -
correct Answers -LFTs
What lab means pregnancy? - correct Answers -HCG
