LMR GeoRGette’s PMHNP CeRtifiCatioN
Exam latest updates!!! 2026-2027 |
correct solutions with quiz &
answers | highly graded a+
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
Why is Clozaril used? - CORRECT ANSWERS-Treatment resistant schizophrenia,
improves SI, and improves negative symptoms of schizophrenia
What two medications have the highest risk of agranulocytosis and aplastic anemia? -
CORRECT ANSWERS-Clozaril and Tegretol
What symptoms may mean a Clozaril induced infection? - CORRECT ANSWERS-Sore
throats, sores in mouth/gums, fever
When should you discontinue Clozaril or Tegretol? - CORRECT ANSWERS-WBC <
2000 or ANC <1000
What should you check in Asian patients taking Tegretol? - CORRECT ANSWERS-For
the HLA-B*1502 allele (higher risk of SJS)
What two epidermal issues can arise from Tegretol or Lamictal? - CORRECT
ANSWERS-Toxic epidermal necrosis and SJS
What may be the issue if a patient on Lamictal presents with a fever and severe
headache? - CORRECT ANSWERS-Aspetic meningitis
What three antipsychotics have very low weight gaining effects? - CORRECT
ANSWERS-Geodon, Abilify, and Latuda
Mini-Cog - CORRECT ANSWERS-3 word recall and
clock drawing
MMSE scoring - CORRECT ANSWERS-24-30 severe impairment
18-23 mild impairment
17 and less no impairment
What happens during pruning? - CORRECT ANSWERS-Brain eliminates extra
synapses during infancy
Exam latest updates!!! 2026-2027 |
correct solutions with quiz &
answers | highly graded a+
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
Why is Clozaril used? - CORRECT ANSWERS-Treatment resistant schizophrenia,
improves SI, and improves negative symptoms of schizophrenia
What two medications have the highest risk of agranulocytosis and aplastic anemia? -
CORRECT ANSWERS-Clozaril and Tegretol
What symptoms may mean a Clozaril induced infection? - CORRECT ANSWERS-Sore
throats, sores in mouth/gums, fever
When should you discontinue Clozaril or Tegretol? - CORRECT ANSWERS-WBC <
2000 or ANC <1000
What should you check in Asian patients taking Tegretol? - CORRECT ANSWERS-For
the HLA-B*1502 allele (higher risk of SJS)
What two epidermal issues can arise from Tegretol or Lamictal? - CORRECT
ANSWERS-Toxic epidermal necrosis and SJS
What may be the issue if a patient on Lamictal presents with a fever and severe
headache? - CORRECT ANSWERS-Aspetic meningitis
What three antipsychotics have very low weight gaining effects? - CORRECT
ANSWERS-Geodon, Abilify, and Latuda
Mini-Cog - CORRECT ANSWERS-3 word recall and
clock drawing
MMSE scoring - CORRECT ANSWERS-24-30 severe impairment
18-23 mild impairment
17 and less no impairment
What happens during pruning? - CORRECT ANSWERS-Brain eliminates extra
synapses during infancy
