LMR Georgette PMHNP Certification Exam
Practice Questions And Well-Elaborated Answers
Guaranteed Pass!!
, EXAM STRUCTURE
Total Questions: 100
Format: Multiple Choice
Time Allowed: 150 minutes
Passing Standard: 70% or higher
SECTION 1: PSYCHOPHARMACOLOGY (Questions 1-30)
1. A patient on lithium presents with dark brown urine. What is your priority action?
A. Hold the next dose and call 911
B. Check renal function
C. Increase fluid intake
D. Administer dantrolene
Correct Answer: B
Rationale: Dark brown urine in a patient on lithium may indicate dehydration, renal impairment,
or rhabdomyolysis. Lithium is entirely excreted by the kidneys, so renal function must be assessed
immediately. Checking BUN and creatinine determines whether lithium is accumulating to toxic levels-1-
4.
2. A patient on Clozaril (clozapine) presents with fever. What lab value do you check?
, A. Lithium level
B. ANC (Absolute Neutrophil Count)
C. TSH
D. Hemoglobin A1C
Correct Answer: B
Rationale: Fever in a patient on clozapine is a red flag for agranulocytosis, a life-threatening
drop in white blood cells. Clozapine requires regular ANC monitoring because agranulocytosis can occur
at any time during treatment. If ANC drops below 1,000, the medication must be discontinued-1-2-4.
3. What lab values are indicative of Neuroleptic Malignant Syndrome (NMS)?
A. Decreased WBC and decreased CPK
B. Elevated WBC (over 11,000) and elevated CPK
C. Normal WBC and elevated B12
D. Decreased CPK and elevated TSH
Correct Answer: B
Rationale: NMS is characterized by elevated white blood cell count (leukocytosis, often >11,000)
and elevated creatine phosphokinase (CPK) due to muscle breakdown. These labs, combined with clinical
signs of muscle rigidity, hyperthermia, and autonomic instability, confirm the diagnosis-1-4.
4. What are the classic signs and symptoms of Serotonin Syndrome?
, A. Muscle rigidity, bradycardia, hypothermia
B. Hyperreflexia, muscle spasms, myoclonus, fever, tachycardia
C. Cogwheel rigidity, drooling, shuffling gait
D. Bradycardia, hypotension, sedation
Correct Answer: B
Rationale: Serotonin Syndrome presents with neuromuscular excitation (hyperreflexia,
myoclonus, muscle spasms), autonomic hyperactivity (fever, tachycardia, hypertension, diarrhea), and
altered mental status. It differs from NMS, which features lead-pipe rigidity and slower onset-4.
5. What is the onset and typical duration of NMS?
A. Within 24 hours; resolves in 2-3 days
B. Slow onset (1-2 weeks after medication change); resolves in 9-14 days
C. Immediate onset; resolves in 24 hours
D. Onset at 1 month; resolves in 30 days
Correct Answer: B
Rationale: NMS has a slower onset, typically 1-2 weeks after starting or changing antipsychotic
therapy, and resolves within 9-14 days after discontinuation. This distinguishes it from Serotonin
Syndrome, which occurs within 24 hours-4.
6. What medication is used to treat Serotonin Syndrome?
Practice Questions And Well-Elaborated Answers
Guaranteed Pass!!
, EXAM STRUCTURE
Total Questions: 100
Format: Multiple Choice
Time Allowed: 150 minutes
Passing Standard: 70% or higher
SECTION 1: PSYCHOPHARMACOLOGY (Questions 1-30)
1. A patient on lithium presents with dark brown urine. What is your priority action?
A. Hold the next dose and call 911
B. Check renal function
C. Increase fluid intake
D. Administer dantrolene
Correct Answer: B
Rationale: Dark brown urine in a patient on lithium may indicate dehydration, renal impairment,
or rhabdomyolysis. Lithium is entirely excreted by the kidneys, so renal function must be assessed
immediately. Checking BUN and creatinine determines whether lithium is accumulating to toxic levels-1-
4.
2. A patient on Clozaril (clozapine) presents with fever. What lab value do you check?
, A. Lithium level
B. ANC (Absolute Neutrophil Count)
C. TSH
D. Hemoglobin A1C
Correct Answer: B
Rationale: Fever in a patient on clozapine is a red flag for agranulocytosis, a life-threatening
drop in white blood cells. Clozapine requires regular ANC monitoring because agranulocytosis can occur
at any time during treatment. If ANC drops below 1,000, the medication must be discontinued-1-2-4.
3. What lab values are indicative of Neuroleptic Malignant Syndrome (NMS)?
A. Decreased WBC and decreased CPK
B. Elevated WBC (over 11,000) and elevated CPK
C. Normal WBC and elevated B12
D. Decreased CPK and elevated TSH
Correct Answer: B
Rationale: NMS is characterized by elevated white blood cell count (leukocytosis, often >11,000)
and elevated creatine phosphokinase (CPK) due to muscle breakdown. These labs, combined with clinical
signs of muscle rigidity, hyperthermia, and autonomic instability, confirm the diagnosis-1-4.
4. What are the classic signs and symptoms of Serotonin Syndrome?
, A. Muscle rigidity, bradycardia, hypothermia
B. Hyperreflexia, muscle spasms, myoclonus, fever, tachycardia
C. Cogwheel rigidity, drooling, shuffling gait
D. Bradycardia, hypotension, sedation
Correct Answer: B
Rationale: Serotonin Syndrome presents with neuromuscular excitation (hyperreflexia,
myoclonus, muscle spasms), autonomic hyperactivity (fever, tachycardia, hypertension, diarrhea), and
altered mental status. It differs from NMS, which features lead-pipe rigidity and slower onset-4.
5. What is the onset and typical duration of NMS?
A. Within 24 hours; resolves in 2-3 days
B. Slow onset (1-2 weeks after medication change); resolves in 9-14 days
C. Immediate onset; resolves in 24 hours
D. Onset at 1 month; resolves in 30 days
Correct Answer: B
Rationale: NMS has a slower onset, typically 1-2 weeks after starting or changing antipsychotic
therapy, and resolves within 9-14 days after discontinuation. This distinguishes it from Serotonin
Syndrome, which occurs within 24 hours-4.
6. What medication is used to treat Serotonin Syndrome?
