ANCC PMHNP CERTIFICATION
NEWEST EXAM VERSION 2024-2025
QUESTIONS WITH CORRECT ANSWERS
GRADED A
What is the recommended folic acid dose for child bearing
age woman using neuroleptic medication? - correct
answer✔✔0.4 - 0.8 mg daily to support neural tube
development
What is the gold standard for manic episode treatment? -
correct answer✔✔Lithium
What is the narrow therapeutic window for lithium? -
correct answer✔✔0.5 - 1.2 mEq/L
Lithium toxicity sx can occur at what level? - correct
answer✔✔Over 1.5 mEq/L
Labs prior to initiating Lithium - correct
answer✔✔Urinalysis (to check for protein in urine)
TSH (to rule out hyperthyroidism)
BUN (to check kidney function)
HCG (for pregnancy)
ECG (for clients older than 50 y.o. (to rule out cardiac
risks)
,A patient is experiencing lithium toxicity, what's the priority
intervention? - correct answer✔✔Stop the lithium and
check levels
What are common side effects associated with lithium? -
correct answer✔✔Hypothyroidism, fine hand tremors,
maculopapular rash, diabetes insipidous, T-wave
inversion, and leukocytosis.
What are symptoms of lithium toxicity? - correct
answer✔✔GI upset, confusion, drowsiness, slurred
speech, convulsions, blurred vision, coarse hand tremors,
ataxia, muscle weakness, and heart palpitations.
What increases lithium levels? - correct
answer✔✔Medications that cause decreased renal
clearance (NSAIDs, ace inhibitors, thiazides), dehydration
and hyponatremia/over hydration.
What foods increase the risk of hyertensive crisis? -
correct answer✔✔Foods high in tyramine
Symptoms of hypertensive crisis - correct
answer✔✔Increased BP, headache, palpitations,
diaphoresis, fever, pupillary dilation and facial flushing
Treatment for hypertensive crisis consists of what? -
correct answer✔✔Discontinuing MAOI, administering
phentolamine, stabilizing fever, reevaluating
diet/adherence, and reiterating medication guidelines
,Lamictal has a black box warning for - correct
answer✔✔Steven Johnson syndrome
What are symptoms of Steven Johnson syndrome? -
correct answer✔✔Fever, sore throat, facial swelling,
tongue swelling, rash, skin sloughing, and
headache/malaise/arthralgia/painful membranes before
rash occurs
Valproic acid (Depakote) has a black box warning for
what? - correct answer✔✔Hepatotoxicity and pancreatitis
Carbamazepine (tegretol) has a black box warning for
what? - correct answer✔✔Agranulocytosis and aplastic
anemia (pallor, fever, headache, nosebleeds, bleeding
gums, SOB and skin rash
Steven Johnson syndrome is an increased risk for the
what population of people who use Carbamazepine
(tegretol) because of what gene? - correct
answer✔✔Asians and HLAB-1502 allele
Normal ANC - correct answer✔✔2500 - 6000
Normal WBC - correct answer✔✔4500 - 11000
Risk for neutropenia is monitored by the which white blood
cell level? - correct answer✔✔ANC, not in conjunction with
WBC
, What is the monitoring schedule for clozapine (Clozaril)? -
correct answer✔✔Monitor ANC weekly - first 6 months
Monitor ANC biweekly - second 6 months
Then monthly if ANC is normal
When should clozapine/carbamazepine be discontinued
according to ANC? - correct answer✔✔When the ANC is
less than 1,000
When should clozapine/carbamazepine be discontinued
according to WBC? - correct answer✔✔When the WBC is
less than 3,000
What are signs to monitor while taking
clozaril/carbamazepine? - correct answer✔✔Sudden
fever, sore throat, and weakness
Normal range BMI - correct answer✔✔18.5-24.9 kg/m^2
What BMI would indicate the need for further
evaluation/hospitalization? - correct answer✔✔Less than
15
An eating disorder that typically has a normal BMI - correct
answer✔✔Bulimia Nervosa
An eating disorder characterized by recurrent, episodic
binge eating w/compensatory behaviors at least twice
weekly for 3 months - correct answer✔✔Bulimia Nervosa
NEWEST EXAM VERSION 2024-2025
QUESTIONS WITH CORRECT ANSWERS
GRADED A
What is the recommended folic acid dose for child bearing
age woman using neuroleptic medication? - correct
answer✔✔0.4 - 0.8 mg daily to support neural tube
development
What is the gold standard for manic episode treatment? -
correct answer✔✔Lithium
What is the narrow therapeutic window for lithium? -
correct answer✔✔0.5 - 1.2 mEq/L
Lithium toxicity sx can occur at what level? - correct
answer✔✔Over 1.5 mEq/L
Labs prior to initiating Lithium - correct
answer✔✔Urinalysis (to check for protein in urine)
TSH (to rule out hyperthyroidism)
BUN (to check kidney function)
HCG (for pregnancy)
ECG (for clients older than 50 y.o. (to rule out cardiac
risks)
,A patient is experiencing lithium toxicity, what's the priority
intervention? - correct answer✔✔Stop the lithium and
check levels
What are common side effects associated with lithium? -
correct answer✔✔Hypothyroidism, fine hand tremors,
maculopapular rash, diabetes insipidous, T-wave
inversion, and leukocytosis.
What are symptoms of lithium toxicity? - correct
answer✔✔GI upset, confusion, drowsiness, slurred
speech, convulsions, blurred vision, coarse hand tremors,
ataxia, muscle weakness, and heart palpitations.
What increases lithium levels? - correct
answer✔✔Medications that cause decreased renal
clearance (NSAIDs, ace inhibitors, thiazides), dehydration
and hyponatremia/over hydration.
What foods increase the risk of hyertensive crisis? -
correct answer✔✔Foods high in tyramine
Symptoms of hypertensive crisis - correct
answer✔✔Increased BP, headache, palpitations,
diaphoresis, fever, pupillary dilation and facial flushing
Treatment for hypertensive crisis consists of what? -
correct answer✔✔Discontinuing MAOI, administering
phentolamine, stabilizing fever, reevaluating
diet/adherence, and reiterating medication guidelines
,Lamictal has a black box warning for - correct
answer✔✔Steven Johnson syndrome
What are symptoms of Steven Johnson syndrome? -
correct answer✔✔Fever, sore throat, facial swelling,
tongue swelling, rash, skin sloughing, and
headache/malaise/arthralgia/painful membranes before
rash occurs
Valproic acid (Depakote) has a black box warning for
what? - correct answer✔✔Hepatotoxicity and pancreatitis
Carbamazepine (tegretol) has a black box warning for
what? - correct answer✔✔Agranulocytosis and aplastic
anemia (pallor, fever, headache, nosebleeds, bleeding
gums, SOB and skin rash
Steven Johnson syndrome is an increased risk for the
what population of people who use Carbamazepine
(tegretol) because of what gene? - correct
answer✔✔Asians and HLAB-1502 allele
Normal ANC - correct answer✔✔2500 - 6000
Normal WBC - correct answer✔✔4500 - 11000
Risk for neutropenia is monitored by the which white blood
cell level? - correct answer✔✔ANC, not in conjunction with
WBC
, What is the monitoring schedule for clozapine (Clozaril)? -
correct answer✔✔Monitor ANC weekly - first 6 months
Monitor ANC biweekly - second 6 months
Then monthly if ANC is normal
When should clozapine/carbamazepine be discontinued
according to ANC? - correct answer✔✔When the ANC is
less than 1,000
When should clozapine/carbamazepine be discontinued
according to WBC? - correct answer✔✔When the WBC is
less than 3,000
What are signs to monitor while taking
clozaril/carbamazepine? - correct answer✔✔Sudden
fever, sore throat, and weakness
Normal range BMI - correct answer✔✔18.5-24.9 kg/m^2
What BMI would indicate the need for further
evaluation/hospitalization? - correct answer✔✔Less than
15
An eating disorder that typically has a normal BMI - correct
answer✔✔Bulimia Nervosa
An eating disorder characterized by recurrent, episodic
binge eating w/compensatory behaviors at least twice
weekly for 3 months - correct answer✔✔Bulimia Nervosa
