Page 1 of 239
Georgette Review. PMHNP- 1400 QUESTIONS- WITH
COMPLETE SOLUTIONS 2025/26 Georgette Review Exam
Questions with Correct Answers, ANCC Review Manual
PMHNP
When many answers are remarkably similar, they are usually _____________ - Answer: wrong
Interprofessional collaboration is encouraged. - Answer: Collaborate is usually right.
Delegate is usually wrong.
ADPIER - Answer: Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
Lithium - Answer: Normal 0.6-1.2
Lithium toxicity occurs at levels - Answer: > 1.5
Signs of Lithium toxicity - Answer: severe nausea, diarrhea, vomiting, confusion, drowsiness, muscle
weakness, heart palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard for - Answer: MANIA
Lithium has evidence shown to - Answer: reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester - Answer: Ebstein anomaly (congenital
heart defect)
dehydration and hyponatremia cause lithium levels to - Answer: rise
Baseline labs before initiation of lithium - Answer: TSH
creatinine (0.6-1.2)
,Page 2 of 239
BUN (10-20)
HCG (all psychotropics females 12-51)
EKG 50+
Urinalysis (check for proteins, 4+ may indicate kidney disease)
Side Effects of Lithium - Answer: hypothyroidism
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Pt education for lithimum - Answer: staying hydrated
avoiding NSAIDS
compliance
Depakote normal level - Answer: 50-125
Depakote toxicity level - Answer: greater than 150
Teratogenic effects of Depakote - Answer: spina bifida
Adverse effects of depakote - Answer: alopecia
hepatotoxicity (RUQ pain or brown/red urine--order LFTs) AST 5-40, ALT 5-35, yellowing of skin or eyes,
fatigue
Signs of Depakote toxicity - Answer: disorientation, lethargy, respiratory depression, nausea/vomiting
,Page 3 of 239
Intervention for depakote toxicity - Answer: DC med
check level
LFT
ammonia
MAOI + tyramine causes - Answer: hypertensive crisis
Symptoms of hypertensive crisis - Answer: elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI + - Answer: MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis - Answer: DC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzos - Answer: floppy baby, cleft palate
, Page 4 of 239
Teratogenic effects of tegratol - Answer: neural tube defect
teratogenic effects of lithium - Answer: ebstein anomaly (heart defect) (avoid, especially 1st trimester)
teratogenic effects of depakote - Answer: neural tube defects/spina bifida
Adverse reaction to Lamictal - Answer: Steven Johnson's Syndrome
Signs of SJS - Answer: FEVER --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 cause - Answer: sedation or weight gain
Carbamazepine (tegretol) black box warning - Answer: agranulocytosis (decrease WBCs)
aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin rash, SOA)
Carbamazepine and asians - Answer: Screen for HLAB-1502 allele before initiating, due to high incidence
of SJS if positive for allele.
Child-bearing aged women - Answer: check for pregnancy before starting mood stabilizer
Georgette Review. PMHNP- 1400 QUESTIONS- WITH
COMPLETE SOLUTIONS 2025/26 Georgette Review Exam
Questions with Correct Answers, ANCC Review Manual
PMHNP
When many answers are remarkably similar, they are usually _____________ - Answer: wrong
Interprofessional collaboration is encouraged. - Answer: Collaborate is usually right.
Delegate is usually wrong.
ADPIER - Answer: Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
Lithium - Answer: Normal 0.6-1.2
Lithium toxicity occurs at levels - Answer: > 1.5
Signs of Lithium toxicity - Answer: severe nausea, diarrhea, vomiting, confusion, drowsiness, muscle
weakness, heart palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard for - Answer: MANIA
Lithium has evidence shown to - Answer: reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester - Answer: Ebstein anomaly (congenital
heart defect)
dehydration and hyponatremia cause lithium levels to - Answer: rise
Baseline labs before initiation of lithium - Answer: TSH
creatinine (0.6-1.2)
,Page 2 of 239
BUN (10-20)
HCG (all psychotropics females 12-51)
EKG 50+
Urinalysis (check for proteins, 4+ may indicate kidney disease)
Side Effects of Lithium - Answer: hypothyroidism
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxicity. Monitor closely.
anorexia
t wave inversions
leukocytosis
Pt education for lithimum - Answer: staying hydrated
avoiding NSAIDS
compliance
Depakote normal level - Answer: 50-125
Depakote toxicity level - Answer: greater than 150
Teratogenic effects of Depakote - Answer: spina bifida
Adverse effects of depakote - Answer: alopecia
hepatotoxicity (RUQ pain or brown/red urine--order LFTs) AST 5-40, ALT 5-35, yellowing of skin or eyes,
fatigue
Signs of Depakote toxicity - Answer: disorientation, lethargy, respiratory depression, nausea/vomiting
,Page 3 of 239
Intervention for depakote toxicity - Answer: DC med
check level
LFT
ammonia
MAOI + tyramine causes - Answer: hypertensive crisis
Symptoms of hypertensive crisis - Answer: elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI + - Answer: MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis - Answer: DC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzos - Answer: floppy baby, cleft palate
, Page 4 of 239
Teratogenic effects of tegratol - Answer: neural tube defect
teratogenic effects of lithium - Answer: ebstein anomaly (heart defect) (avoid, especially 1st trimester)
teratogenic effects of depakote - Answer: neural tube defects/spina bifida
Adverse reaction to Lamictal - Answer: Steven Johnson's Syndrome
Signs of SJS - Answer: FEVER --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 cause - Answer: sedation or weight gain
Carbamazepine (tegretol) black box warning - Answer: agranulocytosis (decrease WBCs)
aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin rash, SOA)
Carbamazepine and asians - Answer: Screen for HLAB-1502 allele before initiating, due to high incidence
of SJS if positive for allele.
Child-bearing aged women - Answer: check for pregnancy before starting mood stabilizer
