PMHNP Board Exam Review 1 2026–2027 – Psychiatry &
Pharmacology Questions, Answers & Study Guide
When many answers are remarkably similar, they are usually _____________ - correct answers -wrong
Interprofessional collaboration is encouraged. - correct answers -Collaborate is usually right.
Delegate is usually wrong.
ADPIER - correct answers -Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
Lithium - correct answers -Normal 0.6-1.2
Lithium toxicity occurs at levels - correct answers -> 1.5
Signs of Lithium toxicity - correct answers -severe nausea, diarrhea, vomiting, confusion, drowsiness,
muscle weakness, heart palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard for - correct answers -MANIA
Lithium has evidence shown to - correct answers -reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester - correct answers -Ebstein anomaly
(congenital heart defect)
1
,dehydration and hyponatremia cause lithium levels to - correct answers -rise
Baseline labs before initiation of lithium - correct answers -TSH
creatinine (0.6-1.2)
BUN (10-20)
HCG (all psychotropics females 12-51)
EKG 50+
Urinalysis (check for proteins, 4+ may indicate kidney disease)
Side Effects of Lithium - correct answers -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 - correct answers -staying hydrated
avoiding NSAIDS
compliance
Depakote normal level - correct answers -50-125
2
,Depakote toxicity level - correct answers -greater than 150
Teratogenic effects of Depakote - correct answers -spina bifida
Adverse effects of depakote - correct answers -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 - correct answers -disorientation, lethargy, respiratory depression,
nausea/vomiting
Intervention for depakote toxicity - correct answers -DC med
check level
LFT
ammonia
MAOI + tyramine causes - correct answers -hypertensive crisis
Symptoms of hypertensive crisis - correct answers -elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
3
, fever
Hypertensive crisis occurs with MAOI + - correct answers -MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis - correct answers -DC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzos - correct answers -floppy baby, cleft palate
Teratogenic effects of tegratol - correct answers -neural tube defect
teratogenic effects of lithium - correct answers -ebstein anomaly (heart defect) (avoid, especially 1st
trimester)
teratogenic effects of depakote - correct answers -neural tube defects/spina bifida
4
Pharmacology Questions, Answers & Study Guide
When many answers are remarkably similar, they are usually _____________ - correct answers -wrong
Interprofessional collaboration is encouraged. - correct answers -Collaborate is usually right.
Delegate is usually wrong.
ADPIER - correct answers -Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
Lithium - correct answers -Normal 0.6-1.2
Lithium toxicity occurs at levels - correct answers -> 1.5
Signs of Lithium toxicity - correct answers -severe nausea, diarrhea, vomiting, confusion, drowsiness,
muscle weakness, heart palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard for - correct answers -MANIA
Lithium has evidence shown to - correct answers -reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester - correct answers -Ebstein anomaly
(congenital heart defect)
1
,dehydration and hyponatremia cause lithium levels to - correct answers -rise
Baseline labs before initiation of lithium - correct answers -TSH
creatinine (0.6-1.2)
BUN (10-20)
HCG (all psychotropics females 12-51)
EKG 50+
Urinalysis (check for proteins, 4+ may indicate kidney disease)
Side Effects of Lithium - correct answers -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 - correct answers -staying hydrated
avoiding NSAIDS
compliance
Depakote normal level - correct answers -50-125
2
,Depakote toxicity level - correct answers -greater than 150
Teratogenic effects of Depakote - correct answers -spina bifida
Adverse effects of depakote - correct answers -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 - correct answers -disorientation, lethargy, respiratory depression,
nausea/vomiting
Intervention for depakote toxicity - correct answers -DC med
check level
LFT
ammonia
MAOI + tyramine causes - correct answers -hypertensive crisis
Symptoms of hypertensive crisis - correct answers -elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
3
, fever
Hypertensive crisis occurs with MAOI + - correct answers -MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis - correct answers -DC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzos - correct answers -floppy baby, cleft palate
Teratogenic effects of tegratol - correct answers -neural tube defect
teratogenic effects of lithium - correct answers -ebstein anomaly (heart defect) (avoid, especially 1st
trimester)
teratogenic effects of depakote - correct answers -neural tube defects/spina bifida
4
