Georgette Review PMHNP Exam with Verified Answers
1. When many answers are re-
markably similar, they are usu-
ally
2. Interprofessional collabora-
tion is encouraged.
wrong
Collaborate is usually right.
Delegate is usually wrong.
3. ADPIER Assessment, diagnosis, Plan, intervention,
evalu...
1. When many answers are re- wrong
markably similar, they are usu-
ally
2. Interprofessional collabora- Collaborate is usually right.
tion is encouraged. Delegate is usually wrong.
3. ADPIER Assessment, diagnosis, Plan, intervention,
evaluate, refer out last.
4. Lithium Normal 0.6-1.2
5. Lithium toxicity occurs at lev- > 1.5
els
6. Signs of Lithium toxicity severe nausea, diarrhea, vomiting, confu-
sion, drowsiness, muscle weakness, heart
palpitation, coarse hand tremors, unsteady
gait
7. Lithium is gold standard for MANIA
8. Lithium has evidence shown reduce suicidal ideation
to
9. What does lithium cause Ebstein anomaly (congenital heart defect)
in neonate, especially 1st
trimester
10. dehydration and hyponatrem- rise
ia cause lithium levels to
11. Baseline labs before initiation TSH
of lithium creatinine (0.6-1.2)
BUN (10-20)
HCG (all psychotropics females 12-51)
EKG 50+
Urinalysis (check for proteins, 4+ may indi-
cate kidney disease)
, Georgette Review PMHNP Exam with Verified Answers
12. Side Effects of Lithium hypothyroidism
coase hand tremors with toxicity
maculopapular rash
diarrhea, vomiting, cramps--signs of toxici-
ty. Monitor closely.
anorexia
t wave inversions
leukocytosis
13. Pt education for lithimum staying hydrated
avoiding NSAIDS
compliance
14. Depakote normal level 50-125
15. Depakote toxicity level greater than 150
16. Teratogenic effects of De- spina bifida
pakote
17. Adverse effects of depakote alopecia
hepatotoxicity (RUQ pain or brown/red
urine--order LFTs) AST 5-40, ALT 5-35, yel-
lowing of skin or eyes, fatigue
18. Signs of Depakote toxicity disorientation, lethargy, respiratory depres-
sion, nausea/vomiting
19. Intervention for depakote tox- DC med
icity check level
LFT
ammonia
20. MAOI + tyramine causes hypertensive crisis
21. Symptoms of hypertensive elevated BP
crisis sudden explosive like headache
facial flushing
palpitations
pupillary dilation
, Georgette Review PMHNP Exam with Verified Answers
diaphoresis
fever
22. Hypertensive crisis occurs MEPERIDINE
with MAOI + STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
23. Treatment for hypertensive DC offending agent
crisis Administer PHENTOLAMINE
24. Teratogenic effects of benzos floppy baby, cleft palate
25. Teratogenic effects of tegratol neural tube defect
32. Carbamazepine and asians Screen for HLAB-1502 allele before initiat-
ing, due to high incidence of SJS if positive
for allele.
33. Child-bearing aged women check for pregnancy before starting mood
stabilizer
start on folic acid to support neural tube
development during the first month that a
woman is pregnant
34. Clozaril/clozapine can cause agranulocytosis and neutropenia
35. For monitoring neutropenia in ANC
Clozaril, monitor
36. DC clozarli if ANC less than 1000
37. DC clozaril if WBC 2000-3000, risk of agranulocytosis
38. When on clozaril monitor for signs and symptoms of infection: sudden
fever, chills, sore throat, weakness
39. Clozaril only known antipsy- decrease risk of suicide in patients with
chotic to schizophrenia.
40. Your patient with bipolar dis- Answer: Lithium can invert the t waves.
order is admitted to a medical
hospital. The internist con-
tacts your office and asks
whether the lithium you pre-
scribed him is effecting his
ECG. How do you respond?
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