LMR GEORGETTE’S PMHNP Certification
Module 1 & 2 All Questions Answered
1. Test Taking Strategies - ANS Read the entire question carefully before answering
and identifying what the question is seeking. Do not skim over the words or read them
too quickly.
Þ When reading the question pay attention to keywords.
2. Test Taking Strategies - ANS Do not read into the question. Only use the
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information provided by the examiner to answer the question without making any
assumptions or adding more information in the question.
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3. Test Taking Strategies - ANS Read all the answer choices.
Þ Narrow down options to 2 possible right answers.
Þ Partially correct answers are not the correct answer.
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Þ When two answer choices are the opposite of one another, one is usually the correct
answer.
Þ The right answer option might have the same word(s) as the test question; it can be
the same word or synonym of the word.
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Þ Choose client-focused answers.
· Best Answer/Choice: Answers that acknowledge a patient's feelings and makes the
patient feel heard.
Þ When many response choices are remarkably similar in meaning, they usually are
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wrong.
Þ Be wary of absolutes: all, only, always, every, must, never, none, everything, nothing,
etc. usually wrong.
4. Test Taking Strategies - ANS Questions that use adjectives like "priority," "Initial
action," test your ability to prioritize.
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Þ Airway, Breathing, and Circulation,
Þ Maslow's Hierarchy of Needs (physiological needs (food, water, warmth, rest), safety,
and security, etc.).
Þ Nursing Process (Assessment before intervention). Assessment is collecting data to
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support the problem towards a resolution.
5. Test Taking Strategies - ANS Safety for the patient and others is usually the right
answer.
6. Test Taking Strategies - ANS Culture is important to be included in all nursing care.
7. Test Taking Strategies - ANS Critical thinking is important.
8. Test Taking Strategies - ANS Interprofessional collaboration is encouraged.
,Refer Out
Lithium (0.6-1.2 mEq/L) (PB pg. 180) - ANS Lithium toxicity can occur when this level
reaches 1.5 mEq/L or higher.
What is the normal value of lithium? - ANS 0.6-1.2 mEq/L
What medication is the gold standard when treating manic episodes? - ANS Lithium
Which medication for the treatment of Bipolar 1 has evidence of anti-suicidal effects? -
ANS Lithium
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Which medication is neuroprotective treatment of choice for bipolar? - ANS Lithium
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Baseline labs to get before initiation of lithium to ensure safety and efficacy (PB pg. 180)
- ANS · Thyroid panel (TSH)
· Serum creatine (0.6-1.2 mg/dl)
· Blood urea nitrogen (BUN) (10-20 mg/dl)
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· Pregnancy test (human chorionic gonadotropin (HCG)
· ECG for clients older than age 50
Side effects of Lithium (PB pg. 181)
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Endocrine - ANS Hypothyroidism
Weight gain
Side effects of Lithium (PB pg. 181)
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Central nervous system - ANS Fine hand tremors
Fatigue
Mental cloudiness
Headaches
Coarse hand tremors occur with toxicity
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Nystagmus
Side effects of Lithium (PB pg. 181)
Dermatological - ANS Maculopapular rash
Pruritis
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Acne
Side effects of Lithium (PB pg. 181)
Gastrointestinal - ANS GI upset
Diarrhea
Vomiting
Cramps
Anorexia
Side effects of Lithium (PB pg. 181)
, Renal - ANS Diabetes insipidus: Polyuria, Polydipsia
Edema
Microscopic tubular changes
Side effects of Lithium (PB pg. 181)
Cardiac - ANS T-wave inversions
Dysrhythmia
Side effects of Lithium (PB pg. 181)
Hematologic - ANS Leukocytosis (Increases WBCs)
Signs of Lithium toxicity - ANS Severe nausea, vomiting, and diarrhea, confusion,
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convulsions, drowsiness, blurred vision, slurred speech, muscle weakness, heart
palpitations, coarse hand tremors, and unsteadiness while standing or walking (ataxia).
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What is the intervention of lithium toxicity? - ANS DC Li and check serum Li levels
Hypertensive crisis (PB pg. 157) - ANS Hypertensive crisis occurs when MAOIs are
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taken in conjunction with foods containing tyramine, a dietary precursor to
norepinephrine.
Hypertensive crisis is life-threatening and cannot be reversed unless... - ANS more
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MAO is produced by the body.
Hypertensive crisis and death also can occur when MAOIs are taken in conjunction with
what certain medications: - ANS Þ Meperidine
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Þ Stimulants and other sympathomimetics
Þ Decongestants
Þ Tricyclic antidepressants (TCAs)
Þ Atypical antipsychotics
Þ St. John's wort
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Þ L-tryptophan
Þ Asthma medication
Symptoms of Hypertensive Crisis (PB pg. 157) - ANS · Elevated blood pressure
· Sudden, explosive-like headache, usually occipital region
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· Facial flushing
· Palpitations
· Pupillary dilation
· Diaphoresis
· Fever
Symptoms of Hypertensive Crisis (PB pg. 157)
Treatment - ANS · DC the offending agent (MAOI)
· Administer phentolamine
· Stabilize fever