Exam (elaborations)
GEORGETTE REVIEW EXAM QUESTIONS & ANSWERS, ANCC REVIEW MANUAL PMHNP
- Course
- Institution
GEORGETTE REVIEW EXAM QUESTIONS & ANSWERS, ANCC REVIEW MANUAL PMHNP
[Show more]
Content preview
GEORGETTE REVIEW EXAM QUESTIONS &ANSWERS, ANCC REVIEW MANUAL PMHNP
When many answers are remarkably similar, they are usually _____________ -
Answers- wrong
Interprofessional collaboration is encouraged. - Answers- Collaborate is usually right.
Delegate is usually wrong.
ADPIER - Answers- Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
Lithium - Answers- Normal 0.6-1.2
Lithium toxicity occurs at levels - Answers- > 1.5
Signs of Lithium toxicity - Answers- severe nausea, diarrhea, vomiting, confusion,
drowsiness, muscle weakness, heart palpitation, coarse hand tremors, unsteady gait
Lithium is gold standard for - Answers- MANIA
Lithium has evidence shown to - Answers- reduce suicidal ideation
What does lithium cause in neonate, especially 1st trimester - Answers- Ebstein
anomaly (congenital heart defect)
dehydration and hyponatremia cause lithium levels to - Answers- rise
Baseline labs before initiation of lithium - 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 - 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 - Answers- staying hydrated
avoiding NSAIDS
compliance
,Depakote normal level - Answers- 50-125
Depakote toxicity level - Answers- greater than 150
Teratogenic effects of Depakote - Answers- spina bifida
Adverse effects of depakote - 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 - Answers- disorientation, lethargy, respiratory depression,
nausea/vomiting
Intervention for depakote toxicity - Answers- DC med
check level
LFT
ammonia
MAOI + tyramine causes - Answers- hypertensive crisis
Symptoms of hypertensive crisis - Answers- elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever
Hypertensive crisis occurs with MAOI + - Answers- MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds
Treatment for hypertensive crisis - Answers- DC offending agent
Administer PHENTOLAMINE
Teratogenic effects of benzos - Answers- floppy baby, cleft palate
Teratogenic effects of tegratol - Answers- neural tube defect
,teratogenic effects of lithium - Answers- ebstein anomaly (heart defect) (avoid,
especially 1st trimester)
teratogenic effects of depakote - Answers- neural tube defects/spina bifida
Adverse reaction to Lamictal - Answers- Steven Johnson's Syndrome
Signs of SJS - Answers- 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 - Answers- sedation or weight gain
Carbamazepine (tegretol) black box warning - Answers- agranulocytosis (decrease
WBCs)
aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin rash, SOA)
Carbamazepine and asians - Answers- Screen for HLAB-1502 allele before initiating,
due to high incidence of SJS if positive for allele.
Child-bearing aged women - Answers- 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
Clozaril/clozapine can cause - Answers- agranulocytosis and neutropenia
For monitoring neutropenia in Clozaril, monitor - Answers- ANC
DC clozarli if ANC - Answers- less than 1000
DC clozaril if WBC - Answers- 2000-3000, risk of agranulocytosis
Mary is a 45-year-old African American female who has been treated on Isocarboxazid
(Marplan) for over 6 years. Mary is going in for a surgical procedure. Which medication
is strictly contraindicated with Isocarboxazid? - Answers- Answer: Methylphenidate
, You are treating a client with schizophrenia who takes clozapine. What lab values will
indicate the client needs to discontinue treatment? - Answers- Answer: ANC less than
1000
If given during pregnancy, sodium valproate can cause which of the following medical
problems in the baby? - Answers- Spina bifida
When on clozaril monitor for - Answers- signs and symptoms of infection: sudden fever,
chills, sore throat, weakness
Clozaril only known antipsychotic to - Answers- decrease risk of suicide in patients with
schizophrenia.
Your patient with bipolar disorder is admitted to a medical hospital. The internist
contacts your office and asks whether the lithium you prescribed him is effecting his
ECG. How do you respond? - Answers- Answer: Lithium can invert the t waves.
Which mood stabilizer is associated with potential life-threatening rash in the Asian
population? - Answers- Carbamazepine
Bulimia, weight is ___________ - Answers- within the normal range.
Pharm treatment for bulimia - Answers- Fluoxetine
SSRIs and TCAs effective in reducing binging and purging
Signs of anorexia nervosa - Answers- low BMI
Amennorrhea
Emaciation
Bradycardua
Hypotension
Pharm treatment for anorexia - Answers- there is none
therapy
Which of the following physical exam findings would help the PMHNP differentiate
anorexia nervosa from bulimia nervosa? - Answers- Low BMI
If a patient is depression, low energy, fatigued, you would prescribe - Answers-
Wellbutrin
Wellbutrin is contraindicated in patients with - Answers- seizure disorder or conditions
that increase risk of seizures such as eating disorder.
Which of the following medications has a unique mechanism that is both a
norepinephrine and dopamine reuptake inhibitor? - Answers- bupropion
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller GEEKA. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $14.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
78252 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now