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Georgette's LMR Exam (LATEST UPDATE) 257 Questions and Answer Solutions
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Georgette's LMR Exam (LATEST UPDATE) 257Questions and Answer Solutions
There is a medication class that is contraindicated when a patient has tics. What is that class of
medication?
Stimulants --often used for ADHD
What action do you take if a patient reports being a victim of abuse.
Safety first!
Provide patient with an environment of safety and reassure them of their safety in the
clinic/hospital.
If you work inpatient, what do you do before discharging a patient who says they have been
abused?
Make sure the patient will be safe.
If you work inpatient, is a safety contract sufficient to determine that you are releasing a
patient into a safe home?
No. A safety contract is not enough. The NP has to confirm that the patient is going to be safe
for themselves or their environment is safe.
Inpatient--for safety, where should the NP interview the patient and why?
Safety is more important than privacy. In an office with a door open or partially open. The day
room would be a breach of confidentiality and a closed door or in their room would give the
patient access to harming the NP.
,If a child comes into the office with their parents and say they have been abused, what action
does the NP take?
interview the child separately from the parents THEN report to CPS
If a child comes into an appointment without their parents and plays with a toy in a sexual way,
what action does the NP take?
This makes the NP suspect abuse so initial action is to immediately report to CPS.
What is the cornerstone of building a therapeutic alliance with adolescents?
Confidentiality with the explanation that confidentiality must be broken if they are a danger to
self or others
Do we interview adolescents with their parents in the room?
No because the adolescent may have info that they want kept confidential from their parents.
If an adolescent comes in with their parents, do you keep the parents and adolescent together
or separate theme?
Separate them and speak to adolescent alone because the adolescent has a right to
confidentiality.
Which ethnic group has the highest incidence of suicide and suicide attempts ?
Native American
,Native Americans believe in their healing stick. If a staff member tries to take it away, what
should the NP do?
Educate the staff member in cultural competency and sensitivity.
If a patient wants a traditional healer to accompany them to an appointment, what does the NP
have to do ?
Get consent from the patient and allow the traditional healer to attend as well. With
permission from the patient, you can include the healer in the care plan as follow up.
Which labs should be taken before treating for depression or mania?
TSH
What is the normal range of TSH?
0.5-5.0 mu/L
Symptoms of hypothyroidism mimic which mental illness?
Depression
Symptoms of hyperthyroidism mimic which mental illness?
Mania
, If TSH is low i.e. 0.4 or lower, what is happening to T4 an T3 and what condition does patient
have?
T4 and T3 will be high and patient will have hyperthyroidism
If TSH is high e.g. 7.0, what is happening to T4 an T3 and what condition does patient have?
T4 and T3 will be low and patient will have hypothyroidism.
What are the symptoms of hyperthyroidism that can mimic mania? And what are other
symptoms?
agitation, anxiety, irritability, mood swings, weight loss.
Other symptoms are heat intolerance and tachycardia
What are symptoms of hypothyroidism that mimic depression? And what are other symptoms?
lethargy, weight gain, decreased libido.
And, cold intolerance
What is the Black Box warning for Depakote?
Pancreatitis
What are physical side effects/ dangers of Depakote (Divalproex)--for patient or fetus
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