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Georgette Review. PMHNP- 388 QUESTIONS- WITH COMPLETE SOLUTIONS $13.49   Add to cart

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Georgette Review. PMHNP- 388 QUESTIONS- WITH COMPLETE SOLUTIONS

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When many answers are remarkably similar, they are usually _____________ correct answer: wrong Interprofessional collaboration is encouraged. correct answer: Collaborate is usually right. Delegate is usually wrong. ADPIER correct answer: Assessment, diagnosis, Plan, intervention, evaluate, refer ou...

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  • August 19, 2024
  • 33
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • pmhnp
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Georgette Review. PMHNP- 388 QUESTIONS- WITH
COMPLETE SOLUTIONS

,Georgette Review. PMHNP- 388 QUESTIONS- WITH
COMPLETE SOLUTIONS

When many answers are remarkably similar, they are usually -
wrong

Interprofessional collaboration is encouraged. - Collaborate is usually right.
Delegate is usually wrong.

ADPIER - Assessment, diagnosis, Plan, intervention, evaluate, refer out last.

Lithium - Normal 0.6-1.2

Lithium toxicity occurs at levels - > 1.5

Signs of Lithium toxicity - severe nausea, diarrhea, vomiting, confusion, drowsiness,
muscle weakness, heart palpitation, coarse hand tremors, unsteady gait

Lithium is gold standard for - MANIA

Lithium has evidence shown to - reduce suicidal ideation

What does lithium cause in neonate, especially 1st trimester - Ebstein anomaly
(congenital heart defect)

dehydration and hyponatremia cause lithium levels to - rise

Baseline labs before initiation of lithium - 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 - 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 - staying hydrated
avoiding NSAIDS

,Georgette Review. PMHNP- 388 QUESTIONS- WITH
COMPLETE SOLUTIONS
compliance

Depakote normal level - 50-125

Depakote toxicity level - greater than 150

Teratogenic effects of Depakote - spina bifida

Adverse effects of depakote - 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 - disorientation, lethargy, respiratory depression,
nausea/vomiting

Intervention for depakote toxicity - DC med
check level
LFT
ammonia

MAOI + tyramine causes - hypertensive crisis

Symptoms of hypertensive crisis - elevated BP
sudden explosive like headache
facial flushing
palpitations
pupillary dilation
diaphoresis
fever

Hypertensive crisis occurs with MAOI + - MEPERIDINE
STIMULANTS
decongestants
TCAs
atypicals
St. John's wart
L-tryptophan
asthma meds

Treatment for hypertensive crisis - DC offending agent
Administer PHENTOLAMINE

Teratogenic effects of benzos - floppy baby, cleft palate

Teratogenic effects of tegratol - neural tube defect

, Georgette Review. PMHNP- 388 QUESTIONS- WITH
COMPLETE SOLUTIONS
teratogenic effects of lithium - ebstein anomaly (heart defect) (avoid, especially 1st
trimester)

teratogenic effects of depakote -neural tube defects/spina bifida

Adverse reaction to Lamictal - Steven Johnson's Syndrome

Signs of SJS - 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 - sedation or weight gain

Carbamazepine (tegretol) black box warning - agranulocytosis (decrease WBCs)
aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin rash,
SOA)

Carbamazepine and asians - Screen for HLAB-1502 allele before initiating, due to
high incidence of SJS if positive for allele.

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

Clozaril/clozapine can cause - agranulocytosis and neutropenia

For monitoring neutropenia in Clozaril, monitor - ANC

DC clozarli if ANC - less than 1000

DC clozaril if WBC - 2000-3000, risk of agranulocytosis

When on clozaril monitor for - signs and symptoms of infection: sudden fever, chills,
sore throat, weakness

Clozaril only known antipsychotic to - decrease risk of suicide in patients with
schizophrenia.

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