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Georgette Review Exam Questions and Answers 2025.

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Georgette Review Exam Questions and Answers 2025.

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  • November 11, 2024
  • 32
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • Georgette PMHNP
  • Georgette PMHNP
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Georgette Review Exam Questions and Answers 2025


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

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

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

Lithium - Answer Normal 0.6-1.2

Lithium toxicity occurs at levels - Answer > 1.5

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

Lithium is gold standard for - Answer MANIA

Lithium has evidence shown to - Answer reduce suicidal ideation

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

dehydration and hyponatremia cause lithium levels to - Answer rise

Baseline labs before initiation of lithium - Answer 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 - Answer 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 - Answer staying hydrated


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,avoiding NSAIDS
compliance

Depakote normal level - Answer 50-125

Depakote toxicity level - Answer greater than 150

Teratogenic effects of Depakote - Answer spina bifida

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

Intervention for depakote toxicity - Answer DC med
check level
LFT
ammonia

MAOI + tyramine causes - Answer hypertensive crisis

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

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

Treatment for hypertensive crisis - Answer DC offending agent
Administer PHENTOLAMINE

Teratogenic effects of benzos - Answer floppy baby, cleft palate

Teratogenic effects of tegratol - Answer neural tube defect


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,teratogenic effects of lithium - Answer ebstein anomaly (heart defect) (avoid, especially
1st trimester)

teratogenic effects of depakote - Answer neural tube defects/spina bifida

Adverse reaction to Lamictal - Answer Steven Johnson's Syndrome

Signs of SJS - Answer 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 - Answer sedation or weight gain

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

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

Child-bearing aged women - Answer 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 - Answer agranulocytosis and neutropenia

For monitoring neutropenia in Clozaril, monitor - Answer ANC

DC clozarli if ANC - Answer less than 1000

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

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




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, Clozaril only known antipsychotic to - Answer 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?
A. Lithium can prolong the QT interval
B. Lithium has no effect on his ECG
C. Lithium can invert the t waves
D. Lithium can shorten the PR interval - Answer Answer: Lithium can invert the t waves.

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?
A. Morphine
B. NSAIDS
C. Methylphenidate
D. Acetaminophen - Answer Answer: Methylphenidate

You are treating a client with schizophrenia who takes clozapine. What lab values will
indicate the client needs to discontinue treatment?
A. WBC less than 1800 and ANC less than 1200
B. ANC less than 1,000
C. WBC less than 5,000
D. ANC less than 2000 - Answer Answer: ANC less than 1000

If given during pregnancy, socium valproate can cause which of the following medical
problems in the baby?
A. SJS
B. Ebstein's anomaly
C. Spina bifida
D. Cleft palate - Answer A. Spina bifida

Which mood stabilizer is associated with potential life-threatening rash in the Asian
population?
A. Carbamazepine (tegretol)
B. Depakote
C. Lithium
D. Lamictal - Answer A. Carbamazepine

Bulimia, weight is - Answer within the normal range.

Pharm treatment for bulimia - Answer Fluoxetine
SSRIs and TCAs effective in reducing binging and purging

Signs of anorexia nervosa - Answer low BMI


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