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GEORGETTE'S LMR EXAM QUESTIONS AND ANSWERS
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GEORGETTE'S LMR EXAM QUESTIONS AND ANSWERS
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GEORGETTE'S LMR EXAM QUESTIONS AND ANSWERSWhat should you not do when advocating for a patient? - answer- Judge or confront
What class of medication is contraindicated with tics? - answer- Stimulants
What should you provide for prior to assessing abuse victims? - answer- A safe environment
What are your actions if a child reports abuse? - answer- First interview separately from parents then report to CPS
What should you do if a child plays with toys in a way that you suspect abuse? - answer- Report to CPS
In what setting as an inpatient provider should you interview a patient? - answer- Use a private room with the door partially open
How should you begin your interview with adolescents? - answer- By building rapport with them by ensuring confidentiality absent exceptions
Should you interview adolescents with or without parents? - answer- Without
What if an adolescent tells you they are homosexual and they don't want their parents to
know? - answer- This is confidential
The patient is being discharged and would like their labs faxed to the rehab facility. What is your initial action? - answer- Get informed consent/ROI
What do you do if a medical evaluation is needed? - answer- Refer out - this is out of scope
What do you do if a patient is takes something and is feeling really funny/unwell in your office? - answer- Collect UDS and then refer out
Is it considered a mental illness if it is an expected response culturally? What do you offer as treatment? - answer- No; brief supportive therapy - not medication
A mother states her child is experiencing a cultural illness. What is your initial action? - answer- Respect the mother's cultural understanding of illness prior to assessment
Native Americans view mental illness and SUDs as? - answer- An imbalance between the individual and the world What ethnic group has the highest rate of suicidality in the US? - answer- Native Americans
If a patient believes they need a healing stick in their room, but the staff nurses removed
it from them - what should you do? - answer- Teach cultural sensitivity and make accommodations for patient to have healing stick available such as 1:1
Psychoeducation should be based on? - answer- Cultural context
How do you promote health in a location with multiple ethnicities and education levels? -
answer- Multiple cultural education and ethnospecific assessment parameters
What if a patient wants a traditional healer? - answer- Allow this - remember ROI/informed consent
Normal TSH? - answer- 0.5-5.0
TSH < 0.5 = ? - answer- Hyperthyroidism
TSH > 5.0 = ? - answer- Hypothyroidism
Relationship between TSH & T3/T4? - answer- Inverse
Hyperthyroidism can present as? - answer- Mania
Hypothyroidism can present as? - answer- Depression
Normal depakote level? - answer- 50-125
Toxic depakote level? - answer- 150+
Birth defect caused by depakote? - answer- Spina Bifida
S/S of depakote toxicity? - answer- Disorientation, lethargy, decreased respiratory rate, and N/V
What to do if there is depakote toxicity? - answer- D/C depakote and check VPA level, LFTs, and ammonia
S/S of hepatotoxicity? - answer- RUQ pain, reddish brown urine, jaundice, fatigue, and elevated LFTs
Normal AST? - answer- 5-40
Normal ALT? - answer- 5-35 Kava kava can cause? - answer- Liver damage and heavy sedation
Kava kava is c/i with? - answer- Benzos or sedatives
Mood stabilizer most associated with SJS? - answer- Lamictal
Mood stabilizer with least weight gain? - answer- Lamictal
SGAs with least weight gain? - answer- ziprasidone, abilify, and latuda
Least sedating SGA? - answer- Abilify
Routine labs with SGAs? - answer- BMI, hip to waist ratio, glucose, A1C, and lipid panel
Management of metabolic syndrome with SGAs? - answer- 1. Nonpharm = exercise or nutritional counseling
2. Pharm = switch to other SGA with lower chance of metabolic syndrome
Carbamazepine can cause? - answer- Agranulocytosis and aplastic anemia
What should you screen for prior to starting Asians on carbamazepine and why? - answer- HLAB1502 Allele; risk of SJS
When should you d/c carbamazepine if agranulocytosis is suspected? - answer- If ANC is < 1000 with or without s/s of infection
Lithium range? - answer- 0.6 - 1.2
What to do if lithium is 1.3 or 1.4? - answer- Monitor
What to do if lithium is 1.5+? - answer- D/C
Benefits of lithium? - answer- Gold standard for mania, neuroprotective, and antisuicidal
effects
S/S of lithium toxicity? - answer- Severe N/V, polydipsia, polyuria, leukocytosis, palpitations, coarse tremor
What to do if lithium toxicity is suspected? - answer- D/C and check serum levels prior to checking VS
Kidney disease and drugs that reduce renal clearance can raise lithium levels. What are
these drugs? - answer- NSAIDs, ace inhibitors for heart failure (-pril), and thiazides (HCTZ)
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