LMR Georgette’s PMHNP Certification Exam Latest 2023-2024 Questions And Correct Answers(Verified Answers)

LMR Georgette’s PMHNP Certification

Exam Latest 2023-2024 Questions And

Correct Answers(Verified Answers)

A patient is being treated for schizophrenia with olanzapine. Which of the

following is the most common side effect of olanzapine?

A. Increased waist circumference

B. EPS (not as common in atypical antipsychotics d/t 5HT2A)-receptor antagonism

C. Increased Lipids

D. Metabolic Syndrome

D. Metabolic Syndrome (UMBRELLA ANSWER)

Which antipsychotics have the least weight gain?

Latuda, Abilify, (also least sedating), Geodon-if patient has metabolic

syndrome consider switching to one of the medications above. Or if the patient

is overly sedated try switching to ABILIFY

Which mood stabilizer have the least weight gain?

Lamictal

-But remember all mood stabilizers cause some weight gain

When presented with a question about typical vs atypical antipsychotic the answer

is usually to start of a

atypical

A client presents with complains of changes in appetite, feeling fatigued,

problems with sleep-rest cycle, and changes in libido. What is the

neuroanatomical area of the brain that is responsible for the normal

regulation of these functions?

A. Thalamus

B. Hypothalamus

C. Limbic System

D. Hippocampus

Hypothalamus

A, B, & D are all part of the limbic system so you can rule that out

When a patient is hesitant to participate in treatment you should encourage?

Bring a support person like a husband

Thyroid-Stimulating hormone normal level

0.5-5.0 Mu/L

When T4 and T3 are high and TSH is low what is the diagnosis

HYPERTHYROIDISM, TSH secretion decreases: TSH LOW à key symptoms

HEAT INTOLERANCE

Key symptoms of Heat Intolerance

Hyperthyroidism

When T4 and T3 are Low and TSH is high what is the diagnosis

(HYPOTHYROIDISM) TSH secretion increased: TSH HIGH à COLD

INTERANCE

Key symptoms of Cold Intolerance

Hypothyroidism

Hyperthyroid can mimic

Mania

Hypothyroid can mimic

Depression

A patient on depakote complains of RUQ pain and has reddish/brown urine

Hepatoxicity

-Check LFTs

Signs of Depakote toxicity

Disorientation, confusion, lethargy

You suspect depakote toxicity what do you do?

Check

-LFT

-Ammonia

-Depakote Level

What herbal supplement can cause hepatoxicity?

Kava Kava

When taking Kava Kava in combinations with other medications you should

caution about

Risk of Hepatoxicity and Sedation

TCAs carry a risk of

Hepatotoxicity

Signs of Stevens-Johnson Syndrome

-fever, mouth pain, swelling, burning eyes, blisters, skin pain

two psychotropics known to cause steven johnson syndrome

lamictal and tegretol

What nationality is most suseptible of getting steven johnson?

Asians

When treating asians with tegretal screen for?

HLAB-1502 Allele

What two medications cause agranulocytosis?

Clozaril & Tegretal

Agranulocytosis when to discontinue medication

Less than 1000

When monitoring for agranulocytosis in patients look for s/s of what?

Infection

-Fever, sore throat, fatigue, chills

Before starting any mood stabilizer in a female of childbearing age be sure to

check?

HCG

Which two medications may decrease the risk of suicide?

clozaril and lithium

Medications that increase lithium level

NSAID-ibuprofen, INDOCIN

THIAZIDES-hydrochlorithiazide ACE INHIBITORS-lisinopril

Ace inhibitors are treatment of choice for?

Heart Failure

Certain medications are known to increase lithium level, but HOW?

by reducing renal clearance

When educating a patient about lithium teach them about

Hyponatremia

Dehydration-hot days, exercise

Normal Lithium Level

0.6-1.2

Lithium Toxicity

1.5 or above

Discontinue and re-order lithium level

Lithium level of 1.4

Monitor for toxicity

Labs before starting lithium

TSH, BUN, CREATININE, HCG, U/A to check for presence of protein in the

urine (4+ protein is concerning for renal impairment)à4+ protein in

urine=MONITOR FOR TOXICITY

4+ protein in the urine of a patient on lithium