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LMR GEORGETTE’S PMHNP CERTIFICATION EXAM QUESTIONS WITH COMPLETE SOLUTIONS, Exams of Nursing

Johns Hopkins University (JHU)Nursing

LMR GEORGETTE’S PMHNP CERTIFICATION EXAM QUESTIONS WITH COMPLETE SOLUTIONS GUARANTEED PASS BRAND NEW 2025

Typology: Exams

2024/2025

Available from 07/14/2025

Prof.-Robert-Atkins
Prof.-Robert-Atkins 🇺🇸

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LMR GEORGETTE’S PMHNP CERTIFICATION EXAM QUESTIONS WITH COMPLETE
SOLUTIONS GUARANTEED PASS BRAND NEW 2025
1. Which patient is at highest risk for SI
A. 30y/o married AA female with previous SI attempt *1 risk factor
B. 35 y/o single Asian male with previous SI attempt *3 risk factors
C. 38 y/o single AA male who is a manager of a bank *2 risk factors
D. 68 y/o single white male with depression *5 risk factors (age, male, white,
depression): D. 68 y/o single white male with depression *5 risk factors (age,
male, white, depression)
Count the risk factors
2. When interview teenagers (16 y/o) that arrive with their parents what
should you do?: interview them separately from parents.
-This helps Build therapeutic rapport with teens by telling them the info is
confidential. Parents may be upset but remember you are advocating for the child.
3. Which Ethnic group has the highest rate of suicide?: Native Americans
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Download LMR GEORGETTE’S PMHNP CERTIFICATION EXAM QUESTIONS WITH COMPLETE SOLUTIONS and more Exams Nursing in PDF only on Docsity!

LMR GEORGETTE’S PMHNP CERTIFICATION EXAM QUESTIONS WITH COMPLETE

SOLUTIONS GUARANTEED PASS BRAND NEW 2025

  1. Which patient is at highest risk for SI *A. 30y/o married AA female with previous SI attempt 1 risk factor *B. 35 y/o single Asian male with previous SI attempt 3 risk factors *C. 38 y/o single AA male who is a manager of a bank 2 risk factors *D. 68 y/o single white male with depression 5 risk factors (age, male, white, depression): D. 68 y/o single white male with depression *5 risk factors (age, male, white, depression) Count the risk factors
  2. When interview teenagers (16 y/o) that arrive with their parents what should you do?: interview them separately from parents.
  • This helps Build therapeutic rapport with teens by telling them the info is confidential. Parents may be upset but remember you are advocating for the child.
  1. Which Ethnic group has the highest rate of suicide?: Native Americans
  1. Example 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 antag-onism C. Increased Lipids D. Metabolic Syndrome: D. Metabolic Syndrome (UMBRELLA ANSWER)
    1. Which antipsychotics have the least weight gain?: FYLatuda, 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 ability
    2. Which mood stabilizer have the least weight gain?: Lamictal
  • But remember all mood stabilizers cause some weight gain
    1. When presented with a question about typical vs atypical antipsychotic the answer is usually to start of a: atypical
    2. A client presents with complains of changes in appetite, feeling fatigued, problems with sleep-rest cycle, and changes in libido. What is the
  1. Hyperthyroid can mimic: Mania
  2. Hypothyroid can mimic: Depression
  3. A patient on depakote complains of RUQ pain and has reddish/brown urine: Hepatoxicity
  • Check LFTs
  1. Signs of Depakote toxicity: Disorientation, confusion, lethargy
  2. You suspect depakote toxicity what do you do?: Check - LFT
  • Ammonia
  • Depakote Level
  1. What herbal supplement can cause hepatoxicity?: Kava Kava
  2. When taking Kava Kava in combinations with other medications you should caution about: Risk of Hepatoxicity and Sedation
  3. TCAs carry a risk of: Hepatotoxicity
  4. Signs of Stevens-Johnson Syndrome: - fever, mouth pain, swelling, burning eyes, blisters, skin pain
  5. two psychotropics known to cause steven johnson syndrome: lamictal and tegretol
  6. What nationality is most suseptible of getting steven johnson?: Asians
  1. When treating asians with tegretal screen for?: HLAB-1502 Allele
  2. What two medications cause agranulocytosis?: Clozaril & Tegretal
  3. Agranulocytosis when to discontinue medication: Less than 1000
  4. When monitoring for agranulocytosis in patients look for s/s of what?: Infection
  • Fever, sore throat, fatigue, chills
  1. Before starting any mood stabilizer in a female of childbearing age be sure to check?: HCG
  2. Which two medications may decrease the risk of suicide?: clozaril and lithium
  3. Medications that increase lithium level: NSAID-ibuprofen, INDOCIN THIAZIDES-hydrochlorithiazide ACE INHIBITORS-lisinopril 33 Ace inhibitors are treatment of choice for?: Heart Failure
  4. Certain medications are known to increase lithium level, but HOW?: by reducing renal clearance
  5. When educating a patient about lithium teach them about: Hyponatremia Dehydration-hot days, exercise
  6. Normal Lithium Level: 0.6-1.
  1. Cherry colored urine in a patient that exercises a lot: test for myoglobinuria may be a sign of rhabdo
  2. Serotonin Syndrome: With any drug that increases 5-HT (e.g., MAO inhibitors, SNRIs, TCAs) hyperthermia, confusion, myoclonus, cardiovascular instability, flushing, diarrhea, seizures.
  • Treatment: cyproheptadine (5-HT2 receptor antagonist).
  1. Treatment for NMS: Stop Offending Medication
  • Dantrolene (muscle relaxer)
  • Bromocriptine (Dopamine D2 agonist). *In question focus on what they are asking for....dopamine agonist vs muscle relaxer
  1. Treatment for Serotonin Syndrome: Stop Med (1 or more SSRI, SSNRI, TCA, MOAI)
  • Cyproheptadine
  1. Triptans: Used for MIGRAINES
  • These meds increase serotonin example SUMATRIPTAN

49 patient taking Prozac and started on sumatriptan: - call PCP to ask them to switch the migraine med if patient already on SUMATRIPTAN do not start antidepressant without talking to PCP

  1. How long do you wait when switching between an SSRI to an MAOI?: 2 weeks
  2. How long do you wait when switching between Prozac and MAOI?: 5 - 6 weeks wash out period
  3. What is the first line treatment for depression and why?: SSRI-First line treatment for depression due to less risk of injury from OVERDOSE
  4. If a cancer patient has depression what should you consider?: Treating with a medication with minimal drug/drug side effects like Lexapro
  5. Patient with depression worries about sexual dysfunction what would be the medication of choice?: Wellbutrin
  6. Primary symptoms of depression include fatigue and low energy what med would you chose?: Wellbutrin
  7. Wellbutrin is contraindicated in patients with: Seizures and anorexia
  8. Which medications are best for neuropathic pain?: SNRI

MUST ASK ABOUT SI, EVERYTIME (frequency, severity of thoughts)

  1. What increases the causes or increases the risk or schizophrenia: excessive pruning of synapses - inadequate synapse formation,
  • intrauterine insults such as maternal exposure to toxins, viral agents, maternal substance use, maternal illness, maternal malnutrition, fetal oxygen deprivation,
  • first order relative (mom/dad)
    1. MRI or PET scan what is seen in schizophrenia: EVERYTHING DECREASES EXCEPT VENTRICLES
  • You will see VENTRICULAR ENLARGEMENT
    1. Stimulants can potentiate the release of what neurotransmitter?: Dopamine which can worsen symptoms of schizophrenia
    2. Assertive Community Treatment (ACT): a form of rehabilitation post hospitalization, in home treatment
    3. What level of prevention is ACT?: Tertiary
    4. What adjunctive treatment is important in schizophrenia: - social skills training - Exercise
    5. Exercise for mental health patients can promote: Cognition Quality of Life Long-term health
    6. ACT is ideal for patients with a history of: Treatment non-compliance
  1. If patient is unable to draw a clock this indicates: Problem with the right hemisphere, cerebrum, or parietal lobe
  2. mesolimbic pathway: Hyperactivity of dopamine in the this pathway mediates positive psychotic symptoms
  • Antagonism of D2 receptors in this pathway treats positive psychotic symptoms
  1. mesocortical pathway: - Decreased dopamine in the this projection to the dorsolateral prefrontal cortex is postulated to be responsible for negative and depressive symptoms of schizophrenia
  2. Nigrostriatal Pathway: - This pathway mediates motor movements
  • Dopamine blockade in this pathway can lead to increase acetylcholine levels
  • Blockade of dopamine (D2) receptors in this pathway can lead to EPS, i.e dystonia, parkinsonian symptoms and akathisia
  1. Low Dopamine in the nigrostriatal pathway increases which neurotransmitter: - Dopamine has a reciprocal relationship with acetylcholine (Ach) (LOW DOPAMINE INCREASE Ach)
  1. Long-standing D2 blockade in the nigrostriatal pathway can lead to: tardrive dyskinesia
  2. Tuberoinfundibular pathway: - Blockade of D2 receptors in this pathway can lead to increase prolactin levels leading to hyperprolactinemia which clinically manifests as amenorrhea, galactorrhea, and sexual dysfunction, gynecomastia
  • DECREASE DOPAMINE INCREASED PROLACTIN
  1. Long-term hyperprolactinemia can be associated with what condition: osteoporosis
  2. Normal Prolactin Level in Men: level less than 20ng/ml
  3. Normal Prolactin Level in Women: less than 25ng/ml
  4. Which medication is the highest offender for increasing prolactin: Risperdal
  5. Acute Dystonia + Treatment: neck stiffness, muscle spasm of upper body especially neck/face/tongue
  • Treatment is IM COGENTIN + continue PO COGENTIN for several days

CLOZARIL, Switch to different med, VINPAT

  1. Does Cogentin Treat TD: COGENTIN MAKES TD WORSE
  2. Typical onset of TD: OCCURS 1-2 years TYPICALLY, but can be ACUTE ONSET ALSO
  3. What non-psych med can cause TD?: REGLAN (Metoclopramide) can CAUSE Tardive Dyskinesia must educate patient that this med or the combination of this PLUS antipsychotic can increase risk of TD*** encourage them to discontinue reglan if TD develops
  4. InDucers CYP450: DECREASE Carbamazepine Rifampin Alcoholics (chronic) Phenytoin Grisiofulvin Phenobarb Sulphonylureas

Crap GPS Induces me to Madness!

  1. InhIbitors of CYP450: INCREASE Ciprofloxacin Ritonavir Amiodarone Cimetidine Ketoconazole Acute Etoh Macrolides INH Grapefruit Juice Omeprazole Crack Amigos
  2. Erythromycin and Clarithromycin can cause: Increased tegretol levels
  3. Patient started on Clozaril or Zyprexa and two months later starts smoking: as a provider you know that the smoking can decrease the medication effectiveness

Psychosis patient is taking flonase while on antipsychotic but you find that the antipsychotic is ineffective it is likely because the flonase is exacerbating psychosis

  • increase the dose of antipsychotic
  1. Neurotransmitters involved in Addiction: Dopamine and GABA

113 Symptoms of Stimulant Abuse: 1. agitation/aggression

  1. impaired judgment
  2. euphoria
  3. elevated BP
  4. tachycardia
  5. dilated pupils
  6. hallucinations
  7. TREMORS
  8. IMSOMNIA
  9. If an anorexic patient complains of pain or bloating after eating this may indicate: delayed gastric emptying
  10. Medications that delay gastric emptying: Omeprazole, ranitidine, famotidine 116. Proton Pump Inhibitors (omeprazole & Protonix): Decrease absorption of antipsychotics & SSRI
  • MUST WAIT TWO HOURS BEFORE TAKING ANTIPSYCHOTIC OR SSRI
  1. When initiating an SSRI on an elderly patient you should advise about: increased anxiety