2023 LMR Mental Health PMHNP Certification Review Exam With Answers (520 Solved Questions)

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LMR-Georgette's 2023 Qbank Georgette'sPMHNP Certification Exam Review; Latest2023Georgette'sLMRPMHNPCertificationExamReview,2023WhatdrugsshouldbeavoidedwithKavaKava?-AlprazolamCNSdepressants(e.g.,phenobarbital,zolpidem)Cultural Formulation Interview perform what 3 functions?-Clarify meaning ofillnessEmpowerthepatientValidatesymptomswithinculturalcontextWhatdoesaculturalformulationinterviewdo?-culturalassessmentWhatisthenormal rangeforTSH?-0.5-5.0mu/LWhat are lab values in Hyperthyroidism-Decreased TSHIncreased T4andT3What are labs in Hypothyroidism?-Increased TSHDecreased T4andT3What are 5 primary symptoms of Hyperthyroidism?-Heat intoleranceAgitation,Anxiety,IrritabilityTachycardiaMood swingsWeightloss

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What are 4 primary symptoms of Hypothyroidism?-Cold intoleranceLethargyWeight gainDecreasedlibidoHypothyroidismmimicssymptomsofwhatpsychiatricdisorder?-DepressionHyperthyroidismmimicssymptomsofwhatpsychiatricdisorder?-ManiaValproicacidproduceswhatteratogeniceffect?-Spinabifida(neuraltubedefect)Whatistheprimaryorganwherevalproicacidistoxic?-Liver(hepatoxicity)

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What are 4 signs of hepatoxicity?-Abdominal pain in the URQReddish-brown urineYellowingoftheskinandscleraFatigueAbdominal pain in the URQ, Reddish-brown urine, Yellowing of the skin and sclera,and Fatigue are signsof-HepatoxicityWhatisthetherapeuticrangeforvalproicacid?-50-125mcg/mlWhatisatoxiclevelofvalproicacid?->150mcg/mlWhat are 4 signs of valproic acid toxicity?-DisorientationLethargyRespiratory depressionNausea/vomitingDisorientation,Lethargy,Respiratorydepression,andNausea/vomitingaresymptomsoftoxicitywithwhatdrug?-Valproic acidWith suspected toxicity with valproic acid, what labs should be drawn?-DC drugCheck druglevelObtainLFTsObtainammonialevelWhatisthemajorsideeffect withKavaKava?-LiverdamageWhatherbalsupplementissuedforanxiety,stress,andinsomnia?-KavaKavaWhat are 5 symptoms of Stephen's Johnson Syndrome?-FeverBodyachesSevere red rashPeeling skinFacialandtongueswellingSevereredrash,Fever,Bodyaches,Peelingskin,and Facialandtongueswellingaresymptoms of-Stephen'sJohnsonSyndromeWhichmoodstabilizercausestheleastweightgain?-Lamotrigine(Lamictal)

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Which 3 SGAs cause the least weight gain?-Lurasidone (Latuda)Aripiprazole(Abilify)Ziprasidone(Geodon)WhichSGAistheleastsedating?-Aripiprazole(Abilify)What are 3 hallmark symptoms of delirium?-Acute disturbance of LOCimpaired cognitioninattentionAcute disturbance of LOC, cognition, and inattention are hallmark symptoms of-DeliriumHowareagitationandpsychoticsymptomstreatedindelirium?-LowdoseHaldolWhat 4 drugs can cause mania?-SteroidsDisulfiram(Antabuse)Isoniazid (INH)Antidepressants(inBPD)Steroids,Disulfiram(Antabuse),andIsoniazid(INH)caninduce-ManiaWhat 6 drugs can induce depression?-SteroidsBetablockersInterferon, Isotretinoin (Accutane)Retroviraldrugs,AntineoplasticdrugsBenzodiazepinesProgesteroneSteroids can induce what 3 psychiatric states?-ManiaDepressionPsychosisWhatmedicationtotreatacnecausecausebirthdefects?-Isotretinoin(Accutane)Whatisthetherapeuticrangeforlithium?-0.6-1.2mEq/LWhatmedicationhasaneuroprotectiveeffectforbipolardisorder?-LithiumWhatisthegoldstandardfortreatingmanicepisodes-Lithium

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Whatmoodstabilizerhasanti-suicidaleffects?-LithiumWhat5labsshouldbedrawnwithlithium?-Thyroidpanel(TSH)SerumcreatinineBUNUrinalysisHCGWhatisanormalSCrrange?-0.6-1.2mg/dLWhatisthenormal rangeforBUN?-10-20 mg/dLWhenshouldyoususpectkidneydiseasewithaurinalysis?-4+protein4+proteininthekidneysuggests-KidneydiseaseWhat are 7 side effects of lithium?-HypothyroidismFinehandtremorsMaculopapularrashGI upset (N/V/D, cramps, anorexia)Polyuria,polydipsia,diabetesinsipidusT-waveinversionsLeucocytosisWhat are 7 signs of lithium toxicity?-Severe nausea, vomiting, diarrheaConfusionDrowsinessMuscle weaknessHeartpalpitationsCoarsehandtremorUnsteadinesswhilestandingorwalkingWhich 3 drugs can increase lithium levels by decreasing renal clearance?-NSAIDs(ibuprofen,indomethacin)ThiazidesACEIWhatisatoxicleveloflithium?-1.5mEq/LorhigherAtwhatleveldoyoumonitorlithiumclosely(butnotdiscontinue)?-1.3mEq/Lorhigher

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Withsuspectedlithiumtoxicity,whatdoyoudofirst?-Lithiumlevel(notVS)What is the appropriate action if lithium level is 1.5 mEq/L?-DC lithiumCheck lithiumlevelWhat 2 conditions can increase lithium levels?-DehydrationHyponatremiaWhatbirth defect canlithiumcause?-Ebsteinanomaly(congenitalheartdefect)What3neurotransmittersareassociatedwithADHD?-DNSWhat 3 parts of the brain are affected with ADHD?-Frontal cortexBasal gangliaReticularActivatingSystemTheFrontalcortex,Basalganglia,ReticularActivatingSystemareassociatedwithwhich psychiatric disorder?-ADHDInattentive Type ADHD demonstrates abnormalities in which part of the brain?-PrefrontalcortexWhat should be done before placing a patient on stimulants for ADHD (priority)?-CardiachistoryExcessive worry, apprehension, or anxiety about events or activities that occurs moredays thannotforaperiodofatleast6 monthsis-GADIfapatientisreceivingHaldol5mgPObid,howmuchHaldolDecanoateshouldtheyreceive?-20x10 mg=200mg(qmonth)Whatistheformulaforconverting oralHaldoltodepotform?-20xdailydoseWhatdoesthoughtprocessassess?-thoughtsandideasThewayapatientorganizeshisthoughtsandideasiscalled-ThoughtprocessA normal thought process is described as-LogicalLinearCoherent

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Goal-orientedMoving from thought to thought and never getting to the point is called-Tangentiality("goesontangent")Providing unnecessary detail but eventually getting tothe point is called-Circumstantiality("goesincircles")Themes that occupy a patient's thoughts and perceptual disturbances is called-Thought contentThought content includes 3 items-Suicidal ideationHomicidalideationHallucinations/DelusionsAskingapatienttocountbackwardfrom100byseven(serial7s)measures3processes-ConcentrationAttentionCalculationAskingtheyear,season,date,month,andlocationmeasures-OrientationAskingapatienttorepeat"bed,bad,ball"measures-Registration(abilitytolearnnewmaterial)Askingapatienttorepeatobjects5minuteslatermeasures-Recall(memory)Asking the patient who is the president of the US or governor of state is measuring-Fundof KnowledgeWhatisasimpletestthatcanbeadministeredinaminuteortwotomeasurepossibledementia?-ClockDrawingTestImpairments in the clock drawingtest (CDT) can be associated with damage to-Right parietallobe (righthemisphere)Hyperactivity of dopamine in the mesolimbic pathway modulates-positive psychoticsymptomsDecreased dopamine in the mesocortical pathway (dorsolateral prefrontal cortex)leadstowhat2symptoms?-Negativesymptoms

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DepressivesymptomsThenigrostriatalpathwaymodulates-motormovementsDopaminehaswhattypeofrelationshipwithacetycholine-InverseDopamine blockage in the nigrostriatal pathway leads to what 4 side effects?-AcutedystoniaParkinsonismsyndromesAkathisiaTardivedyskinesiaBlockingthetuberoinfundibularpathwayleadsto-IncreasedprolactinWhat are 5 symptoms of hyperprolactinemia?-AmenorrheaGalactorrheaSexual dysfunctionGynecomastiaOsteoporosis(Long-term)Whatantipsychotichasthegreatesteffectonprolactin?-RisperidoneWhatistheblackboxwarningforcarbamazepine?-AgranulocytosisWhat are 8 symptoms of aplastic anemia?-PallorFatigueHeadacheFeverNosebleedsBleedinggumsSkin rashSOBPallor,Fatigue,Headache,Fever,Nosebleeds,Bleedinggums,Skinrash,andSOBaresymptomsof-AplasticanemiaWhatethnicgroupismostsusceptibletoSJSwithcarbamazepine?-AsiansHavingtheHLA-B*1502 alleleincreasestheriskfor-SJSWhichethicgroup isatmost likelyto havetheHLA-B*1502 allele?-Asians

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Asiansaremostlikelytohavewhatallele?-HLA-B*1502In which ethnic group must you screen for the HLA-B*1502 allele before initiatingtherapy?-AsianWhich 2 drugs have the highest likelihood of causing agranulocytosis?-ClozarilCarbamazepineA sudden fever, chills, a sore throat, and weakness are symptoms of-AgranulocytosisWhat are 4 symptoms of agranulocytosis-A sudden feverChillsSore throatWeaknessAtwhatANCshouldclozapinebestopped(evenifasymptomatic)?-<1000Whatisneutropenia?-<2000PMNsWhatisagranulocytosis?-<500ANCWhat does DIGFAST stand for?-DistractibilityIndiscretionGrandiosityFOIActivity increasedSleep decreasedTalkativenessWhat are 5 neurological symptoms in Conversion Disorder?-BlindnessMutismParalysisParesthesia(glovestockingsyndrome)SeizuresWhen do symptoms typically begin with Conversion Disorder?-After a stressfulexperience(suddenly)

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What are 5 stressful events in a child's life that can cause adjustment disorder?-FamilymoveParentdivorce/separationLoss ofpetBirthofsiblingSuddenorchronicillnessA child with an Adjustment Disorder with disturbances of conduct may have whatsymptoms?-Notgoingtoschool,destroyingproperty,drivingrecklessly,orfightingWhat is the required duration of behavior for a DSM-5 diagnosis of OppositionalDefiant Disorder (ODD)?-6 monthsHow many symptoms must a child with Oppositional Defiant Disorder (ODD)displaytomeetDSM-5criteria?-4An enduring pattern of angry or irritable mood and argumentative, defiant, orvindictivebehaviorischaracteristicof-OppositionalDefiantDisorder(ODD)WhatisthemainstaytreatmentofOppositionalDefiantDisorder(ODD)?-TherapyWhat is the primary therapy used to treat Oppositional Defiant Disorder (ODD)?-Child andparentproblem-solving skillstrainingA repetitive and persistent pattern of behavior in which the rights of others or societalnorms orrules areviolatedis what disorder?-ConductDisorderWhat are 3 characteristics of Conduct Disorder?-Destruction of propertyDeceit ortheftLackofremorseWhat 2 factors differentiate Conduct Disorder from ODD?-SeverityAggressionWhat are 4 pharmacologic treatments for Conduct Disorder?-AntipsychoticsMoodstabilizersSSRIsAlphaagonistsWhatisthemainstaytreatmentforConductDisorder?-Therapy

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WhattypeoftherapyisusedinthetreatmentofConductDisorder?-BehavioraltherapyWhat is Multisystemic family therapy?-Home-based model for youth with seriousantisocialandcriminaloffensesbyempoweringparentswithresourcesandskillsandreducing barriersto resourcesneeded for effectivemanagementofyouthWhat is the goal of multisystemic family therapy (MFT)?-Reduce barriers toresources for youth withproblematicbehaviorWhat type of therapy target's youth who present with serious antisocial behavior?-MultisystemicfamilytherapyWhat isthemoderaterange forMMSE-10-20WhatisthemoderaterangeforSLUM?-10-20What isthemoderaterangeforHAM-D?-14-18What isthemoderaterangeforPHQ-9-10-14What isthemoderaterangeforBDI?-19-29What isthemoderaterangeforHAM-A?-18-24What isthemoderaterangefor GAD-7-10-14WhatisthemoderaterangeforCOWS?-13-24Ifapatient'sCOWSscoreisbetween5-12,whatdoyoudo?-AdministerclonidineIf a patient's COWS score is between 13-24, what do you do?-Administerbuprenorphine(Suboxone)WhendoyouadministerclonidineontheCOWS?-mildsymptoms(>7)When do you administer buprenorphine (Suboxone) on the COWS?-moderatesymptoms (13-24)WhatisamoderaterangeontheCIWA?-16-20

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When do you administer prn benzodiazepine on the CIWA?-Mild symptoms (8 orgreater)When do you administer scheduled benzodiazepine on the CIWA?-moderatesymptoms (15orhigher)If a patient has severe depression (over 18 on HAM-D) (over 14 on PHQ-9)(over 29on BDI),howdoyoutreatit?-Medicationand/ortherapyAssessforsuicidalideationIf a patient has moderate depression (14-18 on HAM-D) (10-14 on PHQ-9) (19-29onBDI),howdoyou treatit?-Medicationand/ortherapyIf a patient has mild depression (<14 on HAM-D) (<10 on PHQ-9) (<19 on BDI),howdoyoutreatit?-TherapyornothingIf a patient has mild anxiety (<18 on HAM-A) (<10 on GAD-7), how do you treat?-Therapyor nothingIf a patient has severe anxiety (>24 on HAM-A) (>14 on GAD-7) how do you treat?-Medication and/ortherapyIf a patient has moderate anxiety (18-24 on HAM-A) (10-14 on GAD-7) how doyou treatit?-Medicationand/ortherapyWhatare4areasinthebrainthatcancauseaggression,impulsivity,anddifficultywith abstractthinking?-PrefrontalcortexAmygdalaBasal gangliaHippocampusAbnormalitiesinthePrefrontalcortex,Amygdala,Basalganglia,andHippocampuscan causewhat 3symptoms?-AggressionImpulsivityDifficultywithabstractthinkingWhat are 6 symptoms of NMS?-Extreme muscular rigidityMutismElevated CPK (creatine phosphokinase)MyoglobinuriaLeukocytosis

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ElevatedLFTsExtrememuscularrigidity,Mutism,ElevatedCPK(creatinephosphokinase),Myoglobinuria,Leukocytosis,andElevatedLFTsaresymptomsof-NMSWhat are 2 symptoms of Serotonin Syndrome?-HyperreflexiaMyoclonicjerksHyperreflexiaandmyoclonicjerksaresymptomsof-SerotoninSyndromeHow do you treat NMS?-DC antipsychoticBromocriptineorDantroleneWhatdoesDantrolenetreatinNMS?-MusclerigidityHow do you treat Serotonin Syndrome?-DC AntidepressantCyproheptadineWhat combination medications increases the risk of Serotonin Syndrome-multipleantidepressants (SSRI/SNRI/TCA/MOAI)WhenswitchingfromanMAOItoSSRI/SNRI,howlongshould youwait?-2 weeksWhenswitching fromProzactoan MAOI,howlongshould youwait?-5-6 weeksWhenswitching fromProzactoanyantidepressant (TCA,SNRA,orMAOI),howlong shouldyouwait?-5-6weeksWhen switching from an SSRI/SNRI to a MAOI, how long should you wait?-2weeksWhatisthefunctionofcompulsionsinOCD?-ReducesubjectiveanxietylevelWhatisPANDAS?-PediatricAutoimmuneNeuropsychiatricDisorderassociatedwith streptococcalinfections inchildrenIfachildhasbothintrusivethoughtsandtics,hismostlikelydiagnosisis-OCDIf a child has multiple tics both no ruminating thoughts, his diagnosis is most likely-Tourette's

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What 2 neurotransmitters are associated with OCD?-SerotoninNorepinephrineAchildhooddepressivedisorderthatisdiagnosedinchildrenolderthan6butyoungerthan18is mostlikely-DMDDAchildwithchronicdysregulatedmood("mood"),frequentintensetemperoutbursts,severeirritability,and angeris mostlikelytohavewhatdiagnosis?-DMDDThe age criteria for a DSM-5 diagnosis of Disruptive Mood Dysregulation Disorder(DMDD)is->6and<18(7-17yrs.)Achildwhoischronically"moody"ismostlikelytohavewhatdiagnosis?-DMDDWhat are 2 symptoms associated with lead poisoning?-Developmental delay(learning difficulties)Pica (paint chips)alsogastrointestinalWhich 2 demographic characteristics are associated with lead poisoning?-rural areas1970'sA child with developmental delay who eats things (such as paint chips) may have-Lead poisoningWhat4assessmentsshouldbedoneinapatientreceivinganantipsychoticthatcausesweightgain?-BMIHip-to-waist ratioGlucoseLipidpanelWhere is norepinephrine produced?-Locus coeruleusMedullaryreticular formationTheneurotransmitterproducedinthelocuscoeruleusandmedullaryreticularformation is-NorepinephrineWhat neurotransmitter is produced in the raphe nuclei in the brainstem?-SerotoninSerotoninisproducedin-raphenucleiinthebrainstem

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Whatneurotransmitterisproducedinthesubstantianigra,theventraltegmentalarea(VTA),andthe nucleus accumbens?-DopamineWhat 3 areas of the brain is dopamine produced?-Substantia nigraVentraltegmentalarea (VTA)NucleusAccumbensWhereisacetylcholinesynthesized?-BasalnucleusofMeynertThe Basal nucleus of Meynert is the area where what neurotransmitter is produced?-AcetycholineWhatisthefunctionoftheamygdala?-Emotions(aggression,fear,anxiety)Emotions (aggression, fear, and anxiety) originate from what area of the brain?-AmygdalaWhat are 4 functions of the hippocampus?-EmotionsStressLearningMemoryEmotions, stress, learning, and memory are functions of what structure of the brain?-HippocampusWhatdisorderisassociatedwithpersistentdeficitsinsocialcommunicationandsocialinteractionsacrossmultiplesettings?-AutismSpectrumDisorderWhat 3 neurotransmitters are associated with Autism Spectrum Disorder?-GlutamateGABASerotoninA child who does not respond when called by name may have-AutismAchildthathaslittleor no eye contactmayhave-AutismAchild wholikes to lineup,stack,ororganizeobjectsandtoysinontidyrowsmayhave-Autism

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