LMR GEORGETTE’S PMHNP CERTIFICATION EXAM ACTUAL EXAM 2026 | ALL
QUESTIONS AND CORRECT ANSWERS | ALREADY GRADED A+ | VERIFIED
ANSWERS | BRAND NEW VERSION!
Question 1
A parent calls the Psychiatric-Mental Health Nurse Practitioner (PMHNP) stating that their 5-
year-old child was raped by their 15-year-old brother. Which set of actions represents the most
appropriate immediate response?
A) Call the police, prescribe anxiolytics for the child, and refer to long-term play therapy.
B) Educate the parent to not leave the child alone with the brother, report the incident to Child
Protective Services (CPS), and initiate crisis therapy.
C) Immediately hospitalize the 15-year-old, call the police, and provide the parent with literature
on sibling rivalry.
D) Schedule an intake appointment for the following week, advise the parent to keep the siblings
separate, and monitor for symptoms of PTSD.
E) Conduct a forensic interview over the phone, call the local district attorney, and advise the
family to seek legal counsel.
Correct Answer: B) Educate the parent to not leave the child alone with the brother, report
the incident to Child Protective Services (CPS), and initiate crisis therapy.
Rationale: The priority in cases of suspected child abuse or sexual assault is the immediate
safety of the victim and the fulfillment of legal reporting mandates. The PMHNP must
ensure the child is no longer in a vulnerable position with the perpetrator (the brother). As
a mandated reporter, a call to CPS is required by law. Crisis therapy is the appropriate
immediate psychological intervention to stabilize the family and the victim during the acute
phase of trauma.
Question 2
When evaluating a patient with a confirmed diagnosis of Rheumatoid Arthritis who is presenting
with new-onset psychiatric symptoms, which laboratory value should the PMHNP prioritize to
monitor systemic inflammation?
A) Thyroid Stimulating Hormone (TSH)
B) Erythrocyte Sedimentation Rate (ESR)
C) Complete Blood Count (CBC)
, 2
D) Serum Creatinine
E) Liver Function Tests (LFTs)
Correct Answer: B) Erythrocyte Sedimentation Rate (ESR)
Rationale: Rheumatoid Arthritis is a systemic inflammatory autoimmune disorder. The
Erythrocyte Sedimentation Rate (ESR) is a non-specific marker of inflammation in the
body. Psychiatric symptoms can sometimes be exacerbated by systemic inflammation or
"cytokine storms" associated with autoimmune flares. Monitoring the ESR helps the
PMHNP understand the patient's current inflammatory burden, which may influence
treatment decisions regarding both physical and mental health.
Question 3
In the evidence-based practice framework known as PICOT, what does the "C" represent?
A) Context of the clinical setting
B) Control group demographics
C) Comparison intervention
D) Clinical significance of findings
E) Case-controlled study design
Correct Answer: C) Comparison intervention
Rationale: PICOT is a mnemonic used to derive a searchable clinical question. It stands for
Population (P), Intervention (I), Comparison intervention (C), Outcome (O), and Time (T).
The "C" is essential because evidence-based practice requires weighing a new or proposed
intervention against the current standard of care or an alternative treatment to determine
which provides the best outcome.
Question 4
When reviewing the hierarchy of evidence for clinical decision-making, which of the following
is considered the "Gold Standard" or Level I evidence?
A) Expert opinion and clinical case reports
B) Systematic review or meta-analysis of all relevant Randomized Controlled Trials (RCTs)
C) Single well-designed descriptive or qualitative studies
, 3
D) Case-control or cohort studies
E) Evidence from a single randomized controlled trial
Correct Answer: B) Systematic review or meta-analysis of all relevant Randomized
Controlled Trials (RCTs)
Rationale: The hierarchy of evidence places systematic reviews and meta-analyses at the
top (Level I) because they synthesize the data from multiple high-quality studies (RCTs),
providing the most robust and least biased information. A single RCT is typically
considered Level II evidence. As the hierarchy descends, the potential for bias increases
and the strength of the recommendation decreases.
Question 5
What is the most effective way for a PMHNP to promote and integrate evidence-based research
into their daily clinical practice?
A) Relying solely on the prescribing habits of senior colleagues
B) Attending pharmaceutical dinners to learn about new medications
C) Ensuring consistent access to current peer-reviewed journals and databases
D) Using the same treatment protocols learned during initial nursing school
E) Implementing only the most expensive new technologies as they arrive
Correct Answer: C) Have access to current journals
Rationale: To practice evidence-based medicine, a clinician must be able to find, appraise,
and apply the most recent findings in the field. Having access to current journals ensures
that the PMHNP is informed about new treatment guidelines, drug safety updates, and
emerging therapeutic modalities. This prevents clinical stagnation and ensures patients
receive the highest standard of care.
Question 6
During the assessment of an infant, the PMHNP notes a "shrill, high-pitched cry." What
underlying physiological concern does this specific finding typically indicate?
A) Normal hunger response
B) Severe abdominal colic
C) Increased intracranial pressure
, 4
D) Onset of an ear infection
E) Developmental delay in vocalization
Correct Answer: C) Increased intracranial pressure
Rationale: A shrill, high-pitched cry in an infant is a classic neurological "red flag." It is
frequently associated with increased intracranial pressure (ICP), which can be caused by
meningitis, hydrocephalus, or traumatic brain injury. This finding requires an immediate
referral for neurological evaluation and potential imaging.
Question 7
A parent expresses concern that their 4-year-old child has been observed masturbating. Based on
Freudian developmental theory, how should the PMHNP respond?
A) Diagnose the child with early-onset paraphilia
B) Inform the parent that this is a sign of severe trauma and call CPS
C) Explain that this is normal behavior for the Phallic Stage of development
D) Advise the parent to use punitive measures to stop the behavior
E) Refer the child for an immediate brain scan to rule out a tumor
Correct Answer: C) Normal. This is the phallic stage
Rationale: In Freud’s psychosexual stages, children aged 3 to 6 years are in the Phallic
Stage. During this time, children become aware of their bodies and the differences between
genders. Masturbation or self-touching is considered a normal part of developmental
exploration during this stage. The PMHNP should provide parental education and
reassurance rather than pathologizing the behavior.
Question 8
A 12-year-old boy presents with tenderness, slight swelling, and enlargement of the breast tissue.
He is distressed by this change. What is the most appropriate education for the patient and his
parents?
A) He requires immediate hormonal replacement therapy
B) This is a common sign of a pituitary adenoma
C) This is a normal developmental occurrence that typically resolves within 6 months
QUESTIONS AND CORRECT ANSWERS | ALREADY GRADED A+ | VERIFIED
ANSWERS | BRAND NEW VERSION!
Question 1
A parent calls the Psychiatric-Mental Health Nurse Practitioner (PMHNP) stating that their 5-
year-old child was raped by their 15-year-old brother. Which set of actions represents the most
appropriate immediate response?
A) Call the police, prescribe anxiolytics for the child, and refer to long-term play therapy.
B) Educate the parent to not leave the child alone with the brother, report the incident to Child
Protective Services (CPS), and initiate crisis therapy.
C) Immediately hospitalize the 15-year-old, call the police, and provide the parent with literature
on sibling rivalry.
D) Schedule an intake appointment for the following week, advise the parent to keep the siblings
separate, and monitor for symptoms of PTSD.
E) Conduct a forensic interview over the phone, call the local district attorney, and advise the
family to seek legal counsel.
Correct Answer: B) Educate the parent to not leave the child alone with the brother, report
the incident to Child Protective Services (CPS), and initiate crisis therapy.
Rationale: The priority in cases of suspected child abuse or sexual assault is the immediate
safety of the victim and the fulfillment of legal reporting mandates. The PMHNP must
ensure the child is no longer in a vulnerable position with the perpetrator (the brother). As
a mandated reporter, a call to CPS is required by law. Crisis therapy is the appropriate
immediate psychological intervention to stabilize the family and the victim during the acute
phase of trauma.
Question 2
When evaluating a patient with a confirmed diagnosis of Rheumatoid Arthritis who is presenting
with new-onset psychiatric symptoms, which laboratory value should the PMHNP prioritize to
monitor systemic inflammation?
A) Thyroid Stimulating Hormone (TSH)
B) Erythrocyte Sedimentation Rate (ESR)
C) Complete Blood Count (CBC)
, 2
D) Serum Creatinine
E) Liver Function Tests (LFTs)
Correct Answer: B) Erythrocyte Sedimentation Rate (ESR)
Rationale: Rheumatoid Arthritis is a systemic inflammatory autoimmune disorder. The
Erythrocyte Sedimentation Rate (ESR) is a non-specific marker of inflammation in the
body. Psychiatric symptoms can sometimes be exacerbated by systemic inflammation or
"cytokine storms" associated with autoimmune flares. Monitoring the ESR helps the
PMHNP understand the patient's current inflammatory burden, which may influence
treatment decisions regarding both physical and mental health.
Question 3
In the evidence-based practice framework known as PICOT, what does the "C" represent?
A) Context of the clinical setting
B) Control group demographics
C) Comparison intervention
D) Clinical significance of findings
E) Case-controlled study design
Correct Answer: C) Comparison intervention
Rationale: PICOT is a mnemonic used to derive a searchable clinical question. It stands for
Population (P), Intervention (I), Comparison intervention (C), Outcome (O), and Time (T).
The "C" is essential because evidence-based practice requires weighing a new or proposed
intervention against the current standard of care or an alternative treatment to determine
which provides the best outcome.
Question 4
When reviewing the hierarchy of evidence for clinical decision-making, which of the following
is considered the "Gold Standard" or Level I evidence?
A) Expert opinion and clinical case reports
B) Systematic review or meta-analysis of all relevant Randomized Controlled Trials (RCTs)
C) Single well-designed descriptive or qualitative studies
, 3
D) Case-control or cohort studies
E) Evidence from a single randomized controlled trial
Correct Answer: B) Systematic review or meta-analysis of all relevant Randomized
Controlled Trials (RCTs)
Rationale: The hierarchy of evidence places systematic reviews and meta-analyses at the
top (Level I) because they synthesize the data from multiple high-quality studies (RCTs),
providing the most robust and least biased information. A single RCT is typically
considered Level II evidence. As the hierarchy descends, the potential for bias increases
and the strength of the recommendation decreases.
Question 5
What is the most effective way for a PMHNP to promote and integrate evidence-based research
into their daily clinical practice?
A) Relying solely on the prescribing habits of senior colleagues
B) Attending pharmaceutical dinners to learn about new medications
C) Ensuring consistent access to current peer-reviewed journals and databases
D) Using the same treatment protocols learned during initial nursing school
E) Implementing only the most expensive new technologies as they arrive
Correct Answer: C) Have access to current journals
Rationale: To practice evidence-based medicine, a clinician must be able to find, appraise,
and apply the most recent findings in the field. Having access to current journals ensures
that the PMHNP is informed about new treatment guidelines, drug safety updates, and
emerging therapeutic modalities. This prevents clinical stagnation and ensures patients
receive the highest standard of care.
Question 6
During the assessment of an infant, the PMHNP notes a "shrill, high-pitched cry." What
underlying physiological concern does this specific finding typically indicate?
A) Normal hunger response
B) Severe abdominal colic
C) Increased intracranial pressure
, 4
D) Onset of an ear infection
E) Developmental delay in vocalization
Correct Answer: C) Increased intracranial pressure
Rationale: A shrill, high-pitched cry in an infant is a classic neurological "red flag." It is
frequently associated with increased intracranial pressure (ICP), which can be caused by
meningitis, hydrocephalus, or traumatic brain injury. This finding requires an immediate
referral for neurological evaluation and potential imaging.
Question 7
A parent expresses concern that their 4-year-old child has been observed masturbating. Based on
Freudian developmental theory, how should the PMHNP respond?
A) Diagnose the child with early-onset paraphilia
B) Inform the parent that this is a sign of severe trauma and call CPS
C) Explain that this is normal behavior for the Phallic Stage of development
D) Advise the parent to use punitive measures to stop the behavior
E) Refer the child for an immediate brain scan to rule out a tumor
Correct Answer: C) Normal. This is the phallic stage
Rationale: In Freud’s psychosexual stages, children aged 3 to 6 years are in the Phallic
Stage. During this time, children become aware of their bodies and the differences between
genders. Masturbation or self-touching is considered a normal part of developmental
exploration during this stage. The PMHNP should provide parental education and
reassurance rather than pathologizing the behavior.
Question 8
A 12-year-old boy presents with tenderness, slight swelling, and enlargement of the breast tissue.
He is distressed by this change. What is the most appropriate education for the patient and his
parents?
A) He requires immediate hormonal replacement therapy
B) This is a common sign of a pituitary adenoma
C) This is a normal developmental occurrence that typically resolves within 6 months
