PMHNP CERTIFICATION EXAM QUESTIONS
AND ANSWERS 2026 EXAM TEST PAPER
COMPLETE QUESTIONS AND ANSWERS
ALREADY PASSED
◉ Bipolar biological theories. Answer: -GABA deregulation
-increased noradrenergic activity
-voltage-gated ion channel abnormalities
-abnormalities lead to abnormal balances of intracellular and
extracellular levels of neurotransmitters, which then cause
subsequent disruption of electric signal transmission in brain
regions
-kinding
◉ kindling. Answer: -process of neuronal membrane threshold
sensitivity dysfunction
-long-lasting, epileptogenic changes induced by daily subthreshold
brain stimulation
-brain becomes overly sensitive to electrical stimuli
-neuronal misfiring occurs
-process becomes automatic; neuronal firing occurs even without
stimuli
,◉ Bipolar diagnostic criteria. Answer: -period of abnormally or
persistent elevated, expansive, or irritable mood lasting for at least 1
week
-mood episode has rapid development and escalation of symptoms
over a few days
-often precipitated by significant environmental stressor
-mood disturbance may result in brief psychotic symptoms
-manic episodes last days to several months
-briefer duration and ending more abruptly tan major depressive
episodes
-60% of people, a major depressive episode immediately precedes
or follows a manic episode
-persistent symptoms of mania
-recurrent shifts on polarity
-expansive or elevated mood symptoms
◉ Bipolar I. Answer: clinical history characterized by occurrence of
1 or more manic or mixed episodes
◉ Bipolar II. Answer: -Clinical hx characterized by occurrences of
one or more major depressive episodes accompanied by at least 1
manic or hypomanic episode
-recurrent shifts in polarity can occur more frequently-rapid cycling
,◉ rapid cycling. Answer: -occurrence of 4 or more mood episodes
during the previous 12 months
-mood episodes are either major depressive or manic
-other than occurring more frequently, mood episodes are same as
nonrapid-cycling episodes
-20% of people
-most are women
-identification is important
-antidepressants may accelerate cycling
-poorer prognosis
◉ mixed state. Answer: dysphoric hypomania
◉ lithium in BP. Answer: -gold standard for manic episodes
-antisucidial effects
-action unknown
-rapid cycling rarely responds to monotherapy
◉ baseline labs prior to lithium initiatin. Answer: -Thyroid
-Serum creatinine
-BUN
-Prego
, -ECG for pts over 50yo
◉ endocrine SE of lithium. Answer: weight gain
impaired thyroid functioning
◉ CNS SE of lithium. Answer: fine hand tremors
fatigue
mental cloudiness
headaches
coarse hand tremors with toxicity
nystagmus
◉ derm SE of lithium. Answer: maculopapular rash
pruritus
acne
◉ GI SE of lithium. Answer: GI upset
diarrhea
vomiting
cramps
anorexia
AND ANSWERS 2026 EXAM TEST PAPER
COMPLETE QUESTIONS AND ANSWERS
ALREADY PASSED
◉ Bipolar biological theories. Answer: -GABA deregulation
-increased noradrenergic activity
-voltage-gated ion channel abnormalities
-abnormalities lead to abnormal balances of intracellular and
extracellular levels of neurotransmitters, which then cause
subsequent disruption of electric signal transmission in brain
regions
-kinding
◉ kindling. Answer: -process of neuronal membrane threshold
sensitivity dysfunction
-long-lasting, epileptogenic changes induced by daily subthreshold
brain stimulation
-brain becomes overly sensitive to electrical stimuli
-neuronal misfiring occurs
-process becomes automatic; neuronal firing occurs even without
stimuli
,◉ Bipolar diagnostic criteria. Answer: -period of abnormally or
persistent elevated, expansive, or irritable mood lasting for at least 1
week
-mood episode has rapid development and escalation of symptoms
over a few days
-often precipitated by significant environmental stressor
-mood disturbance may result in brief psychotic symptoms
-manic episodes last days to several months
-briefer duration and ending more abruptly tan major depressive
episodes
-60% of people, a major depressive episode immediately precedes
or follows a manic episode
-persistent symptoms of mania
-recurrent shifts on polarity
-expansive or elevated mood symptoms
◉ Bipolar I. Answer: clinical history characterized by occurrence of
1 or more manic or mixed episodes
◉ Bipolar II. Answer: -Clinical hx characterized by occurrences of
one or more major depressive episodes accompanied by at least 1
manic or hypomanic episode
-recurrent shifts in polarity can occur more frequently-rapid cycling
,◉ rapid cycling. Answer: -occurrence of 4 or more mood episodes
during the previous 12 months
-mood episodes are either major depressive or manic
-other than occurring more frequently, mood episodes are same as
nonrapid-cycling episodes
-20% of people
-most are women
-identification is important
-antidepressants may accelerate cycling
-poorer prognosis
◉ mixed state. Answer: dysphoric hypomania
◉ lithium in BP. Answer: -gold standard for manic episodes
-antisucidial effects
-action unknown
-rapid cycling rarely responds to monotherapy
◉ baseline labs prior to lithium initiatin. Answer: -Thyroid
-Serum creatinine
-BUN
-Prego
, -ECG for pts over 50yo
◉ endocrine SE of lithium. Answer: weight gain
impaired thyroid functioning
◉ CNS SE of lithium. Answer: fine hand tremors
fatigue
mental cloudiness
headaches
coarse hand tremors with toxicity
nystagmus
◉ derm SE of lithium. Answer: maculopapular rash
pruritus
acne
◉ GI SE of lithium. Answer: GI upset
diarrhea
vomiting
cramps
anorexia
