PMHNP ANCC Final Exam Questions with
100% Correct Answers Updated 2025\2026
Top Rated
In forming a therapeutic relationship with clients, the PMHNP
must consider developing many characteristics that are
known to be helpful in relationship-building. Which of the
following is an essential part of building a therapeutic
relationship?
a. Collecting a family history
b. Like-mindedness
c. Authenticity
d. Accuracy in assessment
C. Authenticity. Being genuine, honest, and respectful are
essential elements in establishing a working relationship with any
client. Like-mindedness is not a part of the therapeutic
relationship. Although an important aspect of the PMHNP role,
collecting a family history and accuracy in assessment does not in
and of itself facilitate relationship building.
According to the DSM-5, which of the following is true? (Ch.
3)
a. A mental disorder is equivalent to the need for treatment.
b. Diagnostic criteria are used to inform clinical judgment.
c. Socially deviant behavior is considered a mental disorder.
d. A culturally expected response to a stressor is not a
mental disorder.
D. All DSM-5 disorders need to be made taking a person's culture
into account. A cultural expression of a response to grief, loss, or
stress is not considered a DSM-5 diagnosis.
Mrs. French has been in individual therapy for 3 months. She
has shown much growth and improvement in her functioning
and insight and is to discontinue services within the next few
,weeks. In the next session, after you discuss service
termination, she suddenly begins to demonstrate the original
symptoms that had brought her to treatment initially. She is
now hesitant to discharge, wants to continue services, and is
displaying an increase in regressive defense mechanisms.
What is the best explanation for Ms. French's behavior?
a. An exacerbation of her symptoms related to stress
b. The normal cyclic nature of chronic mental health
symptoms
c. A sign of normal resistance to termination seen in the
termination phase of therapy
d. A sign of pathological attachment to the therapist that
must be addressed
C. Clients frequently display resistance and regression at the
termination of a meaningful therapeutic process. The PMHNP is
responsible for planning an effective termination and monitoring
clients during the termination period.
A client is displaying low self-esteem, poor self-control, self-
doubt, and a high level of dependency. These behaviors
indicate developmental failure of which of the following
stages of development:
a. Infancy
b. Early childhood
c. Late childhood
d. School age
B. These signs indicate developmental failure of early childhood.
Mr. Thompson has been forgetful lately, for example,
forgetting where he has placed his keys or what time
appointments are scheduled, and he has stated that he
thinks these are just random behaviors that have no
particular meaning. Which Freudian-based psychodynamic
principle assumes that all behavior and actions are
purposeful?
a. Pleasure principle
b. Psychic determinism principle
,c. Reality principle
d. Unconsciousness principle
B. The psychic determinism principle states that all behavior has
purpose and meaning, often unconscious in nature, and that no
behaviors occur randomly or by coincidence.
An example of a mature, healthy defense mechanism is
a. Denial
b. Rationalization
c. Repression
d. Suppression
D. Suppression is the only defense mechanism listed in which the
client channels conflicting energies into growth-promoting
activities.
Mr. Johnson is a 54-year-old client you have been seeing for
several weeks in therapy. While discussing his current
concerns of marital stress, he lies on the floor and assumes
the fetal position. This is most likely an example of
a. Immature regressive defense mechanism
b. Denial of reality
c. Immature fantasy defense mechanism
d. Repressive behavior
A. Immature regressive defense mechanism is a return to a
behavior common to an earlier stage of development.
Defense mechanisms are best viewed as a function of the
ego
a. To alert us to harm and danger
b. To alert us to problems
c. Used to resolve a conflict
d. Used to protect the id
C. Defense mechanisms are a function of the ego used to resolve
a conflict.
One of the health care changes that has occurred as a result
of the affordable care act (ACA) is that
doctors/hospitals/clinic groups or health systems are coming
together and assuming the responsibility for quality care to
, large groups of individuals insured by Medicare. The health
care clinics/systems doctors or hospitals that join together
are called which of the following?
a. Health Maintenance Organization (HMO)
b. Preferred Provider Network (PPO)
c. Accountable Care Organization (ACO)
d. Individual Health Plan (IHP)
C. ACO's are groups of doctors or other health care providers
who voluntarily come together and assume the care provided to
Medicare patients.
Health care economics is concerned with making decisions
so the benefits outweigh the cost of resource utilization.
What are two concepts that healthcare economics is
concerned with in regard to fair distribution of resources and
allocation?
a. Equity and efficiency
b. Cost and benefits
c. Opportunity and waste
d. Affordable and quality
A. Health care efficiency is making risk and benefit decision about
how care resources are allocated and equity is ensuring that there
is a fair distribution of the resources.
What four elements need to be present for a malpractice
lawsuit to be filed?
a. Beneficence, Non-Maleficence, Truthfulness, and Justice
b. Duty of care, Breach of standard of care, Injury, and Injury
must be related to breach of the standard of care
c. Abandonment, Breach of care, Violation of ethics, and
Reimbursement for poor care
d. Breach of standard of care, Injury, Deceit, and Malpractice
B. The four elements that must be satisfied for malpractice to
have occurred are a duty of care between clinician and patient,
breach of standard of care, an injury to the patient, and the
patient's injury must be related to the clinician's breach of care.
100% Correct Answers Updated 2025\2026
Top Rated
In forming a therapeutic relationship with clients, the PMHNP
must consider developing many characteristics that are
known to be helpful in relationship-building. Which of the
following is an essential part of building a therapeutic
relationship?
a. Collecting a family history
b. Like-mindedness
c. Authenticity
d. Accuracy in assessment
C. Authenticity. Being genuine, honest, and respectful are
essential elements in establishing a working relationship with any
client. Like-mindedness is not a part of the therapeutic
relationship. Although an important aspect of the PMHNP role,
collecting a family history and accuracy in assessment does not in
and of itself facilitate relationship building.
According to the DSM-5, which of the following is true? (Ch.
3)
a. A mental disorder is equivalent to the need for treatment.
b. Diagnostic criteria are used to inform clinical judgment.
c. Socially deviant behavior is considered a mental disorder.
d. A culturally expected response to a stressor is not a
mental disorder.
D. All DSM-5 disorders need to be made taking a person's culture
into account. A cultural expression of a response to grief, loss, or
stress is not considered a DSM-5 diagnosis.
Mrs. French has been in individual therapy for 3 months. She
has shown much growth and improvement in her functioning
and insight and is to discontinue services within the next few
,weeks. In the next session, after you discuss service
termination, she suddenly begins to demonstrate the original
symptoms that had brought her to treatment initially. She is
now hesitant to discharge, wants to continue services, and is
displaying an increase in regressive defense mechanisms.
What is the best explanation for Ms. French's behavior?
a. An exacerbation of her symptoms related to stress
b. The normal cyclic nature of chronic mental health
symptoms
c. A sign of normal resistance to termination seen in the
termination phase of therapy
d. A sign of pathological attachment to the therapist that
must be addressed
C. Clients frequently display resistance and regression at the
termination of a meaningful therapeutic process. The PMHNP is
responsible for planning an effective termination and monitoring
clients during the termination period.
A client is displaying low self-esteem, poor self-control, self-
doubt, and a high level of dependency. These behaviors
indicate developmental failure of which of the following
stages of development:
a. Infancy
b. Early childhood
c. Late childhood
d. School age
B. These signs indicate developmental failure of early childhood.
Mr. Thompson has been forgetful lately, for example,
forgetting where he has placed his keys or what time
appointments are scheduled, and he has stated that he
thinks these are just random behaviors that have no
particular meaning. Which Freudian-based psychodynamic
principle assumes that all behavior and actions are
purposeful?
a. Pleasure principle
b. Psychic determinism principle
,c. Reality principle
d. Unconsciousness principle
B. The psychic determinism principle states that all behavior has
purpose and meaning, often unconscious in nature, and that no
behaviors occur randomly or by coincidence.
An example of a mature, healthy defense mechanism is
a. Denial
b. Rationalization
c. Repression
d. Suppression
D. Suppression is the only defense mechanism listed in which the
client channels conflicting energies into growth-promoting
activities.
Mr. Johnson is a 54-year-old client you have been seeing for
several weeks in therapy. While discussing his current
concerns of marital stress, he lies on the floor and assumes
the fetal position. This is most likely an example of
a. Immature regressive defense mechanism
b. Denial of reality
c. Immature fantasy defense mechanism
d. Repressive behavior
A. Immature regressive defense mechanism is a return to a
behavior common to an earlier stage of development.
Defense mechanisms are best viewed as a function of the
ego
a. To alert us to harm and danger
b. To alert us to problems
c. Used to resolve a conflict
d. Used to protect the id
C. Defense mechanisms are a function of the ego used to resolve
a conflict.
One of the health care changes that has occurred as a result
of the affordable care act (ACA) is that
doctors/hospitals/clinic groups or health systems are coming
together and assuming the responsibility for quality care to
, large groups of individuals insured by Medicare. The health
care clinics/systems doctors or hospitals that join together
are called which of the following?
a. Health Maintenance Organization (HMO)
b. Preferred Provider Network (PPO)
c. Accountable Care Organization (ACO)
d. Individual Health Plan (IHP)
C. ACO's are groups of doctors or other health care providers
who voluntarily come together and assume the care provided to
Medicare patients.
Health care economics is concerned with making decisions
so the benefits outweigh the cost of resource utilization.
What are two concepts that healthcare economics is
concerned with in regard to fair distribution of resources and
allocation?
a. Equity and efficiency
b. Cost and benefits
c. Opportunity and waste
d. Affordable and quality
A. Health care efficiency is making risk and benefit decision about
how care resources are allocated and equity is ensuring that there
is a fair distribution of the resources.
What four elements need to be present for a malpractice
lawsuit to be filed?
a. Beneficence, Non-Maleficence, Truthfulness, and Justice
b. Duty of care, Breach of standard of care, Injury, and Injury
must be related to breach of the standard of care
c. Abandonment, Breach of care, Violation of ethics, and
Reimbursement for poor care
d. Breach of standard of care, Injury, Deceit, and Malpractice
B. The four elements that must be satisfied for malpractice to
have occurred are a duty of care between clinician and patient,
breach of standard of care, an injury to the patient, and the
patient's injury must be related to the clinician's breach of care.
