PMHNP Across the
Lifespan 8th Edition:
Key Concepts and
Exam Questions and
Answers Updated
2026
0
, lOMoAR cPSD| 64664050
PMHNP ACROSSS THE LIFESPAN 8TH EDITION
TABLE OF CONTENT:
I. Psychotherapy and Related Theories
II. Schizophrenia Spectrum and Other Psychotic Disorders
III. Scientific Foundation
IV. Sexual and Gender Disorders
V. Sleep-wake Disorders
VI. Somatic Symptom and Related Disorders
VII. Substance-Related and Addictive Disorders
VIII. Theory and Practice
IX. Trauma- and Stressor-Related Disorders
X. Young Adult/AduQuestion: 1
An NP is considering treatment options for an older adult diagnosed with depression. Which of
the following antidepressant classes is least likely to cause significant side effects in this
population, making it the first line treatment option?
A. Serotonin-norepinephrine reuptake inhibitors (SNRIs)
B. Tricyclic and tetracyclic antidepressants (TCAs)
C. Selective serotonin reuptake inhibitors (SSRIs)
D. Monoamine oxidase inhibitors (MAOIs)
Answer: C
Rationale: SSRIs are generally preferred for treating depression in older adults due to their
favorable side effect profile and lower toxicity compared to TCAs and MAOIs. TCAs (B) carry
risks of anticholinergic effects and cardiac toxicity. MAOIs (D) have dietary restrictions and
hypertensive crisis risks. SNRIs (A) are effective but may raise blood pressure, warranting
caution.
Question: 2
An adult patient presents to the clinic 6 months after having their third child. The child was
born with fetal alcohol spectrum disorder. Which of the following is the most likely risk
factor for substance use during pregnancy? A. Initiation of prenatal care at 8 weeks
gestation
B. Pregnancy associated with second marriage
C. Prior obstetric history of abruptio placentae
D. Advanced maternal age
Answer: B
Rationale: Substance use during pregnancy is strongly associated with psychosocial stressors,
including complex family dynamics such as second marriages. These changes may increase
stress and risk-taking behaviors like alcohol use. Early prenatal care (A) is protective, while prior
abruptio placentae (C) and advanced maternal age (D) are less directly linked to prenatal
substance use risk.
Question: 3
An NP is managing an adult patient with a history of bipolar disorder who is taking lithium
(Lithobid). Which of the following is a potential complication associated with this medication?
A. Weight loss
B. Polyuria
C. Myocarditis
D. Constipation
Answer: B
Rationale: Lithium commonly causes nephrogenic diabetes insipidus, leading to polyuria due to
impaired kidney response to antidiuretic hormone. This side effect can lead to excessive
Downloaded by Weykey Pinn ()
, lOMoAR cPSD| 64664050
urination and thirst. Weight loss, myocarditis, and constipation are not typical lithium-
associated complications. Monitoring kidney function and fluid balance is essential in patients
on lithium therapy.
Question: 4
A PMHNP is caring for a patient who is prescribed gabapentin (Neurontin). Which of the
following is the most accurate statement about this medication?
A. Taking gabapentin (Neurontin) with antacids increases its bioavailability.
B. Somnolence and dizziness are common side effects of gabapentin (Neurontin).
C. Gabapentin (Neurontin) is metabolized by the liver.
D. Gabapentin (Neurontin) is a cytochrome P450 inhibitor.
Answer: B
Rationale: Gabapentin commonly causes central nervous system side effects such as
somnolence and dizziness, affecting patient alertness and balance. It is not metabolized by the
liver but excreted unchanged by the kidneys, minimizing hepatic drug interactions. Antacids can
reduce, not increase, gabapentin’s absorption. It neither inhibits nor induces cytochrome P450
enzymes.
Question: 5
A young adult patient presents to the emergency department with new-onset paranoia and
auditory hallucinations. The patient has no prior medical or psychiatric history. They are
scheduled to travel to sub-Saharan Africa with the Peace Corps next week and were preparing
for this trip before symptom onset. The patient’s family states that they began "acting this way"
a few days ago. What is the most likely cause of the psychotic symptoms?
A. New-onset schizophrenia
B. Acute stress disorder (reaction to upcoming travel)
C. Malingering
D. Adverse reaction to malaria medication
Answer: D
Rationale: Certain antimalarial drugs, such as mefloquine, are well-documented to cause
neuropsychiatric side effects including paranoia, hallucinations, and psychosis, particularly
shortly after initiation. The timing coinciding with preparation for travel to an endemic area
supports this. New-onset schizophrenia is less likely given the acute onset and contextual
factors, while acute stress disorder typically lacks frank psychosis. Malingering would imply
intentional symptom fabrication, which is less likely without external gain.
Question: 6
An adult patient presents with a history of slurred and slow speech for the last four months.
The patient reports dry skin and hair loss, along with a depressed mood and lethargy. Which of
the following is the most likely diagnosis?
A. Addison’s disease
B. Cushing syndrome
C. Hyperaldosteronism
D. Hypothyroidism
Answer: D
Rationale: Hypothyroidism commonly presents with symptoms such as slowed speech, dry skin,
hair thinning or loss, fatigue, lethargy, and depressed mood. These signs result from decreased
thyroid hormone levels affecting metabolism and neurological function. Addison’s disease and
hyperaldosteronism typically cause electrolyte disturbances without these symptoms, while
Cushing syndrome presents with weight gain and hypertension.
Question: 7
An NP is caring for a child with a caregiver who smokes. The child seems to experience more
frequent upper respiratory infections. The NP concludes that all children exposed to
secondhand smoke will likely develop frequent respiratory infections. What type of reasoning is
the NP employing in this situation?
A. Inferential
B. Inductive
C. Deductive
D. Experimental
Answer: B
Rationale: Inductive reasoning involves drawing a general conclusion based on specific
observations or cases. Here, the NP observes one child exposed to secondhand smoke with
Downloaded by Weykey Pinn ()
, lOMoAR cPSD| 64664050
frequent infections and generalizes this to all children similarly exposed. Deductive reasoning
would start with a general principle and apply it to a specific case, which is not happening here.
Question: 8
Which of the following is a standard of professional performance for all psychiatric-mental
health nurses?
A. Billing and coding
B. Political party advocacy
C. Professional collaboration
D. Delegation and justice
Answer: C
Rationale: Professional collaboration is a core standard of practice for psychiatric-mental health
nurses, emphasizing interdisciplinary teamwork to optimize patient care. It entails effective
communication and cooperation with healthcare providers and community resources. Billing,
political advocacy, and delegation, while relevant in some contexts, are not universal
professional performance standards across psychiatric nursing.
Question: 9
The use of medication during pregnancy can carry risks to the fetus. Which of the following is
the most likely potential neonatal risk associated with the use of duloxetine (Cymbalta), a
serotonin norepinephrine reuptake inhibitor (SNRI) during the third trimester of pregnancy?
A. Pregnancy loss or miscarriage
B. Organ malformation or teratogenesis
C. Gestational diabetes
D. Poor neonatal adaptation syndrome
Answer: D
Rationale: Use of duloxetine during the third trimester can lead to poor neonatal adaptation
syndrome, characterized by respiratory distress, jitteriness, feeding difficulties, and irritability
due to withdrawal or toxicity. Unlike first-trimester exposures linked with teratogenicity, third-
trimester SNRI exposure primarily risks transient neonatal symptoms, requiring monitoring but
generally not permanent damage.
Question: 10
An NP is prescribing galantamine (Razadyne) which is approved for the treatment of mild to
moderate Alzheimer’s disease. What is the primary mechanism of action of this medication?
A. Monoamine oxidase inhibitor (MAOI)
B. N-methyl-D-aspartate (NMDA) receptor antagonist
C. Competitive inhibitor of acetylcholinesterase
D. Selective serotonin reuptake inhibitor (SSRI)
Answer: C
Rationale: Galantamine is a reversible, competitive inhibitor of acetylcholinesterase, which
increases acetylcholine levels by preventing its breakdown. This enhancement of cholinergic
transmission is beneficial in treating cognitive symptoms of mild to moderate Alzheimer’s
disease. It also modulates nicotinic receptors, improving neurotransmission and cognitive
function.
Question: 11
Which of the following medications has a box warning related to an increased risk of liver
failure?
A. Fluoxetine (Prozac)
B. Mirtazapine (Remeron)
C. Nefazodone (Serzone)
D. Fluvoxamine (Luvox)
Answer: C
Rationale: Nefazodone carries a black box warning due to its association with severe
hepatotoxicity and potential liver failure. Though effective as an antidepressant, its use has
Downloaded by Weykey Pinn ()
Lifespan 8th Edition:
Key Concepts and
Exam Questions and
Answers Updated
2026
0
, lOMoAR cPSD| 64664050
PMHNP ACROSSS THE LIFESPAN 8TH EDITION
TABLE OF CONTENT:
I. Psychotherapy and Related Theories
II. Schizophrenia Spectrum and Other Psychotic Disorders
III. Scientific Foundation
IV. Sexual and Gender Disorders
V. Sleep-wake Disorders
VI. Somatic Symptom and Related Disorders
VII. Substance-Related and Addictive Disorders
VIII. Theory and Practice
IX. Trauma- and Stressor-Related Disorders
X. Young Adult/AduQuestion: 1
An NP is considering treatment options for an older adult diagnosed with depression. Which of
the following antidepressant classes is least likely to cause significant side effects in this
population, making it the first line treatment option?
A. Serotonin-norepinephrine reuptake inhibitors (SNRIs)
B. Tricyclic and tetracyclic antidepressants (TCAs)
C. Selective serotonin reuptake inhibitors (SSRIs)
D. Monoamine oxidase inhibitors (MAOIs)
Answer: C
Rationale: SSRIs are generally preferred for treating depression in older adults due to their
favorable side effect profile and lower toxicity compared to TCAs and MAOIs. TCAs (B) carry
risks of anticholinergic effects and cardiac toxicity. MAOIs (D) have dietary restrictions and
hypertensive crisis risks. SNRIs (A) are effective but may raise blood pressure, warranting
caution.
Question: 2
An adult patient presents to the clinic 6 months after having their third child. The child was
born with fetal alcohol spectrum disorder. Which of the following is the most likely risk
factor for substance use during pregnancy? A. Initiation of prenatal care at 8 weeks
gestation
B. Pregnancy associated with second marriage
C. Prior obstetric history of abruptio placentae
D. Advanced maternal age
Answer: B
Rationale: Substance use during pregnancy is strongly associated with psychosocial stressors,
including complex family dynamics such as second marriages. These changes may increase
stress and risk-taking behaviors like alcohol use. Early prenatal care (A) is protective, while prior
abruptio placentae (C) and advanced maternal age (D) are less directly linked to prenatal
substance use risk.
Question: 3
An NP is managing an adult patient with a history of bipolar disorder who is taking lithium
(Lithobid). Which of the following is a potential complication associated with this medication?
A. Weight loss
B. Polyuria
C. Myocarditis
D. Constipation
Answer: B
Rationale: Lithium commonly causes nephrogenic diabetes insipidus, leading to polyuria due to
impaired kidney response to antidiuretic hormone. This side effect can lead to excessive
Downloaded by Weykey Pinn ()
, lOMoAR cPSD| 64664050
urination and thirst. Weight loss, myocarditis, and constipation are not typical lithium-
associated complications. Monitoring kidney function and fluid balance is essential in patients
on lithium therapy.
Question: 4
A PMHNP is caring for a patient who is prescribed gabapentin (Neurontin). Which of the
following is the most accurate statement about this medication?
A. Taking gabapentin (Neurontin) with antacids increases its bioavailability.
B. Somnolence and dizziness are common side effects of gabapentin (Neurontin).
C. Gabapentin (Neurontin) is metabolized by the liver.
D. Gabapentin (Neurontin) is a cytochrome P450 inhibitor.
Answer: B
Rationale: Gabapentin commonly causes central nervous system side effects such as
somnolence and dizziness, affecting patient alertness and balance. It is not metabolized by the
liver but excreted unchanged by the kidneys, minimizing hepatic drug interactions. Antacids can
reduce, not increase, gabapentin’s absorption. It neither inhibits nor induces cytochrome P450
enzymes.
Question: 5
A young adult patient presents to the emergency department with new-onset paranoia and
auditory hallucinations. The patient has no prior medical or psychiatric history. They are
scheduled to travel to sub-Saharan Africa with the Peace Corps next week and were preparing
for this trip before symptom onset. The patient’s family states that they began "acting this way"
a few days ago. What is the most likely cause of the psychotic symptoms?
A. New-onset schizophrenia
B. Acute stress disorder (reaction to upcoming travel)
C. Malingering
D. Adverse reaction to malaria medication
Answer: D
Rationale: Certain antimalarial drugs, such as mefloquine, are well-documented to cause
neuropsychiatric side effects including paranoia, hallucinations, and psychosis, particularly
shortly after initiation. The timing coinciding with preparation for travel to an endemic area
supports this. New-onset schizophrenia is less likely given the acute onset and contextual
factors, while acute stress disorder typically lacks frank psychosis. Malingering would imply
intentional symptom fabrication, which is less likely without external gain.
Question: 6
An adult patient presents with a history of slurred and slow speech for the last four months.
The patient reports dry skin and hair loss, along with a depressed mood and lethargy. Which of
the following is the most likely diagnosis?
A. Addison’s disease
B. Cushing syndrome
C. Hyperaldosteronism
D. Hypothyroidism
Answer: D
Rationale: Hypothyroidism commonly presents with symptoms such as slowed speech, dry skin,
hair thinning or loss, fatigue, lethargy, and depressed mood. These signs result from decreased
thyroid hormone levels affecting metabolism and neurological function. Addison’s disease and
hyperaldosteronism typically cause electrolyte disturbances without these symptoms, while
Cushing syndrome presents with weight gain and hypertension.
Question: 7
An NP is caring for a child with a caregiver who smokes. The child seems to experience more
frequent upper respiratory infections. The NP concludes that all children exposed to
secondhand smoke will likely develop frequent respiratory infections. What type of reasoning is
the NP employing in this situation?
A. Inferential
B. Inductive
C. Deductive
D. Experimental
Answer: B
Rationale: Inductive reasoning involves drawing a general conclusion based on specific
observations or cases. Here, the NP observes one child exposed to secondhand smoke with
Downloaded by Weykey Pinn ()
, lOMoAR cPSD| 64664050
frequent infections and generalizes this to all children similarly exposed. Deductive reasoning
would start with a general principle and apply it to a specific case, which is not happening here.
Question: 8
Which of the following is a standard of professional performance for all psychiatric-mental
health nurses?
A. Billing and coding
B. Political party advocacy
C. Professional collaboration
D. Delegation and justice
Answer: C
Rationale: Professional collaboration is a core standard of practice for psychiatric-mental health
nurses, emphasizing interdisciplinary teamwork to optimize patient care. It entails effective
communication and cooperation with healthcare providers and community resources. Billing,
political advocacy, and delegation, while relevant in some contexts, are not universal
professional performance standards across psychiatric nursing.
Question: 9
The use of medication during pregnancy can carry risks to the fetus. Which of the following is
the most likely potential neonatal risk associated with the use of duloxetine (Cymbalta), a
serotonin norepinephrine reuptake inhibitor (SNRI) during the third trimester of pregnancy?
A. Pregnancy loss or miscarriage
B. Organ malformation or teratogenesis
C. Gestational diabetes
D. Poor neonatal adaptation syndrome
Answer: D
Rationale: Use of duloxetine during the third trimester can lead to poor neonatal adaptation
syndrome, characterized by respiratory distress, jitteriness, feeding difficulties, and irritability
due to withdrawal or toxicity. Unlike first-trimester exposures linked with teratogenicity, third-
trimester SNRI exposure primarily risks transient neonatal symptoms, requiring monitoring but
generally not permanent damage.
Question: 10
An NP is prescribing galantamine (Razadyne) which is approved for the treatment of mild to
moderate Alzheimer’s disease. What is the primary mechanism of action of this medication?
A. Monoamine oxidase inhibitor (MAOI)
B. N-methyl-D-aspartate (NMDA) receptor antagonist
C. Competitive inhibitor of acetylcholinesterase
D. Selective serotonin reuptake inhibitor (SSRI)
Answer: C
Rationale: Galantamine is a reversible, competitive inhibitor of acetylcholinesterase, which
increases acetylcholine levels by preventing its breakdown. This enhancement of cholinergic
transmission is beneficial in treating cognitive symptoms of mild to moderate Alzheimer’s
disease. It also modulates nicotinic receptors, improving neurotransmission and cognitive
function.
Question: 11
Which of the following medications has a box warning related to an increased risk of liver
failure?
A. Fluoxetine (Prozac)
B. Mirtazapine (Remeron)
C. Nefazodone (Serzone)
D. Fluvoxamine (Luvox)
Answer: C
Rationale: Nefazodone carries a black box warning due to its association with severe
hepatotoxicity and potential liver failure. Though effective as an antidepressant, its use has
Downloaded by Weykey Pinn ()
