Colorado Psychiatric Mental Health
Nurse Practitioner Certification Exam
(ANCC PMHNP-BC) Questions With
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
Download Pdf
1. A 24-year-old client presents with episodes of elevated mood,
decreased need for sleep, and impulsive spending lasting 5 days.
Which diagnosis is most appropriate?
A. Major depressive disorder
B. Cyclothymic disorder
C. Bipolar II disorder
D. Bipolar I disorder
Answer: D. Bipolar I disorder
Rationale: The presence of a manic episode lasting at least 7 days (or
requiring hospitalization; duration here strongly suggests mania) with
impaired judgment and impulsivity supports Bipolar I disorder rather
than hypomania or depressive-only disorders.
2. A patient taking haloperidol develops muscle rigidity, fever, and
autonomic instability. What is the priority action?
,A. Administer benztropine
B. Discontinue the medication and initiate dantrolene
C. Give propranolol
D. Increase antipsychotic dose
Answer: B. Discontinue the medication and initiate dantrolene
Rationale: These symptoms indicate neuroleptic malignant syndrome
(NMS), a medical emergency requiring immediate discontinuation of
antipsychotics and treatment with dantrolene or bromocriptine.
3. Which neurotransmitter is most associated with schizophrenia
positive symptoms?
A. Serotonin
B. Dopamine
C. GABA
D. Acetylcholine
Answer: B. Dopamine
Rationale: Positive symptoms of schizophrenia are strongly linked to
hyperactivity of dopamine pathways, particularly in the mesolimbic
system.
4. First-line pharmacologic treatment for generalized anxiety
disorder is:
A. Alprazolam
B. Fluoxetine
,C. Haloperidol
D. Lithium
Answer: B. Fluoxetine
Rationale: SSRIs like fluoxetine are first-line for GAD due to efficacy
and lower dependence risk compared to benzodiazepines.
5. A client with OCD experiences intrusive thoughts and performs
repetitive handwashing. Which therapy is most effective?
A. Psychoanalysis
B. Exposure and response prevention
C. Aversion therapy
D. Group therapy only
Answer: B. Exposure and response prevention
Rationale: ERP is the gold-standard behavioral therapy for OCD,
reducing compulsions through controlled exposure.
6. Which condition is characterized by rapid cycling between
multiple identities?
A. Schizophrenia
B. Dissociative identity disorder
C. Borderline personality disorder
D. Bipolar disorder
Answer: B. Dissociative identity disorder
Rationale: DID involves disruption of identity with distinct personality
states and memory gaps.
, 7. A patient with major depressive disorder reports fatigue,
insomnia, and poor appetite. Which symptom is considered a
vegetative symptom?
A. Guilt
B. Hallucinations
C. Insomnia
D. Delusions
Answer: C. Insomnia
Rationale: Vegetative symptoms include sleep, appetite, and energy
disturbances.
8. Which medication is a mood stabilizer?
A. Sertraline
B. Lithium
C. Lorazepam
D. Risperidone only
Answer: B. Lithium
Rationale: Lithium is a classic mood stabilizer used in bipolar disorder
for mania prevention and treatment.
9. A client expresses fear of public speaking and avoids meetings.
This is most consistent with:
A. Social anxiety disorder
B. Agoraphobia
Nurse Practitioner Certification Exam
(ANCC PMHNP-BC) Questions With
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
Download Pdf
1. A 24-year-old client presents with episodes of elevated mood,
decreased need for sleep, and impulsive spending lasting 5 days.
Which diagnosis is most appropriate?
A. Major depressive disorder
B. Cyclothymic disorder
C. Bipolar II disorder
D. Bipolar I disorder
Answer: D. Bipolar I disorder
Rationale: The presence of a manic episode lasting at least 7 days (or
requiring hospitalization; duration here strongly suggests mania) with
impaired judgment and impulsivity supports Bipolar I disorder rather
than hypomania or depressive-only disorders.
2. A patient taking haloperidol develops muscle rigidity, fever, and
autonomic instability. What is the priority action?
,A. Administer benztropine
B. Discontinue the medication and initiate dantrolene
C. Give propranolol
D. Increase antipsychotic dose
Answer: B. Discontinue the medication and initiate dantrolene
Rationale: These symptoms indicate neuroleptic malignant syndrome
(NMS), a medical emergency requiring immediate discontinuation of
antipsychotics and treatment with dantrolene or bromocriptine.
3. Which neurotransmitter is most associated with schizophrenia
positive symptoms?
A. Serotonin
B. Dopamine
C. GABA
D. Acetylcholine
Answer: B. Dopamine
Rationale: Positive symptoms of schizophrenia are strongly linked to
hyperactivity of dopamine pathways, particularly in the mesolimbic
system.
4. First-line pharmacologic treatment for generalized anxiety
disorder is:
A. Alprazolam
B. Fluoxetine
,C. Haloperidol
D. Lithium
Answer: B. Fluoxetine
Rationale: SSRIs like fluoxetine are first-line for GAD due to efficacy
and lower dependence risk compared to benzodiazepines.
5. A client with OCD experiences intrusive thoughts and performs
repetitive handwashing. Which therapy is most effective?
A. Psychoanalysis
B. Exposure and response prevention
C. Aversion therapy
D. Group therapy only
Answer: B. Exposure and response prevention
Rationale: ERP is the gold-standard behavioral therapy for OCD,
reducing compulsions through controlled exposure.
6. Which condition is characterized by rapid cycling between
multiple identities?
A. Schizophrenia
B. Dissociative identity disorder
C. Borderline personality disorder
D. Bipolar disorder
Answer: B. Dissociative identity disorder
Rationale: DID involves disruption of identity with distinct personality
states and memory gaps.
, 7. A patient with major depressive disorder reports fatigue,
insomnia, and poor appetite. Which symptom is considered a
vegetative symptom?
A. Guilt
B. Hallucinations
C. Insomnia
D. Delusions
Answer: C. Insomnia
Rationale: Vegetative symptoms include sleep, appetite, and energy
disturbances.
8. Which medication is a mood stabilizer?
A. Sertraline
B. Lithium
C. Lorazepam
D. Risperidone only
Answer: B. Lithium
Rationale: Lithium is a classic mood stabilizer used in bipolar disorder
for mania prevention and treatment.
9. A client expresses fear of public speaking and avoids meetings.
This is most consistent with:
A. Social anxiety disorder
B. Agoraphobia
