PMHNP Certification Exam
(2025/2026) Practice Questions &
Answers | Comprehensive PMHNP
Board Exam Study Guide with
Rationales
THIS EXAM INCLUDES;
• Comprehensive PMHNP board-style practice questions
• Verified answers with detailed rationales
• Comprehensive exam review guide
• Printable digital PDF format
• Updated 2025/2026 study resource designed for
certification preparation
, PMHNP Certification Exam (2025/2026) Practice
Questions & Answers | Comprehensive PMHNP Board
Exam Study Guide with Rationales
Section 1: Suicide Risk Assessment
1. Which patient is at highest risk for suicide?
• A) 30 y/o married African American female with previous suicide
attempt
• B) 35 y/o single Asian male with previous suicide attempt
• C) 38 y/o single African American male who is a bank manager
• D) 68 y/o single white male with depression
Answer: D
Rationale: The 68 y/o single white male with depression has the most risk
factors: age (elderly), male gender, white race, depression, and being single.
Count the risk factors - this patient has 5 risk factors, making them highest
risk. Key suicide risk factors include: Sex (Male), Age (Teenager or Elderly),
Depression, Previous Attempt, White race, being single/divorced/widowed,
and lack of social support.
2. Which of the following is TRUE regarding suicide risk?
• A) Women succeed more often than men
• B) Men attempt suicide more often than women
• C) Women attempt more often, but men succeed more often
• D) There is no gender difference in suicide rates
Answer: C
Rationale: Women attempt suicide more often than men, but men succeed
more often (complete suicide). This is an important distinction in suicide
risk assessment.
,Section 2: Withdrawal Assessment Scales
3. What does COWS stand for?
• A) Clinical Opioid Withdrawal Scale
• B) Clinical Observation Withdrawal Scale
• C) Comprehensive Opiate Withdrawal System
• D) Clinical Opiate Withdrawal Symptoms
Answer: A
Rationale: COWS stands for Clinical Opiate Withdrawal Scale, used to
assess the severity of opioid withdrawal symptoms.
4. Which of the following is NOT a component of the COWS scale?
• A) Pulse rate
• B) Pupil size
• C) Blood pressure
• D) Restlessness
Answer: C
Rationale: COWS components include pulse, sweating, restlessness, pupil
size, body aches, rhinorrhea, lacrimation, GI upset (N/V/D), yawning,
tremors, anxiety/irritability, piloerection, and insomnia. Blood pressure is
not a component of the COWS scale.
5. What does CIWA assess for?
• A) Alcohol Use Disorder
• B) Likelihood of alcohol withdrawal or delirium tremens (DTs)
• C) Opioid withdrawal severity
• D) Nicotine dependence
, Answer: B
Rationale: CIWA (Clinical Institute Withdrawal Assessment) is used to
determine the likelihood of ETOH (alcohol) withdrawal or DTs (delirium
tremens), which usually occur within the first 24-72 hours after cessation. It
helps determine when to administer medications for alcohol withdrawal.
6. True or False: CIWA is used to diagnose Alcohol Use Disorder.
• A) True
• B) False
Answer: B
Rationale: CIWA does NOT test for Alcohol Use Disorder. It is specifically
used to assess withdrawal severity, not to diagnose alcohol use disorder
itself.
7. At what CIWA score should PRN medications be started?
• A) 5
• B) 8
• C) 10
• D) 15
Answer: B
Rationale: PRN medications should be started at a CIWA score of 8. Scores
of 15 or above should be considered for scheduled medications.
8. CIWA components include all of the following EXCEPT:
• A) Nausea/Vomiting
• B) Tremor
• C) Blood pressure
• D) Visual disturbances
(2025/2026) Practice Questions &
Answers | Comprehensive PMHNP
Board Exam Study Guide with
Rationales
THIS EXAM INCLUDES;
• Comprehensive PMHNP board-style practice questions
• Verified answers with detailed rationales
• Comprehensive exam review guide
• Printable digital PDF format
• Updated 2025/2026 study resource designed for
certification preparation
, PMHNP Certification Exam (2025/2026) Practice
Questions & Answers | Comprehensive PMHNP Board
Exam Study Guide with Rationales
Section 1: Suicide Risk Assessment
1. Which patient is at highest risk for suicide?
• A) 30 y/o married African American female with previous suicide
attempt
• B) 35 y/o single Asian male with previous suicide attempt
• C) 38 y/o single African American male who is a bank manager
• D) 68 y/o single white male with depression
Answer: D
Rationale: The 68 y/o single white male with depression has the most risk
factors: age (elderly), male gender, white race, depression, and being single.
Count the risk factors - this patient has 5 risk factors, making them highest
risk. Key suicide risk factors include: Sex (Male), Age (Teenager or Elderly),
Depression, Previous Attempt, White race, being single/divorced/widowed,
and lack of social support.
2. Which of the following is TRUE regarding suicide risk?
• A) Women succeed more often than men
• B) Men attempt suicide more often than women
• C) Women attempt more often, but men succeed more often
• D) There is no gender difference in suicide rates
Answer: C
Rationale: Women attempt suicide more often than men, but men succeed
more often (complete suicide). This is an important distinction in suicide
risk assessment.
,Section 2: Withdrawal Assessment Scales
3. What does COWS stand for?
• A) Clinical Opioid Withdrawal Scale
• B) Clinical Observation Withdrawal Scale
• C) Comprehensive Opiate Withdrawal System
• D) Clinical Opiate Withdrawal Symptoms
Answer: A
Rationale: COWS stands for Clinical Opiate Withdrawal Scale, used to
assess the severity of opioid withdrawal symptoms.
4. Which of the following is NOT a component of the COWS scale?
• A) Pulse rate
• B) Pupil size
• C) Blood pressure
• D) Restlessness
Answer: C
Rationale: COWS components include pulse, sweating, restlessness, pupil
size, body aches, rhinorrhea, lacrimation, GI upset (N/V/D), yawning,
tremors, anxiety/irritability, piloerection, and insomnia. Blood pressure is
not a component of the COWS scale.
5. What does CIWA assess for?
• A) Alcohol Use Disorder
• B) Likelihood of alcohol withdrawal or delirium tremens (DTs)
• C) Opioid withdrawal severity
• D) Nicotine dependence
, Answer: B
Rationale: CIWA (Clinical Institute Withdrawal Assessment) is used to
determine the likelihood of ETOH (alcohol) withdrawal or DTs (delirium
tremens), which usually occur within the first 24-72 hours after cessation. It
helps determine when to administer medications for alcohol withdrawal.
6. True or False: CIWA is used to diagnose Alcohol Use Disorder.
• A) True
• B) False
Answer: B
Rationale: CIWA does NOT test for Alcohol Use Disorder. It is specifically
used to assess withdrawal severity, not to diagnose alcohol use disorder
itself.
7. At what CIWA score should PRN medications be started?
• A) 5
• B) 8
• C) 10
• D) 15
Answer: B
Rationale: PRN medications should be started at a CIWA score of 8. Scores
of 15 or above should be considered for scheduled medications.
8. CIWA components include all of the following EXCEPT:
• A) Nausea/Vomiting
• B) Tremor
• C) Blood pressure
• D) Visual disturbances
