PMHNP Certification Review Practice
Exam Questions And Answers Plus
Rationales 2026/27 Instant Pdf Download
1. A 32-year-old male with a history of schizophrenia is brought to
the clinic by his family due to progressive difficulties with
coordination, involuntary jerking movements, and cognitive decline.
He has been on fluphenazine decanoate for 10 years. Which of the
following is the most likely diagnosis?
A. Tardive dyskinesia
B. Neuroleptic malignant syndrome
C. Acute dystonia
D. Parkinsonism
Answer: A. Tardive dyskinesia is a late-onset movement disorder
characterized by choreoathetoid movements (jerking, writhing) of
the tongue, face, and limbs, resulting from long-term exposure to
conventional antipsychotics. The key here is "progressive" and the
long-term history.
2. A patient with major depressive disorder is started on fluoxetine.
Which of the following is the most important initial side effect to
counsel the patient about?
A. Weight gain
,B. Sexual dysfunction
C. GI distress and insomnia
D. Hyponatremia
Answer: C. GI distress (nausea, diarrhea) and insomnia are among
the most common and earliest side effects of SSRIs like fluoxetine.
While sexual dysfunction and weight gain can occur, they are
typically later-onset side effects. Hyponatremia is a concern,
especially in the elderly, but is less common initially.
3. A 45-year-old female with bipolar I disorder, currently in a
depressive episode, is prescribed lamotrigine. What is the most
critical piece of patient education regarding this medication?
A. "Do not stop this medication abruptly."
B. "Watch for a rash, as it could be a sign of a life-threatening
condition."
C. "You need to have regular blood draws to monitor your liver
function."
D. "This medication can cause significant weight gain."
Answer: B. Lamotrigine carries a black box warning for serious skin
rashes, including Stevens-Johnson syndrome. Patients must be
educated to report any rash immediately. While titration is
important to minimize rash risk, the education about the rash itself
is the most critical safety point.
4. According to the DSM-5-TR, which of the following is a required
criterion for the diagnosis of Posttraumatic Stress Disorder (PTSD)?
,A. Exposure to actual or threatened death, serious injury, or sexual
violence.
B. Persistent inability to experience positive emotions.
C. Recurrent, involuntary, and intrusive distressing memories of the
traumatic event.
D. Avoidance of external reminders of the traumatic event.
Answer: A. Criterion A is the gatekeeper for a PTSD diagnosis; the
individual must have been exposed to actual or threatened death,
serious injury, or sexual violence. While B, C, and D are all symptom
clusters, Criterion A is the foundational requirement.
5. A patient presents with symptoms of inattention, hyperactivity,
and impulsivity that have been present since childhood. Which of
the following is a key diagnostic feature that must be present to
diagnose ADHD in adulthood?
A. Symptoms must be present in two or more settings (e.g., home,
work, school).
B. Symptoms must have been present before the age of 12.
C. There must be evidence of significant impairment in social or
occupational functioning.
D. All of the above.
Answer: D. The DSM-5-TR requires several criteria for ADHD,
including: several inattentive or hyperactive-impulsive symptoms
present before age 12, symptoms present in two or more settings,
, and clear evidence that the symptoms interfere with social,
academic, or occupational functioning.
6. A patient with a history of opioid use disorder is started on
buprenorphine/naloxone. What is the primary purpose of the
naloxone in this combination?
A. To potentiate the opioid effects of buprenorphine.
B. To prevent diversion and abuse by injection.
C. To act as a full opioid agonist to reduce cravings.
D. To treat the withdrawal symptoms associated with
buprenorphine.
Answer: B. Naloxone is poorly absorbed sublingually but will
precipitate withdrawal if the medication is crushed and injected. Its
purpose is to deter intravenous misuse. Buprenorphine itself is the
partial agonist that reduces cravings and withdrawal.
7. A patient is prescribed quetiapine for bipolar depression. Which
of the following side effects is most likely to be dose-limiting due to
its anticholinergic properties?
A. Constipation
B. Dry mouth
C. Sedation
D. Weight gain
Answer: B. While all are side effects, dry mouth is a classic and often
bothersome anticholinergic effect. Constipation can also occur, but
dry mouth is frequently cited as a primary reason for non-adherence
Exam Questions And Answers Plus
Rationales 2026/27 Instant Pdf Download
1. A 32-year-old male with a history of schizophrenia is brought to
the clinic by his family due to progressive difficulties with
coordination, involuntary jerking movements, and cognitive decline.
He has been on fluphenazine decanoate for 10 years. Which of the
following is the most likely diagnosis?
A. Tardive dyskinesia
B. Neuroleptic malignant syndrome
C. Acute dystonia
D. Parkinsonism
Answer: A. Tardive dyskinesia is a late-onset movement disorder
characterized by choreoathetoid movements (jerking, writhing) of
the tongue, face, and limbs, resulting from long-term exposure to
conventional antipsychotics. The key here is "progressive" and the
long-term history.
2. A patient with major depressive disorder is started on fluoxetine.
Which of the following is the most important initial side effect to
counsel the patient about?
A. Weight gain
,B. Sexual dysfunction
C. GI distress and insomnia
D. Hyponatremia
Answer: C. GI distress (nausea, diarrhea) and insomnia are among
the most common and earliest side effects of SSRIs like fluoxetine.
While sexual dysfunction and weight gain can occur, they are
typically later-onset side effects. Hyponatremia is a concern,
especially in the elderly, but is less common initially.
3. A 45-year-old female with bipolar I disorder, currently in a
depressive episode, is prescribed lamotrigine. What is the most
critical piece of patient education regarding this medication?
A. "Do not stop this medication abruptly."
B. "Watch for a rash, as it could be a sign of a life-threatening
condition."
C. "You need to have regular blood draws to monitor your liver
function."
D. "This medication can cause significant weight gain."
Answer: B. Lamotrigine carries a black box warning for serious skin
rashes, including Stevens-Johnson syndrome. Patients must be
educated to report any rash immediately. While titration is
important to minimize rash risk, the education about the rash itself
is the most critical safety point.
4. According to the DSM-5-TR, which of the following is a required
criterion for the diagnosis of Posttraumatic Stress Disorder (PTSD)?
,A. Exposure to actual or threatened death, serious injury, or sexual
violence.
B. Persistent inability to experience positive emotions.
C. Recurrent, involuntary, and intrusive distressing memories of the
traumatic event.
D. Avoidance of external reminders of the traumatic event.
Answer: A. Criterion A is the gatekeeper for a PTSD diagnosis; the
individual must have been exposed to actual or threatened death,
serious injury, or sexual violence. While B, C, and D are all symptom
clusters, Criterion A is the foundational requirement.
5. A patient presents with symptoms of inattention, hyperactivity,
and impulsivity that have been present since childhood. Which of
the following is a key diagnostic feature that must be present to
diagnose ADHD in adulthood?
A. Symptoms must be present in two or more settings (e.g., home,
work, school).
B. Symptoms must have been present before the age of 12.
C. There must be evidence of significant impairment in social or
occupational functioning.
D. All of the above.
Answer: D. The DSM-5-TR requires several criteria for ADHD,
including: several inattentive or hyperactive-impulsive symptoms
present before age 12, symptoms present in two or more settings,
, and clear evidence that the symptoms interfere with social,
academic, or occupational functioning.
6. A patient with a history of opioid use disorder is started on
buprenorphine/naloxone. What is the primary purpose of the
naloxone in this combination?
A. To potentiate the opioid effects of buprenorphine.
B. To prevent diversion and abuse by injection.
C. To act as a full opioid agonist to reduce cravings.
D. To treat the withdrawal symptoms associated with
buprenorphine.
Answer: B. Naloxone is poorly absorbed sublingually but will
precipitate withdrawal if the medication is crushed and injected. Its
purpose is to deter intravenous misuse. Buprenorphine itself is the
partial agonist that reduces cravings and withdrawal.
7. A patient is prescribed quetiapine for bipolar depression. Which
of the following side effects is most likely to be dose-limiting due to
its anticholinergic properties?
A. Constipation
B. Dry mouth
C. Sedation
D. Weight gain
Answer: B. While all are side effects, dry mouth is a classic and often
bothersome anticholinergic effect. Constipation can also occur, but
dry mouth is frequently cited as a primary reason for non-adherence
