GEORGETTE'S LMR PMHNP CERTIFICATION EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027
SECTION ONE: QUESTIONS 1–100
1. A 39-year-old male with treatment-resistant schizophrenia has been stable on clozapine for 5 years. He
reports a fever of 101.7°F, sore throat, and fatigue for the past 24 hours. What is the priority action?
A. Prescribe a broad-spectrum antibiotic
B. Advise acetaminophen and rest for 48 hours
C. Obtain an immediate CBC with differential
D. Schedule a follow-up appointment in one week
🟢 C. Obtain an immediate CBC with differential
🔴 RATIONALE: Clozapine carries a black box warning for agranulocytosis, a potentially fatal condition that can
present with fever, sore throat, and malaise. The priority is to obtain a CBC with differential to evaluate
neutrophil count; the medication should be held pending results.
,2. According to DSM-5-TR criteria, which of the following is a required symptom for the diagnosis of major
depressive disorder?
A. Decreased need for sleep
B. Grandiose thinking
C. Psychomotor agitation or retardation nearly every day
D. Flight of ideas
🟢 C. Psychomotor agitation or retardation nearly every day
🔴 RATIONALE: Major depressive disorder requires five or more symptoms during a two-week period, including
depressed mood or anhedonia. Psychomotor agitation/retardation is one of the possible associated symptoms.
Decreased need for sleep, grandiose thinking, and flight of ideas are characteristic of manic or hypomanic
episodes.
3. A patient on phenelzine presents with a hypertensive crisis after eating aged cheese. Which medication
should the nurse anticipate administering?
A. Naloxone
B. Flumazenil
C. Phentolamine
D. Diphenhydramine
🟢 C. Phentolamine
,🔴 RATIONALE: Hypertensive crisis from MAOI–tyramine interaction is a medical emergency. Phentolamine, an
alpha-blocker, is the treatment of choice to rapidly lower blood pressure.
4. What is the primary role of the Psychiatric-Mental Health Nurse Practitioner (PMHNP)?
A. To prescribe medications only
B. To provide psychotherapy exclusively
C. To assess, diagnose, and treat individuals and families with psychiatric disorders across the lifespan
D. To conduct research on mental health treatments
🟢 C. To assess, diagnose, and treat individuals and families with psychiatric disorders across the lifespan
🔴 RATIONALE: The PMHNP's role is comprehensive, encompassing assessment, diagnosis, and treatment of
individuals and families with psychiatric disorders across the lifespan. This goes beyond medication
management or psychotherapy alone.
5. Which of the following herbal supplements is associated with liver damage and should be avoided with
CNS depressants?
A. St. John's Wort
B. Kava Kava
C. Ginkgo Biloba
D. Valerian Root
, 🟢 B. Kava Kava
🔴 RATIONALE: Kava Kava is associated with hepatotoxicity and should be avoided with CNS depressants,
including alprazolam and phenobarbital, due to potential interactions and liver damage risk.
6. A patient with bipolar I disorder is prescribed lithium. Which laboratory test is most important to monitor
during maintenance therapy to prevent toxicity?
A. Serum creatinine and BUN
B. Serum sodium
C. Serum potassium
D. Liver function tests
🟢 A. Serum creatinine and BUN
🔴 RATIONALE: Lithium has a narrow therapeutic index and is excreted renally. Monitoring renal function
(creatinine, BUN) is essential because decreased clearance can lead to lithium accumulation and toxicity.
7. A 16-year-old patient with ADHD is prescribed a stimulant. Which assessment finding would indicate the
need to discontinue the medication?
A. Mild appetite suppression
B. Difficulty falling asleep
ANSWERS) PLUS RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027
SECTION ONE: QUESTIONS 1–100
1. A 39-year-old male with treatment-resistant schizophrenia has been stable on clozapine for 5 years. He
reports a fever of 101.7°F, sore throat, and fatigue for the past 24 hours. What is the priority action?
A. Prescribe a broad-spectrum antibiotic
B. Advise acetaminophen and rest for 48 hours
C. Obtain an immediate CBC with differential
D. Schedule a follow-up appointment in one week
🟢 C. Obtain an immediate CBC with differential
🔴 RATIONALE: Clozapine carries a black box warning for agranulocytosis, a potentially fatal condition that can
present with fever, sore throat, and malaise. The priority is to obtain a CBC with differential to evaluate
neutrophil count; the medication should be held pending results.
,2. According to DSM-5-TR criteria, which of the following is a required symptom for the diagnosis of major
depressive disorder?
A. Decreased need for sleep
B. Grandiose thinking
C. Psychomotor agitation or retardation nearly every day
D. Flight of ideas
🟢 C. Psychomotor agitation or retardation nearly every day
🔴 RATIONALE: Major depressive disorder requires five or more symptoms during a two-week period, including
depressed mood or anhedonia. Psychomotor agitation/retardation is one of the possible associated symptoms.
Decreased need for sleep, grandiose thinking, and flight of ideas are characteristic of manic or hypomanic
episodes.
3. A patient on phenelzine presents with a hypertensive crisis after eating aged cheese. Which medication
should the nurse anticipate administering?
A. Naloxone
B. Flumazenil
C. Phentolamine
D. Diphenhydramine
🟢 C. Phentolamine
,🔴 RATIONALE: Hypertensive crisis from MAOI–tyramine interaction is a medical emergency. Phentolamine, an
alpha-blocker, is the treatment of choice to rapidly lower blood pressure.
4. What is the primary role of the Psychiatric-Mental Health Nurse Practitioner (PMHNP)?
A. To prescribe medications only
B. To provide psychotherapy exclusively
C. To assess, diagnose, and treat individuals and families with psychiatric disorders across the lifespan
D. To conduct research on mental health treatments
🟢 C. To assess, diagnose, and treat individuals and families with psychiatric disorders across the lifespan
🔴 RATIONALE: The PMHNP's role is comprehensive, encompassing assessment, diagnosis, and treatment of
individuals and families with psychiatric disorders across the lifespan. This goes beyond medication
management or psychotherapy alone.
5. Which of the following herbal supplements is associated with liver damage and should be avoided with
CNS depressants?
A. St. John's Wort
B. Kava Kava
C. Ginkgo Biloba
D. Valerian Root
, 🟢 B. Kava Kava
🔴 RATIONALE: Kava Kava is associated with hepatotoxicity and should be avoided with CNS depressants,
including alprazolam and phenobarbital, due to potential interactions and liver damage risk.
6. A patient with bipolar I disorder is prescribed lithium. Which laboratory test is most important to monitor
during maintenance therapy to prevent toxicity?
A. Serum creatinine and BUN
B. Serum sodium
C. Serum potassium
D. Liver function tests
🟢 A. Serum creatinine and BUN
🔴 RATIONALE: Lithium has a narrow therapeutic index and is excreted renally. Monitoring renal function
(creatinine, BUN) is essential because decreased clearance can lead to lithium accumulation and toxicity.
7. A 16-year-old patient with ADHD is prescribed a stimulant. Which assessment finding would indicate the
need to discontinue the medication?
A. Mild appetite suppression
B. Difficulty falling asleep
