PMHNP CERTIFICATION EXAM – QUESTIONS AND
ANSWERS | VERIFIED AND WELL DETAILED
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1. A psychiatric mental health nurse practitioner is evaluating a patient who
reports depressed mood, loss of interest in activities, fatigue, and sleep
disturbance for the past 3 weeks. Which diagnosis is MOST appropriate?
A. Adjustment disorder
B. Major depressive disorder
C. Generalized anxiety disorder
D. Bipolar II disorder
Correct Answer: B. Major depressive disorder
Rationale: Major depressive disorder is characterized by at least 2 weeks of
depressed mood or anhedonia with associated symptoms causing functional
impairment. Adjustment disorder requires symptoms linked to an identifiable
stressor, while anxiety and bipolar disorders have different diagnostic criteria.
2. A patient taking an SSRI reports increased energy, decreased need for
sleep, and impulsive spending after several weeks of treatment. What should
the PMHNP suspect?
A. Medication adherence improvement
B. Antidepressant-induced mania
C. Normal SSRI side effects
D. Improved depressive symptoms only
Correct Answer: B. Antidepressant-induced mania
Rationale: Antidepressants can trigger manic episodes in individuals with
underlying bipolar disorder. Increased energy with reduced sleep and impulsivity
requires evaluation for mania.
,3. Which neurotransmitter is most strongly associated with the mechanism of
action of selective serotonin reuptake inhibitors (SSRIs)?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. Gamma-aminobutyric acid
Correct Answer: B. Serotonin
Rationale: SSRIs primarily increase serotonin availability in the synaptic cleft by
inhibiting serotonin reuptake.
4. A patient with schizophrenia reports hearing voices that others cannot
hear. This symptom is classified as:
A. Negative symptom
B. Cognitive symptom
C. Positive symptom
D. Mood symptom
Correct Answer: C. Positive symptom
Rationale: Hallucinations are positive symptoms because they involve an addition
of abnormal experiences, such as hearing voices.
5. A patient taking an antipsychotic medication develops fever, severe muscle
rigidity, confusion, and elevated creatine kinase levels. What condition is
suspected?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Acute anxiety reaction
D. Extrapyramidal symptoms
Correct Answer: B. Neuroleptic malignant syndrome
,Rationale: Neuroleptic malignant syndrome is a potentially life-threatening
reaction to antipsychotics characterized by rigidity, fever, altered mental status,
and elevated CK levels.
6. Which screening tool is commonly used to assess severity of depressive
symptoms?
A. PHQ-9
B. MMSE
C. AUDIT
D. CAGE
Correct Answer: A. PHQ-9
Rationale: The Patient Health Questionnaire-9 (PHQ-9) is widely used to screen
for and monitor depression severity.
7. A patient experiencing panic attacks reports sudden intense fear, chest
discomfort, and shortness of breath. Which diagnosis is most likely?
A. Panic disorder
B. Schizophrenia
C. Delirium
D. Obsessive-compulsive personality disorder
Correct Answer: A. Panic disorder
Rationale: Panic disorder involves recurrent unexpected panic attacks with
significant concern or behavioral changes related to future attacks.
8. Which medication class is considered first-line treatment for generalized
anxiety disorder?
A. SSRIs
B. Antipsychotics
, C. Stimulants
D. Barbiturates
Correct Answer: A. SSRIs
Rationale: SSRIs are commonly recommended first-line pharmacologic
treatments for generalized anxiety disorder due to effectiveness and safety
compared with older agents.
9. A PMHNP evaluates a patient with decreased need for sleep, grandiosity,
pressured speech, and risky behavior lasting 10 days. Which diagnosis is most
likely?
A. Major depressive disorder
B. Bipolar I disorder
C. Generalized anxiety disorder
D. Persistent depressive disorder
Correct Answer: B. Bipolar I disorder
Rationale: Bipolar I disorder includes at least one manic episode lasting 7 days
or requiring hospitalization, with symptoms such as grandiosity, decreased need
for sleep, and impaired judgment.
10. Which medication requires regular serum level monitoring due to a
narrow therapeutic range?
A. Fluoxetine
B. Lithium
C. Sertraline
D. Buspirone
Correct Answer: B. Lithium
Rationale: Lithium has a narrow therapeutic index and requires monitoring to
prevent toxicity.
ANSWERS | VERIFIED AND WELL DETAILED
ANSWERS PLUS RATIONALES | GUARANTEED PASS |
LATEST EXAM UPDATE | EXAM PREP | STUDY GUIDE
| PRACTICE TEST| DOWNLOAD INSTANT PDF
1. A psychiatric mental health nurse practitioner is evaluating a patient who
reports depressed mood, loss of interest in activities, fatigue, and sleep
disturbance for the past 3 weeks. Which diagnosis is MOST appropriate?
A. Adjustment disorder
B. Major depressive disorder
C. Generalized anxiety disorder
D. Bipolar II disorder
Correct Answer: B. Major depressive disorder
Rationale: Major depressive disorder is characterized by at least 2 weeks of
depressed mood or anhedonia with associated symptoms causing functional
impairment. Adjustment disorder requires symptoms linked to an identifiable
stressor, while anxiety and bipolar disorders have different diagnostic criteria.
2. A patient taking an SSRI reports increased energy, decreased need for
sleep, and impulsive spending after several weeks of treatment. What should
the PMHNP suspect?
A. Medication adherence improvement
B. Antidepressant-induced mania
C. Normal SSRI side effects
D. Improved depressive symptoms only
Correct Answer: B. Antidepressant-induced mania
Rationale: Antidepressants can trigger manic episodes in individuals with
underlying bipolar disorder. Increased energy with reduced sleep and impulsivity
requires evaluation for mania.
,3. Which neurotransmitter is most strongly associated with the mechanism of
action of selective serotonin reuptake inhibitors (SSRIs)?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. Gamma-aminobutyric acid
Correct Answer: B. Serotonin
Rationale: SSRIs primarily increase serotonin availability in the synaptic cleft by
inhibiting serotonin reuptake.
4. A patient with schizophrenia reports hearing voices that others cannot
hear. This symptom is classified as:
A. Negative symptom
B. Cognitive symptom
C. Positive symptom
D. Mood symptom
Correct Answer: C. Positive symptom
Rationale: Hallucinations are positive symptoms because they involve an addition
of abnormal experiences, such as hearing voices.
5. A patient taking an antipsychotic medication develops fever, severe muscle
rigidity, confusion, and elevated creatine kinase levels. What condition is
suspected?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Acute anxiety reaction
D. Extrapyramidal symptoms
Correct Answer: B. Neuroleptic malignant syndrome
,Rationale: Neuroleptic malignant syndrome is a potentially life-threatening
reaction to antipsychotics characterized by rigidity, fever, altered mental status,
and elevated CK levels.
6. Which screening tool is commonly used to assess severity of depressive
symptoms?
A. PHQ-9
B. MMSE
C. AUDIT
D. CAGE
Correct Answer: A. PHQ-9
Rationale: The Patient Health Questionnaire-9 (PHQ-9) is widely used to screen
for and monitor depression severity.
7. A patient experiencing panic attacks reports sudden intense fear, chest
discomfort, and shortness of breath. Which diagnosis is most likely?
A. Panic disorder
B. Schizophrenia
C. Delirium
D. Obsessive-compulsive personality disorder
Correct Answer: A. Panic disorder
Rationale: Panic disorder involves recurrent unexpected panic attacks with
significant concern or behavioral changes related to future attacks.
8. Which medication class is considered first-line treatment for generalized
anxiety disorder?
A. SSRIs
B. Antipsychotics
, C. Stimulants
D. Barbiturates
Correct Answer: A. SSRIs
Rationale: SSRIs are commonly recommended first-line pharmacologic
treatments for generalized anxiety disorder due to effectiveness and safety
compared with older agents.
9. A PMHNP evaluates a patient with decreased need for sleep, grandiosity,
pressured speech, and risky behavior lasting 10 days. Which diagnosis is most
likely?
A. Major depressive disorder
B. Bipolar I disorder
C. Generalized anxiety disorder
D. Persistent depressive disorder
Correct Answer: B. Bipolar I disorder
Rationale: Bipolar I disorder includes at least one manic episode lasting 7 days
or requiring hospitalization, with symptoms such as grandiosity, decreased need
for sleep, and impaired judgment.
10. Which medication requires regular serum level monitoring due to a
narrow therapeutic range?
A. Fluoxetine
B. Lithium
C. Sertraline
D. Buspirone
Correct Answer: B. Lithium
Rationale: Lithium has a narrow therapeutic index and requires monitoring to
prevent toxicity.