PMHNP CERTIFICATION PRACTICE QUESTIONS
COMPLETE WITH 100% VERIFIED ANSWERS AND
RATIONALES
1. A mother reports her child woke up screaming in the middle of the
night. What is the most appropriate initial response?
A) Prescribe a sleep aid immediately
B) Refer to a sleep specialist
C) Ask if it's happened before to assess for sleep issue patterns
D) Recommend behavioral therapy
Correct Answer: C
Rationale: Assessing for patterns of sleep issues is the appropriate
initial approach before intervening. This helps determine if the issue is
isolated or recurrent, guiding further assessment and treatment
decisions.
2. What does the "I" stand for in ADPIE?
A) Intervention
B) Implementation
C) Initiation
D) Investigation
Correct Answer: B
Rationale: ADPIE stands for Assessment, Diagnosis, Planning,
,Implementation, and Evaluation. "I" represents Implementation, which
is the step where the planned interventions are carried out.
3. A patient presents with fungus on their toenail. What is the
appropriate action?
A) Prescribe oral antifungal medication
B) Refer to dermatology
C) Scrape nail and send for testing
D) Recommend over-the-counter antifungal cream
Correct Answer: C
Rationale: Scraping the nail and sending it for testing is the appropriate
diagnostic step to confirm fungal infection before initiating treatment.
4. A patient on lithium presents with dark brown urine. What should
you do?
A) Check renal function
B) Decrease lithium dose
C) Increase fluid intake
D) Order a urine culture
Correct Answer: A
Rationale: Dark brown urine in a patient on lithium may indicate renal
impairment or toxicity. Checking renal function is essential to assess
kidney status and guide treatment decisions.
,5. A patient on Clozaril presents with fever. What is the priority
assessment?
A) Complete blood count
B) Check ANC level to assess for agranulocytosis
C) Blood culture
D) Chest X-ray
Correct Answer: B
Rationale: Fever in a patient on Clozaril (clozapine) is concerning for
agranulocytosis. Checking the Absolute Neutrophil Count (ANC) is
critical as agranulocytosis is a potentially fatal side effect requiring
immediate intervention.
6. Which of the following can cause serotonin syndrome?
A) Lithium and NSAIDs
B) Antidepressants, St. John's Wort, Same-E, Kava Kava, and Tryptophan
C) Antipsychotics and beta-blockers
D) Benzodiazepines and alcohol
Correct Answer: B
Rationale: Serotonin syndrome can be caused by combinations of
serotonergic agents including antidepressants, St. John's Wort, SAM-e,
Kava Kava, and tryptophan. These substances increase serotonin levels
and can lead to toxicity when combined.
7. Which labs are indicative of Neuroleptic Malignant Syndrome
(NMS)?
, A) Elevated liver enzymes and low glucose
B) Elevated WBC (over 11,000) and elevated CPK
C) Low sodium and high potassium
D) Elevated BUN and creatinine
Correct Answer: B
Rationale: NMS is characterized by elevated WBC (>11,000) and
elevated creatine phosphokinase (CPK). These lab findings, along with
clinical symptoms, help diagnose this life-threatening condition.
8. Which of the following is a sign/symptom of NMS?
A) Hyperreflexia and myoclonus
B) Muscle rigidity, hyperthermia, tachycardia, and cherry colored urine
C) Hypotension and bradycardia
D) Dry mouth and constipation
Correct Answer: B
Rationale: NMS presents with muscle rigidity, hyperthermia,
tachycardia, abnormal blood pressure, sweating, altered mental status,
and cherry colored urine (indicating rhabdomyolysis).
9. A patient presents with cherry colored urine. What should you
check?
A) Urinalysis for infection
B) Check for rhabdo with CPK
C) Renal ultrasound
D) Liver function tests
COMPLETE WITH 100% VERIFIED ANSWERS AND
RATIONALES
1. A mother reports her child woke up screaming in the middle of the
night. What is the most appropriate initial response?
A) Prescribe a sleep aid immediately
B) Refer to a sleep specialist
C) Ask if it's happened before to assess for sleep issue patterns
D) Recommend behavioral therapy
Correct Answer: C
Rationale: Assessing for patterns of sleep issues is the appropriate
initial approach before intervening. This helps determine if the issue is
isolated or recurrent, guiding further assessment and treatment
decisions.
2. What does the "I" stand for in ADPIE?
A) Intervention
B) Implementation
C) Initiation
D) Investigation
Correct Answer: B
Rationale: ADPIE stands for Assessment, Diagnosis, Planning,
,Implementation, and Evaluation. "I" represents Implementation, which
is the step where the planned interventions are carried out.
3. A patient presents with fungus on their toenail. What is the
appropriate action?
A) Prescribe oral antifungal medication
B) Refer to dermatology
C) Scrape nail and send for testing
D) Recommend over-the-counter antifungal cream
Correct Answer: C
Rationale: Scraping the nail and sending it for testing is the appropriate
diagnostic step to confirm fungal infection before initiating treatment.
4. A patient on lithium presents with dark brown urine. What should
you do?
A) Check renal function
B) Decrease lithium dose
C) Increase fluid intake
D) Order a urine culture
Correct Answer: A
Rationale: Dark brown urine in a patient on lithium may indicate renal
impairment or toxicity. Checking renal function is essential to assess
kidney status and guide treatment decisions.
,5. A patient on Clozaril presents with fever. What is the priority
assessment?
A) Complete blood count
B) Check ANC level to assess for agranulocytosis
C) Blood culture
D) Chest X-ray
Correct Answer: B
Rationale: Fever in a patient on Clozaril (clozapine) is concerning for
agranulocytosis. Checking the Absolute Neutrophil Count (ANC) is
critical as agranulocytosis is a potentially fatal side effect requiring
immediate intervention.
6. Which of the following can cause serotonin syndrome?
A) Lithium and NSAIDs
B) Antidepressants, St. John's Wort, Same-E, Kava Kava, and Tryptophan
C) Antipsychotics and beta-blockers
D) Benzodiazepines and alcohol
Correct Answer: B
Rationale: Serotonin syndrome can be caused by combinations of
serotonergic agents including antidepressants, St. John's Wort, SAM-e,
Kava Kava, and tryptophan. These substances increase serotonin levels
and can lead to toxicity when combined.
7. Which labs are indicative of Neuroleptic Malignant Syndrome
(NMS)?
, A) Elevated liver enzymes and low glucose
B) Elevated WBC (over 11,000) and elevated CPK
C) Low sodium and high potassium
D) Elevated BUN and creatinine
Correct Answer: B
Rationale: NMS is characterized by elevated WBC (>11,000) and
elevated creatine phosphokinase (CPK). These lab findings, along with
clinical symptoms, help diagnose this life-threatening condition.
8. Which of the following is a sign/symptom of NMS?
A) Hyperreflexia and myoclonus
B) Muscle rigidity, hyperthermia, tachycardia, and cherry colored urine
C) Hypotension and bradycardia
D) Dry mouth and constipation
Correct Answer: B
Rationale: NMS presents with muscle rigidity, hyperthermia,
tachycardia, abnormal blood pressure, sweating, altered mental status,
and cherry colored urine (indicating rhabdomyolysis).
9. A patient presents with cherry colored urine. What should you
check?
A) Urinalysis for infection
B) Check for rhabdo with CPK
C) Renal ultrasound
D) Liver function tests
