PMHNP ANCC Review Exam 2025–2026 Accurate
Real Exam Questions and Verified Correct Answers
JUST RELEASED
Which is true about pharmacologic treatment of anxiety in older adults?
a. Course of treatment is generally shorter than for younger adults.
b. Drugs that are highly oxidized are more unpredictable than drugs that are mostly
conjugated.
c. The therapeutic dose of SSRIs is generally lower than for young adults.
d. Highly lipophilic drugs have a more linear elimination in older adults. - answer>>>B.
Liver enzyme functioning (among other things) diminishes as we age. All of the other
statements are false.
A client returns for a follow-up appointment 3 weeks after starting on fluoxetine 20 mg.
During this appointment you notice that her speech is a little rapid, in marked contrast to
the psychomotor retardation and paucity of spontaneous speech she displayed on her
first visit. Instead of looking at the floor, she now makes normal eye contact. Her affect
has gone from constricted to expansive. She continues to have difficulty sleeping, but her
energy has improved and she states she feels "so much better!" What should you
conclude about the shift in the client's presentation?
a. She is experiencing the activating side effects of fluoxetine.
b. She is becoming euthymic.
c. She is becoming hypomanic.
d. She is in a mixed state. - answer>>>C. In this case, you see a shifting set of symptoms,
the most important being her expansive mood and statement "so much better" that
indicates she
has gone beyond euthymia.
Mr. D. is a 35-year-old, married, high-tech industry executive who is referred to the
PMHNP for "insomnia." Mr. D. reports that he falls asleep quickly, but has difficulty
staying asleep. He wakes up several times during the night, and believes he tosses and
turns even when he is sleeping. He wakes up feeling exhausted and drinks "a pot of
coffee" to stay awake and
concentrate during his long work day. He drinks 1 glass of wine most evenings. He denies
any illicit substance use. He denies any symptoms of a mood or anxiety disorder, but is
,feeling increasingly frustrated and concerned about his sleep. Which of the following is
the most likely contributing factor to Mr. D.'s ongoing middle insomnia?
a. Obstructive sleep apnea (OSA)
b. Caffeine dependence
c. Alcohol withdrawal
d. Attention-deficit hyperactivity disorder (ADHD) - answer>>>A. OSA is the only plausible
possibility if the rest of the information given by the client is accurate. OSA causes clients
to have frequent awakenings and
a sense that they are not sleeping deeply ("tossing and turning") that is caused by apnea.
The client should be assessed further for snoring and awareness of apnea. Although the
client states he drinks a lot of coffee, this is driven by his sleep issues. Drinking 1 glass of
wine in the evening would not cause the degree of sleep pathology
he is exhibiting. Other than diminishing concentration that is consistent with sleep
deprivation, there are no other signs and symptoms of ADHD.
Tina is a 54-year-old single white woman who has been a Psychiatric-Mental Health Nurse
Practitioner for over 20 years. She is considering making application to a Doctor of
Nursing Practice (DNP) program but states "if a DNP is required to practice I'll get
grandfathered in, no need for me to go back to school." Following the 2008 License,
Accreditation, Certification, and Education (LACE) Consensus Model for Advanced Practice
Registered Nurse Regulation, which statement is correct?
a. Tina is correct: if the DNP becomes a requirement, she will be grandfathered in and
obtain a DNP degree.
b. The DNP is an academic terminal degree and there will not be an opportunity for Tina
to be grandfathered in a DNP.
c. Tina will be grandfathered in and obtain a DNP only if her state requires a DNP to
practice as an APRN.
d. The DNP is a certification and Tina will have to take an examination to be grandfathered
in to obtain a DN - answer>>>B. APRNs are not grandfathered into an academic degree;
degrees must be earned from accredited academic institutions.
Tim is a board-certified Psychiatric-Mental Health Nurse Practitioner (PMHNP) working in
a busy community mental health center (CMHC). He is currently seeing a client diagnosed
with bipolar I disorder who has comorbid hypertension and diabetes. During the visit, Tim
takes the client's blood pressure and her reading is 160/94 mm Hg. The client denies any
, headaches, nausea, chest pain, or shortness of breath. The client states "I can't afford all
these medications so I haven't seen my doctor in 7 months and I am out of all my blood
pressure and sugar medications, can you give me some?" What is Tim's most appropriate
action?
a. Call the pharmacy to find out what medications the client is taking and refill for 1
month
to cover until she can get in to see his primary care provider.
b. Tell the client he cannot refill her medications and inform her to go to the emergency
room should she develop any signs or symptoms of an - answer>>>C. It is not within the
scope of practice of a PMHNP to treat hypertension. Coordination of care to ensure the
client does not run out of medication is the appropriate course of action.
The chief nursing officer of a large behavioral health system approached the PMHNP to
discuss the new Healthcare Effectiveness Data and Information Set (HEDIS) behavioral
health measures and specifications. The PMHNP is asked to do a retrospective chart
review of all hospital discharge clients who received a follow-up visit within 7 days of
discharge and within 30 days of discharge. The PMHNP has been asked to engage in which
of the following?
a. Needs assessment project
b. Plan, do, study, act project
c. A task that is outside of the PMHNP's scope of practice
d. Quality improvement initiativ - answer>>>D. Engaging in a project to assess whether a
standard of care was met is a quality improvement project.
A PMHNP who is working on the consult liaison service is referred to a patient in the
medical intensive care unit by the attending hospitalist. The consult note read "Evaluate
the patient for competency to make independent medical decisions and consent for a
surgical procedure." Based on the scope of practice of a PMHNP, which response would
be most appropriate?
a. Complete the patient assessment and write up the findings in the patient's medical
record.
b. Complete a patient assessment, including the mini mental status examination and
family collateral data to determine competency.
c. Call the hospitalist and provide education that competency is a legal concept and
explain that you can assess the patient for the capacity to make medical decisions.
d. Refuse the consult and inform the hospitalist that this is outside your scope of practice.
- answer>>>C. The legal system makes determination whether a person is competent;
Real Exam Questions and Verified Correct Answers
JUST RELEASED
Which is true about pharmacologic treatment of anxiety in older adults?
a. Course of treatment is generally shorter than for younger adults.
b. Drugs that are highly oxidized are more unpredictable than drugs that are mostly
conjugated.
c. The therapeutic dose of SSRIs is generally lower than for young adults.
d. Highly lipophilic drugs have a more linear elimination in older adults. - answer>>>B.
Liver enzyme functioning (among other things) diminishes as we age. All of the other
statements are false.
A client returns for a follow-up appointment 3 weeks after starting on fluoxetine 20 mg.
During this appointment you notice that her speech is a little rapid, in marked contrast to
the psychomotor retardation and paucity of spontaneous speech she displayed on her
first visit. Instead of looking at the floor, she now makes normal eye contact. Her affect
has gone from constricted to expansive. She continues to have difficulty sleeping, but her
energy has improved and she states she feels "so much better!" What should you
conclude about the shift in the client's presentation?
a. She is experiencing the activating side effects of fluoxetine.
b. She is becoming euthymic.
c. She is becoming hypomanic.
d. She is in a mixed state. - answer>>>C. In this case, you see a shifting set of symptoms,
the most important being her expansive mood and statement "so much better" that
indicates she
has gone beyond euthymia.
Mr. D. is a 35-year-old, married, high-tech industry executive who is referred to the
PMHNP for "insomnia." Mr. D. reports that he falls asleep quickly, but has difficulty
staying asleep. He wakes up several times during the night, and believes he tosses and
turns even when he is sleeping. He wakes up feeling exhausted and drinks "a pot of
coffee" to stay awake and
concentrate during his long work day. He drinks 1 glass of wine most evenings. He denies
any illicit substance use. He denies any symptoms of a mood or anxiety disorder, but is
,feeling increasingly frustrated and concerned about his sleep. Which of the following is
the most likely contributing factor to Mr. D.'s ongoing middle insomnia?
a. Obstructive sleep apnea (OSA)
b. Caffeine dependence
c. Alcohol withdrawal
d. Attention-deficit hyperactivity disorder (ADHD) - answer>>>A. OSA is the only plausible
possibility if the rest of the information given by the client is accurate. OSA causes clients
to have frequent awakenings and
a sense that they are not sleeping deeply ("tossing and turning") that is caused by apnea.
The client should be assessed further for snoring and awareness of apnea. Although the
client states he drinks a lot of coffee, this is driven by his sleep issues. Drinking 1 glass of
wine in the evening would not cause the degree of sleep pathology
he is exhibiting. Other than diminishing concentration that is consistent with sleep
deprivation, there are no other signs and symptoms of ADHD.
Tina is a 54-year-old single white woman who has been a Psychiatric-Mental Health Nurse
Practitioner for over 20 years. She is considering making application to a Doctor of
Nursing Practice (DNP) program but states "if a DNP is required to practice I'll get
grandfathered in, no need for me to go back to school." Following the 2008 License,
Accreditation, Certification, and Education (LACE) Consensus Model for Advanced Practice
Registered Nurse Regulation, which statement is correct?
a. Tina is correct: if the DNP becomes a requirement, she will be grandfathered in and
obtain a DNP degree.
b. The DNP is an academic terminal degree and there will not be an opportunity for Tina
to be grandfathered in a DNP.
c. Tina will be grandfathered in and obtain a DNP only if her state requires a DNP to
practice as an APRN.
d. The DNP is a certification and Tina will have to take an examination to be grandfathered
in to obtain a DN - answer>>>B. APRNs are not grandfathered into an academic degree;
degrees must be earned from accredited academic institutions.
Tim is a board-certified Psychiatric-Mental Health Nurse Practitioner (PMHNP) working in
a busy community mental health center (CMHC). He is currently seeing a client diagnosed
with bipolar I disorder who has comorbid hypertension and diabetes. During the visit, Tim
takes the client's blood pressure and her reading is 160/94 mm Hg. The client denies any
, headaches, nausea, chest pain, or shortness of breath. The client states "I can't afford all
these medications so I haven't seen my doctor in 7 months and I am out of all my blood
pressure and sugar medications, can you give me some?" What is Tim's most appropriate
action?
a. Call the pharmacy to find out what medications the client is taking and refill for 1
month
to cover until she can get in to see his primary care provider.
b. Tell the client he cannot refill her medications and inform her to go to the emergency
room should she develop any signs or symptoms of an - answer>>>C. It is not within the
scope of practice of a PMHNP to treat hypertension. Coordination of care to ensure the
client does not run out of medication is the appropriate course of action.
The chief nursing officer of a large behavioral health system approached the PMHNP to
discuss the new Healthcare Effectiveness Data and Information Set (HEDIS) behavioral
health measures and specifications. The PMHNP is asked to do a retrospective chart
review of all hospital discharge clients who received a follow-up visit within 7 days of
discharge and within 30 days of discharge. The PMHNP has been asked to engage in which
of the following?
a. Needs assessment project
b. Plan, do, study, act project
c. A task that is outside of the PMHNP's scope of practice
d. Quality improvement initiativ - answer>>>D. Engaging in a project to assess whether a
standard of care was met is a quality improvement project.
A PMHNP who is working on the consult liaison service is referred to a patient in the
medical intensive care unit by the attending hospitalist. The consult note read "Evaluate
the patient for competency to make independent medical decisions and consent for a
surgical procedure." Based on the scope of practice of a PMHNP, which response would
be most appropriate?
a. Complete the patient assessment and write up the findings in the patient's medical
record.
b. Complete a patient assessment, including the mini mental status examination and
family collateral data to determine competency.
c. Call the hospitalist and provide education that competency is a legal concept and
explain that you can assess the patient for the capacity to make medical decisions.
d. Refuse the consult and inform the hospitalist that this is outside your scope of practice.
- answer>>>C. The legal system makes determination whether a person is competent;
