PMHNP Certification Review 2026–2027 | 100 Practice
Questions with Verified Answers & Detailed Rationales |
ANCC PMHNP-BC & AANPCB Exam Prep
1. A patient with major depressive disorder has been taking sertraline for 2 weeks with no
improvement. What is the best response?
A. Discontinue the medication immediately. B. Increase the dose to the maximum. C.
Continue the current dose and reassess in several weeks. D. Switch to an antipsychotic.
Answer: C
Rationale: SSRIs typically require 4–6 weeks before significant therapeutic effects are seen.
Unless adverse effects are severe, continuing the medication is appropriate.
2. Which neurotransmitter is most associated with Parkinson disease?
A. Serotonin B. Dopamine C. Acetylcholine D. GABA
Answer: B
Rationale: Parkinson disease results from degeneration of dopamine-producing neurons in
the substantia nigra.
3. A patient reports hearing voices that no one else hears. This symptom is classified as:
A. Illusion B. Delusion C. Hallucination D. Obsession
Answer: C
Rationale: Hallucinations are sensory perceptions without external stimuli. Hearing voices
is an auditory hallucination.
4. Which medication requires routine monitoring of serum lithium levels?
A. Fluoxetine B. Lithium C. Buspirone D. Venlafaxine
Answer: B
Rationale: Lithium has a narrow therapeutic index and requires regular monitoring to
prevent toxicity.
5. A patient taking clozapine should be monitored for:
A. Hyperglycemia only B. Agranulocytosis C. Hypertension D. Cataracts
,Answer: B
Rationale: Clozapine carries a risk of agranulocytosis, requiring regular absolute neutrophil
count (ANC) monitoring.
6. Which symptom is considered negative in schizophrenia?
A. Delusions B. Hallucinations C. Flat affect D. Disorganized speech
Answer: C
Rationale: Negative symptoms include flat affect, avolition, anhedonia, and alogia.
7. The first-line treatment for panic disorder is:
A. Haloperidol B. SSRIs C. Lithium D. Carbamazepine
Answer: B
Rationale: SSRIs are considered first-line pharmacologic treatment for panic disorder.
8. Which medication is most associated with serotonin syndrome when combined with
MAOIs?
A. Sertraline B. Metformin C. Lisinopril D. Omeprazole
Answer: A
Rationale: Combining SSRIs with MAOIs significantly increases serotonin syndrome risk.
9. A manic patient demonstrates decreased need for sleep, grandiosity, and pressured
speech. The most likely diagnosis is:
A. Major depressive disorder B. Bipolar I disorder C. Persistent depressive disorder D.
Generalized anxiety disorder
Answer: B
Rationale: Mania is diagnostic for Bipolar I disorder.
10. Which defense mechanism involves refusing to accept reality?
A. Projection B. Denial C. Sublimation D. Displacement
Answer: B
Rationale: Denial is the unconscious refusal to acknowledge reality.
11. The most important initial intervention for a suicidal patient is:
, A. Prescribe an antidepressant B. Ensure patient safety C. Begin psychotherapy D. Obtain
laboratory studies
Answer: B
Rationale: Safety is always the first priority during suicide risk assessment.
12. Which medication is FDA-approved for ADHD?
A. Methylphenidate B. Risperidone C. Lamotrigine D. Quetiapine
Answer: A
Rationale: Stimulants such as methylphenidate are first-line treatments for ADHD.
13. Which cognitive therapy technique identifies and challenges distorted thinking?
A. Flooding B. Cognitive restructuring C. Aversion therapy D. Free association
Answer: B
Rationale: Cognitive restructuring is a core component of cognitive behavioral therapy
(CBT).
14. A patient taking valproate should have routine monitoring of:
A. Liver function tests B. Vision only C. Hearing tests D. Bone density
Answer: A
Rationale: Valproate can cause hepatotoxicity and requires liver function monitoring.
15. Which disorder is characterized by recurrent binge eating followed by compensatory
behaviors?
A. Anorexia nervosa B. Bulimia nervosa C. ARFID D. Pica
Answer: B
Rationale: Bulimia nervosa includes binge eating and compensatory behaviors such as
purging.
16. Which symptom is characteristic of delirium?
A. Gradual onset B. Fluctuating level of consciousness C. Stable cognition D. Chronic
progression
Answer: B
Questions with Verified Answers & Detailed Rationales |
ANCC PMHNP-BC & AANPCB Exam Prep
1. A patient with major depressive disorder has been taking sertraline for 2 weeks with no
improvement. What is the best response?
A. Discontinue the medication immediately. B. Increase the dose to the maximum. C.
Continue the current dose and reassess in several weeks. D. Switch to an antipsychotic.
Answer: C
Rationale: SSRIs typically require 4–6 weeks before significant therapeutic effects are seen.
Unless adverse effects are severe, continuing the medication is appropriate.
2. Which neurotransmitter is most associated with Parkinson disease?
A. Serotonin B. Dopamine C. Acetylcholine D. GABA
Answer: B
Rationale: Parkinson disease results from degeneration of dopamine-producing neurons in
the substantia nigra.
3. A patient reports hearing voices that no one else hears. This symptom is classified as:
A. Illusion B. Delusion C. Hallucination D. Obsession
Answer: C
Rationale: Hallucinations are sensory perceptions without external stimuli. Hearing voices
is an auditory hallucination.
4. Which medication requires routine monitoring of serum lithium levels?
A. Fluoxetine B. Lithium C. Buspirone D. Venlafaxine
Answer: B
Rationale: Lithium has a narrow therapeutic index and requires regular monitoring to
prevent toxicity.
5. A patient taking clozapine should be monitored for:
A. Hyperglycemia only B. Agranulocytosis C. Hypertension D. Cataracts
,Answer: B
Rationale: Clozapine carries a risk of agranulocytosis, requiring regular absolute neutrophil
count (ANC) monitoring.
6. Which symptom is considered negative in schizophrenia?
A. Delusions B. Hallucinations C. Flat affect D. Disorganized speech
Answer: C
Rationale: Negative symptoms include flat affect, avolition, anhedonia, and alogia.
7. The first-line treatment for panic disorder is:
A. Haloperidol B. SSRIs C. Lithium D. Carbamazepine
Answer: B
Rationale: SSRIs are considered first-line pharmacologic treatment for panic disorder.
8. Which medication is most associated with serotonin syndrome when combined with
MAOIs?
A. Sertraline B. Metformin C. Lisinopril D. Omeprazole
Answer: A
Rationale: Combining SSRIs with MAOIs significantly increases serotonin syndrome risk.
9. A manic patient demonstrates decreased need for sleep, grandiosity, and pressured
speech. The most likely diagnosis is:
A. Major depressive disorder B. Bipolar I disorder C. Persistent depressive disorder D.
Generalized anxiety disorder
Answer: B
Rationale: Mania is diagnostic for Bipolar I disorder.
10. Which defense mechanism involves refusing to accept reality?
A. Projection B. Denial C. Sublimation D. Displacement
Answer: B
Rationale: Denial is the unconscious refusal to acknowledge reality.
11. The most important initial intervention for a suicidal patient is:
, A. Prescribe an antidepressant B. Ensure patient safety C. Begin psychotherapy D. Obtain
laboratory studies
Answer: B
Rationale: Safety is always the first priority during suicide risk assessment.
12. Which medication is FDA-approved for ADHD?
A. Methylphenidate B. Risperidone C. Lamotrigine D. Quetiapine
Answer: A
Rationale: Stimulants such as methylphenidate are first-line treatments for ADHD.
13. Which cognitive therapy technique identifies and challenges distorted thinking?
A. Flooding B. Cognitive restructuring C. Aversion therapy D. Free association
Answer: B
Rationale: Cognitive restructuring is a core component of cognitive behavioral therapy
(CBT).
14. A patient taking valproate should have routine monitoring of:
A. Liver function tests B. Vision only C. Hearing tests D. Bone density
Answer: A
Rationale: Valproate can cause hepatotoxicity and requires liver function monitoring.
15. Which disorder is characterized by recurrent binge eating followed by compensatory
behaviors?
A. Anorexia nervosa B. Bulimia nervosa C. ARFID D. Pica
Answer: B
Rationale: Bulimia nervosa includes binge eating and compensatory behaviors such as
purging.
16. Which symptom is characteristic of delirium?
A. Gradual onset B. Fluctuating level of consciousness C. Stable cognition D. Chronic
progression
Answer: B
