APEA PMHNP EXAM PRACTICE QUESTIONS 2026
EDITION|450 MULTIPLECHOICE QUESTIONS WITH
ANSWERS AND RATIONALES
Section 1: Psychiatric Assessment & Diagnosis (Questions 175)
1. A 32yearold patient presents with depressed mood, anhedonia, significant
weight loss, and early morning awakening for the past 4 weeks. Which
specifier best applies to this presentation?
A) Atypical features
B) Melancholic features
C) Catatonic features
D) Peripartum onset
Correct Answer: B
Rationale: Melancholic features are characterized by anhedonia, early
morning awakening, significant weight loss, and psychomotor disturbances.
These features indicate a more severe form of depression that often responds
better to certain treatments. Atypical features would include increased
appetite and hypersomnia. Catatonic features involve motor immobility or
excessive motor activity.
,2. A 28yearold woman reports recurrent episodes of pulling out her hair from
her scalp and eyebrows, resulting in noticeable bald patches. She experiences
increasing tension before pulling and relief afterward. What is the most likely
diagnosis?
A) Trichotillomania
B) Excoriation disorder
C) Body dysmorphic disorder
D) Obsessivecompulsive disorder
Correct Answer: A
Rationale: Trichotillomania (hairpulling disorder) is characterized by
recurrent pulling out of one's hair resulting in hair loss, with increasing
tension before the act and pleasure, gratification, or relief afterward.
3. A 45yearold patient presents with a 6month history of excessive worry
about various life circumstances. She reports difficulty controlling the worry,
restlessness, fatigue, and difficulty concentrating. What is the most likely
diagnosis?
A) Panic disorder
B) Generalized anxiety disorder
C) Social anxiety disorder
D) Obsessivecompulsive disorder
Correct Answer: B
,Rationale: Generalized anxiety disorder (GAD) is characterized by excessive
anxiety and worry about multiple domains occurring more days than not for
at least 6 months, along with difficulty controlling the worry and associated
symptoms such as restlessness, fatigue, and difficulty concentrating.
4. A 19yearold college student is preoccupied with a perceived defect in her
nose. She spends hours checking it in the mirror and has consulted multiple
plastic surgeons. What is the most likely diagnosis?
A) Body dysmorphic disorder
B) Illness anxiety disorder
C) Obsessivecompulsive disorder
D) Narcissistic personality disorder
Correct Answer: A
Rationale: Body dysmorphic disorder (BDD) involves preoccupation with one
or more perceived defects or flaws in physical appearance that are not
observable or appear slight to others, with repetitive behaviors such as mirror
checking.
5. A 50yearold man with no psychiatric history tells you his neighbor has
installed cameras in his smoke detectors to spy on him. He has no other
psychotic symptoms and has maintained his job. What is the most likely
diagnosis?
, A) Schizophrenia
B) Delusional disorder
C) Schizoaffective disorder
D) Paranoid personality disorder
Correct Answer: B
Rationale: Delusional disorder is characterized by the presence of one or more
delusions for at least 1 month without other prominent psychotic symptoms.
Functioning is not markedly impaired, and behavior is not obviously bizarre.
6. A 34yearold patient reports a 2month history of depressed mood, fatigue,
poor concentration, insomnia, and unintentional weight loss. She denies
suicidal ideation. What is the most appropriate initial pharmacologic
treatment?
A) Bupropion
B) Fluoxetine
C) Mirtazapine
D) Sertraline
Correct Answer: C
Rationale: Mirtazapine is particularly suitable for patients with depression
accompanied by insomnia and weight loss because it promotes sleep and
increases appetite through its antihistaminergic properties. For patients with
EDITION|450 MULTIPLECHOICE QUESTIONS WITH
ANSWERS AND RATIONALES
Section 1: Psychiatric Assessment & Diagnosis (Questions 175)
1. A 32yearold patient presents with depressed mood, anhedonia, significant
weight loss, and early morning awakening for the past 4 weeks. Which
specifier best applies to this presentation?
A) Atypical features
B) Melancholic features
C) Catatonic features
D) Peripartum onset
Correct Answer: B
Rationale: Melancholic features are characterized by anhedonia, early
morning awakening, significant weight loss, and psychomotor disturbances.
These features indicate a more severe form of depression that often responds
better to certain treatments. Atypical features would include increased
appetite and hypersomnia. Catatonic features involve motor immobility or
excessive motor activity.
,2. A 28yearold woman reports recurrent episodes of pulling out her hair from
her scalp and eyebrows, resulting in noticeable bald patches. She experiences
increasing tension before pulling and relief afterward. What is the most likely
diagnosis?
A) Trichotillomania
B) Excoriation disorder
C) Body dysmorphic disorder
D) Obsessivecompulsive disorder
Correct Answer: A
Rationale: Trichotillomania (hairpulling disorder) is characterized by
recurrent pulling out of one's hair resulting in hair loss, with increasing
tension before the act and pleasure, gratification, or relief afterward.
3. A 45yearold patient presents with a 6month history of excessive worry
about various life circumstances. She reports difficulty controlling the worry,
restlessness, fatigue, and difficulty concentrating. What is the most likely
diagnosis?
A) Panic disorder
B) Generalized anxiety disorder
C) Social anxiety disorder
D) Obsessivecompulsive disorder
Correct Answer: B
,Rationale: Generalized anxiety disorder (GAD) is characterized by excessive
anxiety and worry about multiple domains occurring more days than not for
at least 6 months, along with difficulty controlling the worry and associated
symptoms such as restlessness, fatigue, and difficulty concentrating.
4. A 19yearold college student is preoccupied with a perceived defect in her
nose. She spends hours checking it in the mirror and has consulted multiple
plastic surgeons. What is the most likely diagnosis?
A) Body dysmorphic disorder
B) Illness anxiety disorder
C) Obsessivecompulsive disorder
D) Narcissistic personality disorder
Correct Answer: A
Rationale: Body dysmorphic disorder (BDD) involves preoccupation with one
or more perceived defects or flaws in physical appearance that are not
observable or appear slight to others, with repetitive behaviors such as mirror
checking.
5. A 50yearold man with no psychiatric history tells you his neighbor has
installed cameras in his smoke detectors to spy on him. He has no other
psychotic symptoms and has maintained his job. What is the most likely
diagnosis?
, A) Schizophrenia
B) Delusional disorder
C) Schizoaffective disorder
D) Paranoid personality disorder
Correct Answer: B
Rationale: Delusional disorder is characterized by the presence of one or more
delusions for at least 1 month without other prominent psychotic symptoms.
Functioning is not markedly impaired, and behavior is not obviously bizarre.
6. A 34yearold patient reports a 2month history of depressed mood, fatigue,
poor concentration, insomnia, and unintentional weight loss. She denies
suicidal ideation. What is the most appropriate initial pharmacologic
treatment?
A) Bupropion
B) Fluoxetine
C) Mirtazapine
D) Sertraline
Correct Answer: C
Rationale: Mirtazapine is particularly suitable for patients with depression
accompanied by insomnia and weight loss because it promotes sleep and
increases appetite through its antihistaminergic properties. For patients with
