NUR 670 PMHNP APEA Exam Prep:
Complete Test Bank with 650 Real
Questions, Verified Answers & Clinical
Rationales (2026/2027 Updated)
## Question 1
A PMHNP is considering prescribing a selective serotonin reuptake inhibitor (SSRI)
for a 23-year-old male client. What is the most important education for this
client?
**A.** The client must be informed of the potential sexual side effects associated
with SSRIs.
**B.** The client must be informed about increased mania and hypomania with
SSRI use.
**C.** The client must be informed about gastrointestinal side effects and
headaches with SSRI use.
**D.** The client must be informed about the potential for blurred vision and
urinary retention.
**Answer: A**
**Rationale:** Sexual side effects (e.g., decreased libido, erectile dysfunction,
anorgasmia) are among the most common and distressing side effects of SSRIs,
affecting up to 70% of patients. This is critical education as it impacts medication
adherence. Mania/hypomania is a concern but more specific to bipolar disorder;
GI effects and headaches are common but less impactful on adherence; blurred
,vision and urinary retention are more characteristic of TCAs or anticholinergic
medications.
## Question 2
A patient reports feeling "keyed up" and fears losing control. Symptoms have
been present for the past 3 years. The patient reports low energy, insomnia, low
self-esteem, and difficulty making decisions. Which is the most likely diagnosis?
**A.** Persistent depressive disorder with anxious distress
**B.** Major depressive disorder with atypical features
**C.** Bipolar 2 disorder with melancholic features
**D.** Bipolar 1 disorder with melancholic features
**Answer: A**
**Rationale:** Persistent depressive disorder (dysthymia) requires depressed
mood for at least 2 years in adults, along with at least two of the following: poor
appetite/overeating, insomnia/hypersomnia, low energy, low self-esteem, poor
concentration, or hopelessness. The addition of "anxious distress" specifier fits
this presentation of feeling "keyed up" and fear of losing control.
## Question 3
According to DSM-5 criteria, the symptoms of a panic attack develop abruptly and
reach a peak within how many minutes?
,**A.** 1 minute
**B.** 60 minutes
**C.** 10 minutes
**D.** 30 minutes
**Answer: C**
**Rationale:** DSM-5 specifies that a panic attack is an abrupt surge of intense
fear or intense discomfort that reaches a peak within minutes (typically 10
minutes) and during which time four or more of a list of 13 symptoms occur.
## Question 4
An elderly woman's house has piles of junk ("treasures") from floor to ceiling,
with only a narrow pathway between rooms. She experiences tremendous
anxiety when trying to discard any possessions. Which diagnosis is most
appropriate?
**A.** Major depressive disorder
**B.** Obsessive-compulsive disorder
**C.** Hoarding disorder
**D.** Body dysmorphic disorder
**Answer: C**
, **Rationale:** Hoarding disorder is characterized by persistent difficulty
discarding possessions regardless of their actual value, leading to accumulation
that congest active living areas. The distress associated with discarding items is a
hallmark feature.
## Question 5
Fear activates which response?
**A.** A psychological but not physiological response
**B.** A physiological but not psychological response
**C.** A decrease in inhibitory mechanisms in the somatic nervous system so we
can flee
**D.** A surge of energy in the autonomic nervous system so we can flee
**Answer: D**
**Rationale:** Fear activates the autonomic nervous system (ANS), specifically
the sympathetic branch, resulting in a surge of energy (fight-or-flight response) to
enable escape from perceived threat. Both psychological and physiological
responses occur.
## Question 6
Which is an accurate statement about panic disorder?
Complete Test Bank with 650 Real
Questions, Verified Answers & Clinical
Rationales (2026/2027 Updated)
## Question 1
A PMHNP is considering prescribing a selective serotonin reuptake inhibitor (SSRI)
for a 23-year-old male client. What is the most important education for this
client?
**A.** The client must be informed of the potential sexual side effects associated
with SSRIs.
**B.** The client must be informed about increased mania and hypomania with
SSRI use.
**C.** The client must be informed about gastrointestinal side effects and
headaches with SSRI use.
**D.** The client must be informed about the potential for blurred vision and
urinary retention.
**Answer: A**
**Rationale:** Sexual side effects (e.g., decreased libido, erectile dysfunction,
anorgasmia) are among the most common and distressing side effects of SSRIs,
affecting up to 70% of patients. This is critical education as it impacts medication
adherence. Mania/hypomania is a concern but more specific to bipolar disorder;
GI effects and headaches are common but less impactful on adherence; blurred
,vision and urinary retention are more characteristic of TCAs or anticholinergic
medications.
## Question 2
A patient reports feeling "keyed up" and fears losing control. Symptoms have
been present for the past 3 years. The patient reports low energy, insomnia, low
self-esteem, and difficulty making decisions. Which is the most likely diagnosis?
**A.** Persistent depressive disorder with anxious distress
**B.** Major depressive disorder with atypical features
**C.** Bipolar 2 disorder with melancholic features
**D.** Bipolar 1 disorder with melancholic features
**Answer: A**
**Rationale:** Persistent depressive disorder (dysthymia) requires depressed
mood for at least 2 years in adults, along with at least two of the following: poor
appetite/overeating, insomnia/hypersomnia, low energy, low self-esteem, poor
concentration, or hopelessness. The addition of "anxious distress" specifier fits
this presentation of feeling "keyed up" and fear of losing control.
## Question 3
According to DSM-5 criteria, the symptoms of a panic attack develop abruptly and
reach a peak within how many minutes?
,**A.** 1 minute
**B.** 60 minutes
**C.** 10 minutes
**D.** 30 minutes
**Answer: C**
**Rationale:** DSM-5 specifies that a panic attack is an abrupt surge of intense
fear or intense discomfort that reaches a peak within minutes (typically 10
minutes) and during which time four or more of a list of 13 symptoms occur.
## Question 4
An elderly woman's house has piles of junk ("treasures") from floor to ceiling,
with only a narrow pathway between rooms. She experiences tremendous
anxiety when trying to discard any possessions. Which diagnosis is most
appropriate?
**A.** Major depressive disorder
**B.** Obsessive-compulsive disorder
**C.** Hoarding disorder
**D.** Body dysmorphic disorder
**Answer: C**
, **Rationale:** Hoarding disorder is characterized by persistent difficulty
discarding possessions regardless of their actual value, leading to accumulation
that congest active living areas. The distress associated with discarding items is a
hallmark feature.
## Question 5
Fear activates which response?
**A.** A psychological but not physiological response
**B.** A physiological but not psychological response
**C.** A decrease in inhibitory mechanisms in the somatic nervous system so we
can flee
**D.** A surge of energy in the autonomic nervous system so we can flee
**Answer: D**
**Rationale:** Fear activates the autonomic nervous system (ANS), specifically
the sympathetic branch, resulting in a surge of energy (fight-or-flight response) to
enable escape from perceived threat. Both psychological and physiological
responses occur.
## Question 6
Which is an accurate statement about panic disorder?
