PMHNP BOARD EXAM
COMPREHENSIVE PREP 2026/2027
QUESTIONS AND ANSWERS
1. A 42-year-old male patient on Clozapine presents with a sudden onset of high fever,
pharyngitis, and ulcerations of the mucous membranes. Which laboratory value is the priority
for the PMHNP to evaluate?
A. Serum Clozapine level
B. Liver function tests
C. Absolute Neutrophil Count (ANC)
D. Fast blood glucose
Answer: C
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. A
sudden onset of fever and sore throat indicates potential neutropenia, requiring an
immediate check of the ANC.
2. Which brain structure is primarily responsible for the ‘alarm’ response and is found to be
hyperactive in patients with Post-Traumatic Stress Disorder (PTSD)?
A. Hippocampus
,B. Prefrontal Cortex
C. Basal Ganglia
D. Amygdala
Answer: D
Conceptual Explanation: The amygdala processes fear and emotional memories;
hyperactivity in this area is a hallmark of PTSD neurobiology.
3. A PMHNP is treating a patient with Bipolar I disorder who is planning to become pregnant.
Which medication carries the highest risk for Ebstein’s anomaly during the first trimester?
A. Valproate
B. Lamotrigine
C. Quetiapine
D. Lithium
Answer: D
Conceptual Explanation: Lithium exposure in the first trimester is specifically associated
with Ebstein’s anomaly, a malformation of the tricuspid valve.
4. According to the DSM-5-TR, what is the minimum duration of symptoms required to
diagnose Cyclothymic Disorder in an adult?
A. 2 years
B. 1 year
, C. 6 months
D. 5 years
Answer: A
Conceptual Explanation: Adults must have symptoms for at least 2 years, while children
and adolescents require only 1 year for a Cyclothymic diagnosis.
5. Which cytochrome P450 enzyme is significantly induced by cigarette smoking, potentially
lowering the serum levels of Olanzapine?
A. CYP2D6
B. CYP3A4
C. CYP1A2
D. CYP2C19
Answer: C
Conceptual Explanation: Polycyclic aromatic hydrocarbons in cigarette smoke induce
CYP1A2, which metabolizes drugs like Olanzapine and Clozapine.
6. In the context of health policy, what does the ‘LACE’ model stand for regarding the APRN
role?
A. Leadership, Advocacy, Clinicals, Ethics
B. Licensure, Accreditation, Certification, Education
C. Law, Authority, Competency, Evaluation
COMPREHENSIVE PREP 2026/2027
QUESTIONS AND ANSWERS
1. A 42-year-old male patient on Clozapine presents with a sudden onset of high fever,
pharyngitis, and ulcerations of the mucous membranes. Which laboratory value is the priority
for the PMHNP to evaluate?
A. Serum Clozapine level
B. Liver function tests
C. Absolute Neutrophil Count (ANC)
D. Fast blood glucose
Answer: C
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. A
sudden onset of fever and sore throat indicates potential neutropenia, requiring an
immediate check of the ANC.
2. Which brain structure is primarily responsible for the ‘alarm’ response and is found to be
hyperactive in patients with Post-Traumatic Stress Disorder (PTSD)?
A. Hippocampus
,B. Prefrontal Cortex
C. Basal Ganglia
D. Amygdala
Answer: D
Conceptual Explanation: The amygdala processes fear and emotional memories;
hyperactivity in this area is a hallmark of PTSD neurobiology.
3. A PMHNP is treating a patient with Bipolar I disorder who is planning to become pregnant.
Which medication carries the highest risk for Ebstein’s anomaly during the first trimester?
A. Valproate
B. Lamotrigine
C. Quetiapine
D. Lithium
Answer: D
Conceptual Explanation: Lithium exposure in the first trimester is specifically associated
with Ebstein’s anomaly, a malformation of the tricuspid valve.
4. According to the DSM-5-TR, what is the minimum duration of symptoms required to
diagnose Cyclothymic Disorder in an adult?
A. 2 years
B. 1 year
, C. 6 months
D. 5 years
Answer: A
Conceptual Explanation: Adults must have symptoms for at least 2 years, while children
and adolescents require only 1 year for a Cyclothymic diagnosis.
5. Which cytochrome P450 enzyme is significantly induced by cigarette smoking, potentially
lowering the serum levels of Olanzapine?
A. CYP2D6
B. CYP3A4
C. CYP1A2
D. CYP2C19
Answer: C
Conceptual Explanation: Polycyclic aromatic hydrocarbons in cigarette smoke induce
CYP1A2, which metabolizes drugs like Olanzapine and Clozapine.
6. In the context of health policy, what does the ‘LACE’ model stand for regarding the APRN
role?
A. Leadership, Advocacy, Clinicals, Ethics
B. Licensure, Accreditation, Certification, Education
C. Law, Authority, Competency, Evaluation
