PMH-BC Exam 2026/2027 Psychiatric Mental
Health Nursing Certification | Verified
Questions & Accurate Answers
1. A PMH nurse assesses a client with major depressive disorder. Which
symptom would be a priority to report to the provider?
A) Anhedonia
B) Hypersomnia
C) Suicidal ideation with a plan
D) Feelings of worthlessness
Answer C: Suicidal ideation with a plan
Rationale: Suicidal ideation with a plan indicates imminent risk; safety is always
the first priority in psychiatric nursing .
2. A client states, “The FBI is following me because I know the truth about
aliens.” This is an example of:
A) Illusion
B) Delusion of persecution
C) Hallucination
D) Ideas of reference
Answer B: Delusion of persecution
,Rationale: Persecutory delusions involve the false belief of being targeted, spied
on, or harmed by others .
3. Which finding suggests serotonin syndrome?
A) Hypothermia, bradycardia, constipation
B) Hyperthermia, clonus, diaphoresis
C) Polyuria, polydipsia, weight loss
D) Tremors, bradykinesia, rigidity
Answer B: Hyperthermia, clonus, diaphoresis
Rationale: Serotonin syndrome includes hyperthermia, autonomic instability,
clonus, and hyperreflexia .
4. A client with bipolar I disorder is speaking rapidly, jumping between
topics, and has grandiose plans to “cure cancer.” This speech pattern is:
A) Flight of ideas
B) Neologisms
C) Pressured speech
D) Circumstantiality
Answer A: Flight of ideas
Rationale: Flight of ideas is a rapid, continuous flow of speech with abrupt topic
changes, often seen in mania .
,5. A client on clozapine has a WBC of 2,500/mm³. The nurse should:
A) Continue clozapine and recheck in 1 week
B) Hold clozapine and notify the provider stat
C) Give ibuprofen for fever
D) Monitor for s/s of infection
Answer B: Hold clozapine and notify the provider stat
Rationale: Clozapine can cause agranulocytosis; WBC <3,000/mm³ requires
immediate discontinuation and provider notification .
6. A client with alcohol use disorder has a CIWA-Ar score of 25. The nurse
expects:
A) Mild withdrawal
B) Moderate withdrawal
C) Severe withdrawal
D) No withdrawal
Answer C: Severe withdrawal
Rationale: CIWA-Ar ≥20 indicates severe withdrawal, with risk of seizures and
delirium tremens .
7. Which lab finding is most concerning in a client on lithium?
A) Na 140 mEq/L
B) Li 0.8 mEq/L
C) Li 1.5 mEq/L
, D) Creatinine 0.9 mg/dL
Answer C: Li 1.5 mEq/L
Rationale: Lithium >1.5 mEq/L is nearing toxicity; levels >2.0 mEq/L are
considered severe toxicity .
8. A 55-year-old male with schizophrenia has been stable on risperidone 4
mg daily for 2 years. He presents with involuntary, jerky movements of his
face and tongue. Which condition does the nurse suspect?
A) Acute dystonia
B) Akathisia
C) Tardive dyskinesia
D) Parkinsonism
Answer C: Tardive dyskinesia
Rationale: Tardive dyskinesia is a late-onset extrapyramidal symptom
characterized by involuntary, repetitive movements of the face and tongue, often
developing after long-term antipsychotic use .
9. A 38-year-old woman with PTSD reports recurrent nightmares related to a
sexual assault 3 years ago. Which medication has demonstrated efficacy for
PTSD-related nightmares?
A) Sertraline
B) Paroxetine
C) Prazosin
Health Nursing Certification | Verified
Questions & Accurate Answers
1. A PMH nurse assesses a client with major depressive disorder. Which
symptom would be a priority to report to the provider?
A) Anhedonia
B) Hypersomnia
C) Suicidal ideation with a plan
D) Feelings of worthlessness
Answer C: Suicidal ideation with a plan
Rationale: Suicidal ideation with a plan indicates imminent risk; safety is always
the first priority in psychiatric nursing .
2. A client states, “The FBI is following me because I know the truth about
aliens.” This is an example of:
A) Illusion
B) Delusion of persecution
C) Hallucination
D) Ideas of reference
Answer B: Delusion of persecution
,Rationale: Persecutory delusions involve the false belief of being targeted, spied
on, or harmed by others .
3. Which finding suggests serotonin syndrome?
A) Hypothermia, bradycardia, constipation
B) Hyperthermia, clonus, diaphoresis
C) Polyuria, polydipsia, weight loss
D) Tremors, bradykinesia, rigidity
Answer B: Hyperthermia, clonus, diaphoresis
Rationale: Serotonin syndrome includes hyperthermia, autonomic instability,
clonus, and hyperreflexia .
4. A client with bipolar I disorder is speaking rapidly, jumping between
topics, and has grandiose plans to “cure cancer.” This speech pattern is:
A) Flight of ideas
B) Neologisms
C) Pressured speech
D) Circumstantiality
Answer A: Flight of ideas
Rationale: Flight of ideas is a rapid, continuous flow of speech with abrupt topic
changes, often seen in mania .
,5. A client on clozapine has a WBC of 2,500/mm³. The nurse should:
A) Continue clozapine and recheck in 1 week
B) Hold clozapine and notify the provider stat
C) Give ibuprofen for fever
D) Monitor for s/s of infection
Answer B: Hold clozapine and notify the provider stat
Rationale: Clozapine can cause agranulocytosis; WBC <3,000/mm³ requires
immediate discontinuation and provider notification .
6. A client with alcohol use disorder has a CIWA-Ar score of 25. The nurse
expects:
A) Mild withdrawal
B) Moderate withdrawal
C) Severe withdrawal
D) No withdrawal
Answer C: Severe withdrawal
Rationale: CIWA-Ar ≥20 indicates severe withdrawal, with risk of seizures and
delirium tremens .
7. Which lab finding is most concerning in a client on lithium?
A) Na 140 mEq/L
B) Li 0.8 mEq/L
C) Li 1.5 mEq/L
, D) Creatinine 0.9 mg/dL
Answer C: Li 1.5 mEq/L
Rationale: Lithium >1.5 mEq/L is nearing toxicity; levels >2.0 mEq/L are
considered severe toxicity .
8. A 55-year-old male with schizophrenia has been stable on risperidone 4
mg daily for 2 years. He presents with involuntary, jerky movements of his
face and tongue. Which condition does the nurse suspect?
A) Acute dystonia
B) Akathisia
C) Tardive dyskinesia
D) Parkinsonism
Answer C: Tardive dyskinesia
Rationale: Tardive dyskinesia is a late-onset extrapyramidal symptom
characterized by involuntary, repetitive movements of the face and tongue, often
developing after long-term antipsychotic use .
9. A 38-year-old woman with PTSD reports recurrent nightmares related to a
sexual assault 3 years ago. Which medication has demonstrated efficacy for
PTSD-related nightmares?
A) Sertraline
B) Paroxetine
C) Prazosin
