LMR Georgette’s PMHNP Certification Exam
INTRODUCTION
This comprehensive study guide features verified practice questions
covering the most frequently tested topics on the PMHNP Certification
Board Examination for the 2026/2027 cycle, based on the latest ANCC
and AANPCB exam blueprints and Dr. Georgette Quie's Last Minute Review
(LMR) methodology. The content includes scientific foundations
(neuroanatomy, neurophysiology, psychopharmacology), advanced
practice skills (clinical interviewing, mental status exam, risk
assessment), diagnosis and treatment (DSM-5-TR criteria, differential
diagnosis), psychotherapy and related theories, and ethics/legal
principles. Each question is paired with the correct answer in bold italics
and a detailed clinical rationale explaining the underlying psychiatric
principles and clinical decision-making processes. This resource is
designed for psychiatric-mental health nurse practitioner candidates
seeking to pass the certification exam on the first attempt.
,SECTION 1: DRUG INTERACTIONS & HERBAL SUPPLEMENTS
Question 1
What drugs should be avoided with Kava Kava?
A) SSRIs
B) Alprazolam and CNS depressants (e.g., phenobarbital, zolpidem)
C) Antipsychotics
D) Beta-blockers
Answer: B) Alprazolam and CNS depressants (e.g., phenobarbital,
zolpidem)
Explanation: Kava Kava should be avoided with alprazolam and other CNS
depressants (phenobarbital, zolpidem) due to additive sedative effects
and increased risk of respiratory depression. Kava Kava also carries a
risk of liver damage and should be used with caution .**
Question 2
What is the major side effect associated with Kava Kava?
A) Nephrotoxicity
B) Liver damage
C) Cardiotoxicity
D) Neurotoxicity
Answer: B) Liver damage
,Explanation: Kava Kava is associated with hepatotoxicity (liver damage),
which can be severe and potentially fatal. Patients should be monitored
for signs of liver injury, including jaundice, dark urine, and abdominal pain
.**
Question 3
What herbal supplement is used for anxiety, stress, and insomnia?
A) St. John's Wort
B) Kava Kava
C) SAM-e
D) Ginkgo Biloba
Answer: B) Kava Kava
Explanation: Kava Kava is commonly used for anxiety, stress, and
insomnia. However, it carries a risk of liver damage and should be used
with caution. Patients should be monitored for hepatotoxicity .**
Question 4
What is the therapeutic range for valproic acid?
A) 25-50 mcg/mL
B) 50-125 mcg/mL
C) 125-150 mcg/mL
D) 150-200 mcg/mL
, Answer: B) 50-125 mcg/mL
Explanation: The therapeutic range for valproic acid is 50-125 mcg/mL.
Levels above 150 mcg/mL are considered toxic. Regular monitoring is
required due to the risk of hepatotoxicity and pancreatitis .**
Question 5
What is a toxic level of valproic acid?
A) >100 mcg/mL
B) >125 mcg/mL
C) >150 mcg/mL
D) >200 mcg/mL
Answer: C) >150 mcg/mL
Explanation: A valproic acid level greater than 150 mcg/mL is considered
toxic. Signs of toxicity include disorientation, lethargy, respiratory
depression, and nausea/vomiting. Immediate medical intervention is
required .**
Question 6
What are 4 signs of valproic acid toxicity?
A) Disorientation, lethargy, respiratory depression, nausea/vomiting
B) Hypertension, tachycardia, fever, rash
INTRODUCTION
This comprehensive study guide features verified practice questions
covering the most frequently tested topics on the PMHNP Certification
Board Examination for the 2026/2027 cycle, based on the latest ANCC
and AANPCB exam blueprints and Dr. Georgette Quie's Last Minute Review
(LMR) methodology. The content includes scientific foundations
(neuroanatomy, neurophysiology, psychopharmacology), advanced
practice skills (clinical interviewing, mental status exam, risk
assessment), diagnosis and treatment (DSM-5-TR criteria, differential
diagnosis), psychotherapy and related theories, and ethics/legal
principles. Each question is paired with the correct answer in bold italics
and a detailed clinical rationale explaining the underlying psychiatric
principles and clinical decision-making processes. This resource is
designed for psychiatric-mental health nurse practitioner candidates
seeking to pass the certification exam on the first attempt.
,SECTION 1: DRUG INTERACTIONS & HERBAL SUPPLEMENTS
Question 1
What drugs should be avoided with Kava Kava?
A) SSRIs
B) Alprazolam and CNS depressants (e.g., phenobarbital, zolpidem)
C) Antipsychotics
D) Beta-blockers
Answer: B) Alprazolam and CNS depressants (e.g., phenobarbital,
zolpidem)
Explanation: Kava Kava should be avoided with alprazolam and other CNS
depressants (phenobarbital, zolpidem) due to additive sedative effects
and increased risk of respiratory depression. Kava Kava also carries a
risk of liver damage and should be used with caution .**
Question 2
What is the major side effect associated with Kava Kava?
A) Nephrotoxicity
B) Liver damage
C) Cardiotoxicity
D) Neurotoxicity
Answer: B) Liver damage
,Explanation: Kava Kava is associated with hepatotoxicity (liver damage),
which can be severe and potentially fatal. Patients should be monitored
for signs of liver injury, including jaundice, dark urine, and abdominal pain
.**
Question 3
What herbal supplement is used for anxiety, stress, and insomnia?
A) St. John's Wort
B) Kava Kava
C) SAM-e
D) Ginkgo Biloba
Answer: B) Kava Kava
Explanation: Kava Kava is commonly used for anxiety, stress, and
insomnia. However, it carries a risk of liver damage and should be used
with caution. Patients should be monitored for hepatotoxicity .**
Question 4
What is the therapeutic range for valproic acid?
A) 25-50 mcg/mL
B) 50-125 mcg/mL
C) 125-150 mcg/mL
D) 150-200 mcg/mL
, Answer: B) 50-125 mcg/mL
Explanation: The therapeutic range for valproic acid is 50-125 mcg/mL.
Levels above 150 mcg/mL are considered toxic. Regular monitoring is
required due to the risk of hepatotoxicity and pancreatitis .**
Question 5
What is a toxic level of valproic acid?
A) >100 mcg/mL
B) >125 mcg/mL
C) >150 mcg/mL
D) >200 mcg/mL
Answer: C) >150 mcg/mL
Explanation: A valproic acid level greater than 150 mcg/mL is considered
toxic. Signs of toxicity include disorientation, lethargy, respiratory
depression, and nausea/vomiting. Immediate medical intervention is
required .**
Question 6
What are 4 signs of valproic acid toxicity?
A) Disorientation, lethargy, respiratory depression, nausea/vomiting
B) Hypertension, tachycardia, fever, rash
