PMH-C (PERINATAL MENTAL HEALTH
CERTIFICATION) EXAM 2026/2027 | 250 VERIFIED
QUESTIONS WITH COMPLETE SOLUTIONS | A+
GRADED | 100% VERIFIED
1. Which screening tool is most commonly used to screen for perinatal depression?
A) PHQ-9
B) Edinburgh Postnatal Depression Scale (EPDS)
C) GAD-7
D) Beck Depression Inventory
Answer: B
Rationale: The EPDS is validated for perinatal populations and excludes somatic symptoms that overlap
with pregnancy.
2. A client at 28 weeks gestation scores 15 on the EPDS. What is the most appropriate next step?
A) Reassure the client that these feelings are normal
B) Conduct a comprehensive clinical assessment including suicide risk
C) Wait 2 weeks and rescreen
D) Refer to a dietitian
Answer: B
Rationale: EPDS >13 indicates probable depression; comprehensive assessment including suicide risk is
essential.
3. Which of the following is a risk factor for postpartum psychosis?
A) History of major depressive disorder
B) History of bipolar disorder or previous postpartum psychosis
C) History of generalized anxiety disorder
,D) History of OCD
Answer: B
Rationale: Bipolar disorder and prior postpartum psychosis are the strongest risk factors for postpartum
psychosis.
4. A client with postpartum depression is prescribed sertraline. Which statement about
breastfeeding is correct?
A) Sertraline is contraindicated during breastfeeding
B) Sertraline has low levels in breast milk and is considered compatible with breastfeeding
C) The infant should be weaned before starting sertraline
D) Sertraline causes sedation in breastfed infants
Answer: B
Rationale: Sertraline has low relative infant dose and is one of the preferred SSRIs during lactation.
5. Which symptom distinguishes postpartum psychosis from postpartum depression?
A) Sadness and tearfulness
B) Hallucinations, delusions, and disorganized thinking
C) Fatigue and insomnia
D) Anxiety and worry
Answer: B
Rationale: Postpartum psychosis includes psychotic features (hallucinations, delusions) and is a
psychiatric emergency.
6. A client with perinatal OCD has intrusive thoughts of harming her infant. Which response is
most appropriate?
A) “You must tell me if you plan to hurt your baby.”
B) “These thoughts are frightening, but they are a symptom of OCD. Let’s talk about treatment.”
C) “Everyone has these thoughts; they don’t mean anything.”
,D) “You should be admitted to the hospital immediately.”
Answer: B
Rationale: Ego-dystonic intrusive thoughts in OCD are distressing but rarely lead to action; validate and
treat.
7. Which medication is most appropriate for a breastfeeding mother with severe postpartum
depression who did not respond to sertraline?
A) Fluoxetine
B) Venlafaxine
C) Paroxetine
D) Lithium
Answer: B
Rationale: Venlafaxine (SNRI) is an option for treatment-resistant depression and has low milk levels.
8. A client at 20 weeks gestation presents with panic attacks. Which class of medication is first-
line?
A) Benzodiazepines
B) SSRIs
C) Antipsychotics
D) Mood stabilizers
Answer: B
Rationale: SSRIs are first-line for panic disorder in pregnancy; benzodiazepines are used with caution.
9. Which of the following is a protective factor against perinatal depression?
A) History of childhood trauma
B) Strong social support and partner support
C) Unplanned pregnancy
D) Financial stress
, Answer: B
Rationale: Social support is a key protective factor; trauma and stress are risk factors.
10. A client with postpartum depression reports thoughts of “running away.” Which action should
the nurse take first?
A) Reassure the client that these feelings will pass
B) Assess for suicidal ideation and plan
C) Encourage the client to rest
D) Notify the partner
Answer: B
Rationale: Thoughts of escape may indicate severe depression; suicide risk assessment is priority.
11. Which therapy is most effective for perinatal depression?
A) Psychoanalysis
B) Cognitive-behavioral therapy (CBT) or interpersonal therapy (IPT)
C) Hypnosis
D) Electroconvulsive therapy
Answer: B
Rationale: CBT and IPT have the strongest evidence for perinatal depression.
12. A client with bipolar disorder is planning pregnancy. Which medication is most teratogenic?
A) Lamotrigine
B) Lithium
C) Quetiapine
D) Sertraline
Answer: B
Rationale: Lithium is associated with Ebstein’s anomaly (cardiac defect) though risk is lower than
previously thought.
CERTIFICATION) EXAM 2026/2027 | 250 VERIFIED
QUESTIONS WITH COMPLETE SOLUTIONS | A+
GRADED | 100% VERIFIED
1. Which screening tool is most commonly used to screen for perinatal depression?
A) PHQ-9
B) Edinburgh Postnatal Depression Scale (EPDS)
C) GAD-7
D) Beck Depression Inventory
Answer: B
Rationale: The EPDS is validated for perinatal populations and excludes somatic symptoms that overlap
with pregnancy.
2. A client at 28 weeks gestation scores 15 on the EPDS. What is the most appropriate next step?
A) Reassure the client that these feelings are normal
B) Conduct a comprehensive clinical assessment including suicide risk
C) Wait 2 weeks and rescreen
D) Refer to a dietitian
Answer: B
Rationale: EPDS >13 indicates probable depression; comprehensive assessment including suicide risk is
essential.
3. Which of the following is a risk factor for postpartum psychosis?
A) History of major depressive disorder
B) History of bipolar disorder or previous postpartum psychosis
C) History of generalized anxiety disorder
,D) History of OCD
Answer: B
Rationale: Bipolar disorder and prior postpartum psychosis are the strongest risk factors for postpartum
psychosis.
4. A client with postpartum depression is prescribed sertraline. Which statement about
breastfeeding is correct?
A) Sertraline is contraindicated during breastfeeding
B) Sertraline has low levels in breast milk and is considered compatible with breastfeeding
C) The infant should be weaned before starting sertraline
D) Sertraline causes sedation in breastfed infants
Answer: B
Rationale: Sertraline has low relative infant dose and is one of the preferred SSRIs during lactation.
5. Which symptom distinguishes postpartum psychosis from postpartum depression?
A) Sadness and tearfulness
B) Hallucinations, delusions, and disorganized thinking
C) Fatigue and insomnia
D) Anxiety and worry
Answer: B
Rationale: Postpartum psychosis includes psychotic features (hallucinations, delusions) and is a
psychiatric emergency.
6. A client with perinatal OCD has intrusive thoughts of harming her infant. Which response is
most appropriate?
A) “You must tell me if you plan to hurt your baby.”
B) “These thoughts are frightening, but they are a symptom of OCD. Let’s talk about treatment.”
C) “Everyone has these thoughts; they don’t mean anything.”
,D) “You should be admitted to the hospital immediately.”
Answer: B
Rationale: Ego-dystonic intrusive thoughts in OCD are distressing but rarely lead to action; validate and
treat.
7. Which medication is most appropriate for a breastfeeding mother with severe postpartum
depression who did not respond to sertraline?
A) Fluoxetine
B) Venlafaxine
C) Paroxetine
D) Lithium
Answer: B
Rationale: Venlafaxine (SNRI) is an option for treatment-resistant depression and has low milk levels.
8. A client at 20 weeks gestation presents with panic attacks. Which class of medication is first-
line?
A) Benzodiazepines
B) SSRIs
C) Antipsychotics
D) Mood stabilizers
Answer: B
Rationale: SSRIs are first-line for panic disorder in pregnancy; benzodiazepines are used with caution.
9. Which of the following is a protective factor against perinatal depression?
A) History of childhood trauma
B) Strong social support and partner support
C) Unplanned pregnancy
D) Financial stress
, Answer: B
Rationale: Social support is a key protective factor; trauma and stress are risk factors.
10. A client with postpartum depression reports thoughts of “running away.” Which action should
the nurse take first?
A) Reassure the client that these feelings will pass
B) Assess for suicidal ideation and plan
C) Encourage the client to rest
D) Notify the partner
Answer: B
Rationale: Thoughts of escape may indicate severe depression; suicide risk assessment is priority.
11. Which therapy is most effective for perinatal depression?
A) Psychoanalysis
B) Cognitive-behavioral therapy (CBT) or interpersonal therapy (IPT)
C) Hypnosis
D) Electroconvulsive therapy
Answer: B
Rationale: CBT and IPT have the strongest evidence for perinatal depression.
12. A client with bipolar disorder is planning pregnancy. Which medication is most teratogenic?
A) Lamotrigine
B) Lithium
C) Quetiapine
D) Sertraline
Answer: B
Rationale: Lithium is associated with Ebstein’s anomaly (cardiac defect) though risk is lower than
previously thought.
