Psychiatric-Mental Health Clinical Nurse
Specialist (PMHCNS-BC) certification practice
test exam
1. A 32-year-old patient presents with persistent sadness,
anhedonia, insomnia, and impaired concentration for 3 weeks
following job loss. There is no prior psychiatric history. Which
diagnosis is most appropriate?
A. Adjustment disorder with depressed mood
B. Persistent depressive disorder
C. Major depressive disorder
D. Acute stress disorder
Answer: C
Rationale: Symptoms exceed 2 weeks and meet full criteria for
major depressive disorder, not limited to a stress reaction alone
.
2. A patient with bipolar I disorder presents with decreased
need for sleep, grandiosity, and excessive spending for 10 days
requiring hospitalization. This episode is best classified as:
,A. Hypomanic
B. Mixed
C. Cyclothymic
D. Manic
Answer: D
Rationale: Duration >7 days with marked impairment and
hospitalization defines mania .
3. A patient reports hearing voices commenting on her
behavior for 8 months without mood symptoms. Most likely
diagnosis?
A. Brief psychotic disorder
B. Schizophreniform disorder
C. Schizophrenia
D. Schizoaffective disorder
Answer: C
,Rationale: Continuous psychotic symptoms >6 months without
mood episode dominance indicates schizophrenia .
4. Which defense mechanism is demonstrated when a patient
attributes their own hostility to others?
A. Displacement
B. Regression
C. Reaction formation
D. Projection
Answer: D
Rationale: Projection involves attributing unacceptable
impulses to others .
5. A 22-year-old patient is brought to the emergency
department by police after being found wandering in traffic.
The patient is disorganized, unable to answer questions
coherently, and appears to be responding to internal stimuli.
What is the priority nursing intervention?
A. Obtain a thorough history from the patient
, B. Assess for safety and the need for immediate containment
C. Administer a sedative to calm the patient
D. Order a toxicology screen
Answer: B
Rationale: The priority is safety assessment. The patient is
displaying signs of psychosis with disorganization and potential
risk to self. The CNS must first ensure safety, which may include
a psychiatric hold and/or medication for agitation .
6. A PMHCNS is assessing a patient who reports hearing voices
that comment on their behavior. The patient states, "The voices
tell me I'm worthless and that I should harm myself." Which
finding should the CNS prioritize?
A. Assess for command hallucinations
B. Assess for suicidal ideation
C. Assess for substance use
D. Assess for thought disorder
Answer: B
Specialist (PMHCNS-BC) certification practice
test exam
1. A 32-year-old patient presents with persistent sadness,
anhedonia, insomnia, and impaired concentration for 3 weeks
following job loss. There is no prior psychiatric history. Which
diagnosis is most appropriate?
A. Adjustment disorder with depressed mood
B. Persistent depressive disorder
C. Major depressive disorder
D. Acute stress disorder
Answer: C
Rationale: Symptoms exceed 2 weeks and meet full criteria for
major depressive disorder, not limited to a stress reaction alone
.
2. A patient with bipolar I disorder presents with decreased
need for sleep, grandiosity, and excessive spending for 10 days
requiring hospitalization. This episode is best classified as:
,A. Hypomanic
B. Mixed
C. Cyclothymic
D. Manic
Answer: D
Rationale: Duration >7 days with marked impairment and
hospitalization defines mania .
3. A patient reports hearing voices commenting on her
behavior for 8 months without mood symptoms. Most likely
diagnosis?
A. Brief psychotic disorder
B. Schizophreniform disorder
C. Schizophrenia
D. Schizoaffective disorder
Answer: C
,Rationale: Continuous psychotic symptoms >6 months without
mood episode dominance indicates schizophrenia .
4. Which defense mechanism is demonstrated when a patient
attributes their own hostility to others?
A. Displacement
B. Regression
C. Reaction formation
D. Projection
Answer: D
Rationale: Projection involves attributing unacceptable
impulses to others .
5. A 22-year-old patient is brought to the emergency
department by police after being found wandering in traffic.
The patient is disorganized, unable to answer questions
coherently, and appears to be responding to internal stimuli.
What is the priority nursing intervention?
A. Obtain a thorough history from the patient
, B. Assess for safety and the need for immediate containment
C. Administer a sedative to calm the patient
D. Order a toxicology screen
Answer: B
Rationale: The priority is safety assessment. The patient is
displaying signs of psychosis with disorganization and potential
risk to self. The CNS must first ensure safety, which may include
a psychiatric hold and/or medication for agitation .
6. A PMHCNS is assessing a patient who reports hearing voices
that comment on their behavior. The patient states, "The voices
tell me I'm worthless and that I should harm myself." Which
finding should the CNS prioritize?
A. Assess for command hallucinations
B. Assess for suicidal ideation
C. Assess for substance use
D. Assess for thought disorder
Answer: B
