2026 Georgette’s LMR
PMHNP Board Exam Review
High-Yield Practice Exam & Study Guide for Psychiatric-Mental Health
Nurse Practitioners
Part I: PMHNP Board Practice Questions
1. A 34-year-old female presents to the psychiatric clinic reporting
severe mood swings, irritability, breast tenderness, and bloating that
occur consistently during the week prior to menses and resolve
within a few days of onset of menses. This significantly impairs her
work functioning. Which of the following is the most appropriate
diagnosis?
A. Major Depressive Disorder with seasonal pattern
B. Premenstrual Dysphoric Disorder (PMDD)
C. Bipolar II Disorder
D. Persistent Depressive Disorder (Dysthymia)
Answer: B. Premenstrual Dysphoric Disorder (PMDD)
Rationale: PMDD is characterized by affective, cognitive, and physical
symptoms that occur during the luteal phase and remit shortly after
menses begins, causing significant functional impairment. SSRIs are
first-line pharmacological treatment.
, 2. A PMHNP is evaluating an 8-year-old male brought in by his
parents due to severe, recurrent temper outbursts manifested
verbally and/or behaviorally that are grossly out of proportion in
intensity or duration to the situation. Outbursts occur 3-4 times per
week, and the mood between outbursts is persistently irritable most
of the day, nearly every day. Symptoms have been present for over
18 months across multiple settings. What is the most accurate
diagnosis?
A. Bipolar I Disorder
B. Disruptive Mood Dysregulation Disorder (DMDD)
C. Oppositional Defiant Disorder (ODD)
D. Intermittent Explosive Disorder
Answer: B. Disruptive Mood Dysregulation Disorder (DMDD)
Rationale: DMDD is diagnosed in children ages 6 to 18 who exhibit
severe, chronic irritability and recurrent temper outbursts. It was
introduced in DSM-5 to prevent the overdiagnosis of pediatric bipolar
disorder.
3. Which neurotransmitter pathway is primarily implicated in the
positive symptoms of schizophrenia and is targeted by traditional
antipsychotic medications?
A. Mesocortical pathway (Dopamine)
B. Nigrostriatal pathway (Dopamine)
C. Mesolimbic pathway (Dopamine)
D. Tuberoinfundibular pathway (Dopamine)
PMHNP Board Exam Review
High-Yield Practice Exam & Study Guide for Psychiatric-Mental Health
Nurse Practitioners
Part I: PMHNP Board Practice Questions
1. A 34-year-old female presents to the psychiatric clinic reporting
severe mood swings, irritability, breast tenderness, and bloating that
occur consistently during the week prior to menses and resolve
within a few days of onset of menses. This significantly impairs her
work functioning. Which of the following is the most appropriate
diagnosis?
A. Major Depressive Disorder with seasonal pattern
B. Premenstrual Dysphoric Disorder (PMDD)
C. Bipolar II Disorder
D. Persistent Depressive Disorder (Dysthymia)
Answer: B. Premenstrual Dysphoric Disorder (PMDD)
Rationale: PMDD is characterized by affective, cognitive, and physical
symptoms that occur during the luteal phase and remit shortly after
menses begins, causing significant functional impairment. SSRIs are
first-line pharmacological treatment.
, 2. A PMHNP is evaluating an 8-year-old male brought in by his
parents due to severe, recurrent temper outbursts manifested
verbally and/or behaviorally that are grossly out of proportion in
intensity or duration to the situation. Outbursts occur 3-4 times per
week, and the mood between outbursts is persistently irritable most
of the day, nearly every day. Symptoms have been present for over
18 months across multiple settings. What is the most accurate
diagnosis?
A. Bipolar I Disorder
B. Disruptive Mood Dysregulation Disorder (DMDD)
C. Oppositional Defiant Disorder (ODD)
D. Intermittent Explosive Disorder
Answer: B. Disruptive Mood Dysregulation Disorder (DMDD)
Rationale: DMDD is diagnosed in children ages 6 to 18 who exhibit
severe, chronic irritability and recurrent temper outbursts. It was
introduced in DSM-5 to prevent the overdiagnosis of pediatric bipolar
disorder.
3. Which neurotransmitter pathway is primarily implicated in the
positive symptoms of schizophrenia and is targeted by traditional
antipsychotic medications?
A. Mesocortical pathway (Dopamine)
B. Nigrostriatal pathway (Dopamine)
C. Mesolimbic pathway (Dopamine)
D. Tuberoinfundibular pathway (Dopamine)
