Purple Book PMHNP 100 multiple choice
questions with verified answers 2026/2027
Mr. Johnson is a 54-year-old client you have been seeing for several weeks in therapy.
While discussing his current concerns of marital stress, he lies on the floor and
assumes the fetal position. This is most likely an example of
a) Immature regressive defense mechanism
b) Denial of reality
c) Immature fantasy defense mechanism
d) Repressive behavior
A. Immature regressive defense mechanism is a return to a behavior common to an
earlier stage of development.
Defense mechanisms are best viewed as a function of the ego
a) To alert us to harm and danger
b) To alert us to problems
c) Used to resolve a conflict
d) Used to protect the id
C. Defense mechanisms are a function of the ego used to resolve a conflict.
One of the health care changes that has occurred as a result of the affordable care act
(ACA) is that doctors/hospitals/clinic groups or health systems are coming together and
assuming the responsibility for quality care to large groups of individuals insured by
Medicare. The health care clinics/systems doctors or hospitals that join together are
called which of the following?
a) Health Maintenance Organization (HMO)
,b) Preferred Provider Network (PPO)
c) Accountable Care Organization (ACO)
d) Individual Health Plan (IHP)
Correct Answer: C. ACO's are groups of doctors or other health care providers who
voluntarily come together and assume the care provided to Medicare patients.
Health care economics is concerned with making decisions so the benefits outweigh the
cost of resource utilization. What are two concepts that healthcare economics is
concerned with in regard to fair distribution of resources and allocation?
a) Equity and efficiency
b) Cost and benefits
c) Opportunity and waste
d) Affordable and quality
A. Health care efficiency is making risk and benefit decision about how care resources
are allocated and equity is ensuring that there is a fair distribution of the resources.
What four elements need to be present for a malpractice lawsuit to be filed?
a) Beneficence, Non-Maleficence, Truthfulness, and Justice
b) Duty of care, Breach of standard of care, Injury, and Injury must be related to breach
of the standard of care
c) Abandonment, Breach of care, Violation of ethics, and Reimbursement for poor care
d) Breach of standard of care, Injury, Deceit, and Malpractice
B. The four elements that must be satisfied for malpractice to have occurred are a duty
of care between clinician and patient, breach of standard of care, an injury to the
patient, and the patient's injury must be related to the clinician's breach of care.
,Mary is a Psychiatric-Mental Health Nurse Practitioner (PMHNP) who is working in a
hospitalist role. Mary has encountered over five incidences in which attending
psychiatrists and medical residents have been demeaning to nursing staff and not
answering calls in the middle of the night or telling the nursing staff to write orders and
the MD would sign offin the a.m. Mary is concerned about errors and wants to improve
quality, reduce errors to promote safety. What concept is Mary employing?
a) Bullying
b) Abuse
c) Civil Disobedience
d) Just Culture
D. The ANA has a position statement that nurses are responsible for developing health
care settings that include just culture initiatives understanding that human error can
cause error and harm by creating an open and fair environment.
The role of neurotransmitters in the central nervous system is to function as
a) A communication medium
b) A gatekeeper for transmissions
c) A building block for amino acids
d) An agent to break down enzymes
A. Neurotransmitters in the central nervous system function as a communication
medium.
A client presents with complaints of changes in appetite, feeling fatigued, problems with
sleep-rest cycle, and changes in libido. What is the neuroanatomical area of the brain
that is responsible for the normal regulation of these functions?
a) Thalamus
b) Hypothalamus
, c) Limbic system
d) Hippocampus
B. Appetite, sleep, and libido are regulated by the hypothalamus.
In considering whether to order an MRI of the head for a client, which of the following
would be a contraindication to this diagnostic test?
a) Prosthetic limb
b) History of head trauma
c) Pacemaker
d) Pregnancy
C. A client with a pacemaker should not receive an MRI of the head.
The primary excitatory neurotransmitter is
a) a. GABA
b) b. Serotonin
c) c. Dopamine
d) d. Glutamate
D. Glutamate is the primary excitatory neurotransmitter.
A client who is experiencing difficulties with working memory, planning and prioritizing,
insight into his problems, and impulse control presents for assessment. In planning his
care, the PMHNP should apply his or her knowledge that these symptoms represent
problems with the
a) Frontal lobe
b) Temporal lobe
questions with verified answers 2026/2027
Mr. Johnson is a 54-year-old client you have been seeing for several weeks in therapy.
While discussing his current concerns of marital stress, he lies on the floor and
assumes the fetal position. This is most likely an example of
a) Immature regressive defense mechanism
b) Denial of reality
c) Immature fantasy defense mechanism
d) Repressive behavior
A. Immature regressive defense mechanism is a return to a behavior common to an
earlier stage of development.
Defense mechanisms are best viewed as a function of the ego
a) To alert us to harm and danger
b) To alert us to problems
c) Used to resolve a conflict
d) Used to protect the id
C. Defense mechanisms are a function of the ego used to resolve a conflict.
One of the health care changes that has occurred as a result of the affordable care act
(ACA) is that doctors/hospitals/clinic groups or health systems are coming together and
assuming the responsibility for quality care to large groups of individuals insured by
Medicare. The health care clinics/systems doctors or hospitals that join together are
called which of the following?
a) Health Maintenance Organization (HMO)
,b) Preferred Provider Network (PPO)
c) Accountable Care Organization (ACO)
d) Individual Health Plan (IHP)
Correct Answer: C. ACO's are groups of doctors or other health care providers who
voluntarily come together and assume the care provided to Medicare patients.
Health care economics is concerned with making decisions so the benefits outweigh the
cost of resource utilization. What are two concepts that healthcare economics is
concerned with in regard to fair distribution of resources and allocation?
a) Equity and efficiency
b) Cost and benefits
c) Opportunity and waste
d) Affordable and quality
A. Health care efficiency is making risk and benefit decision about how care resources
are allocated and equity is ensuring that there is a fair distribution of the resources.
What four elements need to be present for a malpractice lawsuit to be filed?
a) Beneficence, Non-Maleficence, Truthfulness, and Justice
b) Duty of care, Breach of standard of care, Injury, and Injury must be related to breach
of the standard of care
c) Abandonment, Breach of care, Violation of ethics, and Reimbursement for poor care
d) Breach of standard of care, Injury, Deceit, and Malpractice
B. The four elements that must be satisfied for malpractice to have occurred are a duty
of care between clinician and patient, breach of standard of care, an injury to the
patient, and the patient's injury must be related to the clinician's breach of care.
,Mary is a Psychiatric-Mental Health Nurse Practitioner (PMHNP) who is working in a
hospitalist role. Mary has encountered over five incidences in which attending
psychiatrists and medical residents have been demeaning to nursing staff and not
answering calls in the middle of the night or telling the nursing staff to write orders and
the MD would sign offin the a.m. Mary is concerned about errors and wants to improve
quality, reduce errors to promote safety. What concept is Mary employing?
a) Bullying
b) Abuse
c) Civil Disobedience
d) Just Culture
D. The ANA has a position statement that nurses are responsible for developing health
care settings that include just culture initiatives understanding that human error can
cause error and harm by creating an open and fair environment.
The role of neurotransmitters in the central nervous system is to function as
a) A communication medium
b) A gatekeeper for transmissions
c) A building block for amino acids
d) An agent to break down enzymes
A. Neurotransmitters in the central nervous system function as a communication
medium.
A client presents with complaints of changes in appetite, feeling fatigued, problems with
sleep-rest cycle, and changes in libido. What is the neuroanatomical area of the brain
that is responsible for the normal regulation of these functions?
a) Thalamus
b) Hypothalamus
, c) Limbic system
d) Hippocampus
B. Appetite, sleep, and libido are regulated by the hypothalamus.
In considering whether to order an MRI of the head for a client, which of the following
would be a contraindication to this diagnostic test?
a) Prosthetic limb
b) History of head trauma
c) Pacemaker
d) Pregnancy
C. A client with a pacemaker should not receive an MRI of the head.
The primary excitatory neurotransmitter is
a) a. GABA
b) b. Serotonin
c) c. Dopamine
d) d. Glutamate
D. Glutamate is the primary excitatory neurotransmitter.
A client who is experiencing difficulties with working memory, planning and prioritizing,
insight into his problems, and impulse control presents for assessment. In planning his
care, the PMHNP should apply his or her knowledge that these symptoms represent
problems with the
a) Frontal lobe
b) Temporal lobe
