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ANCC PMHNP Certification Exam Practice Questions (100 Questions)
Section 1: Scientific Foundation (Questions 1–22)
1. Which of the following is a major source of serotonin (5-HT)?
A. Locus ceruleus
B. Dorsal column nuclei
C. Raphe nuclei
D. Basal nucleus
Answer: C (The raphe nuclei are the primary source of serotonin in the brain)
2. A patient on escitalopram shows improvements in sleep and energy after four weeks.
Which statement is correct regarding suicide risk?
A. Discontinue the medication
B. Increase the medication
C. Risk for suicide is not a concern
D. Suicide potential is increased
Answer: D (As energy and motivation improve before mood fully stabilizes, patients may
have increased capacity to act on suicidal thoughts)
3. What is the therapeutic range for valproate in bipolar disorder?
A. 10–50 mcg/mL
B. 50–125 mcg/mL
C. 125–200 mcg/mL
D. 200–300 mcg/mL
Answer: B (Therapeutic range is 50–125 mcg/mL; 45 mcg/mL is subtherapeutic)
4. Which cytochrome P450 enzyme is most commonly responsible for drug-drug
interactions in psychiatric practice?
A. CYP1A2
B. CYP3A4
C. CYP2D6
D. CYP2C19
Answer: B (CYP3A4 metabolizes approximately 50% of all medications)
5. A patient with schizophrenia has failed trials of two antipsychotics. Which medication is
most likely to reduce risk of suicide?
A. Aripiprazole
B. Lurasidone
C. Iloperidone
D. Clozapine
Answer: D (Clozapine is the only antipsychotic shown to reduce suicide risk in schizophrenia)
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6. The monoamine hypothesis of depression identifies dysregulation of which
neurotransmitter as a key mechanism?
A. GABA
B. Glutamate
C. Serotonin
D. Acetylcholine
Answer: C (Serotonin dysregulation is central to the monoamine hypothesis)
7. What is the mechanism of action of SSRIs?
A. Block reuptake of serotonin and norepinephrine
B. Selectively block reuptake of serotonin
C. Inhibit monoamine oxidase
D. Block dopamine receptors
Answer: B
8. Which brain structure is primarily associated with fear and emotional processing?
A. Hippocampus
B. Amygdala
C. Prefrontal cortex
D. Hypothalamus
Answer: B
9. A client who is experiencing difficulties with working memory, planning and prioritizing,
insight into his problems, and impulse control presents for assessment. These symptoms
represent problems with the:
A. Frontal lobe
B. Temporal lobe
C. Parietal lobe
D. Occipital lobe
Answer: A (These executive functions are localized to the frontal lobe)
10. Which laboratory test should be ordered to rule out a medical cause of dementia
symptoms?
A. CBC
B. TSH
C. Liver function tests
D. Electrolyte panel
Answer: B (Thyroid dysfunction can cause cognitive symptoms)
11. What is the mechanism of action of benzodiazepines?
A. Increase serotonin availability
B. Enhance GABA-A receptor activity
C. Block dopamine D2 receptors
, 3
D. Inhibit norepinephrine reuptake
Answer: B
12. A patient with atypical depression is most likely to respond well to which medication?
A. Atomoxetine
B. Loxapine
C. Phenelzine
D. Olanzapine
Answer: C (MAOIs like phenelzine are particularly effective for atypical depression)
13. What is the black box warning associated with clozapine?
A. Hepatotoxicity
B. Agranulocytosis
C. Nephrotoxicity
D. Cardiotoxicity
Answer: B (Clozapine requires weekly ANC monitoring for the first 6 months)
14. Which neurotransmitter is primarily associated with schizophrenia?
A. Serotonin
B. Dopamine
C. GABA
D. Acetylcholine
Answer: B
15. What is the function of the hippocampus?
A. Fear processing
B. Memory consolidation
C. Executive function
D. Motor control
Answer: B
16. Which medication class is associated with tardive dyskinesia?
A. SSRIs
B. First-generation antipsychotics
C. Benzodiazepines
D. Mood stabilizers
Answer: B
17. A patient on haloperidol develops involuntary, repetitive movements of the mouth and
tongue after 3 years of treatment. What is the most likely diagnosis?
A. Acute dystonia
B. Parkinsonism
C. Tardive dyskinesia
D. Akathisia
ANCC PMHNP Certification Exam Practice Questions (100 Questions)
Section 1: Scientific Foundation (Questions 1–22)
1. Which of the following is a major source of serotonin (5-HT)?
A. Locus ceruleus
B. Dorsal column nuclei
C. Raphe nuclei
D. Basal nucleus
Answer: C (The raphe nuclei are the primary source of serotonin in the brain)
2. A patient on escitalopram shows improvements in sleep and energy after four weeks.
Which statement is correct regarding suicide risk?
A. Discontinue the medication
B. Increase the medication
C. Risk for suicide is not a concern
D. Suicide potential is increased
Answer: D (As energy and motivation improve before mood fully stabilizes, patients may
have increased capacity to act on suicidal thoughts)
3. What is the therapeutic range for valproate in bipolar disorder?
A. 10–50 mcg/mL
B. 50–125 mcg/mL
C. 125–200 mcg/mL
D. 200–300 mcg/mL
Answer: B (Therapeutic range is 50–125 mcg/mL; 45 mcg/mL is subtherapeutic)
4. Which cytochrome P450 enzyme is most commonly responsible for drug-drug
interactions in psychiatric practice?
A. CYP1A2
B. CYP3A4
C. CYP2D6
D. CYP2C19
Answer: B (CYP3A4 metabolizes approximately 50% of all medications)
5. A patient with schizophrenia has failed trials of two antipsychotics. Which medication is
most likely to reduce risk of suicide?
A. Aripiprazole
B. Lurasidone
C. Iloperidone
D. Clozapine
Answer: D (Clozapine is the only antipsychotic shown to reduce suicide risk in schizophrenia)
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6. The monoamine hypothesis of depression identifies dysregulation of which
neurotransmitter as a key mechanism?
A. GABA
B. Glutamate
C. Serotonin
D. Acetylcholine
Answer: C (Serotonin dysregulation is central to the monoamine hypothesis)
7. What is the mechanism of action of SSRIs?
A. Block reuptake of serotonin and norepinephrine
B. Selectively block reuptake of serotonin
C. Inhibit monoamine oxidase
D. Block dopamine receptors
Answer: B
8. Which brain structure is primarily associated with fear and emotional processing?
A. Hippocampus
B. Amygdala
C. Prefrontal cortex
D. Hypothalamus
Answer: B
9. A client who is experiencing difficulties with working memory, planning and prioritizing,
insight into his problems, and impulse control presents for assessment. These symptoms
represent problems with the:
A. Frontal lobe
B. Temporal lobe
C. Parietal lobe
D. Occipital lobe
Answer: A (These executive functions are localized to the frontal lobe)
10. Which laboratory test should be ordered to rule out a medical cause of dementia
symptoms?
A. CBC
B. TSH
C. Liver function tests
D. Electrolyte panel
Answer: B (Thyroid dysfunction can cause cognitive symptoms)
11. What is the mechanism of action of benzodiazepines?
A. Increase serotonin availability
B. Enhance GABA-A receptor activity
C. Block dopamine D2 receptors
, 3
D. Inhibit norepinephrine reuptake
Answer: B
12. A patient with atypical depression is most likely to respond well to which medication?
A. Atomoxetine
B. Loxapine
C. Phenelzine
D. Olanzapine
Answer: C (MAOIs like phenelzine are particularly effective for atypical depression)
13. What is the black box warning associated with clozapine?
A. Hepatotoxicity
B. Agranulocytosis
C. Nephrotoxicity
D. Cardiotoxicity
Answer: B (Clozapine requires weekly ANC monitoring for the first 6 months)
14. Which neurotransmitter is primarily associated with schizophrenia?
A. Serotonin
B. Dopamine
C. GABA
D. Acetylcholine
Answer: B
15. What is the function of the hippocampus?
A. Fear processing
B. Memory consolidation
C. Executive function
D. Motor control
Answer: B
16. Which medication class is associated with tardive dyskinesia?
A. SSRIs
B. First-generation antipsychotics
C. Benzodiazepines
D. Mood stabilizers
Answer: B
17. A patient on haloperidol develops involuntary, repetitive movements of the mouth and
tongue after 3 years of treatment. What is the most likely diagnosis?
A. Acute dystonia
B. Parkinsonism
C. Tardive dyskinesia
D. Akathisia
