PMHNP CERTIFICATION EXAM 2025 (ACTUAL 400+ ACTUAL
QUESTIONS & CORRECT VERIFIED ANSWERS GRADE A+)
1. Which patient is at highest risk for SI
A. 30y/o married AA female with previous SI attempt *1 risk factor
B. 35 y/o single Asian male with previous SI attempt *3 risk factors
C. 38 y/o single AA male who is a manager of a bank *2 risk factors
D. 68 y/o single white male with depression *5 risk factors (age, male, white,
depression) ANS D. 68 y/o single white male with depression *5 risk factors (age,
male, white, depression)
Count the risk factors
2. COWS scale components ANS · Opioid W/D
,Pulse, sweating, restlessness, pupil size- dilation (if pinpoint= opioid intoxication,
not w/d), body aches, Rhinorrhea (running nose), Lacrimation (eye tearing), GI
upset (N/V/D), yawning, tremors, anxiety/irritability, Piloerection (gooseflesh skin),
insomnia
3. What does COWS stand for? ANS Clinical Opiate Withdrawal Scale
4. What does CIWA stand for? ANS Clinical Institute Withdrawal Assessment
5. What does CIWA assess for? ANS --used to determine likelihood of ETOH
withdraw- al or DTs
--usually occur within the first 24-72 hours after cessation
o used to determine when to administer medications for ETOH withdrawal
6. What does CIWA NOT test for? ANS Alcohol Use Disorder
7. What are the CIWA scale components? ANS · N/V, tremor, paroxysmal
sweats, anxiety, agitation, tactile disturbances, auditory disturbances, visual
disturbances, H/A, orientation
Each component is scored from 0(none)-7(severe) except orientation wh/ is (0
(AA0x4)-4 (disoriented)
Score ANS
<10 ANS Very mild Start PRN meds at score of 8
>10 to 15 ANS Mild scheduled + PRN meds
>16 to 20 ANS Moderate
>21 ANS Severe Diazepam, Librium, Ativan
8. When interview teenagers (16 y/o) that arrive with their parents what should
you do? ANS interview them separately from parents.
-This helps Build therapeutic rapport with teens by telling them the info is confiden-
,tial. Parents may be upset but remember you are advocating for the child.
9. Which Ethnic group has the highest rate of suicide? ANS Native Americans
10. Example A patient is being treated for schizophrenia with olanzapine.
Which of the following is the most common side effect of olanzapine?
, A. Increased waist circumference
B. EPS (not as common in atypical antipsychotics d/t 5HT2A)-receptor antag-
onism
C. Increased Lipids
D. Metabolic Syndrome ANS D. Metabolic Syndrome (UMBRELLA ANSWER)
11. Which antipsychotics have the least weight gain? ANS Latuda, Abilify, (also
least sedating), Geodon-if patient has metabolic syndrome consider switching to
one of the medications above. Or if the patient is overly sedated try switching to
ABILIFY
12. Which mood stabilizer have the least weight gain? ANS Lamictal
-But remember all mood stabilizers cause some weight gain
13. When presented with a question about typical vs atypical antipsychotic
the answer is usually to start of a ANS atypical
14. A client presents with complains of changes in appetite, feeling fatigued,
problems with sleep-rest cycle, and changes in libido. What is the neu-
roanatomical area of the brain that is responsible for the normal regulation
of these functions?
A. Thalamus
B. Hypothalamus
C. Limbic System
D. Hippocampus ANS Hypothalamus
A, B, & D are all part of the limbic system so you can rule that out
15. When a patient is hesitant to participate in treatment you should encour-
4 B/ B76
QUESTIONS & CORRECT VERIFIED ANSWERS GRADE A+)
1. Which patient is at highest risk for SI
A. 30y/o married AA female with previous SI attempt *1 risk factor
B. 35 y/o single Asian male with previous SI attempt *3 risk factors
C. 38 y/o single AA male who is a manager of a bank *2 risk factors
D. 68 y/o single white male with depression *5 risk factors (age, male, white,
depression) ANS D. 68 y/o single white male with depression *5 risk factors (age,
male, white, depression)
Count the risk factors
2. COWS scale components ANS · Opioid W/D
,Pulse, sweating, restlessness, pupil size- dilation (if pinpoint= opioid intoxication,
not w/d), body aches, Rhinorrhea (running nose), Lacrimation (eye tearing), GI
upset (N/V/D), yawning, tremors, anxiety/irritability, Piloerection (gooseflesh skin),
insomnia
3. What does COWS stand for? ANS Clinical Opiate Withdrawal Scale
4. What does CIWA stand for? ANS Clinical Institute Withdrawal Assessment
5. What does CIWA assess for? ANS --used to determine likelihood of ETOH
withdraw- al or DTs
--usually occur within the first 24-72 hours after cessation
o used to determine when to administer medications for ETOH withdrawal
6. What does CIWA NOT test for? ANS Alcohol Use Disorder
7. What are the CIWA scale components? ANS · N/V, tremor, paroxysmal
sweats, anxiety, agitation, tactile disturbances, auditory disturbances, visual
disturbances, H/A, orientation
Each component is scored from 0(none)-7(severe) except orientation wh/ is (0
(AA0x4)-4 (disoriented)
Score ANS
<10 ANS Very mild Start PRN meds at score of 8
>10 to 15 ANS Mild scheduled + PRN meds
>16 to 20 ANS Moderate
>21 ANS Severe Diazepam, Librium, Ativan
8. When interview teenagers (16 y/o) that arrive with their parents what should
you do? ANS interview them separately from parents.
-This helps Build therapeutic rapport with teens by telling them the info is confiden-
,tial. Parents may be upset but remember you are advocating for the child.
9. Which Ethnic group has the highest rate of suicide? ANS Native Americans
10. Example A patient is being treated for schizophrenia with olanzapine.
Which of the following is the most common side effect of olanzapine?
, A. Increased waist circumference
B. EPS (not as common in atypical antipsychotics d/t 5HT2A)-receptor antag-
onism
C. Increased Lipids
D. Metabolic Syndrome ANS D. Metabolic Syndrome (UMBRELLA ANSWER)
11. Which antipsychotics have the least weight gain? ANS Latuda, Abilify, (also
least sedating), Geodon-if patient has metabolic syndrome consider switching to
one of the medications above. Or if the patient is overly sedated try switching to
ABILIFY
12. Which mood stabilizer have the least weight gain? ANS Lamictal
-But remember all mood stabilizers cause some weight gain
13. When presented with a question about typical vs atypical antipsychotic
the answer is usually to start of a ANS atypical
14. A client presents with complains of changes in appetite, feeling fatigued,
problems with sleep-rest cycle, and changes in libido. What is the neu-
roanatomical area of the brain that is responsible for the normal regulation
of these functions?
A. Thalamus
B. Hypothalamus
C. Limbic System
D. Hippocampus ANS Hypothalamus
A, B, & D are all part of the limbic system so you can rule that out
15. When a patient is hesitant to participate in treatment you should encour-
4 B/ B76
