ANCC PMHNP REVIEW MANUAL STUDY GUIDE
2025/2026 ACCURATE QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES || 100%
GUARANTEED PASS <LATEST VERSION>
A 25-year-old presents with 2 weeks of depressed mood, anhedonia, insomnia, weight loss,
and impaired concentration. Which diagnosis fits best?
A. Persistent depressive disorder (dysthymia)
B. Adjustment disorder with depressed mood
C. Major depressive disorder, single episode
D. Cyclothymic disorder
First-line pharmacologic treatment for acute major depressive disorder in adults (without
psychotic features) often includes:
A. Lithium
B. An SSRI
C. Typical antipsychotic
D. Benzodiazepine
A patient reports hearing voices commenting on their actions for 6 months with functional
decline. The most likely diagnosis is:
A. Schizophreniform disorder
B. Schizoaffective disorder
C. Schizophrenia
D. Brief psychotic disorder
Which side effect is most associated with high potency typical antipsychotics?
A. Metabolic syndrome
B. Anticholinergic effects
C. Extrapyramidal symptoms (EPS)
D. Sedation
First-line treatment for generalized anxiety disorder (GAD) includes:
A. Buspirone or SSRI/SNRI
B. High-dose benzodiazepines only
,C. Beta-blocker monotherapy
D. Typical antipsychotic
A 45-year-old with sudden onset of intense fear, palpitations, sweating, and sense of doom
lasting 20 minutes — best diagnosis:
A. Specific phobia
B. Panic attack / panic disorder
C. Social anxiety disorder
D. Generalized anxiety disorder
The recommended monitoring when initiating an SSRI that may cause hyponatremia in older
adults is primarily:
A. Liver function tests monthly
B. Serum sodium (for SIADH)
C. Fasting lipids
D. Renal ultrasound
A patient on lithium should have routine monitoring of:
A. CBC only
B. Lithium level, renal function, thyroid function
C. Blood glucose only
D. LFTs only
Which agent is FDA-approved for treatment of acute mania?
A. Fluoxetine
B. Lithium
C. Bupropion
D. Sertraline
The hallmark of borderline personality disorder is:
A. Grandiosity
B. Instability in interpersonal relationships and affect with fear of abandonment
C. Social awkwardness only
D. Lack of remorse
Best initial intervention for mild alcohol withdrawal risk (CIWA < 8) is:
A. High-dose benzodiazepines immediately
B. Outpatient monitoring and supportive care
C. Started on naloxone
D. Start disulfiram
, A 70-year-old with progressive memory loss, visuospatial deficits, and visual hallucinations
likely has:
A. Vascular dementia
B. Lewy body dementia
C. Frontotemporal dementia
D. Normal pressure hydrocephalus
The first-line pharmacotherapy for ADHD in adults usually is:
A. Stimulant medication (e.g., methylphenidate/amphetamines)
B. SSRI
C. Typical antipsychotic
D. Benzodiazepine
For a patient with major depressive disorder and suicidal ideation requiring inpatient safety,
the immediate priority is:
A. Schedule outpatient psychotherapy
B. Ensure safety with observation and possible hospitalization
C. Start an SSRI and discharge same day
D. Provide only psychoeducation
A 30-year-old has obsessions about contamination and spends 3–4 hours daily washing. Best
DSM diagnosis:
A. Obsessive-compulsive disorder (OCD)
B. Generalized anxiety disorder
C. Body dysmorphic disorder
D. Specific phobia
First-line treatment options for OCD include:
A. Exposure and response prevention (ERP) therapy and SSRIs
B. Antipsychotics alone
C. Benzodiazepines alone
D. Electroconvulsive therapy (ECT) only
The most specific sign of neuroleptic malignant syndrome (NMS) is:
A. Mild tremor
B. Rapidly rising fever and severe muscle rigidity
C. Hypertension only
D. Bradykinesia
2025/2026 ACCURATE QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES || 100%
GUARANTEED PASS <LATEST VERSION>
A 25-year-old presents with 2 weeks of depressed mood, anhedonia, insomnia, weight loss,
and impaired concentration. Which diagnosis fits best?
A. Persistent depressive disorder (dysthymia)
B. Adjustment disorder with depressed mood
C. Major depressive disorder, single episode
D. Cyclothymic disorder
First-line pharmacologic treatment for acute major depressive disorder in adults (without
psychotic features) often includes:
A. Lithium
B. An SSRI
C. Typical antipsychotic
D. Benzodiazepine
A patient reports hearing voices commenting on their actions for 6 months with functional
decline. The most likely diagnosis is:
A. Schizophreniform disorder
B. Schizoaffective disorder
C. Schizophrenia
D. Brief psychotic disorder
Which side effect is most associated with high potency typical antipsychotics?
A. Metabolic syndrome
B. Anticholinergic effects
C. Extrapyramidal symptoms (EPS)
D. Sedation
First-line treatment for generalized anxiety disorder (GAD) includes:
A. Buspirone or SSRI/SNRI
B. High-dose benzodiazepines only
,C. Beta-blocker monotherapy
D. Typical antipsychotic
A 45-year-old with sudden onset of intense fear, palpitations, sweating, and sense of doom
lasting 20 minutes — best diagnosis:
A. Specific phobia
B. Panic attack / panic disorder
C. Social anxiety disorder
D. Generalized anxiety disorder
The recommended monitoring when initiating an SSRI that may cause hyponatremia in older
adults is primarily:
A. Liver function tests monthly
B. Serum sodium (for SIADH)
C. Fasting lipids
D. Renal ultrasound
A patient on lithium should have routine monitoring of:
A. CBC only
B. Lithium level, renal function, thyroid function
C. Blood glucose only
D. LFTs only
Which agent is FDA-approved for treatment of acute mania?
A. Fluoxetine
B. Lithium
C. Bupropion
D. Sertraline
The hallmark of borderline personality disorder is:
A. Grandiosity
B. Instability in interpersonal relationships and affect with fear of abandonment
C. Social awkwardness only
D. Lack of remorse
Best initial intervention for mild alcohol withdrawal risk (CIWA < 8) is:
A. High-dose benzodiazepines immediately
B. Outpatient monitoring and supportive care
C. Started on naloxone
D. Start disulfiram
, A 70-year-old with progressive memory loss, visuospatial deficits, and visual hallucinations
likely has:
A. Vascular dementia
B. Lewy body dementia
C. Frontotemporal dementia
D. Normal pressure hydrocephalus
The first-line pharmacotherapy for ADHD in adults usually is:
A. Stimulant medication (e.g., methylphenidate/amphetamines)
B. SSRI
C. Typical antipsychotic
D. Benzodiazepine
For a patient with major depressive disorder and suicidal ideation requiring inpatient safety,
the immediate priority is:
A. Schedule outpatient psychotherapy
B. Ensure safety with observation and possible hospitalization
C. Start an SSRI and discharge same day
D. Provide only psychoeducation
A 30-year-old has obsessions about contamination and spends 3–4 hours daily washing. Best
DSM diagnosis:
A. Obsessive-compulsive disorder (OCD)
B. Generalized anxiety disorder
C. Body dysmorphic disorder
D. Specific phobia
First-line treatment options for OCD include:
A. Exposure and response prevention (ERP) therapy and SSRIs
B. Antipsychotics alone
C. Benzodiazepines alone
D. Electroconvulsive therapy (ECT) only
The most specific sign of neuroleptic malignant syndrome (NMS) is:
A. Mild tremor
B. Rapidly rising fever and severe muscle rigidity
C. Hypertension only
D. Bradykinesia
