PHYCHATRIC NURSE PRACTITIONER-ANCC PMHNP EXAM
PRACTICE-QUESTION AND COLLECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2025/2026 Q&A |INSTANT DOWNLOAD PDF
1. Which neurotransmitter imbalance is most commonly associated with schizophrenia?
A. Dopamine
B. Serotonin
C. GABA
D. Acetylcholine
Correct answer: A. Dopamine
Rationale: Schizophrenia is linked to dopamine dysregulation, particularly hyperactivity in
mesolimbic pathways and hypoactivity in mesocortical pathways.
2. A patient with bipolar disorder presents with pressured speech, flight of ideas, and
decreased need for sleep. What phase is this?
A. Depressive
B. Manic
C. Hypomanic
D. Mixed
Correct answer: B. Manic
Rationale: Symptoms such as pressured speech, flight of ideas, grandiosity, and decreased need
for sleep indicate mania.
3. Which antidepressant has the highest risk of dietary tyramine interaction?
A. SSRIs
B. TCAs
C. MAOIs
D. SNRIs
Correct answer: C. MAOIs
Rationale: MAOIs inhibit breakdown of tyramine, leading to hypertensive crisis if dietary
restrictions are not followed.
4. Which of the following is considered a first-line treatment for generalized anxiety
disorder (GAD)?
A. Benzodiazepines
,B. SSRIs
C. Antipsychotics
D. Stimulants
Correct answer: B. SSRIs
Rationale: SSRIs and SNRIs are first-line for GAD due to effectiveness and lower dependence
risk compared to benzodiazepines.
5. Clozapine requires regular monitoring of which lab test?
A. Liver function tests
B. White blood cell count (WBC/ANC)
C. Kidney function
D. Electrolytes
Correct answer: B. White blood cell count (WBC/ANC)
Rationale: Clozapine carries risk of agranulocytosis; ANC monitoring is mandatory.
6. Which symptom is considered “negative” in schizophrenia?
A. Hallucinations
B. Delusions
C. Flat affect
D. Disorganized speech
Correct answer: C. Flat affect
Rationale: Negative symptoms involve absence of normal behaviors such as affective flattening,
avolition, and alogia.
7. A 25-year-old patient on lithium presents with tremors, nausea, and confusion. What is
the likely cause?
A. Dehydration
B. Lithium toxicity
C. Hypoglycemia
D. Hyponatremia
Correct answer: B. Lithium toxicity
Rationale: Signs of lithium toxicity include tremors, GI upset, ataxia, and confusion, often due to
elevated serum levels.
, 8. Which benzodiazepine is preferred for alcohol withdrawal management?
A. Lorazepam
B. Clonazepam
C. Alprazolam
D. Diazepam
Correct answer: D. Diazepam
Rationale: Long-acting benzodiazepines like diazepam and chlordiazepoxide are preferred for
alcohol withdrawal due to smoother withdrawal control.
9. What is the primary mechanism of action of SSRIs?
A. Block dopamine reuptake
B. Inhibit serotonin reuptake
C. Increase norepinephrine release
D. Block GABA receptors
Correct answer: B. Inhibit serotonin reuptake
Rationale: SSRIs increase serotonin availability in synaptic cleft by inhibiting reuptake.
10. In major depressive disorder, which symptom is necessary for diagnosis?
A. Insomnia
B. Appetite disturbance
C. Depressed mood or loss of interest/pleasure
D. Fatigue
Correct answer: C. Depressed mood or loss of interest/pleasure
Rationale: At least one of these two symptoms must be present for diagnosis of MDD.
11. Which medication is most associated with metabolic syndrome?
A. Haloperidol
B. Olanzapine
C. Fluoxetine
D. Lithium
Correct answer: B. Olanzapine
Rationale: Second-generation antipsychotics like olanzapine and clozapine are strongly linked to
metabolic side effects.
PRACTICE-QUESTION AND COLLECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2025/2026 Q&A |INSTANT DOWNLOAD PDF
1. Which neurotransmitter imbalance is most commonly associated with schizophrenia?
A. Dopamine
B. Serotonin
C. GABA
D. Acetylcholine
Correct answer: A. Dopamine
Rationale: Schizophrenia is linked to dopamine dysregulation, particularly hyperactivity in
mesolimbic pathways and hypoactivity in mesocortical pathways.
2. A patient with bipolar disorder presents with pressured speech, flight of ideas, and
decreased need for sleep. What phase is this?
A. Depressive
B. Manic
C. Hypomanic
D. Mixed
Correct answer: B. Manic
Rationale: Symptoms such as pressured speech, flight of ideas, grandiosity, and decreased need
for sleep indicate mania.
3. Which antidepressant has the highest risk of dietary tyramine interaction?
A. SSRIs
B. TCAs
C. MAOIs
D. SNRIs
Correct answer: C. MAOIs
Rationale: MAOIs inhibit breakdown of tyramine, leading to hypertensive crisis if dietary
restrictions are not followed.
4. Which of the following is considered a first-line treatment for generalized anxiety
disorder (GAD)?
A. Benzodiazepines
,B. SSRIs
C. Antipsychotics
D. Stimulants
Correct answer: B. SSRIs
Rationale: SSRIs and SNRIs are first-line for GAD due to effectiveness and lower dependence
risk compared to benzodiazepines.
5. Clozapine requires regular monitoring of which lab test?
A. Liver function tests
B. White blood cell count (WBC/ANC)
C. Kidney function
D. Electrolytes
Correct answer: B. White blood cell count (WBC/ANC)
Rationale: Clozapine carries risk of agranulocytosis; ANC monitoring is mandatory.
6. Which symptom is considered “negative” in schizophrenia?
A. Hallucinations
B. Delusions
C. Flat affect
D. Disorganized speech
Correct answer: C. Flat affect
Rationale: Negative symptoms involve absence of normal behaviors such as affective flattening,
avolition, and alogia.
7. A 25-year-old patient on lithium presents with tremors, nausea, and confusion. What is
the likely cause?
A. Dehydration
B. Lithium toxicity
C. Hypoglycemia
D. Hyponatremia
Correct answer: B. Lithium toxicity
Rationale: Signs of lithium toxicity include tremors, GI upset, ataxia, and confusion, often due to
elevated serum levels.
, 8. Which benzodiazepine is preferred for alcohol withdrawal management?
A. Lorazepam
B. Clonazepam
C. Alprazolam
D. Diazepam
Correct answer: D. Diazepam
Rationale: Long-acting benzodiazepines like diazepam and chlordiazepoxide are preferred for
alcohol withdrawal due to smoother withdrawal control.
9. What is the primary mechanism of action of SSRIs?
A. Block dopamine reuptake
B. Inhibit serotonin reuptake
C. Increase norepinephrine release
D. Block GABA receptors
Correct answer: B. Inhibit serotonin reuptake
Rationale: SSRIs increase serotonin availability in synaptic cleft by inhibiting reuptake.
10. In major depressive disorder, which symptom is necessary for diagnosis?
A. Insomnia
B. Appetite disturbance
C. Depressed mood or loss of interest/pleasure
D. Fatigue
Correct answer: C. Depressed mood or loss of interest/pleasure
Rationale: At least one of these two symptoms must be present for diagnosis of MDD.
11. Which medication is most associated with metabolic syndrome?
A. Haloperidol
B. Olanzapine
C. Fluoxetine
D. Lithium
Correct answer: B. Olanzapine
Rationale: Second-generation antipsychotics like olanzapine and clozapine are strongly linked to
metabolic side effects.
