LMR Georgette’s PMHNP Certification Test Bank
2026 – Verified Exam Questions & Correct
Solutions
Psychopharmacology
1. A patient with bipolar I disorder is stable on lithium 600 mg daily. They present with
nausea, vomiting, and a coarse tremor. What is the most appropriate initial action?
A. Administer the next dose of lithium as scheduled.
B. Check a stat lithium level and electrolytes. ✓
C. Switch from lithium to valproic acid.
D. Order an ECG to rule out cardiac involvement.
2. Which antipsychotic medication carries the highest risk for agranulocytosis and requires
regular CBC monitoring?
A. Risperidone (Risperdal)
B. Olanzapine (Zyprexa)
C. Clozapine (Clozaril) ✓
D. Quetiapine (Seroquel)
3. A patient taking an SSRI for 3 weeks reports feeling "anxious," "restless," and having
trouble sleeping. The most likely explanation is:
A. Serotonin syndrome.
B. Activation syndrome, a common side effect. ✓
C. The medication is ineffective.
D. An undiagnosed bipolar disorder.
4. The primary reason for using divided doses when initiating a tricyclic antidepressant (TCA)
is to:
A. Enhance its absorption.
B. Minimize anticholinergic side effects. ✓
C. Prevent the development of tolerance.
D. Reduce its cost.
5. Which of the following is a contraindication for the use of a Monoamine Oxidase Inhibitor
(MAOI)?
A. History of migraines.
,B. Concurrent use of a sympathomimetic agent (e.g., pseudoephedrine). ✓
C. Family history of diabetes.
D. Past history of alcohol use disorder.
6. A patient on long-term valproic acid therapy should be routinely monitored for:
A. Renal function.
B. Thyroid function.
C. Liver function and platelets. ✓
D. Ophthalmologic changes.
7. Which medication is FDA-approved for both the treatment of acute mania and the
maintenance treatment of bipolar I disorder?
A. Lamotrigine (Lamictal)
B. Carbamazepine (Tegretol)
C. Aripiprazole (Abilify) ✓
D. Topiramate (Topamax)
8. The mechanism of action of bupropion (Wellbutrin) is best described as:
A. Serotonin and norepinephrine reuptake inhibition.
B. Norepinephrine and dopamine reuptake inhibition. ✓
C. Selective serotonin reuptake inhibition.
D. Serotonin antagonist and reuptake inhibition.
9. A patient experiences severe muscle rigidity and a fever of 102°F after a single dose of
haloperidol. This is most suggestive of:
A. Anticholinergic toxicity.
B. Neuroleptic Malignant Syndrome (NMS). ✓
C. Acute dystonic reaction.
D. Tardive dyskinesia.
10. Which medication requires a baseline and periodic eye exams due to the risk of
retinopathy?
A. Lithium
B. Quetiapine
C. Thioridazine ✓
D. Sertraline
Diagnosis & Assessment
11. The DSM-5-TR diagnostic criteria for Major Depressive Disorder require the presence of
symptoms for a minimum duration of:
,A. 1 week.
B. 2 weeks. ✓
C. 1 month.
D. 2 months.
12. A 25-year-old presents with a history of recurrent, unexpected panic attacks and
persistent worry about having more attacks for the past 4 months. The most likely diagnosis
is:
A. Generalized Anxiety Disorder.
B. Agoraphobia.
C. Panic Disorder. ✓
D. Social Anxiety Disorder.
13. Which of the following is a positive symptom of schizophrenia?
A. Avolition.
B. Blunted affect.
C. Disorganized speech. ✓
D. Alogia.
14. A key feature differentiating Borderline Personality Disorder from Bipolar II Disorder is:
A. The presence of depressive episodes.
B. The instability of interpersonal relationships and identity. ✓
C. The presence of mood swings.
D. A history of self-injurious behavior.
15. In Obsessive-Compulsive Disorder, compulsions are defined as:
A. Persistent, intrusive thoughts.
B. Repetitive behaviors or mental acts performed to reduce anxiety. ✓
C. Irrational fears of specific objects.
D. Memories of a traumatic event.
16. A patient with a history of combat exposure has nightmares, flashbacks, and avoids
crowded places. The most appropriate diagnosis to consider is:
A. Acute Stress Disorder.
B. Adjustment Disorder.
C. Post-Traumatic Stress Disorder (PTSD). ✓
D. Generalized Anxiety Disorder.
17. The diagnosis of Generalized Anxiety Disorder (GAD) requires excessive anxiety and worry
occurring more days than not for at least:
, A. 1 month.
B. 3 months.
C. 6 months. ✓
D. 1 year.
18. A patient exhibits grandiosity, decreased need for sleep, and racing thoughts. This cluster
of symptoms is most characteristic of:
A. A Major Depressive Episode.
B. A Manic Episode. ✓
C. A Panic Attack.
D. A Mixed Episode.
19. Which disorder is characterized by a pervasive pattern of social inhibition, feelings of
inadequacy, and hypersensitivity to negative evaluation?
A. Schizoid Personality Disorder.
B. Avoidant Personality Disorder. ✓
C. Dependent Personality Disorder.
D. Obsessive-Compulsive Personality Disorder.
20. The primary distinction between bulimia nervosa and binge-eating disorder is:
A. The frequency of binge episodes.
B. The presence of recurrent compensatory behaviors (e.g., purging). ✓
C. The type of food consumed during binges.
D. The level of distress about the binge eating.
Clinical Application & Treatment Planning
21. A patient with schizophrenia who is adherent to risperidone reports galactorrhea. This is
most likely due to:
A. Hyperprolactinemia. ✓
B. Hepatic enzyme induction.
C. Anticholinergic effects.
D. Orthostatic hypotension.
22. What is the first-line psychosocial treatment for Borderline Personality Disorder?
A. Cognitive Behavioral Therapy (CBT)
B. Dialectical Behavior Therapy (DBT) ✓
C. Psychodynamic Psychotherapy
D. Supportive Therapy
2026 – Verified Exam Questions & Correct
Solutions
Psychopharmacology
1. A patient with bipolar I disorder is stable on lithium 600 mg daily. They present with
nausea, vomiting, and a coarse tremor. What is the most appropriate initial action?
A. Administer the next dose of lithium as scheduled.
B. Check a stat lithium level and electrolytes. ✓
C. Switch from lithium to valproic acid.
D. Order an ECG to rule out cardiac involvement.
2. Which antipsychotic medication carries the highest risk for agranulocytosis and requires
regular CBC monitoring?
A. Risperidone (Risperdal)
B. Olanzapine (Zyprexa)
C. Clozapine (Clozaril) ✓
D. Quetiapine (Seroquel)
3. A patient taking an SSRI for 3 weeks reports feeling "anxious," "restless," and having
trouble sleeping. The most likely explanation is:
A. Serotonin syndrome.
B. Activation syndrome, a common side effect. ✓
C. The medication is ineffective.
D. An undiagnosed bipolar disorder.
4. The primary reason for using divided doses when initiating a tricyclic antidepressant (TCA)
is to:
A. Enhance its absorption.
B. Minimize anticholinergic side effects. ✓
C. Prevent the development of tolerance.
D. Reduce its cost.
5. Which of the following is a contraindication for the use of a Monoamine Oxidase Inhibitor
(MAOI)?
A. History of migraines.
,B. Concurrent use of a sympathomimetic agent (e.g., pseudoephedrine). ✓
C. Family history of diabetes.
D. Past history of alcohol use disorder.
6. A patient on long-term valproic acid therapy should be routinely monitored for:
A. Renal function.
B. Thyroid function.
C. Liver function and platelets. ✓
D. Ophthalmologic changes.
7. Which medication is FDA-approved for both the treatment of acute mania and the
maintenance treatment of bipolar I disorder?
A. Lamotrigine (Lamictal)
B. Carbamazepine (Tegretol)
C. Aripiprazole (Abilify) ✓
D. Topiramate (Topamax)
8. The mechanism of action of bupropion (Wellbutrin) is best described as:
A. Serotonin and norepinephrine reuptake inhibition.
B. Norepinephrine and dopamine reuptake inhibition. ✓
C. Selective serotonin reuptake inhibition.
D. Serotonin antagonist and reuptake inhibition.
9. A patient experiences severe muscle rigidity and a fever of 102°F after a single dose of
haloperidol. This is most suggestive of:
A. Anticholinergic toxicity.
B. Neuroleptic Malignant Syndrome (NMS). ✓
C. Acute dystonic reaction.
D. Tardive dyskinesia.
10. Which medication requires a baseline and periodic eye exams due to the risk of
retinopathy?
A. Lithium
B. Quetiapine
C. Thioridazine ✓
D. Sertraline
Diagnosis & Assessment
11. The DSM-5-TR diagnostic criteria for Major Depressive Disorder require the presence of
symptoms for a minimum duration of:
,A. 1 week.
B. 2 weeks. ✓
C. 1 month.
D. 2 months.
12. A 25-year-old presents with a history of recurrent, unexpected panic attacks and
persistent worry about having more attacks for the past 4 months. The most likely diagnosis
is:
A. Generalized Anxiety Disorder.
B. Agoraphobia.
C. Panic Disorder. ✓
D. Social Anxiety Disorder.
13. Which of the following is a positive symptom of schizophrenia?
A. Avolition.
B. Blunted affect.
C. Disorganized speech. ✓
D. Alogia.
14. A key feature differentiating Borderline Personality Disorder from Bipolar II Disorder is:
A. The presence of depressive episodes.
B. The instability of interpersonal relationships and identity. ✓
C. The presence of mood swings.
D. A history of self-injurious behavior.
15. In Obsessive-Compulsive Disorder, compulsions are defined as:
A. Persistent, intrusive thoughts.
B. Repetitive behaviors or mental acts performed to reduce anxiety. ✓
C. Irrational fears of specific objects.
D. Memories of a traumatic event.
16. A patient with a history of combat exposure has nightmares, flashbacks, and avoids
crowded places. The most appropriate diagnosis to consider is:
A. Acute Stress Disorder.
B. Adjustment Disorder.
C. Post-Traumatic Stress Disorder (PTSD). ✓
D. Generalized Anxiety Disorder.
17. The diagnosis of Generalized Anxiety Disorder (GAD) requires excessive anxiety and worry
occurring more days than not for at least:
, A. 1 month.
B. 3 months.
C. 6 months. ✓
D. 1 year.
18. A patient exhibits grandiosity, decreased need for sleep, and racing thoughts. This cluster
of symptoms is most characteristic of:
A. A Major Depressive Episode.
B. A Manic Episode. ✓
C. A Panic Attack.
D. A Mixed Episode.
19. Which disorder is characterized by a pervasive pattern of social inhibition, feelings of
inadequacy, and hypersensitivity to negative evaluation?
A. Schizoid Personality Disorder.
B. Avoidant Personality Disorder. ✓
C. Dependent Personality Disorder.
D. Obsessive-Compulsive Personality Disorder.
20. The primary distinction between bulimia nervosa and binge-eating disorder is:
A. The frequency of binge episodes.
B. The presence of recurrent compensatory behaviors (e.g., purging). ✓
C. The type of food consumed during binges.
D. The level of distress about the binge eating.
Clinical Application & Treatment Planning
21. A patient with schizophrenia who is adherent to risperidone reports galactorrhea. This is
most likely due to:
A. Hyperprolactinemia. ✓
B. Hepatic enzyme induction.
C. Anticholinergic effects.
D. Orthostatic hypotension.
22. What is the first-line psychosocial treatment for Borderline Personality Disorder?
A. Cognitive Behavioral Therapy (CBT)
B. Dialectical Behavior Therapy (DBT) ✓
C. Psychodynamic Psychotherapy
D. Supportive Therapy
