PMHNP ANCC REVIEW QUESTIONS AND ANSWERS 2025
The purpose of the American Nurses Association's Psychiatric-Mental Health Nursing:
Scope and Standards of Practice is to
a. Define the role and actions for the NP
b. Establish the legal authority for the prescription of psychotropic medications
c. Define the legal statutes of the role of the PMHNP
d. Define the differences between the physician role and the NP role - (ANSWER)A. The ANAs Psych-
Mental Health Nursing Scope and Standards of Practice defines the role and actions of the nurse
practitioner.
D. Information reduces incidence of disease. - (ANSWER)Primary prevention care practices are an
essential aspect of the PMHNP role. Which of the following is the best example of a primary prevention
care strategy for community behavioral health?
a. Aftercare program for chronically mentally ill clients recently discharged from the hospital
b. Court-ordered counseling for abusive parents
c. 24-hour crisis hotlines
d. Parenting skills classes for pregnant adolescents
The trend in legal rulings on cases involving mental illness over the past 25 years has been to
a. Encourage juries to find defendants not guilty by reason of insanity
b. Protect the person's freedoms or rights when he or she is committed to a mental hospital
c. Place increasing trust in mental health professionals to make good and ethical decisions
d. Decrease the "red tape" associated with commitments so that commitments are faster and easier -
(ANSWER)B. Identifies the trend of ensuring the protection of individual civil liberties for psychiatric
clients.
Mr. Smithers, an involuntarily hospitalized patient experiencing psychotic symptoms, refuses to take any
of his ordered medication because he believes "Jesus Christ told me I am the prophet and must fast for a
year." Your actions should be based on your knowledge of which of the following?
a. Psychiatric clients cannot refuse treatment
b. Psychiatric clients do not always know what is good for them
,PMHNP ANCC REVIEW QUESTIONS AND ANSWERS 2025
c. Psychiatric clients can refuse treatment
d. Psychiatric clients cannot be trusted to make good healthcare decisions and, therefore, the nurse's
best clinical judgment should guide actions - (ANSWER)C. As with any client, psychiatric clients can
refuse treatment unless a legal process resulting in involuntary commitment or mandatory court order
for treatment has been obtained.
Which of the following statements best reflects the difference between the nurse-client (N-C)
relationship and a social relationship?
a. In the N-C relationship, the primary focus is on the client and the client's needs.
b. Goals in the N-C relationship are deliberately left vague and unspoken so that the client can work on
any issue.
c. In the N-C relationship, the nurse is solely responsible for making the relationship work.
d. In the N-C relationship, there is no place for social interaction. - (ANSWER)A. Social relationships are
mutual interpersonal relationships in which the needs of both parties are addressed. The N-C
relationship is most concerned with meeting the needs of the client.
A community has an unusually high incidence of depression and drug use among the teenage
population. The public health nurses decide to address this problem, in part, by modifying the
environment and strengthening the capacities of families to prevent the development of new cases of
depression and drug use. What is this is an example of?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Protective factorial prevention - (ANSWER)A. This action focuses on interventions designed to reduce
the incidence of new cases of disease.
Mrs. Kemp is voluntarily admitted to the hospital. After 24 hours, she states she wishes to leave because
"this place can't help me." The best nursing action that reflects the legal right of this client is
a. Discharge the client
b. Explain that the client cannot leave until you can complete further assessment
c. Allow the client to leave but have her sign forms stating she is leaving against medical advice
,PMHNP ANCC REVIEW QUESTIONS AND ANSWERS 2025
d. Immediately start the paperwork to commit the client and to allow you to treat her against her wishes
- (ANSWER)B. Almost every state allows for a brief for a period detainment to assess a client for
dangerousness to self or others before allowing the client to leave a hospital setting, even if the
admission was voluntary.
In forming a therapeutic relationship with clients, the PMHNP must consider developing many
characteristics that are known to be helpful in relationship-building. Which of the following is an
essential part of building a therapeutic relationship?
a. Collecting a family history
b. Like-mindedness
c. Authenticity
d. Accuracy in assessment - (ANSWER)C. Authenticity. Being genuine, honest, and respectful are
essential elements in establishing a working relationship with any client. Like-mindedness is not a part of
the therapeutic relationship. Although an important aspect of the PMHNP role, collecting a family
history and accuracy in assessment does not in and of itself facilitate relationship building.
According to the DSM-5, which of the following is true? (Ch. 3)
a. A mental disorder is equivalent to the need for treatment.
b. Diagnostic criteria are used to inform clinical judgment.
c. Socially deviant behavior is considered a mental disorder.
d. A culturally expected response to a stressor is not a mental disorder. - (ANSWER)D. All DSM-5
disorders need to be made taking a person's culture into account. A cultural expression of a response to
grief, loss, or stress is not considered a DSM-5 diagnosis.
Mrs. French has been in individual therapy for 3 months. She has shown much growth and improvement
in her functioning and insight and is to discontinue services within the next few weeks. In the next
session, after you discuss service termination, she suddenly begins to demonstrate the original
symptoms that had brought her to treatment initially. She is now hesitant to discharge, wants to
continue services, and is displaying an increase in regressive defense mechanisms. What is the best
explanation for Ms. French's behavior?
a. An exacerbation of her symptoms related to stress
b. The normal cyclic nature of chronic mental health symptoms
c. A sign of normal resistance to termination seen in the termination phase of therapy
, PMHNP ANCC REVIEW QUESTIONS AND ANSWERS 2025
d. A sign of pathological attachment to the therapist that must be addressed - (ANSWER)C. Clients
frequently display resistance and regression at the termination of a meaningful therapeutic process. The
PMHNP is responsible for planning an effective termination and monitoring clients during the
termination period.
A client is displaying low self-esteem, poor self-control, self-doubt, and a high level of dependency.
These behaviors indicate developmental failure of which of the following stages of development:
a. Infancy
b. Early childhood
c. Late childhood
d. School age - (ANSWER)B. These signs indicate developmental failure of early childhood.
Mr. Thompson has been forgetful lately, for example, forgetting where he has placed his keys or what
time appointments are scheduled, and he has stated that he thinks these are just random behaviors that
have no particular meaning. Which Freudian-based psychodynamic principle assumes that all behavior
and actions are purposeful?
a. Pleasure principle
b. Psychic determinism principle
c. Reality principle
d. Unconsciousness principle - (ANSWER)B. The psychic determinism principle states that all behavior
has purpose and meaning, often unconscious in nature, and that no behaviors occur randomly or by
coincidence.
An example of a mature, healthy defense mechanism is
a. Denial
b. Rationalization
c. Repression
d. Suppression - (ANSWER)D. Suppression is the only defense mechanism listed in which the client
channels conflicting energies into growth-promoting activities.
The purpose of the American Nurses Association's Psychiatric-Mental Health Nursing:
Scope and Standards of Practice is to
a. Define the role and actions for the NP
b. Establish the legal authority for the prescription of psychotropic medications
c. Define the legal statutes of the role of the PMHNP
d. Define the differences between the physician role and the NP role - (ANSWER)A. The ANAs Psych-
Mental Health Nursing Scope and Standards of Practice defines the role and actions of the nurse
practitioner.
D. Information reduces incidence of disease. - (ANSWER)Primary prevention care practices are an
essential aspect of the PMHNP role. Which of the following is the best example of a primary prevention
care strategy for community behavioral health?
a. Aftercare program for chronically mentally ill clients recently discharged from the hospital
b. Court-ordered counseling for abusive parents
c. 24-hour crisis hotlines
d. Parenting skills classes for pregnant adolescents
The trend in legal rulings on cases involving mental illness over the past 25 years has been to
a. Encourage juries to find defendants not guilty by reason of insanity
b. Protect the person's freedoms or rights when he or she is committed to a mental hospital
c. Place increasing trust in mental health professionals to make good and ethical decisions
d. Decrease the "red tape" associated with commitments so that commitments are faster and easier -
(ANSWER)B. Identifies the trend of ensuring the protection of individual civil liberties for psychiatric
clients.
Mr. Smithers, an involuntarily hospitalized patient experiencing psychotic symptoms, refuses to take any
of his ordered medication because he believes "Jesus Christ told me I am the prophet and must fast for a
year." Your actions should be based on your knowledge of which of the following?
a. Psychiatric clients cannot refuse treatment
b. Psychiatric clients do not always know what is good for them
,PMHNP ANCC REVIEW QUESTIONS AND ANSWERS 2025
c. Psychiatric clients can refuse treatment
d. Psychiatric clients cannot be trusted to make good healthcare decisions and, therefore, the nurse's
best clinical judgment should guide actions - (ANSWER)C. As with any client, psychiatric clients can
refuse treatment unless a legal process resulting in involuntary commitment or mandatory court order
for treatment has been obtained.
Which of the following statements best reflects the difference between the nurse-client (N-C)
relationship and a social relationship?
a. In the N-C relationship, the primary focus is on the client and the client's needs.
b. Goals in the N-C relationship are deliberately left vague and unspoken so that the client can work on
any issue.
c. In the N-C relationship, the nurse is solely responsible for making the relationship work.
d. In the N-C relationship, there is no place for social interaction. - (ANSWER)A. Social relationships are
mutual interpersonal relationships in which the needs of both parties are addressed. The N-C
relationship is most concerned with meeting the needs of the client.
A community has an unusually high incidence of depression and drug use among the teenage
population. The public health nurses decide to address this problem, in part, by modifying the
environment and strengthening the capacities of families to prevent the development of new cases of
depression and drug use. What is this is an example of?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Protective factorial prevention - (ANSWER)A. This action focuses on interventions designed to reduce
the incidence of new cases of disease.
Mrs. Kemp is voluntarily admitted to the hospital. After 24 hours, she states she wishes to leave because
"this place can't help me." The best nursing action that reflects the legal right of this client is
a. Discharge the client
b. Explain that the client cannot leave until you can complete further assessment
c. Allow the client to leave but have her sign forms stating she is leaving against medical advice
,PMHNP ANCC REVIEW QUESTIONS AND ANSWERS 2025
d. Immediately start the paperwork to commit the client and to allow you to treat her against her wishes
- (ANSWER)B. Almost every state allows for a brief for a period detainment to assess a client for
dangerousness to self or others before allowing the client to leave a hospital setting, even if the
admission was voluntary.
In forming a therapeutic relationship with clients, the PMHNP must consider developing many
characteristics that are known to be helpful in relationship-building. Which of the following is an
essential part of building a therapeutic relationship?
a. Collecting a family history
b. Like-mindedness
c. Authenticity
d. Accuracy in assessment - (ANSWER)C. Authenticity. Being genuine, honest, and respectful are
essential elements in establishing a working relationship with any client. Like-mindedness is not a part of
the therapeutic relationship. Although an important aspect of the PMHNP role, collecting a family
history and accuracy in assessment does not in and of itself facilitate relationship building.
According to the DSM-5, which of the following is true? (Ch. 3)
a. A mental disorder is equivalent to the need for treatment.
b. Diagnostic criteria are used to inform clinical judgment.
c. Socially deviant behavior is considered a mental disorder.
d. A culturally expected response to a stressor is not a mental disorder. - (ANSWER)D. All DSM-5
disorders need to be made taking a person's culture into account. A cultural expression of a response to
grief, loss, or stress is not considered a DSM-5 diagnosis.
Mrs. French has been in individual therapy for 3 months. She has shown much growth and improvement
in her functioning and insight and is to discontinue services within the next few weeks. In the next
session, after you discuss service termination, she suddenly begins to demonstrate the original
symptoms that had brought her to treatment initially. She is now hesitant to discharge, wants to
continue services, and is displaying an increase in regressive defense mechanisms. What is the best
explanation for Ms. French's behavior?
a. An exacerbation of her symptoms related to stress
b. The normal cyclic nature of chronic mental health symptoms
c. A sign of normal resistance to termination seen in the termination phase of therapy
, PMHNP ANCC REVIEW QUESTIONS AND ANSWERS 2025
d. A sign of pathological attachment to the therapist that must be addressed - (ANSWER)C. Clients
frequently display resistance and regression at the termination of a meaningful therapeutic process. The
PMHNP is responsible for planning an effective termination and monitoring clients during the
termination period.
A client is displaying low self-esteem, poor self-control, self-doubt, and a high level of dependency.
These behaviors indicate developmental failure of which of the following stages of development:
a. Infancy
b. Early childhood
c. Late childhood
d. School age - (ANSWER)B. These signs indicate developmental failure of early childhood.
Mr. Thompson has been forgetful lately, for example, forgetting where he has placed his keys or what
time appointments are scheduled, and he has stated that he thinks these are just random behaviors that
have no particular meaning. Which Freudian-based psychodynamic principle assumes that all behavior
and actions are purposeful?
a. Pleasure principle
b. Psychic determinism principle
c. Reality principle
d. Unconsciousness principle - (ANSWER)B. The psychic determinism principle states that all behavior
has purpose and meaning, often unconscious in nature, and that no behaviors occur randomly or by
coincidence.
An example of a mature, healthy defense mechanism is
a. Denial
b. Rationalization
c. Repression
d. Suppression - (ANSWER)D. Suppression is the only defense mechanism listed in which the client
channels conflicting energies into growth-promoting activities.
