ANCC PMHNP Certification Exam – 100
Practice Questions (with Answers &
Explanations)
(All items are original and safe for exam
prep use.)
1–25: Assessment & Diagnosis
1. A 42-year-old patient reports persistent fatigue, anhedonia, and early-morning awakening
for 3 months. Which diagnosis is most likely?
A. Adjustment disorder
B. Persistent depressive disorder
C. Major depressive disorder ✓
D. Bipolar II disorder
Explanation: Duration >2 weeks with neurovegetative symptoms → MDD.
2. A patient with schizophrenia shows waxy flexibility. This is an example of:
A. Negative symptoms ✓
B. Positive symptoms
C. Cognitive symptoms
D. Disorganized speech
Explanation: Catatonic motor symptoms are part of negative symptoms.
3. The most reliable indicator of suicide risk is:
A. Hopelessness
B. History of past suicide attempts ✓
C. Impulsivity
,D. Substance use
Explanation: Past attempt is the strongest predictor.
4. Which condition most commonly co-occurs with ADHD in adults?
A. Schizophrenia
B. Borderline personality disorder
C. Substance use disorder ✓
D. Panic disorder
Explanation: High rates of SUD in untreated ADHD.
5. A child presents with multiple motor tics and at least one vocal tic for >1 year. Diagnosis?
A. Transient tic disorder
B. Tourette’s disorder ✓
C. Stereotypy
D. OCD
Explanation: Tics for >1 year with vocal component → Tourette's.
6. A 78-year-old patient with dementia becomes agitated at sundown. This is known as:
A. Catatonia
B. Sundowning ✓
C. Delirium
D. Agraphia
Explanation: Evening agitation = sundowning.
7. Which laboratory test must be monitored when prescribing carbamazepine?
A. Prolactin
B. Liver function tests ✓
C. TSH
D. HbA1c
Explanation: Carbamazepine hepatotoxicity risk.
8. A client reports panic attacks and fears leaving the house. Likely diagnosis:
A. Specific phobia
,B. Social anxiety disorder
C. Agoraphobia ✓
D. OCD
Explanation: Avoidance of public places due to panic.
9. Which personality disorder involves unstable relationships and chronic emptiness?
A. Narcissistic
B. Avoidant
C. Borderline ✓
D. Schizoid
Explanation: Hallmark features of BPD.
10. Pressured speech, grandiosity, and decreased need for sleep for 4 days indicate:
A. Mania
B. Hypomania ✓
C. MDD
D. Cyclothymia
Explanation: <1 week without severe impairment → hypomania.
11. A patient with PTSD has recurrent nightmares and hypervigilance. The NP expects:
A. Enlarged hippocampus
B. Reduced hippocampal volume ✓
C. Increased frontal lobe activity
D. Increased serotonin synthesis
Explanation: PTSD associated with hippocampal shrinkage.
12. In diagnosing autism spectrum disorder, which feature must be present?
A. Social communication deficits ✓
B. Delusions
C. Motor tics
D. Hallucinations
Explanation: Core impairment is social communication.
, 13. The Mini-Cog includes:
A. PHQ-9
B. 3-item recall and clock drawing ✓
C. Serial sevens
D. Digit span
Explanation: Mini-Cog = recall + clock.
14. A client taking MAOIs must avoid foods high in:
A. Sodium
B. Tyramine ✓
C. Fiber
D. Calcium
Explanation: Tyramine → hypertensive crisis.
15. Which symptom best differentiates delirium from dementia?
A. Memory problems
B. Personality change
C. Fluctuating level of consciousness ✓
D. Disorientation
Explanation: Delirium = acute fluctuating consciousness.
16. A patient presents with somatic complaints but no medical cause. Diagnosis?
A. Illness anxiety disorder
B. ASD
C. Somatic symptom disorder ✓
D. Factitious disorder
Explanation: Somatic symptoms + distress.
17. What is a hallmark of generalized anxiety disorder?
A. Panic attacks
B. Fear of social situations
C. Excessive worry for ≥6 months ✓
D. Flashbacks
Explanation: Chronic worry defines GAD.
Practice Questions (with Answers &
Explanations)
(All items are original and safe for exam
prep use.)
1–25: Assessment & Diagnosis
1. A 42-year-old patient reports persistent fatigue, anhedonia, and early-morning awakening
for 3 months. Which diagnosis is most likely?
A. Adjustment disorder
B. Persistent depressive disorder
C. Major depressive disorder ✓
D. Bipolar II disorder
Explanation: Duration >2 weeks with neurovegetative symptoms → MDD.
2. A patient with schizophrenia shows waxy flexibility. This is an example of:
A. Negative symptoms ✓
B. Positive symptoms
C. Cognitive symptoms
D. Disorganized speech
Explanation: Catatonic motor symptoms are part of negative symptoms.
3. The most reliable indicator of suicide risk is:
A. Hopelessness
B. History of past suicide attempts ✓
C. Impulsivity
,D. Substance use
Explanation: Past attempt is the strongest predictor.
4. Which condition most commonly co-occurs with ADHD in adults?
A. Schizophrenia
B. Borderline personality disorder
C. Substance use disorder ✓
D. Panic disorder
Explanation: High rates of SUD in untreated ADHD.
5. A child presents with multiple motor tics and at least one vocal tic for >1 year. Diagnosis?
A. Transient tic disorder
B. Tourette’s disorder ✓
C. Stereotypy
D. OCD
Explanation: Tics for >1 year with vocal component → Tourette's.
6. A 78-year-old patient with dementia becomes agitated at sundown. This is known as:
A. Catatonia
B. Sundowning ✓
C. Delirium
D. Agraphia
Explanation: Evening agitation = sundowning.
7. Which laboratory test must be monitored when prescribing carbamazepine?
A. Prolactin
B. Liver function tests ✓
C. TSH
D. HbA1c
Explanation: Carbamazepine hepatotoxicity risk.
8. A client reports panic attacks and fears leaving the house. Likely diagnosis:
A. Specific phobia
,B. Social anxiety disorder
C. Agoraphobia ✓
D. OCD
Explanation: Avoidance of public places due to panic.
9. Which personality disorder involves unstable relationships and chronic emptiness?
A. Narcissistic
B. Avoidant
C. Borderline ✓
D. Schizoid
Explanation: Hallmark features of BPD.
10. Pressured speech, grandiosity, and decreased need for sleep for 4 days indicate:
A. Mania
B. Hypomania ✓
C. MDD
D. Cyclothymia
Explanation: <1 week without severe impairment → hypomania.
11. A patient with PTSD has recurrent nightmares and hypervigilance. The NP expects:
A. Enlarged hippocampus
B. Reduced hippocampal volume ✓
C. Increased frontal lobe activity
D. Increased serotonin synthesis
Explanation: PTSD associated with hippocampal shrinkage.
12. In diagnosing autism spectrum disorder, which feature must be present?
A. Social communication deficits ✓
B. Delusions
C. Motor tics
D. Hallucinations
Explanation: Core impairment is social communication.
, 13. The Mini-Cog includes:
A. PHQ-9
B. 3-item recall and clock drawing ✓
C. Serial sevens
D. Digit span
Explanation: Mini-Cog = recall + clock.
14. A client taking MAOIs must avoid foods high in:
A. Sodium
B. Tyramine ✓
C. Fiber
D. Calcium
Explanation: Tyramine → hypertensive crisis.
15. Which symptom best differentiates delirium from dementia?
A. Memory problems
B. Personality change
C. Fluctuating level of consciousness ✓
D. Disorientation
Explanation: Delirium = acute fluctuating consciousness.
16. A patient presents with somatic complaints but no medical cause. Diagnosis?
A. Illness anxiety disorder
B. ASD
C. Somatic symptom disorder ✓
D. Factitious disorder
Explanation: Somatic symptoms + distress.
17. What is a hallmark of generalized anxiety disorder?
A. Panic attacks
B. Fear of social situations
C. Excessive worry for ≥6 months ✓
D. Flashbacks
Explanation: Chronic worry defines GAD.
