PMHNP Certification Exam Practice Questions Complete 2025/2026 Exam Questions with Correct Detailed Solutions ||Already Graded<<UPDATED BRAND NEW VERSION>>

PMHNP Certification Exam Practice Questions Complete 2025/2026 Exam Questions with Correct Detailed Solutions ||Already Graded&lt;&lt;UPDATED BRAND NEW VERSION&gt;&gt; 1. children and adolescent sleep patterns - ANSWER -large amounts of slow-wave sleep 2. insomnia - ANSWER -occurs at least 3 nights per week -present for at least 1 month (episodic insomnia disorder) and may persist for greater than 3 months (persistent insomnia disorder) 3. insomnia etiology - ANSWER -dysfunction in sleep-wake circuits of the brainstem 4. insomnia risk factors - ANSWER -female gender -advancing age 5. hyper somnolence disorder - ANSWER -occurs at least 3 times per week and lasts for several months 6. obstructive sleep apnea - ANSWER -headache upon awakening is common -abnormally small nasopharynx, tonsillar tissue in children, obesity 7. restless leg lab findings to check - ANSWER ferritin level 8. early-morning wakefulness is a possible sign of - ANSWER depression 9. sudden, dramatic decrease in sleep is a sign of possible - ANSWER mania or schizophrenia 10. poor sleep is a sign of possible - ANSWER OCD 11. panic and anxiety episodes during sleep is a sign of possible - ANSWER panic disorder 12. Benzos for sleep disorder - ANSWER -do not use in OSA -flurazepam (Dalmane) -temazepam (restoril) -triazolam (halcyon) 13. melatonin for sleep disorders - ANSWER particularly useful to correct sleep onset issues and may be helpful for the person with ADHD 14. flurazepam (Dalmane) for sleep disorders - ANSWER - long lasting -may cause excessive drowsiness -avoid in older adults 15. nonbenzo hypnotics in sleep disorder - ANSWER -do not use with OSA -zaleplon (sonata) -zolpidem (Ambien, Ambien CR) -Eszopiclone (Lunesta) -Rozerem -Suvorexant (Belsomra) 16. temazepam (Resotril) for sleep dx - ANSWER - intermediate action agent 17. Triazolam (Halcion) for sleep dx - ANSWER -short acting agent -little to no excess sedation -common SE: impaired memory, efficacy decreases over time, should not be used long term 18. Zalplon (Sonata) for sleep dx - ANSWER -ultra short half life makes this particularly useful for initial or middle-phase insomnia 19. Zolpidem (Ambien, Ambien CR) - ANSWER -short half life drugs -may affect person the next morning -must allow for 8 hours before planned awakening -give on empty stomach 20. eszopiclone (Lunesta) - ANSWER -Intermediate acting agent 21. Rozerem - ANSWER -melatonin receptor agonist 22. Suvorexant (Belsomra) - ANSWER -orexin antagonist -suppresses wakefulness -must consider long half-life 23. antidepressants for sleep dx - ANSWER -used for sedation properties -amitriptyline (Elavil), doxepin (Sinequan, Silenor); generally avoid in older adults -mirtazapine (Remeron) -Trazodone 24. wake promoting agents for sleep dx - ANSWER -- Armodafinil (Nuvigil) -indicated for daytime sleepiness associated with OSA 25. sleep hygiene - ANSWER -avoid computer and other electronic devices for 1 hour before bedtime -never lie in bed for more than 15 minutes if not able to sleep -avoid late-in--the-day exercise intensive 26. insomnia in children - ANSWER -most commonly related to stress -often have been poor sleepers since birth -pharm tx not recommended for most children 27. The purpose of the American Nurses Association's Psychiatric-Mental Health Nursing: Scope and Standards of Practice is... - ANSWER Define the Role and actions for the NP 28. Primary Prevention care practices are an essential aspect of the PMHNP role. Which is the best example of a primary prevention care strategy for community behavioral health? - ANSWER Parenting skills classes for pregnant adolescents (Information reduces incidence of disease) 29. The trend in legal rulings on cases involving mental illness over the past 25 years has been too.. - ANSWER protect the persons's freedoms or rights when they are committed to a mental hospital 30. Mr. Smithers, an involuntary 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 what? - ANSWER Psychiatric clients can refuse treatment 31. which statement best reflects the different between nurseclient relationship and a social relationship? - ANSWER in the nurse-client relationship, the primary focus on on the client and the client's needs 32. a community has an unusually high incidence of depression and drug use among the teenage population. the public health nurses decide to address the 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 an example of? - ANSWER primary prevention 33. 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 action that reflects the legal right of this client is - ANSWER explain that the client cannot leave until you can complete further assessment. (almost every state allows for a brief period of detainment to assess a client for dangerousness to self or others before allowing a client to leave a hospital setting, even if the admission was voluntary) 34. in forming a therapeutic relationship with clients, the PMHNP must consider developing many characteristics that are known to be helpful in relationship-building. which is an essential part of building a therapeutic relationship? - ANSWER authenticity 35. according to the DSM5, which is true - ANSWER a culturally expected response to a stressor is not a mental disorder 36. 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. The best explanation of Mrs. French's behaviors is - ANSWER a sign of normal resistance to termination seen in the termination phase of therapy 37. a client is displaying low self-esteem, poor self-control, selfdoubt, and a high level of dependancy. these behaviors indicate developmental failure of which stage of development? - ANSWER early childhood 38. 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? - ANSWER psychic determinism principle 39. an example of a mature, healthy defense mechanisms is... - ANSWER suppression (the client channels conflicting energies into growth-promoting activities) 40. Mr. Johnson is a 54-year-old client you have been seeing for several weeks in therapy. while discussing his current concerns of martial stress, he lies the floor and assumes the fetal position. this is most likely an example of - ANSWER immature regressive defense mechanism 41. defense mechanisms are best viewed as a function of the ego .... - ANSWER used to resolve a conflict 42. one of the health care changes that has occurred as a result of the affordable care act (ACA) is that doctors/hospitals/clinic groups or health systems are coming together and assuming the responsibility for quality care to large groups of individuals insured by Medicare. The health care clinics/systems doctors or hospitals that join together are called what? - ANSWER Accountable Care Organization (ACO) 43. health care economics is concerned with making decisions so the benefits outweigh the cost of resource utilization. what are two concepts that healthcare economics is concerned with in regard to fair distribution of resources and allocation? - ANSWER equity and efficiency 44. what four elements need to be present for a malpractice lawsuit to be filed? - ANSWER duty of care, breach of standard of care, injury, and injury must be related to breach of standard of care 45. Mary is a PMHNP who is working in a hospitalist role. Mary has encountered over five incidences in which attending physicians and medical residents have been demeaning to nursing staff and not answering calls in the middle of the night or telling the nursing staff to write orders and the MD would sign off in the a.m. Mary is concerned about errors and wants to improve quality, reduce error to promote safety. what concepts is Mary employing? - ANSWER just culture 46. the role of neurotransmitters in the CNS is to function as - ANSWER a communication medium 47. serotonins is produced in what location - ANSWER raphe nuclei 48. dopamine is produced in what location - ANSWER substantia nigra 49. a client presents with complaints of changes in appetite, feeling fatigued, problems with sleep-rest cycle, and changes in libido. what is the neuroanatomical area of the brain that is responsible for the normal regulation of these functions? - ANSWER hypothalamus 50. in considering whether to order an MRI of the head for a client, what would be a contra for this diagnostic test? - ANSWER pacemaker 51. the primary excitatory neurotransmitter is - ANSWER glutamate 52. a client who is experiencing difficulties with working memory, planning and prioritizing, insight into his problems, and impulse control presents for assessment. in planning his care, the PMHNP should apply his or her knowledge that these symptoms represent problems with the... - ANSWER frontal lobe 53. the concept of target symptom identification is best explained as - ANSWER identification of specific, precise, and individualized symptoms reasonably expected to improve with medication 54. the goal fo the psychiatric assessment process performed by the PMHNP is to - ANSWER identity the mental health needs of the client 55. Mr. Johnson is a client newly admitted to an inpatient psychiatric hospital. the PMHNP on call as the facility plans to perform the initial intake assessment and diagnostic process. Mr. Johnson asks to please talk in his room because, he says, "people make me nervous". his room is a the end of the hallway and is the farthest away from the nursing station. the PMHNP's action should be based on awareness that the best location to do the assessment is... - ANSWER in a quiet place, but public enough to get assistance with client care should it be required during the assessment 56. which communication technique is the PMHNP using in the following situation? Client: "Sorry I was late. I didn't realize what time it was". PMHNP: " this is the third time now that you have been late for our sessions. I am wondering how committed you are to our working on your problems" - ANSWER recognizing 57. in assessing a client, you ask him the meaning of the proverb "people who live in glass houses shouldn't throw stones". he replies "because it will break the windows". the correct interpretation of this finding is - ANSWER unable to interpret the finding without knowing the client's age 58. (this is a normal thought process in children younger than 12yo) 59. the pmhnp is planning to work with a client using an individual therapy model of care. during the first session, the client makes the following statement: "this is the third time my son has run away. I have grounded him, taken away his bike, even tried cutting off his allowance and confining him to his room. what should I do now?" the most therapeutic response for the PMHNP to make is.. - ANSWER "maybe that depends on what you are trying to accomplish" 60. a client says to the pmhnp "some days life is just not worth it. all my wife and I ever do is fight and scream. things at home would be calmer and simpler if I just wasn't there anymore". the most therapeutic response for the PMHNP to make is - ANSWER tell me what you mean by "it would be simpler if you just weren't there anymore"? 61. Mrs. Shea has come to the mental health center seeking treatment for depression. She has a history of a suicide attempt by overdose one month ago. she was started on imipramine (TCA) after that event but stopped taking the med one week later because it "did no good." The PMHNP meets with Mrs. Shea to plan care with her. What is the most appropriate initial action? - ANSWER asking mrs. shea how to help her 62. in completing the pmhnp assessment for the mrs. shea, the most appropriate lab test for the PMHNP to order at this time is - ANSWER liver function tests 63. a client comes into the clinic with a longstanding history of depression and chronic renal failure. he is on an antidepressant and a diuretic and complains of increased depression, mild confusion, irritability, and overall apathy from being too tired to do anything. the best initial PMHNP action at this time is - ANSWER order a comprehensive metabolic panel 64. Sarah presents for her initial intake appointment with complaints of depression. She is being treated for HTN and asthma by her PCP. Knowing that certain medications may cause or exacerbate depression, you obtain a complete medication history. Which of the following medications is known to exacerbate or cause depression? - ANSWER propranolol d 65. when treating older adults, you should keep in mind that they are more sensitive to issues of drug toxicity because of which reason? - ANSWER decreased protein binding 66. which known teratogenic effects can be causes by the common psychotropic medications divalproex and lithium? - ANSWER divalproex-spina bifida 67. lithium- Epstein anomoly 68. the study of what the body does to the drug is called - ANSWER pharmacokinetics 69. your client sam is being treated for panic disorder with agoraphobia. he currently is being prescribed paroxetine (Paxil CR, 37.5 mg QD) and clonazepam (Klonopin, 0.5mg QD, PRN). he has been on clonazepam for 2 years and admits to needing 4 pills to achieve the same effect that 1 pill initially produced. this is possibly an example of which process? - ANSWER tolerance 70. why is group therapy beneficial? - ANSWER it is always time limited 71. (it increases social skills, is cost-effective, and enables participants to acquire the curative factors) 72. which is the best rationale for using CBT - ANSWER recognize and change his or her automatic thoughts 73. when working with a dysfunctional family, you find that the father worries excessively and is resistant to change. you give him a paradoxical directive to worry extremely well for 1 hour per day, knowing that he will likely be noncompliant, and thus change will occur. with this technique, you are unison which time of therapy? - ANSWER strategic therapy 74. what best describes homeostasis in a family system - ANSWER balance or stability that the family returns to despite its dysfunction 75. In an attempt to bring the client toward the goal he or she is working on, you ask the client, "if a miracle were to happen tonight, while you slept, and you woke in the morning and the problem no longer existed, how would you know, and what would be different?" This technique is used in which type of therapy? - ANSWER solution focused therapy 76. ms. Thomas has been diagnosed with MDD an dis placed on fluoxetine 20mg for her depression. for the PMHNP to effectively monitor her use of the medication, which action should be part of ongoing care. - ANSWER The use of a standardized rating scale of depression 77. what is the best reason for considering the SSRI among the first-line drug choices for treating major depression - ANSWER safe use in suicidal overdose clients 78. a 23 year old women is brought into the ER after attempting suicide by cutting her wrists. which nursing action by the PMHNP would be of highest priority initially. - ANSWER take her vital signs 79. which intervention by the PMHNP for a person experiencing statue de nervosa demonstrates culturally informed care? - ANSWER offering brief supportive psychotherapy 80. the PMHNP working at a student mental health clinic has now been working with a freshman student for several weeks. the PMHNP leans that the student considers himself shy. he tells the NP that he has always felt uncomfortable in social situations or when he has to do oral presentations in class. he had few friends up until senior year of high school when he discovered he could enjoy himself if he had a couple of drinks before going out. he has continued this pattern in college and now occasionally drinks 2 to 3 beers on weekends as well. according to the DSM 5, does this student have a mental disorder? - ANSWER no, at this point, the student does not meet criteria for a mental disorder 81. Jason misses several appointments. the PMHNP notes she feels resentful toward Jason and is struggling with how to respond when he finally comes in for his appointment. which statement demonstrates a therapeutic response? - ANSWER Jason, help me understand what is going on so we can figure out how to proceed 82. what is true about pharmacologic treatment of anxiety in older adults - ANSWER drugs that are highly oxidized are more unpredictable than drugs that are mostly conjugated 83. (liver enzyme functioning among other things diminishes as we age) 84. a client returns for a follow-up appointment 3 weeks after starting on fluoxetine 20mg. during this appointment you notice that her speech is a little rapid, in marked contrast to the psychomotor retardation and paucity of spontaneous speech she displayed on her first visit. instead of looking at the floor, she now makes normal eye contact. her affect has gone from constricted to expansive. she continues to have difficulty sleeping, but her energy has improved and she states she feels so much better! what should you conclude about the shift in the clients presentation? - ANSWER she is becoming hypomanic 85. mr d is a 35 year old, married, high tech industry executive who is referred to the PMHNP for insomnia. mr d reports that he falls asleep quickly bu that difficulty staying asleep. he wakes up several times during the night, and believes he tosses and turns even when he is sleeping. he wakes up feeling exhausted and drinks a pot of coffee to stay awake and concentrate during his long work day. he drinks 1 glass of wine most evenings. he denies any illicit substance use. he denies any symptoms of a mood or anxiety disorder, but is feeling increasingly frustrated and concerned about his sleep. which of the following is the most likely contributing factor to mr. Ds ongoing middle insomnia. - ANSWER obstructive sleep apnea 86. tina is a 54 year old single white women who has been a PMHNP for over 20 years. she is considering making application to a DNP program but states of a DNP is required to practice ill get grandfathered in, no need for me to go back to school. following the 2008 license, accreditation, certification, and education (LACE) consensus model for APRN regulation, what is correct? - ANSWER the DNP is an academic terminal degree and there will not be an opportunity for Tina to be grandfathered into a DNP 87. Tim is a board-certified PMHNP working in a busy community mental health center (CMHC). he is currently seeing a client diagnosed with BPI disorder who has comorbid hypertension and diabetes. during the visit, Tim takes the client's BP and her reading is 160/94mmHg. the client denies any headaches, nausea, chest pain, or shortness of breath. the client states I can't afford all these medications so I haven't seen my doctor in 7 months and I am out of all my blood pressure and sugar medications, can you give me some? what is times most appropriate action? - ANSWER call the client's PCP, explain the situation, and coordinate the client getting an appointment and medication refills 88. the chief nursing officer of a large behavior health system approached the PMHNP to discuss the new healthcare effectiveness data and information set (HEDIS) behavioral health measures and specifications. the pmhnp is asked to do a retrospective chart review of all hospital discharge clients who received a follow up visit within 7 days of discharge and within 30 days of discharge. the PMHNP has been asked to engage in what? - ANSWER quality improvement initiative 89. a pmhnp who is working on the consult liaison service is referred to a patient in the medical intensive care unit by the attending hospitalist. the consult note read evaluate the patient for competency to make independent medical decisions and consent for a surgical procedure. based on the scope of practice of a PMHNP, which response would be most appropriate. - ANSWER call the hospitalist and provide education that competency is a legal concept and explain that you can assess the patient for the capacity to make medical decisions 90. you are asked by a church organization to work with members within your health systems to develop a flu vaccination program. according to public health principles, this is an example of what level of prevention. - ANSWER primary 91. a client with bipolar I disorder presents to your PMHNP office for a follow up visit. during the visit the client informed you that he no longer wants to be treated with medication., and he does not have bipolar disorder, that was a misdiagnosis. he further informs you he stopped all his medication 2 months ago and is here to thank you for your care and tell you that he no longer needs follow up appointments. understanding the ethical conflict, you use which of the following ethical principles in working with this client? - ANSWER autonomy 92. a new client reveals to the PMHNP that her boyfriend screams at her and has repeatedly slapped and pushed her in front of her 3 year old son. she goes on to say that the boyfriend has thrown things at her and on one occasion threw a glass of water at her and hit her son in the back. should the pmhnp report this to CPS? - ANSWER yes, the pmhnp has a duty to report 93. which of the following is a function of the psychiatric interview - ANSWER identify the mental health needs of the client 94. a 74 year old married women was referred to you by her pcp for a psych eval. she had a normal medical and neurological exam in the last 2 months. the client presents with her husband of 45 years who states "my wife is just not the same anymore, she is irritable and asks the same question several times, even though I've answered it many times. the client responds, oh Henry, you do the same thing, its just a normal part of getting older, and the kids think everything is fine. during the assessment you complete the MMSE and the client scores 18. as the pmhnp treating the client, you know the results of her MMSE indicate which level of cognitive impairment. - ANSWER moderate cognitive impairment