PMHNP certification Exam (2025/2026) Questions And Answers (Actual test verified Grade A+).

PMHNPcertification Exam. QuestionsAndAnswers 8u 8u 8u 8u 8u




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1. Which patient is at highest risk for SI 8u 8u 8u 8u 8u 8u 8u




A. 30y/o married AAfemale with previous SI attempt *1 risk factor 8u 8u 8u 8u 8u 8u 8u 8u 8u 8u




B. 35 y/o single Asian male with previous SI attempt *3 risk factors
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C. 38 y/o single AAmale who is a manager of a bank *2 risk factors
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D. 68 y/o single white male with depression *5 risk factors (age, male, white, depression): D. 68 y/o single white male
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8u with depression *5 risk factors (age, male, white, depression)
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Count the risk factors 8u 8u 8u




2. Wheninterviewteenagers(16y/o)thatarrivewiththeirparentswhatshouldyoudo?:interviewthemseparately from
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parents. 8u




-This helps Build therapeutic rapport with teens by telling them the info is confidential. Parents may be upset but remember you are
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advocating for the child.
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3. WhichEthnic group has the highest rate of suicide?: Native Americans 8u 8u 8u 8u 8u 8u 8u 8u 8u 8u




4. Example Apatient is being treated for schizophreniawith olanzapine. 8u u
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8u Which of the following is the most common side effect of olanzapine?
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A. Increased waist circumference 8u 8u




B. EPS(not as commonin atypical antipsychotics d/t 5HT2A)-receptoran-tagonism
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C. Increased Lipids 8u




D. MetabolicSyndrome: D.Metabolic Syndrome(UMBRELLA ANSWER) u
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5. Which antipsychotics have the least weight gain?: Latuda, Abilify, (also least sedating), Geodon-if patient has
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8u metabolic syndrome consider switching to one of the medications above. Or if the patient is overly sedated try switching to ABILIFY
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6. Which mood stabilizer have the least weight gain?: Lamictal -But remember all mood stabilizers cause some weight
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8u gain

7. When presented with a question about typical vs atypical antipsychotic the answer is usually to start of a:
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8u atypical

8. A client presents with complains of changes in appetite, feeling fatigued, problems with sleep-rest cycle, and
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8u changes in libido. What is the neuroanatomical area of the brain that is responsible for the normal regulation of
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8u these functions? A. Thalamus
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B.Hypothalamus
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C.Limbic System
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,D.Hippocampus: Hypothalamus
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A, B, & D are all part of the limbic system so you can rule that out
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9. When a patient is hesitant to participate in treatment you should encourage?: Bring a support person like a
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husband
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10. Thyroid-Stimulatinghormonenormallevel: 0.5-5.0Mu/L 8u 8u 8u 8u 8u




11. When T4 and T3 are high and TSH is low what is the diagnosis: HY- 8u 8u 8u 8u 8u 8u 8u 8u 8u 8u 8u 8u 8u 8u




8u PERTHYROIDISM, TSH secretion decreases: TSH LOW à key symptoms HEAT INTOLERANCE 8u 8u 8u 8u 8u 8u 8u 8u 8u 8u




12. Keysymptoms of Heat Intolerance: Hyperthyroidism 8u 8u 8u 8u 8u




13. When T4 and T3 are Low and TSH is high what is the diagnosis: (HYPOTHYROIDISM) TSH secretion increased: TSH
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8u HIGH à COLD INTERANCE 8u 8u 8u




14. Keysymptoms of Cold Intolerance: Hypothyroidism 8u 8u 8u 8u 8u




15. Hyperthyroid can mimic: Mania 8u 8u 8u




16. Hypothyroid can mimic: Depression 8u 8u 8u




17. Apatient ondepakotecomplains of RUQ pain and has reddish/brown urine: Hepatoxicity -Check LFTs
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18. SignsofDepakotetoxicity: Disorientation, confusion, lethargy 8u 8u 8u 8u 8u 8u




19. You suspect depakotetoxicitywhat do you do?: Check 8u 8u 8u 8u 8u 8u 8u 8u




-LFT
-Ammonia
-Depakote Level 8u




20. Whatherbal supplement cancause hepatoxicity?: Kava Kava 8u 8u 8u 8u 8u 8u 8u




21. When taking Kava Kava in combinations with other medications you should caution about:
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8 u Risk of Hepatoxicity and Sedation
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22. TCAs carry a risk of: Hepatotoxicity 8u 8u 8u 8u 8u




23. SignsofStevens-Johnson Syndrome: -fever,mouth pain, swelling, burningeyes, blisters, skinpain
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24. two psychotropics knownto causesteven johnson syndrome: lamictal and tegretol
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25. Whatnationalityis most suseptible of getting steven johnson?: Asians8u 8u 8u 8u 8u 8u 8u 8u 8u




26. Whentreating asianswith tegretal screen for?: HLAB-1502 Allele 8u 8u 8u 8u 8u 8u 8u 8u




27. Whattwo medicationscause agranulocytosis?: Clozaril & Tegretal 8u 8u 8u 8u 8u 8u 8u




28. Agranulocytosiswhento discontinuemedication: Less than1000 8u 8u 8u 8u 8u 8u 8u




29 Whenmonitoring for agranulocytosis in patients look for s/s of what?: Infection
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-Fever, sore throat, fatigue, chills 8u 8u 8u 8u




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30. Before starting anymood stabilizer in a female of childbearing age be sure to check?: HCG
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31. Which two medications maydecrease the riskof suicide?: clozaril and lithium
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32. Medications that increase lithium level: NSAID-ibuprofen, INDOCIN THIAZIDES-hydrochlorithiazide ACE INHIBITORS-8u 8u 8u 8u 8u 8u 8u 8u 8u




8u lisinopril

33. Ace inhibitors are treatment of choice for?: Heart Failure
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34. Certainmedications are knownto increase lithium level, but HOW?: by reducing renal clearance
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35. Wheneducatinga patient about lithium teachthem about: HyponatremiaDehydration-hot days, exercise
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36. NormalLithium Level: 0.6-1.2 8u 8u 8u




37. LithiumToxicity:1.5orabove u
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8u Discontinue and re-order lithium level 8u 8u 8u 8u




38. Lithiumlevel of 1.4: Monitor for toxicity 8u 8u 8u 8u 8u 8u




39. Labsbefore starting lithium: TSH, BUN, CREATININE, HCG, U/A to check
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for presence of protein in the urine (4+ protein is concerning for renal impairment)à4+ protein in urine=MONITOR FOR TOXICITY
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40. 4+ protein in the urine of a patient on lithium: 4+ protein is concerning for renal impairment 4+
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8u protein in urine=MONITOR FOR TOXICITY
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41. Lithium side effects: hypothyroid, leukocytosis, maculopapular rash, t-wave inversion, Coarse Hand Tremor, GI upset
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8u (nausea, vomiting, anorexia) 8u 8u




-Some of these are also signs of toxicity
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42. Signsoflithiumtoxicity: confusion,ataxia, GI upset, palpitation, tremor
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43. NMS: muscle rigidity,mutism (becauseofmuscle rigidity), increasedCPK
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(caused by muscle contraction and muscle destruction), increase WBC, increased WBC, myoglobinuria (also frommuscle
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destruction)
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44. Cherrycolored urine in a patient that exercises a lot: test for myoglobinuria may be a sign of rhabdo
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45 Serotonin Syndrome: With any drug that increases 5-HT (e.g., MAO inhibitors, SNRIs, TCAs) hyperthermia, confusio
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myoclonus, cardiovascular instability, flushing, diarrhea, seizures.
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-Treatment: cyproheptadine (5-HT2receptorantagonist). 8u 8u 8u u
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46. Treatmentfor NMS: Stop Offending Medication 8u 8u 8u 8u 8u




-Dantrolene (muscle relaxer) 8u 8u




-Bromocriptine (DopamineD2 agonist). 8u u
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*In question focus onwhat they are asking for. ....... dopamine agonist vs muscle relaxer
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47. Treatmentfor Serotonin Syndrome: Stop Med (1 or more SSRI, SSNRI, TCA, MOAI) 8u 8u 8u 8u 8u 8u 8u 8u 8u 8u 8u 8u




-Cyproheptadine

48. Triptans: Used for MIGRAINES 8u 8u 8u




-Thesemedsincrease serotonin example SUMATRIPTAN
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49. patient taking Prozac and started on sumatriptan: -call PCP to ask them to switch the migraine med if patient
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8u already on SUMATRIPTAN do not start antidepressant without talking to PCP
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50. How long do youwait when switching between an SSRI to an MAOI?: 2 weeks
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51. How long do you wait when switching between Prozac andMAOI?: 5-6 weeks washout period
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52. What is the first line treatment for depressionand why?: SSRI-First line treatment for depression due to less risk of
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53. If a cancer patient hasdepressionwhat should you consider?: Treating with a medication with minimal
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8u drug/drug side effects like Lexapro 8u 8u 8u 8u




54. Patientwith depression worries about sexual dysfunctionwhat would be the medication of choice?:
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Wellbutrin

55. Primarysymptoms of depression include fatigue and low energywhat medwould you chose?: Wellbutrin8u 8u 8u 8u 8u 8u 8u 8u 8u 8u 8u 8u 8u 8u




56. Wellbutrin is contraindicated in patientswith: Seizures and anorexia 8u 8u 8u 8u 8u 8u 8u 8u




57. Whichmedications arebest forneuropathicpain?: SNRI 8u 8u 8u 8u 8u 8u 8u




Gabapentin
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TCA
58 Secondary to the black box warning providers caring for patients on antidepressants should assess for?:
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Suicidality, frequency, andseverity at EVERY appointment 8u 8u 8u 8u 8u 8u




59. Whichmedshave theworse serotonin discontinuationsyndrome: Those 8u 8u 8u 8u 8u 8u 8u 8u




8u with short half lives such as zoloft
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60. Symptoms of serotonin withdrawal syndrome: Fever, achiness, soreness, lethargy, fatigue, impaired 8 u 8 u 8 u 8 u 8 u 8 u 8 u 8 u 8 u 8 u




8 u memory, decreased concentration, GI UPSET 8u 8u 8u 8u




Shits and Shivers 8u 8u




61. Ages of onset for schizophrenia inmales vs females: -MALES 18-25 years
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