BOARD CERTIFIED PSYCHIATRIC–
MENTAL HEALTH NURSE PRACTITIONER
(PMHNP-BC) EXAM QUESTION AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A
INSTANT DOWNLOAD PDF
1. A 28-year-old patient presents with persistent depressed mood, anhedonia,
insomnia, and poor concentration for 3 weeks following a breakup. Which
diagnosis is most appropriate?
A. Adjustment disorder with depressed mood
B. Persistent depressive disorder
C. Major depressive disorder
D. Bipolar II disorder
Rationale: Major depressive disorder requires ≥2 weeks of symptoms
including depressed mood or anhedonia with functional impairment.
2. Which neurotransmitter is most associated with the pathophysiology of
depression?
A. Dopamine
B. Serotonin
C. GABA
D. Acetylcholine
Rationale: Serotonin dysregulation is strongly linked to mood disorders,
particularly depression.
,3. A patient with bipolar I disorder is most likely to experience which feature?
A. Hypomania only
B. Chronic low-grade depression
C. Manic episodes
D. Rapid cycling only
Rationale: Bipolar I disorder is defined by the presence of at least one
manic episode.
4. Which medication is first-line for acute mania?
A. Fluoxetine
B. Lithium
C. Bupropion
D. Sertraline
Rationale: Mood stabilizers such as lithium are first-line for acute manic
episodes.
5. A patient taking lithium should be monitored closely for which adverse
effect?
A. Agranulocytosis
B. Nephrotoxicity
C. Hepatotoxicity
D. QT prolongation
Rationale: Lithium can impair renal function and requires regular kidney
monitoring.
6. Which symptom is characteristic of schizophrenia?
A. Flight of ideas
B. Auditory hallucinations
C. Elevated mood
D. Obsessions
Rationale: Auditory hallucinations are a hallmark positive symptom of
schizophrenia.
7. Negative symptoms of schizophrenia include:
A. Hallucinations
, B. Delusions
C. Affective flattening
D. Disorganized speech
Rationale: Negative symptoms involve loss of normal function, such as
reduced emotional expression.
8. Which antipsychotic has the highest risk of agranulocytosis?
A. Risperidone
B. Olanzapine
C. Clozapine
D. Quetiapine
Rationale: Clozapine requires regular CBC monitoring due to
agranulocytosis risk.
9. A patient on clozapine presents with fever and sore throat. What is the
priority action?
A. Reassure the patient
B. Obtain a CBC immediately
C. Reduce the dose
D. Switch to another antipsychotic later
Rationale: Symptoms may indicate agranulocytosis, requiring urgent
blood count evaluation.
10.Which disorder is characterized by intrusive thoughts and repetitive
behaviors?
A. Generalized anxiety disorder
B. Obsessive-compulsive disorder
C. Panic disorder
D. PTSD
Rationale: OCD involves obsessions (intrusive thoughts) and compulsions
(repetitive behaviors).
11.First-line treatment for OCD includes:
A. Benzodiazepines
B. SSRIs
MENTAL HEALTH NURSE PRACTITIONER
(PMHNP-BC) EXAM QUESTION AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A
INSTANT DOWNLOAD PDF
1. A 28-year-old patient presents with persistent depressed mood, anhedonia,
insomnia, and poor concentration for 3 weeks following a breakup. Which
diagnosis is most appropriate?
A. Adjustment disorder with depressed mood
B. Persistent depressive disorder
C. Major depressive disorder
D. Bipolar II disorder
Rationale: Major depressive disorder requires ≥2 weeks of symptoms
including depressed mood or anhedonia with functional impairment.
2. Which neurotransmitter is most associated with the pathophysiology of
depression?
A. Dopamine
B. Serotonin
C. GABA
D. Acetylcholine
Rationale: Serotonin dysregulation is strongly linked to mood disorders,
particularly depression.
,3. A patient with bipolar I disorder is most likely to experience which feature?
A. Hypomania only
B. Chronic low-grade depression
C. Manic episodes
D. Rapid cycling only
Rationale: Bipolar I disorder is defined by the presence of at least one
manic episode.
4. Which medication is first-line for acute mania?
A. Fluoxetine
B. Lithium
C. Bupropion
D. Sertraline
Rationale: Mood stabilizers such as lithium are first-line for acute manic
episodes.
5. A patient taking lithium should be monitored closely for which adverse
effect?
A. Agranulocytosis
B. Nephrotoxicity
C. Hepatotoxicity
D. QT prolongation
Rationale: Lithium can impair renal function and requires regular kidney
monitoring.
6. Which symptom is characteristic of schizophrenia?
A. Flight of ideas
B. Auditory hallucinations
C. Elevated mood
D. Obsessions
Rationale: Auditory hallucinations are a hallmark positive symptom of
schizophrenia.
7. Negative symptoms of schizophrenia include:
A. Hallucinations
, B. Delusions
C. Affective flattening
D. Disorganized speech
Rationale: Negative symptoms involve loss of normal function, such as
reduced emotional expression.
8. Which antipsychotic has the highest risk of agranulocytosis?
A. Risperidone
B. Olanzapine
C. Clozapine
D. Quetiapine
Rationale: Clozapine requires regular CBC monitoring due to
agranulocytosis risk.
9. A patient on clozapine presents with fever and sore throat. What is the
priority action?
A. Reassure the patient
B. Obtain a CBC immediately
C. Reduce the dose
D. Switch to another antipsychotic later
Rationale: Symptoms may indicate agranulocytosis, requiring urgent
blood count evaluation.
10.Which disorder is characterized by intrusive thoughts and repetitive
behaviors?
A. Generalized anxiety disorder
B. Obsessive-compulsive disorder
C. Panic disorder
D. PTSD
Rationale: OCD involves obsessions (intrusive thoughts) and compulsions
(repetitive behaviors).
11.First-line treatment for OCD includes:
A. Benzodiazepines
B. SSRIs
