ANCC PMHNP CERTIFICATION EXAM – IQ
DOMAINS 1–5 MOST TESTED QUESTIONS AND
ANSWERS REAL SUCCESS KIT | INSTANT PDF
DOWNLOAD
Overview:
This exam is designed for Psychiatric-Mental Health Nurse Practitioner (PMHNP) candidates preparing
for the ANCC certification exam. Questions cover all five Intellectual Quality (IQ) Domains:
1. Assessment & Diagnosis – Psychiatric evaluation, mental status examination, differential
diagnosis.
2. Planning & Intervention – Evidence-based treatment planning, pharmacologic and non-
pharmacologic interventions.
3. Implementation & Evaluation – Clinical management, monitoring response, and adjusting
therapy.
4. Professional Role & Ethics – Scope of practice, legal/ethical considerations, collaborative care.
5. Health Promotion & Disease Prevention – Risk reduction, patient education, advocacy, and
wellness strategies.
Each question is scenario-based, includes the correct answer in bold, and provides a detailed rationale
to reinforce critical knowledge and improve exam readiness. Ideal for self-assessment, exam
preparation, and confidence-building.
1.
A 25-year-old patient presents with persistent sadness, anhedonia, and
insomnia for 3 months. Which is the most appropriate next step?
A. Start cognitive behavioral therapy (CBT) without assessment
B. Prescribe benzodiazepines for insomnia
C. Conduct a full psychiatric evaluation and MSE
D. Recommend lifestyle changes only
,Rationale: Comprehensive assessment, including mental status examination
(MSE), is essential for accurate diagnosis before initiating therapy (IQ Domain
👀 1).
2.
Which DSM-5 criterion is required to diagnose major depressive disorder
(MDD)?
A. At least 1 week of low mood
B. At least 2 weeks of depressed mood or anhedonia
C. Suicidal ideation only
D. Anxiety symptoms
Rationale: MDD diagnosis requires ≥2 weeks of depressed mood or loss of
interest/pleasure (IQ Domain 👀 1).
3.
A patient with schizophrenia is nonadherent to oral risperidone. Which is the
best intervention?
A. Stop medication
B. Increase oral dose
C. Consider long-acting injectable antipsychotic
D. Refer to inpatient care immediately
Rationale: Long-acting injectable antipsychotics improve adherence and
outcomes (IQ Domain 👀 2).
4.
,Which lab test is mandatory before initiating lithium therapy?
A. CBC
B. LFTs only
C. Serum creatinine and TSH
D. Fasting glucose
Rationale: Lithium requires baseline renal and thyroid function assessment due
to toxicity risk (IQ Domain 👀 2).
5.
A 32-year-old presents with panic attacks, palpitations, and fear of dying.
Which is the first-line treatment?
A. Benzodiazepines PRN only
B. SSRI and CBT
C. Antipsychotics
D. Avoid treatment
Rationale: SSRIs and CBT are first-line evidence-based treatments for panic
disorder (IQ Domain 👀 2).
6.
Which question is most appropriate when assessing suicidal risk?
A. “Do you feel sad?”
B. “Have you thought about harming yourself or ending your life?”
C. “Do you have family support?”
D. “Are you taking medications?”
, Rationale: Direct questions about suicidal ideation are essential for risk
assessment (IQ Domain 👀 1).
7.
A patient on sertraline develops sexual dysfunction. What is the best
evidence-based intervention?
A. Discontinue abruptly
B. Switch to another SSRI
C. Consider bupropion augmentation or dose adjustment
D. Ignore side effects
Rationale: Bupropion is less likely to cause sexual side effects; evidence-based
augmentation improves adherence (IQ Domain 👀 2).
8.
Which side effect is most concerning with clozapine therapy?
A. Sedation
B. Weight gain
C. Agranulocytosis
D. Dry mouth
Rationale: Clozapine carries a risk of agranulocytosis; CBC monitoring is
mandatory (IQ Domain 👀 2).
9.
DOMAINS 1–5 MOST TESTED QUESTIONS AND
ANSWERS REAL SUCCESS KIT | INSTANT PDF
DOWNLOAD
Overview:
This exam is designed for Psychiatric-Mental Health Nurse Practitioner (PMHNP) candidates preparing
for the ANCC certification exam. Questions cover all five Intellectual Quality (IQ) Domains:
1. Assessment & Diagnosis – Psychiatric evaluation, mental status examination, differential
diagnosis.
2. Planning & Intervention – Evidence-based treatment planning, pharmacologic and non-
pharmacologic interventions.
3. Implementation & Evaluation – Clinical management, monitoring response, and adjusting
therapy.
4. Professional Role & Ethics – Scope of practice, legal/ethical considerations, collaborative care.
5. Health Promotion & Disease Prevention – Risk reduction, patient education, advocacy, and
wellness strategies.
Each question is scenario-based, includes the correct answer in bold, and provides a detailed rationale
to reinforce critical knowledge and improve exam readiness. Ideal for self-assessment, exam
preparation, and confidence-building.
1.
A 25-year-old patient presents with persistent sadness, anhedonia, and
insomnia for 3 months. Which is the most appropriate next step?
A. Start cognitive behavioral therapy (CBT) without assessment
B. Prescribe benzodiazepines for insomnia
C. Conduct a full psychiatric evaluation and MSE
D. Recommend lifestyle changes only
,Rationale: Comprehensive assessment, including mental status examination
(MSE), is essential for accurate diagnosis before initiating therapy (IQ Domain
👀 1).
2.
Which DSM-5 criterion is required to diagnose major depressive disorder
(MDD)?
A. At least 1 week of low mood
B. At least 2 weeks of depressed mood or anhedonia
C. Suicidal ideation only
D. Anxiety symptoms
Rationale: MDD diagnosis requires ≥2 weeks of depressed mood or loss of
interest/pleasure (IQ Domain 👀 1).
3.
A patient with schizophrenia is nonadherent to oral risperidone. Which is the
best intervention?
A. Stop medication
B. Increase oral dose
C. Consider long-acting injectable antipsychotic
D. Refer to inpatient care immediately
Rationale: Long-acting injectable antipsychotics improve adherence and
outcomes (IQ Domain 👀 2).
4.
,Which lab test is mandatory before initiating lithium therapy?
A. CBC
B. LFTs only
C. Serum creatinine and TSH
D. Fasting glucose
Rationale: Lithium requires baseline renal and thyroid function assessment due
to toxicity risk (IQ Domain 👀 2).
5.
A 32-year-old presents with panic attacks, palpitations, and fear of dying.
Which is the first-line treatment?
A. Benzodiazepines PRN only
B. SSRI and CBT
C. Antipsychotics
D. Avoid treatment
Rationale: SSRIs and CBT are first-line evidence-based treatments for panic
disorder (IQ Domain 👀 2).
6.
Which question is most appropriate when assessing suicidal risk?
A. “Do you feel sad?”
B. “Have you thought about harming yourself or ending your life?”
C. “Do you have family support?”
D. “Are you taking medications?”
, Rationale: Direct questions about suicidal ideation are essential for risk
assessment (IQ Domain 👀 1).
7.
A patient on sertraline develops sexual dysfunction. What is the best
evidence-based intervention?
A. Discontinue abruptly
B. Switch to another SSRI
C. Consider bupropion augmentation or dose adjustment
D. Ignore side effects
Rationale: Bupropion is less likely to cause sexual side effects; evidence-based
augmentation improves adherence (IQ Domain 👀 2).
8.
Which side effect is most concerning with clozapine therapy?
A. Sedation
B. Weight gain
C. Agranulocytosis
D. Dry mouth
Rationale: Clozapine carries a risk of agranulocytosis; CBC monitoring is
mandatory (IQ Domain 👀 2).
9.
