ANCC PMHNP Practice Exam – IQ Domains 1–5
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1. A 25-year-old patient presents with persistent low mood,
anhedonia, and insomnia for the past 3 months. Which is the most
appropriate initial pharmacologic treatment?
a. SSRIs
b. MAOIs
c. Typical antipsychotics
d. Benzodiazepines
SSRIs are first-line pharmacologic treatment for major depressive
disorder due to efficacy and safety profile.
2. A patient with schizophrenia reports hearing voices that comment
on their behavior. Which symptom type is this?
a. Negative symptom
b. Cognitive symptom
c. Positive symptom
d. Affective symptom
Positive symptoms are characterized by additions to normal behavior,
such as hallucinations and delusions.
3. Which of the following best describes the primary role of a
PMHNP in collaborative care?
, a. Prescribing only
b. Conducting psychotherapy only
c. Integrating assessment, diagnosis, and management in
collaboration with the healthcare team
d. Providing case management exclusively
PMHNPs function in collaborative care to assess, diagnose, and manage
psychiatric disorders while coordinating with other providers.
4. A patient with generalized anxiety disorder presents with frequent
muscle tension, restlessness, and irritability. Which first-line
medication is recommended?
a. Tricyclic antidepressants
b. SSRIs or SNRIs
c. Benzodiazepines as first-line
d. Antipsychotics
SSRIs and SNRIs are considered first-line due to efficacy and lower risk of
dependence compared to benzodiazepines.
5. When assessing for bipolar disorder, which symptom would most
likely indicate a manic episode?
a. Persistent sadness
b. Fatigue
c. Grandiosity and decreased need for sleep
d. Social withdrawal
Mania is characterized by elevated mood, grandiosity, decreased need
for sleep, and increased goal-directed activity.
6. Which screening tool is most appropriate for identifying
depression in adults in primary care?
, a. CAGE questionnaire
b. MMSE
c. PHQ-9
d. GAD-7
The PHQ-9 is a validated screening tool for depressive symptoms in
adults.
7. A patient reports sudden, intense fear with palpitations, sweating,
and shortness of breath without an obvious trigger. The most
likely diagnosis is:
a. GAD
b. Panic disorder
c. Social anxiety disorder
d. PTSD
Panic disorder is defined by recurrent unexpected panic attacks with
somatic and cognitive symptoms.
8. Which neurotransmitter is most implicated in the pathophysiology
of schizophrenia?
a. Serotonin
b. Norepinephrine
c. Dopamine
d. GABA
Dopamine hyperactivity, particularly in mesolimbic pathways, is linked
to positive symptoms of schizophrenia.
9. In cognitive-behavioral therapy for PTSD, a primary focus is:
a. Medication management
b. Identifying and restructuring maladaptive thoughts
, c. Group therapy only
d. Psychoeducation without intervention
CBT focuses on cognitive restructuring and exposure to reduce PTSD
symptoms.
10. A patient presents with alcohol withdrawal. Which
intervention is most appropriate?
a. Encourage abrupt cessation without support
b. Administer benzodiazepines as needed
c. Prescribe SSRIs
d. Only provide psychotherapy
Benzodiazepines are first-line for managing acute alcohol withdrawal to
prevent seizures and delirium.
11. Which personality disorder is characterized by pervasive
pattern of instability in relationships, self-image, and affect, often
with impulsivity?
a. Narcissistic personality disorder
b. Schizoid personality disorder
c. Borderline personality disorder
d. Avoidant personality disorder
Borderline personality disorder manifests with emotional dysregulation,
unstable relationships, and impulsive behavior.
12. A patient with ADHD is prescribed a stimulant. What is the
most important monitoring parameter?
a. Liver function tests
b. Blood pressure and heart rate
I Questions And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A | Instant
Download Pdf
1. A 25-year-old patient presents with persistent low mood,
anhedonia, and insomnia for the past 3 months. Which is the most
appropriate initial pharmacologic treatment?
a. SSRIs
b. MAOIs
c. Typical antipsychotics
d. Benzodiazepines
SSRIs are first-line pharmacologic treatment for major depressive
disorder due to efficacy and safety profile.
2. A patient with schizophrenia reports hearing voices that comment
on their behavior. Which symptom type is this?
a. Negative symptom
b. Cognitive symptom
c. Positive symptom
d. Affective symptom
Positive symptoms are characterized by additions to normal behavior,
such as hallucinations and delusions.
3. Which of the following best describes the primary role of a
PMHNP in collaborative care?
, a. Prescribing only
b. Conducting psychotherapy only
c. Integrating assessment, diagnosis, and management in
collaboration with the healthcare team
d. Providing case management exclusively
PMHNPs function in collaborative care to assess, diagnose, and manage
psychiatric disorders while coordinating with other providers.
4. A patient with generalized anxiety disorder presents with frequent
muscle tension, restlessness, and irritability. Which first-line
medication is recommended?
a. Tricyclic antidepressants
b. SSRIs or SNRIs
c. Benzodiazepines as first-line
d. Antipsychotics
SSRIs and SNRIs are considered first-line due to efficacy and lower risk of
dependence compared to benzodiazepines.
5. When assessing for bipolar disorder, which symptom would most
likely indicate a manic episode?
a. Persistent sadness
b. Fatigue
c. Grandiosity and decreased need for sleep
d. Social withdrawal
Mania is characterized by elevated mood, grandiosity, decreased need
for sleep, and increased goal-directed activity.
6. Which screening tool is most appropriate for identifying
depression in adults in primary care?
, a. CAGE questionnaire
b. MMSE
c. PHQ-9
d. GAD-7
The PHQ-9 is a validated screening tool for depressive symptoms in
adults.
7. A patient reports sudden, intense fear with palpitations, sweating,
and shortness of breath without an obvious trigger. The most
likely diagnosis is:
a. GAD
b. Panic disorder
c. Social anxiety disorder
d. PTSD
Panic disorder is defined by recurrent unexpected panic attacks with
somatic and cognitive symptoms.
8. Which neurotransmitter is most implicated in the pathophysiology
of schizophrenia?
a. Serotonin
b. Norepinephrine
c. Dopamine
d. GABA
Dopamine hyperactivity, particularly in mesolimbic pathways, is linked
to positive symptoms of schizophrenia.
9. In cognitive-behavioral therapy for PTSD, a primary focus is:
a. Medication management
b. Identifying and restructuring maladaptive thoughts
, c. Group therapy only
d. Psychoeducation without intervention
CBT focuses on cognitive restructuring and exposure to reduce PTSD
symptoms.
10. A patient presents with alcohol withdrawal. Which
intervention is most appropriate?
a. Encourage abrupt cessation without support
b. Administer benzodiazepines as needed
c. Prescribe SSRIs
d. Only provide psychotherapy
Benzodiazepines are first-line for managing acute alcohol withdrawal to
prevent seizures and delirium.
11. Which personality disorder is characterized by pervasive
pattern of instability in relationships, self-image, and affect, often
with impulsivity?
a. Narcissistic personality disorder
b. Schizoid personality disorder
c. Borderline personality disorder
d. Avoidant personality disorder
Borderline personality disorder manifests with emotional dysregulation,
unstable relationships, and impulsive behavior.
12. A patient with ADHD is prescribed a stimulant. What is the
most important monitoring parameter?
a. Liver function tests
b. Blood pressure and heart rate
