PMHNP CERTIFICATION EXAM COMPLETE QUESTIONS AND
OUTLINED CORRECT ANSWERS 2026/27
Example A patient is being treated for schizophrenia with olanzapine. Which
of the following is the most common side effect of olanzapine?
A. Increased waist circumference
B. EPS (not as common in atypical antipsychotics d/t 5HT2A)-receptor
antagonism
C. Increased Lipids
D. Metabolic Syndrome
Which patient is at highest risk for SI
A. 30y/o married AA female with previous SI attempt *1 risk factor
B. 35 y/o single Asian male with previous SI attempt *3 risk factors
C. 38 y/o single AA male who is a manager of a bank *2 risk factors
D. 68 y/o single white male with depression *5 risk factors (age, male,
white, depression)
D. 68 y/o single white male with depression *5 risk factors (age, male, white,
depression)
Which antipsychotics have the least weight gain?
,Latuda, Abilify, (also least sedating), Geodon-if patient has metabolic
syndrome consider switching to one of the medications above. Or if the
patient is overly sedated try switching to ABILIFY
Which mood stabilizer have the least weight gain?
Lamictal
-But remember all mood stabilizers cause some weight gain
When presented with a question about typical vs atypical antipsychotic the
answer is usually to start of aatypical
A client presents with complains 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?
A. Thalamus
B. Hypothalamus
C. Limbic System
D. Hippocampus
Count the risk factorsCOWS scale components
· Opioid W/D
How long do you wait when switching between an SSRI to an MAOI?
2 weeks
How long do you wait when switching between Prozac and MAOI?
5-6 weeks wash out period
,What is the first line treatment for depression and why?
SSRI-First line treatment for depression due to less risk of injury from
OVERDOSE
If a cancer patient has depression what should you consider?
Treating with a medication with minimal drug/drug side effects like
Lexapro
Patient with depression worries about sexual dysfunction what would be the
medication of choice?
Wellbutrin
Primary symptoms of depression include fatigue and low energy what med
would you chose?
Wellbutrin
Wellbutrin is contraindicated in patients with
Seizures and anorexia (bulimia also)
Which medications are best for neuropathic pain?
SNRI
Gabapentin
TCA
Secondary to the black box warning providers caring for patients on
antidepressants should assess for?
Suicidality, frequency, and severity at EVERY appointment
Which meds have the worse serotonin discontinuation syndrome
, Those with short half lives such as Zoloft; TCA's
Symptoms of discontinuation syndrome
flu like symptoms (fatigue, lethargy, myalgia, decreased concentration), n/v,
impaired memory, paresthesia, irritability, anxiety, insomnia, crying w/o
reason, dizziness, and vertigoTx w/periactin
Ages of onset for schizophrenia in males vs females
-MALES 18-25 years
-FEMALE 25-35 years
What nationality is most suseptible of getting steven johnson?
Asians
When treating asians with tegretol screen for?
HLAB-1502 Allele
What two medications cause agranulocytosis?
Clozaril & Tegretol
Agranulocytosis when to discontinue medication
Less than 1000
When monitoring for agranulocytosis in patients look for s/s of what?
Infection
-Fever, sore throat, fatigue, chills
OUTLINED CORRECT ANSWERS 2026/27
Example A patient is being treated for schizophrenia with olanzapine. Which
of the following is the most common side effect of olanzapine?
A. Increased waist circumference
B. EPS (not as common in atypical antipsychotics d/t 5HT2A)-receptor
antagonism
C. Increased Lipids
D. Metabolic Syndrome
Which patient is at highest risk for SI
A. 30y/o married AA female with previous SI attempt *1 risk factor
B. 35 y/o single Asian male with previous SI attempt *3 risk factors
C. 38 y/o single AA male who is a manager of a bank *2 risk factors
D. 68 y/o single white male with depression *5 risk factors (age, male,
white, depression)
D. 68 y/o single white male with depression *5 risk factors (age, male, white,
depression)
Which antipsychotics have the least weight gain?
,Latuda, Abilify, (also least sedating), Geodon-if patient has metabolic
syndrome consider switching to one of the medications above. Or if the
patient is overly sedated try switching to ABILIFY
Which mood stabilizer have the least weight gain?
Lamictal
-But remember all mood stabilizers cause some weight gain
When presented with a question about typical vs atypical antipsychotic the
answer is usually to start of aatypical
A client presents with complains 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?
A. Thalamus
B. Hypothalamus
C. Limbic System
D. Hippocampus
Count the risk factorsCOWS scale components
· Opioid W/D
How long do you wait when switching between an SSRI to an MAOI?
2 weeks
How long do you wait when switching between Prozac and MAOI?
5-6 weeks wash out period
,What is the first line treatment for depression and why?
SSRI-First line treatment for depression due to less risk of injury from
OVERDOSE
If a cancer patient has depression what should you consider?
Treating with a medication with minimal drug/drug side effects like
Lexapro
Patient with depression worries about sexual dysfunction what would be the
medication of choice?
Wellbutrin
Primary symptoms of depression include fatigue and low energy what med
would you chose?
Wellbutrin
Wellbutrin is contraindicated in patients with
Seizures and anorexia (bulimia also)
Which medications are best for neuropathic pain?
SNRI
Gabapentin
TCA
Secondary to the black box warning providers caring for patients on
antidepressants should assess for?
Suicidality, frequency, and severity at EVERY appointment
Which meds have the worse serotonin discontinuation syndrome
, Those with short half lives such as Zoloft; TCA's
Symptoms of discontinuation syndrome
flu like symptoms (fatigue, lethargy, myalgia, decreased concentration), n/v,
impaired memory, paresthesia, irritability, anxiety, insomnia, crying w/o
reason, dizziness, and vertigoTx w/periactin
Ages of onset for schizophrenia in males vs females
-MALES 18-25 years
-FEMALE 25-35 years
What nationality is most suseptible of getting steven johnson?
Asians
When treating asians with tegretol screen for?
HLAB-1502 Allele
What two medications cause agranulocytosis?
Clozaril & Tegretol
Agranulocytosis when to discontinue medication
Less than 1000
When monitoring for agranulocytosis in patients look for s/s of what?
Infection
-Fever, sore throat, fatigue, chills
