ANCC PMHNP IQ – DOMAINS 1–5 PRACTICE
QUESTIONS AND ANSWERS WITH VERIFIED
SOLUTIONS GRADE A+.
DOMAIN 1: SCIENTIFIC FOUNDATION
1. Which neurotransmitter imbalance is most strongly associated with
major depressive disorder?
A. Dopamine
B. Gamma-aminobutyric acid (GABA)
C. Serotonin
D. Acetylcholine
Correct Answer: C. Serotonin
Rationale: Major depressive disorder is associated with decreased serotonergic
activity, which affects mood, sleep, and appetite. Most antidepressants target
serotonin pathways.
2. Which brain structure is primarily responsible for regulating fear and
emotional responses?
A. Hippocampus
B. Amygdala
C. Thalamus
D. Cerebellum
Correct Answer: B. Amygdala
Rationale: The amygdala plays a key role in processing fear, anxiety, and
emotional memory and is hyperactive in anxiety and trauma-related disorders.
3. Which genetic concept explains why individuals with a family history of
bipolar disorder are at higher risk but may never develop the illness?
A. Gene mutation
B. Genetic determinism
C. Epigenetics
D. Chromosomal deletion
,Correct Answer: C. Epigenetics
Rationale: Epigenetics describes how environmental factors influence gene
expression without altering DNA, explaining variable disease manifestation.
DOMAIN 2: ADVANCED PRACTICE SKILLS
4. When initiating lithium therapy, which baseline laboratory test is
essential?
A. Liver function tests
B. Thyroid function tests
C. Coagulation studies
D. Hemoglobin A1c
Correct Answer: B. Thyroid function tests
Rationale: Lithium can cause hypothyroidism; baseline and ongoing thyroid
monitoring is required.
5. A PMHNP is assessing suicide risk. Which factor represents the highest
immediate risk?
A. Passive death wish
B. Family history of suicide
C. Specific plan with access to means
D. Recent job loss
Correct Answer: C. Specific plan with access to means
Rationale: A specific plan and available means indicate imminent suicide risk
and require immediate intervention.
6. Which medication is considered first-line for generalized anxiety
disorder?
A. Haloperidol
B. Buspirone
C. Lithium
D. Clozapine
Correct Answer: B. Buspirone
Rationale: Buspirone is a first-line non-benzodiazepine anxiolytic used for GAD
due to its favorable safety profile.
, DOMAIN 3: DIAGNOSIS AND ASSESSMENT
7. Which symptom is required for a diagnosis of schizophrenia?
A. Depressed mood
B. Hallucinations or delusions
C. Panic attacks
D. Memory impairment
Correct Answer: B. Hallucinations or delusions
Rationale: Schizophrenia requires at least one positive symptom such as
hallucinations, delusions, or disorganized speech.
8. A client presents with elevated mood, decreased need for sleep, and
impulsive behavior lasting 5 days without hospitalization. Which diagnosis
is most likely?
A. Bipolar I disorder
B. Cyclothymic disorder
C. Major depressive disorder
D. Bipolar II disorder
Correct Answer: D. Bipolar II disorder
Rationale: Hypomanic episodes lasting at least 4 days without severe
impairment are characteristic of Bipolar II disorder.
9. Which screening tool is commonly used for depression in primary care
and psychiatric settings?
A. GAD-7
B. MMSE
C. PHQ-9
D. CAGE
Correct Answer: C. PHQ-9
Rationale: The PHQ-9 is a validated, widely used tool for screening and
monitoring depression severity.
DOMAIN 4: PSYCHOTHERAPEUTIC INTERVENTIONS
10. Cognitive Behavioral Therapy (CBT) primarily focuses on changing:
A. Childhood experiences
B. Neurochemical imbalances
QUESTIONS AND ANSWERS WITH VERIFIED
SOLUTIONS GRADE A+.
DOMAIN 1: SCIENTIFIC FOUNDATION
1. Which neurotransmitter imbalance is most strongly associated with
major depressive disorder?
A. Dopamine
B. Gamma-aminobutyric acid (GABA)
C. Serotonin
D. Acetylcholine
Correct Answer: C. Serotonin
Rationale: Major depressive disorder is associated with decreased serotonergic
activity, which affects mood, sleep, and appetite. Most antidepressants target
serotonin pathways.
2. Which brain structure is primarily responsible for regulating fear and
emotional responses?
A. Hippocampus
B. Amygdala
C. Thalamus
D. Cerebellum
Correct Answer: B. Amygdala
Rationale: The amygdala plays a key role in processing fear, anxiety, and
emotional memory and is hyperactive in anxiety and trauma-related disorders.
3. Which genetic concept explains why individuals with a family history of
bipolar disorder are at higher risk but may never develop the illness?
A. Gene mutation
B. Genetic determinism
C. Epigenetics
D. Chromosomal deletion
,Correct Answer: C. Epigenetics
Rationale: Epigenetics describes how environmental factors influence gene
expression without altering DNA, explaining variable disease manifestation.
DOMAIN 2: ADVANCED PRACTICE SKILLS
4. When initiating lithium therapy, which baseline laboratory test is
essential?
A. Liver function tests
B. Thyroid function tests
C. Coagulation studies
D. Hemoglobin A1c
Correct Answer: B. Thyroid function tests
Rationale: Lithium can cause hypothyroidism; baseline and ongoing thyroid
monitoring is required.
5. A PMHNP is assessing suicide risk. Which factor represents the highest
immediate risk?
A. Passive death wish
B. Family history of suicide
C. Specific plan with access to means
D. Recent job loss
Correct Answer: C. Specific plan with access to means
Rationale: A specific plan and available means indicate imminent suicide risk
and require immediate intervention.
6. Which medication is considered first-line for generalized anxiety
disorder?
A. Haloperidol
B. Buspirone
C. Lithium
D. Clozapine
Correct Answer: B. Buspirone
Rationale: Buspirone is a first-line non-benzodiazepine anxiolytic used for GAD
due to its favorable safety profile.
, DOMAIN 3: DIAGNOSIS AND ASSESSMENT
7. Which symptom is required for a diagnosis of schizophrenia?
A. Depressed mood
B. Hallucinations or delusions
C. Panic attacks
D. Memory impairment
Correct Answer: B. Hallucinations or delusions
Rationale: Schizophrenia requires at least one positive symptom such as
hallucinations, delusions, or disorganized speech.
8. A client presents with elevated mood, decreased need for sleep, and
impulsive behavior lasting 5 days without hospitalization. Which diagnosis
is most likely?
A. Bipolar I disorder
B. Cyclothymic disorder
C. Major depressive disorder
D. Bipolar II disorder
Correct Answer: D. Bipolar II disorder
Rationale: Hypomanic episodes lasting at least 4 days without severe
impairment are characteristic of Bipolar II disorder.
9. Which screening tool is commonly used for depression in primary care
and psychiatric settings?
A. GAD-7
B. MMSE
C. PHQ-9
D. CAGE
Correct Answer: C. PHQ-9
Rationale: The PHQ-9 is a validated, widely used tool for screening and
monitoring depression severity.
DOMAIN 4: PSYCHOTHERAPEUTIC INTERVENTIONS
10. Cognitive Behavioral Therapy (CBT) primarily focuses on changing:
A. Childhood experiences
B. Neurochemical imbalances
