PMHNP 2 PRACTICE EXAM
QUESTIONS AND DETAILED
SOLUTIONS 2026
▶ 7. Before an older adult patient initiates pharmacotherapy with a medication that is
cleared by the kidneys, an adult psychiatric and mental health nurse practitioner
assesses the patient's:
A. blood urea nitrogen level.
B. creatinine clearance.
C. specific gravity.
D. urinary sediment. Answer: B. creatinine clearance.
▶ 8. An adult psychiatric and mental health nurse practitioner uses a cognitive-
behavioral approach to help an adolescent patient change self-defeating behaviors.
After identifying the initial stressor that is causing the inappropriate behavior, the
therapeutic intervention is to identify:
A. alternative positive responses to the stressor.
B. negative consequences of the behavioral response to the stressor.
C. possible outcomes of alternative responses.
D. rational and irrational beliefs about the stressor. Answer: D. rational and irrational
beliefs about the stressor.
▶ 9. Which characteristic of fluoxetine (Prozac) provides the greatest degree of safety
for patients who have severe depression?
A. Greater efficacy than tricyclic antidepressants
B. Less potential for drug interaction
C. Less potential for injury with intentional overdose
D. Less potential for suicidal thinking Answer: C. Less potential for injury with
intentional overdose
▶ 10. When lobbying a local congressional representative to include nurse practitioners
in reimbursement for services in all areas of the country, an adult psychiatric and mental
health nurse practitioner emphasizes the:
A. ability of nurse practitioners to provide health care that patients need.
B. fact that nurse practitioners are caring in their patient care delivery.
C. importance of broadening the scope of nursing practice.
, D. necessity of offering equivalent services both to urban and rural patients. Answer: A.
ability of nurse practitioners to provide health care that patients need.
▶ 11. For 12 years, a 65-year-old patient with bipolar affective disorder has been
treated with lithium (Eskalith) 900 mg daily. When oral hydrochlorothiazide (HCTZ) 12.5
mg daily is added for hypertension, the patient develops nausea, vomiting, ataxia, and
muscle weakness and the patient's serum lithium level is 2.0 mEq/L. The interaction of
the lithium and the thiazide diuretic has induced:
A. hypokalemia.
B. hyponatremia.
C. increased renal clearance of lithium.
D. reduced renal clearance of lithium. Answer: D. reduced renal clearance of lithium.
▶ 12. Which statement by a male patient who has posttraumatic stress disorder (PTSD)
and chronic persistent suicidal ideation indicates a need for hospital assessment?
A. "I feel so bad all the time. I wish I were dead."
B. "My wife is so scared that she has taken all my guns out of the house."
C. "My wife just left with the children. I have no one left and no future."
D. "Those medications you gave me make me feel worse. I stopped taking them."
Answer: C. "My wife just left with the children. I have no one left and no future."
▶ 13. A male patient informs an adult psychiatric and mental health nurse practitioner
that he has not slept in three days, has poor concentration, and denies fatigue. The
patient's diagnosis is:
A. attention-deficit hyperactivity disorder.
B. bipolar disorder.
C. panic disorder.
D. primary insomnia. Answer: B. bipolar disorder.
▶ 14. During patient education about sertraline (Zoloft), an adult psychiatric and mental
health nurse practitioner focuses upon the potential side effect of:
A. agranulocytosis.
B. hypernatremia.
C. sexual dysfunction.
D. weight loss. Answer: C. sexual dysfunction
▶ 15. The neurochemical pathophysiology of Tourette disorder involves:
A. decreased levels of gamma-aminobutyric acid and increased levels of glutamate in
the brain.
B. deficits in the prefrontal cortex-mediated executive functions of the brain.
C. imbalances in dopaminergic, serotonergic, and noradrenergic systems in multiple
regions of the brain.
D. overstimulation of noradrenergic activity located in the locus coeruleus of the brain.
Answer: C. imbalances in dopaminergic, serotonergic, and noradrenergic systems in
multiple regions of the brain.
QUESTIONS AND DETAILED
SOLUTIONS 2026
▶ 7. Before an older adult patient initiates pharmacotherapy with a medication that is
cleared by the kidneys, an adult psychiatric and mental health nurse practitioner
assesses the patient's:
A. blood urea nitrogen level.
B. creatinine clearance.
C. specific gravity.
D. urinary sediment. Answer: B. creatinine clearance.
▶ 8. An adult psychiatric and mental health nurse practitioner uses a cognitive-
behavioral approach to help an adolescent patient change self-defeating behaviors.
After identifying the initial stressor that is causing the inappropriate behavior, the
therapeutic intervention is to identify:
A. alternative positive responses to the stressor.
B. negative consequences of the behavioral response to the stressor.
C. possible outcomes of alternative responses.
D. rational and irrational beliefs about the stressor. Answer: D. rational and irrational
beliefs about the stressor.
▶ 9. Which characteristic of fluoxetine (Prozac) provides the greatest degree of safety
for patients who have severe depression?
A. Greater efficacy than tricyclic antidepressants
B. Less potential for drug interaction
C. Less potential for injury with intentional overdose
D. Less potential for suicidal thinking Answer: C. Less potential for injury with
intentional overdose
▶ 10. When lobbying a local congressional representative to include nurse practitioners
in reimbursement for services in all areas of the country, an adult psychiatric and mental
health nurse practitioner emphasizes the:
A. ability of nurse practitioners to provide health care that patients need.
B. fact that nurse practitioners are caring in their patient care delivery.
C. importance of broadening the scope of nursing practice.
, D. necessity of offering equivalent services both to urban and rural patients. Answer: A.
ability of nurse practitioners to provide health care that patients need.
▶ 11. For 12 years, a 65-year-old patient with bipolar affective disorder has been
treated with lithium (Eskalith) 900 mg daily. When oral hydrochlorothiazide (HCTZ) 12.5
mg daily is added for hypertension, the patient develops nausea, vomiting, ataxia, and
muscle weakness and the patient's serum lithium level is 2.0 mEq/L. The interaction of
the lithium and the thiazide diuretic has induced:
A. hypokalemia.
B. hyponatremia.
C. increased renal clearance of lithium.
D. reduced renal clearance of lithium. Answer: D. reduced renal clearance of lithium.
▶ 12. Which statement by a male patient who has posttraumatic stress disorder (PTSD)
and chronic persistent suicidal ideation indicates a need for hospital assessment?
A. "I feel so bad all the time. I wish I were dead."
B. "My wife is so scared that she has taken all my guns out of the house."
C. "My wife just left with the children. I have no one left and no future."
D. "Those medications you gave me make me feel worse. I stopped taking them."
Answer: C. "My wife just left with the children. I have no one left and no future."
▶ 13. A male patient informs an adult psychiatric and mental health nurse practitioner
that he has not slept in three days, has poor concentration, and denies fatigue. The
patient's diagnosis is:
A. attention-deficit hyperactivity disorder.
B. bipolar disorder.
C. panic disorder.
D. primary insomnia. Answer: B. bipolar disorder.
▶ 14. During patient education about sertraline (Zoloft), an adult psychiatric and mental
health nurse practitioner focuses upon the potential side effect of:
A. agranulocytosis.
B. hypernatremia.
C. sexual dysfunction.
D. weight loss. Answer: C. sexual dysfunction
▶ 15. The neurochemical pathophysiology of Tourette disorder involves:
A. decreased levels of gamma-aminobutyric acid and increased levels of glutamate in
the brain.
B. deficits in the prefrontal cortex-mediated executive functions of the brain.
C. imbalances in dopaminergic, serotonergic, and noradrenergic systems in multiple
regions of the brain.
D. overstimulation of noradrenergic activity located in the locus coeruleus of the brain.
Answer: C. imbalances in dopaminergic, serotonergic, and noradrenergic systems in
multiple regions of the brain.
