2026/2027
LMR Georgette PMHNP Board
Exam 2026/2027 Professional
Preparation Workbook for Quizzes,
Case-Based Practice, and Board
Review
Question 1:
A psychiatric-mental health nurse practitioner is advocating for a hospitalized patient
who disagrees with the treatment plan. Which action by the provider would be
considered inappropriate during patient advocacy?
A. Supporting the patient’s right to ask questions
B. Helping the patient understand treatment options
C. Judging or confronting the patient about their choices
D. Facilitating communication between the patient and healthcare team
Correct Answer: C. Judging or confronting the patient about their choices
Rationale:
Effective patient advocacy involves protecting patient autonomy, ensuring informed
decision-making, and supporting the patient without imposing personal beliefs or
criticism. Judging or confronting the patient damages trust and interferes with
therapeutic communication. Supporting questions, facilitating understanding, and
improving communication all strengthen advocacy and empower patients to
participate in their care.
Question 2:
A child diagnosed with Tourette syndrome also has symptoms of ADHD. Which
medication class should generally be avoided because it may worsen tic symptoms?
A. Alpha-2 agonists
B. Selective serotonin reuptake inhibitors (SSRIs)
C. Stimulants
D. Mood stabilizers
Correct Answer: C. Stimulants
Rationale:
Stimulant medications can exacerbate motor and vocal tics in susceptible children
,2026/2027
because they increase dopamine activity within the central nervous system. Although
some patients tolerate stimulants, caution is necessary in children with tic disorders.
Alpha-2 agonists such as clonidine and guanfacine are often preferred because they
may reduce both ADHD symptoms and tics. SSRIs and mood stabilizers are not
primary causes of tic worsening.
Question 3:
Before assessing a suspected abuse victim, what is the nurse practitioner’s priority
intervention?
A. Contacting law enforcement immediately
B. Ensuring the patient is in a safe environment
C. Asking the patient detailed questions in front of family members
D. Obtaining collateral information from the caregiver first
Correct Answer: B. Ensuring the patient is in a safe environment
Rationale:
Safety is the immediate priority when caring for abuse victims. Patients are more
likely to disclose abuse when they feel protected and emotionally secure. Interviewing
patients in unsafe environments or in front of potential abusers may place them at
greater risk and inhibit disclosure. Law enforcement and collateral information may
become necessary later, but patient safety and privacy must be established first.
Question 4:
A 7-year-old child tells the psychiatric nurse practitioner that a parent has been
physically abusive. What is the most appropriate initial action?
A. Ask the parents if the allegation is true
B. Ignore the statement unless physical injuries are visible
C. Interview the child separately and report the concern to Child Protective Services
(CPS)
D. Wait until additional evidence is obtained before acting
Correct Answer: C. Interview the child separately and report the concern to
Child Protective Services (CPS)
Rationale:
Healthcare providers are mandated reporters and are legally required to report
suspected child abuse. The child should first be interviewed separately from
caregivers to reduce intimidation and improve the accuracy of disclosure. Waiting for
proof or confronting parents before reporting may place the child at additional risk.
The provider’s responsibility is to report suspicion, not to personally confirm abuse.
,2026/2027
Question 5:
During a play therapy session, a child repeatedly acts out violent sexual scenarios
with dolls. What is the nurse practitioner’s best response?
A. Assume the behavior is developmentally normal
B. Document the findings and monitor for changes only
C. Report suspected abuse to Child Protective Services
D. Punish the child for inappropriate play behavior
Correct Answer: C. Report suspected abuse to Child Protective Services
Rationale:
Sexualized play beyond developmental expectations may indicate exposure to sexual
abuse or inappropriate experiences. Healthcare providers are mandated reporters and
must report reasonable suspicion of abuse. The goal is to protect the child and initiate
further professional investigation. Punishment or dismissal of the behavior is
inappropriate and may further traumatize the child.
Question 6:
An inpatient psychiatric provider needs to interview a patient regarding sensitive
personal information. Which setting is most appropriate?
A. In the hallway with nursing staff nearby
B. In a private room with the door partially open
C. In the cafeteria to make the patient comfortable
D. At the nurses’ station for easy documentation
Correct Answer: B. In a private room with the door partially open
Rationale:
A private setting promotes confidentiality and therapeutic communication while
maintaining appropriate safety precautions. Keeping the door partially open balances
patient privacy with staff safety. Hallways, cafeterias, and nursing stations
compromise confidentiality and may discourage honest disclosure from the patient.
Question 7:
When beginning an interview with an adolescent patient, which approach is most
therapeutic?
A. Begin by questioning the parents extensively
B. Explain confidentiality and build rapport first
C. Start with direct questions about high-risk behaviors
D. Focus only on obtaining objective data
, 2026/2027
Correct Answer: B. Explain confidentiality and build rapport first
Rationale:
Adolescents are more likely to communicate openly when trust and confidentiality are
established early in the interview. Providers should explain the limits of
confidentiality, including situations involving harm to self or others. Starting with
confrontational or highly sensitive questions too early can damage rapport and reduce
disclosure.
Question 8:
A psychiatric nurse practitioner is assessing an adolescent patient. Which
interviewing strategy is generally recommended?
A. Interview the adolescent only with parents present
B. Interview the adolescent without parents present for part of the session
C. Avoid discussing confidential topics with adolescents
D. Obtain all information exclusively from parents
Correct Answer: B. Interview the adolescent without parents present for part of
the session
Rationale:
Private interviews encourage adolescents to discuss sensitive issues such as sexuality,
substance use, depression, and abuse. While parents provide valuable collateral
information, independent assessment of the adolescent is essential. Exclusive reliance
on parents may limit disclosure and reduce the accuracy of assessment findings.
Question 9:
A 16-year-old patient tells the provider that they identify as homosexual and do not
want their parents informed. What is the best response?
A. Inform the parents because they are minors
B. Encourage the patient to change their sexual orientation
C. Maintain confidentiality unless safety concerns exist
D. Refuse to discuss sexual orientation with the patient
Correct Answer: C. Maintain confidentiality unless safety concerns exist
Rationale:
Sexual orientation is confidential information and should not be disclosed without
patient consent unless there is a safety concern requiring intervention. Maintaining
confidentiality strengthens therapeutic trust and promotes honest communication.
Breaching confidentiality unnecessarily can harm the patient emotionally and damage
the provider-patient relationship.
LMR Georgette PMHNP Board
Exam 2026/2027 Professional
Preparation Workbook for Quizzes,
Case-Based Practice, and Board
Review
Question 1:
A psychiatric-mental health nurse practitioner is advocating for a hospitalized patient
who disagrees with the treatment plan. Which action by the provider would be
considered inappropriate during patient advocacy?
A. Supporting the patient’s right to ask questions
B. Helping the patient understand treatment options
C. Judging or confronting the patient about their choices
D. Facilitating communication between the patient and healthcare team
Correct Answer: C. Judging or confronting the patient about their choices
Rationale:
Effective patient advocacy involves protecting patient autonomy, ensuring informed
decision-making, and supporting the patient without imposing personal beliefs or
criticism. Judging or confronting the patient damages trust and interferes with
therapeutic communication. Supporting questions, facilitating understanding, and
improving communication all strengthen advocacy and empower patients to
participate in their care.
Question 2:
A child diagnosed with Tourette syndrome also has symptoms of ADHD. Which
medication class should generally be avoided because it may worsen tic symptoms?
A. Alpha-2 agonists
B. Selective serotonin reuptake inhibitors (SSRIs)
C. Stimulants
D. Mood stabilizers
Correct Answer: C. Stimulants
Rationale:
Stimulant medications can exacerbate motor and vocal tics in susceptible children
,2026/2027
because they increase dopamine activity within the central nervous system. Although
some patients tolerate stimulants, caution is necessary in children with tic disorders.
Alpha-2 agonists such as clonidine and guanfacine are often preferred because they
may reduce both ADHD symptoms and tics. SSRIs and mood stabilizers are not
primary causes of tic worsening.
Question 3:
Before assessing a suspected abuse victim, what is the nurse practitioner’s priority
intervention?
A. Contacting law enforcement immediately
B. Ensuring the patient is in a safe environment
C. Asking the patient detailed questions in front of family members
D. Obtaining collateral information from the caregiver first
Correct Answer: B. Ensuring the patient is in a safe environment
Rationale:
Safety is the immediate priority when caring for abuse victims. Patients are more
likely to disclose abuse when they feel protected and emotionally secure. Interviewing
patients in unsafe environments or in front of potential abusers may place them at
greater risk and inhibit disclosure. Law enforcement and collateral information may
become necessary later, but patient safety and privacy must be established first.
Question 4:
A 7-year-old child tells the psychiatric nurse practitioner that a parent has been
physically abusive. What is the most appropriate initial action?
A. Ask the parents if the allegation is true
B. Ignore the statement unless physical injuries are visible
C. Interview the child separately and report the concern to Child Protective Services
(CPS)
D. Wait until additional evidence is obtained before acting
Correct Answer: C. Interview the child separately and report the concern to
Child Protective Services (CPS)
Rationale:
Healthcare providers are mandated reporters and are legally required to report
suspected child abuse. The child should first be interviewed separately from
caregivers to reduce intimidation and improve the accuracy of disclosure. Waiting for
proof or confronting parents before reporting may place the child at additional risk.
The provider’s responsibility is to report suspicion, not to personally confirm abuse.
,2026/2027
Question 5:
During a play therapy session, a child repeatedly acts out violent sexual scenarios
with dolls. What is the nurse practitioner’s best response?
A. Assume the behavior is developmentally normal
B. Document the findings and monitor for changes only
C. Report suspected abuse to Child Protective Services
D. Punish the child for inappropriate play behavior
Correct Answer: C. Report suspected abuse to Child Protective Services
Rationale:
Sexualized play beyond developmental expectations may indicate exposure to sexual
abuse or inappropriate experiences. Healthcare providers are mandated reporters and
must report reasonable suspicion of abuse. The goal is to protect the child and initiate
further professional investigation. Punishment or dismissal of the behavior is
inappropriate and may further traumatize the child.
Question 6:
An inpatient psychiatric provider needs to interview a patient regarding sensitive
personal information. Which setting is most appropriate?
A. In the hallway with nursing staff nearby
B. In a private room with the door partially open
C. In the cafeteria to make the patient comfortable
D. At the nurses’ station for easy documentation
Correct Answer: B. In a private room with the door partially open
Rationale:
A private setting promotes confidentiality and therapeutic communication while
maintaining appropriate safety precautions. Keeping the door partially open balances
patient privacy with staff safety. Hallways, cafeterias, and nursing stations
compromise confidentiality and may discourage honest disclosure from the patient.
Question 7:
When beginning an interview with an adolescent patient, which approach is most
therapeutic?
A. Begin by questioning the parents extensively
B. Explain confidentiality and build rapport first
C. Start with direct questions about high-risk behaviors
D. Focus only on obtaining objective data
, 2026/2027
Correct Answer: B. Explain confidentiality and build rapport first
Rationale:
Adolescents are more likely to communicate openly when trust and confidentiality are
established early in the interview. Providers should explain the limits of
confidentiality, including situations involving harm to self or others. Starting with
confrontational or highly sensitive questions too early can damage rapport and reduce
disclosure.
Question 8:
A psychiatric nurse practitioner is assessing an adolescent patient. Which
interviewing strategy is generally recommended?
A. Interview the adolescent only with parents present
B. Interview the adolescent without parents present for part of the session
C. Avoid discussing confidential topics with adolescents
D. Obtain all information exclusively from parents
Correct Answer: B. Interview the adolescent without parents present for part of
the session
Rationale:
Private interviews encourage adolescents to discuss sensitive issues such as sexuality,
substance use, depression, and abuse. While parents provide valuable collateral
information, independent assessment of the adolescent is essential. Exclusive reliance
on parents may limit disclosure and reduce the accuracy of assessment findings.
Question 9:
A 16-year-old patient tells the provider that they identify as homosexual and do not
want their parents informed. What is the best response?
A. Inform the parents because they are minors
B. Encourage the patient to change their sexual orientation
C. Maintain confidentiality unless safety concerns exist
D. Refuse to discuss sexual orientation with the patient
Correct Answer: C. Maintain confidentiality unless safety concerns exist
Rationale:
Sexual orientation is confidential information and should not be disclosed without
patient consent unless there is a safety concern requiring intervention. Maintaining
confidentiality strengthens therapeutic trust and promotes honest communication.
Breaching confidentiality unnecessarily can harm the patient emotionally and damage
the provider-patient relationship.
