ADVANCED PMHNP EXAM 2026 COMPLETE
STUDY GUIDE | PSYCHIATRIC MENTAL
HEALTH NURSE PRACTITIONER BOARD
PREP & PRACTICE QUESTIONS
| GRADED A+ |GUARANTEED SUCCESS
Updated 2026 Questions and Answers
100% Verified Exam Prep and Comprehensive
Rationales Included
,An 8-year-old boy presents for an evaluation for possible b. Arrange for parents to obtain Vanderbilt screening tool or other written
attention-deficit/hyperactivity disorder (ADHD). His feedback from his teacher and return in 2 weeks.
parents report him to be a healthy 3rd-grader with
"plenty of good friends." They are concerned he could
have ADHD because he is "hyperactive" and because his
father had ADHD. The Vanderbilt screening tools
completed by his parents strongly indicate inattention,
with moderate hyperactivity symptoms. Your next best
action is to:
a. Prescribe a low dose of methylphenidate.
b. Arrange for parents to obtain Vanderbilt screening tool
or other written feedback from his teacher and return in 2
weeks.
c. Order a screening head computed topography (CT),
complete blood count (CBC) and thyroid-stimulating
hormone (TSH).
d. Advise to restrict refined carbohydrates, especially
high sugar cereals in the morning prior to school.
You have been asked by the director of a large primary c. Collaborate with the director to plan for implementation of on-site behavioral
care office to serve as a consultant to a primary care health specialists imbedded into the primary care clinic.
clinic to improve access to mental health care services
for their patients. Which of the following actions by the
PMHNP is recognized as an innovative, best practice
model?
a. Schedule lunch and learn sessions to advise the
providers about how to improve treatment of mental
health disorders with their patients.
b. Provide the nursing staff with a list of referral agencies.
c. Collaborate with the director to plan for
implementation of on-site behavioral health specialists
imbedded into the primary care clinic.
d. Arrange your psychiatric clinic to have 2 appointments
per week available for the primary care patients.
,A 60-year-old female who is being treated for stable b. Administer a Montreal cognitive assessment (MoCA) test.
major depressive disorder and generalized anxiety
disorder presents for a follow-up appointment. She
mentions that she sometimes forgets where she has left
her car keys. The NP's next step is to:
a. Refer for neuropsychological testing.
b. Administer a Montreal cognitive assessment (MoCA)
test.
c. Increase the dose of her SSRI.
d. Schedule laboratory testing for TSH, CBC.
For a patient receiving valproate therapy, regular c. TSH.
monitoring for all of the following is recommended
except:
a. ALT and AST.
b. Bilirubin.
c. TSH.
d. Platelet count.
A 76-year-old woman presents with worsening fatigue d. Iron-deficiency anemia.
during the past 6 months. She is currently being treated
with an SSRI for major depressive disorder. Her
laboratory results are as follows:
Hb=9.3 g/dL (13-17) (93 g/L [130-170])
MCV=71 fL (80-96 fL)
This most likely represents:
a. Folate-deficiency anemia.
b. Pernicious anemia.
c. Drug-induced anemia.
d. Iron-deficiency anemia.
A potential laboratory indicator for alcohol abuse is: a. Elevated ALT.
a. Elevated ALT.
b. Diminished creatinine.
c. Elevated alkaline phosphatase.
d. Elevated creatine kinase.
The most accurate laboratory measurement for kidney a. Calculated glomerular filtration rate (GFR).
function is:
a. Calculated glomerular filtration rate (GFR).
b. Serum creatinine.
c. Blood urea nitrogen (BUN).
d. Serum creatine kinase (CK).
, Which of the following medications does not require b. Lamotrigine
initial laboratory testing before implementing therapy?
a. Carbamazepine
b. Lamotrigine
c. Valproate
d. Lithium
Ms. Roberts, 36-year-old woman, is stably treated for c. Inhibition of the CYP1A2 pathway
schizoaffective disorder on olanzapine and lithium. Staff
at residential care facility calls you as she has been
sleeping 3 extra hours at night and has taken more naps
during the day for the past few days. She continues to
shower, eat meals and engage in scheduled activities as
she has in the past, staff noted no other changes in her
mental status. Her mental status exam is unchanged since
last 6 weeks ago. She was seen yesterday by PCP for a
urinary tract infection, she finishes a 7-day course of
ciprofloxacin tomorrow. You consider that one possible
cause of her extra napping, a drug-drug interaction with
the addition of ciprofloxacin to her medication regimen.
The ciprofloxacin may be doing which of the following?
a. Inducing of the CYP219 pathway
b. Inhibiting of the CYP3A4 pathway
c. Inhibition of the CYP1A2 pathway
d. Inducing of the CYP1A2 pathway
What is the PMHNPs next best course of action? c. Reassure her of the increased symptoms and schedule a follow-up in 3 days.
a. Refer her to the emergency department for a delirium
work up
b. Have her stop her ciprofloxacin and call urology in the
morning.
c. Reassure her of the increased symptoms and schedule
a follow-up in 3 days.
d. Schedule her for a sleep study.
STUDY GUIDE | PSYCHIATRIC MENTAL
HEALTH NURSE PRACTITIONER BOARD
PREP & PRACTICE QUESTIONS
| GRADED A+ |GUARANTEED SUCCESS
Updated 2026 Questions and Answers
100% Verified Exam Prep and Comprehensive
Rationales Included
,An 8-year-old boy presents for an evaluation for possible b. Arrange for parents to obtain Vanderbilt screening tool or other written
attention-deficit/hyperactivity disorder (ADHD). His feedback from his teacher and return in 2 weeks.
parents report him to be a healthy 3rd-grader with
"plenty of good friends." They are concerned he could
have ADHD because he is "hyperactive" and because his
father had ADHD. The Vanderbilt screening tools
completed by his parents strongly indicate inattention,
with moderate hyperactivity symptoms. Your next best
action is to:
a. Prescribe a low dose of methylphenidate.
b. Arrange for parents to obtain Vanderbilt screening tool
or other written feedback from his teacher and return in 2
weeks.
c. Order a screening head computed topography (CT),
complete blood count (CBC) and thyroid-stimulating
hormone (TSH).
d. Advise to restrict refined carbohydrates, especially
high sugar cereals in the morning prior to school.
You have been asked by the director of a large primary c. Collaborate with the director to plan for implementation of on-site behavioral
care office to serve as a consultant to a primary care health specialists imbedded into the primary care clinic.
clinic to improve access to mental health care services
for their patients. Which of the following actions by the
PMHNP is recognized as an innovative, best practice
model?
a. Schedule lunch and learn sessions to advise the
providers about how to improve treatment of mental
health disorders with their patients.
b. Provide the nursing staff with a list of referral agencies.
c. Collaborate with the director to plan for
implementation of on-site behavioral health specialists
imbedded into the primary care clinic.
d. Arrange your psychiatric clinic to have 2 appointments
per week available for the primary care patients.
,A 60-year-old female who is being treated for stable b. Administer a Montreal cognitive assessment (MoCA) test.
major depressive disorder and generalized anxiety
disorder presents for a follow-up appointment. She
mentions that she sometimes forgets where she has left
her car keys. The NP's next step is to:
a. Refer for neuropsychological testing.
b. Administer a Montreal cognitive assessment (MoCA)
test.
c. Increase the dose of her SSRI.
d. Schedule laboratory testing for TSH, CBC.
For a patient receiving valproate therapy, regular c. TSH.
monitoring for all of the following is recommended
except:
a. ALT and AST.
b. Bilirubin.
c. TSH.
d. Platelet count.
A 76-year-old woman presents with worsening fatigue d. Iron-deficiency anemia.
during the past 6 months. She is currently being treated
with an SSRI for major depressive disorder. Her
laboratory results are as follows:
Hb=9.3 g/dL (13-17) (93 g/L [130-170])
MCV=71 fL (80-96 fL)
This most likely represents:
a. Folate-deficiency anemia.
b. Pernicious anemia.
c. Drug-induced anemia.
d. Iron-deficiency anemia.
A potential laboratory indicator for alcohol abuse is: a. Elevated ALT.
a. Elevated ALT.
b. Diminished creatinine.
c. Elevated alkaline phosphatase.
d. Elevated creatine kinase.
The most accurate laboratory measurement for kidney a. Calculated glomerular filtration rate (GFR).
function is:
a. Calculated glomerular filtration rate (GFR).
b. Serum creatinine.
c. Blood urea nitrogen (BUN).
d. Serum creatine kinase (CK).
, Which of the following medications does not require b. Lamotrigine
initial laboratory testing before implementing therapy?
a. Carbamazepine
b. Lamotrigine
c. Valproate
d. Lithium
Ms. Roberts, 36-year-old woman, is stably treated for c. Inhibition of the CYP1A2 pathway
schizoaffective disorder on olanzapine and lithium. Staff
at residential care facility calls you as she has been
sleeping 3 extra hours at night and has taken more naps
during the day for the past few days. She continues to
shower, eat meals and engage in scheduled activities as
she has in the past, staff noted no other changes in her
mental status. Her mental status exam is unchanged since
last 6 weeks ago. She was seen yesterday by PCP for a
urinary tract infection, she finishes a 7-day course of
ciprofloxacin tomorrow. You consider that one possible
cause of her extra napping, a drug-drug interaction with
the addition of ciprofloxacin to her medication regimen.
The ciprofloxacin may be doing which of the following?
a. Inducing of the CYP219 pathway
b. Inhibiting of the CYP3A4 pathway
c. Inhibition of the CYP1A2 pathway
d. Inducing of the CYP1A2 pathway
What is the PMHNPs next best course of action? c. Reassure her of the increased symptoms and schedule a follow-up in 3 days.
a. Refer her to the emergency department for a delirium
work up
b. Have her stop her ciprofloxacin and call urology in the
morning.
c. Reassure her of the increased symptoms and schedule
a follow-up in 3 days.
d. Schedule her for a sleep study.
