APEA PMHNP EXAM AND PRACTICE EXAM NEWEST
2026 TEST BANK| APEA PSYCHIATRIC-MENTAL
HEALTH NURSE PRACTITIONER (PMHNP) EXAM
PREP WITH COMPLETE 400 REAL EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS/ ALREADY
GRADED A+ (MOST RECENT!!)
A 28-year-old patient with bipolar I disorder is prescribed lithium.
Which laboratory value is most important to monitor before and during
treatment?
a) Liver enzymes
b) Thyroid function
c) Amylase level
d) Hemoglobin A1c - Correct Answer - b) Thyroid function
Lithium can cause hypothyroidism. Baseline and periodic thyroid
function testing are required. Lithium also requires monitoring of renal
function and serum lithium levels.
A PMHNP evaluates a patient with generalized anxiety disorder who has
been taking alprazolam daily for 2 years. The patient wants to stop the
medication. What is the safest approach?
a) Stop immediately
b) Switch to an antipsychotic
c) Gradually taper the medication
d) Increase the dose before stopping - Correct Answer - c) Gradually
taper the medication
pg. 1
,Long-term benzodiazepine use can cause dependence and withdrawal
symptoms, including seizures. A gradual taper reduces withdrawal risk.
A 7-year-old child is evaluated for ADHD. The parent reports excessive
activity, impulsivity, and inability to maintain attention at home and
school for more than 6 months. Which medication is considered first-
line treatment?
a) Fluoxetine
b) Methylphenidate
c) Lithium
d) Haloperidol - Correct Answer - b) Methylphenidate
Stimulants such as methylphenidate are first-line medications for ADHD
in children when appropriate. They improve attention and reduce
hyperactivity and impulsivity.
A 70-year-old patient develops sudden confusion, fluctuating attention,
and disorientation after hip surgery. The family reports the patient was
cognitively normal before hospitalization. What is the most likely
diagnosis?
a) Major neurocognitive disorder
b) Delirium
c) Schizophrenia
d) Depression - Correct Answer - b) Delirium
Delirium is characterized by acute onset, fluctuating cognition, impaired
attention, and altered awareness, often triggered by medical illness,
surgery, or medications.
pg. 2
,A patient with schizophrenia is started on clozapine after multiple failed
antipsychotic trials. Which monitoring requirement is essential?
a) Weekly CBC monitoring initially
b) Monthly liver biopsy
c) Daily ECG monitoring
d) Routine urine drug screening - Correct Answer - a) Weekly CBC
monitoring initially
Clozapine carries a risk of severe neutropenia/agranulocytosis. Absolute
neutrophil count (ANC) monitoring is required according to REMS
guidelines.
A patient with PTSD begins trauma-focused therapy. Which
psychotherapy approach has strong evidence for PTSD treatment?
a) Cognitive processing therapy
b) Supportive therapy only
c) Psychoanalysis
d) Electroconvulsive therapy - Correct Answer - a) Cognitive processing
therapy
Trauma-focused psychotherapies, including cognitive processing therapy
and prolonged exposure therapy, are evidence-based first-line treatments
for PTSD.
A patient presents with excessive handwashing, fear of contamination,
and intrusive unwanted thoughts about germs. The patient spends
several hours daily performing rituals. Which diagnosis is most likely?
a) Obsessive-compulsive disorder
b) Illness anxiety disorder
pg. 3
, c) Generalized anxiety disorder
d) Somatic symptom disorder - Correct Answer - a) Obsessive-
compulsive disorder
OCD is characterized by obsessions (intrusive thoughts) and
compulsions (repetitive behaviors performed to reduce anxiety) that
consume significant time and impair functioning.
A 16-year-old adolescent reports depressed mood, withdrawal from
friends, declining grades, hopelessness, and thoughts that life is not
worth living. The patient denies a specific suicide plan. What is the
PMHNP’s priority action?
a) Start antidepressant medication immediately without assessment
b) Assess suicide risk and safety
c) Recommend exercise only
d) Ignore passive suicidal thoughts because there is no plan - Correct
Answer - b) Assess suicide risk and safety
Any suicidal thoughts require assessment of intent, plan, means,
previous attempts, protective factors, and immediate safety needs before
treatment decisions.
A patient taking risperidone develops breast enlargement and elevated
prolactin levels. Which adverse effect is occurring?
a) Metabolic syndrome
b) Extrapyramidal symptoms
c) Hyperprolactinemia
d) Neuroleptic malignant syndrome - Correct Answer - c)
Hyperprolactinemia
pg. 4
2026 TEST BANK| APEA PSYCHIATRIC-MENTAL
HEALTH NURSE PRACTITIONER (PMHNP) EXAM
PREP WITH COMPLETE 400 REAL EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS/ ALREADY
GRADED A+ (MOST RECENT!!)
A 28-year-old patient with bipolar I disorder is prescribed lithium.
Which laboratory value is most important to monitor before and during
treatment?
a) Liver enzymes
b) Thyroid function
c) Amylase level
d) Hemoglobin A1c - Correct Answer - b) Thyroid function
Lithium can cause hypothyroidism. Baseline and periodic thyroid
function testing are required. Lithium also requires monitoring of renal
function and serum lithium levels.
A PMHNP evaluates a patient with generalized anxiety disorder who has
been taking alprazolam daily for 2 years. The patient wants to stop the
medication. What is the safest approach?
a) Stop immediately
b) Switch to an antipsychotic
c) Gradually taper the medication
d) Increase the dose before stopping - Correct Answer - c) Gradually
taper the medication
pg. 1
,Long-term benzodiazepine use can cause dependence and withdrawal
symptoms, including seizures. A gradual taper reduces withdrawal risk.
A 7-year-old child is evaluated for ADHD. The parent reports excessive
activity, impulsivity, and inability to maintain attention at home and
school for more than 6 months. Which medication is considered first-
line treatment?
a) Fluoxetine
b) Methylphenidate
c) Lithium
d) Haloperidol - Correct Answer - b) Methylphenidate
Stimulants such as methylphenidate are first-line medications for ADHD
in children when appropriate. They improve attention and reduce
hyperactivity and impulsivity.
A 70-year-old patient develops sudden confusion, fluctuating attention,
and disorientation after hip surgery. The family reports the patient was
cognitively normal before hospitalization. What is the most likely
diagnosis?
a) Major neurocognitive disorder
b) Delirium
c) Schizophrenia
d) Depression - Correct Answer - b) Delirium
Delirium is characterized by acute onset, fluctuating cognition, impaired
attention, and altered awareness, often triggered by medical illness,
surgery, or medications.
pg. 2
,A patient with schizophrenia is started on clozapine after multiple failed
antipsychotic trials. Which monitoring requirement is essential?
a) Weekly CBC monitoring initially
b) Monthly liver biopsy
c) Daily ECG monitoring
d) Routine urine drug screening - Correct Answer - a) Weekly CBC
monitoring initially
Clozapine carries a risk of severe neutropenia/agranulocytosis. Absolute
neutrophil count (ANC) monitoring is required according to REMS
guidelines.
A patient with PTSD begins trauma-focused therapy. Which
psychotherapy approach has strong evidence for PTSD treatment?
a) Cognitive processing therapy
b) Supportive therapy only
c) Psychoanalysis
d) Electroconvulsive therapy - Correct Answer - a) Cognitive processing
therapy
Trauma-focused psychotherapies, including cognitive processing therapy
and prolonged exposure therapy, are evidence-based first-line treatments
for PTSD.
A patient presents with excessive handwashing, fear of contamination,
and intrusive unwanted thoughts about germs. The patient spends
several hours daily performing rituals. Which diagnosis is most likely?
a) Obsessive-compulsive disorder
b) Illness anxiety disorder
pg. 3
, c) Generalized anxiety disorder
d) Somatic symptom disorder - Correct Answer - a) Obsessive-
compulsive disorder
OCD is characterized by obsessions (intrusive thoughts) and
compulsions (repetitive behaviors performed to reduce anxiety) that
consume significant time and impair functioning.
A 16-year-old adolescent reports depressed mood, withdrawal from
friends, declining grades, hopelessness, and thoughts that life is not
worth living. The patient denies a specific suicide plan. What is the
PMHNP’s priority action?
a) Start antidepressant medication immediately without assessment
b) Assess suicide risk and safety
c) Recommend exercise only
d) Ignore passive suicidal thoughts because there is no plan - Correct
Answer - b) Assess suicide risk and safety
Any suicidal thoughts require assessment of intent, plan, means,
previous attempts, protective factors, and immediate safety needs before
treatment decisions.
A patient taking risperidone develops breast enlargement and elevated
prolactin levels. Which adverse effect is occurring?
a) Metabolic syndrome
b) Extrapyramidal symptoms
c) Hyperprolactinemia
d) Neuroleptic malignant syndrome - Correct Answer - c)
Hyperprolactinemia
pg. 4
