LMR Georgette PMHNP Board Exam – 200 Practice
Questions with Answers & Detailed Explanations
for ANCC Psychiatric-Mental Health Nurse
Practitioner Certification |latest update this year
Download now and pass
first try!
Ace the LMR Georgette PMHNP Board Exam! 200 practice questions with verified
answers and detailed explanations covering psychopharmacology, CYP450,
pharmacogenomics, DSM-5-TR diagnosis, neurobiology, psychotherapy (CBT,
DBT), ethics, and cultural care. Aligned with ANCC PMHNP-BC blueprint. Pass first
try – download now!
Table of Contents:
Section 1: Scientific Foundation – Neurobiology & Psychopharmacology
(Questions 1–44)
Section 2: Advanced Practice Skills – Assessment & MSE (Questions 45–98)
Section 3: Diagnosis and Treatment – DSM-5 & Differential Diagnosis (Questions
99–142)
Section 4: Psychotherapy & Related Theories (Questions 143–164)
Section 5: Ethics, Legal Principles, and Cultural Care (Questions 165–200)
Includes: Answer Key with Detailed Explanations for Every Question
Covers: LMR Georgette PMHNP Board Exam, ANCC PMHNP-BC Blueprint,
Psychopharmacology, DSM-5, Psychotherapy, Ethics, and Clinical Management
Across the Lifespan
,Section 1: Scientific Foundation – Neurobiology & Psychopharmacology
(Questions 1-44)
1. A patient with major depressive disorder has failed two adequate trials of
SSRIs. Pharmacogenomic testing reveals a CYP2C19 poor metabolizer
phenotype. Which antidepressant selection is most appropriate based on this
result?
A. Escitalopram 10 mg daily, monitoring for increased side effects
B. Citalopram 40 mg daily, with dose reduction due to prolonged half-life
C. Sertraline 100 mg daily, as it is primarily metabolized by CYP3A4
D. Venlafaxine XR 75 mg daily, avoiding CYP2C19 metabolism
Answer: C. Sertraline 100 mg daily, as it is primarily metabolized by CYP3A4
Explanation: Sertraline is not significantly metabolized by CYP2C19; it uses CYP2B6
and CYP3A4. Escitalopram and citalopram are both metabolized by CYP2C19; in
poor metabolizers, they accumulate, increasing QTc risk (citalopram) or side
effects. Venlafaxine is metabolized by CYP2D6, not relevant. Therefore, sertraline
is a safe choice for this patient based on pharmacogenomic results .
2. A patient with bipolar disorder is started on lithium. The PMHNP orders
baseline labs before initiation. Which of the following is the most important lab
value to obtain before starting lithium therapy?
A. Complete blood count (CBC)
,B. Thyroid-stimulating hormone (TSH) and serum creatinine
C. Liver function tests (LFTs)
D. Serum magnesium level
Answer: B. Thyroid-stimulating hormone (TSH) and serum creatinine
Explanation: Lithium can cause hypothyroidism and nephrogenic diabetes
insipidus, so baseline TSH and creatinine are critical. CBC and LFTs are not
routinely indicated for lithium initiation .
3. A patient on fluoxetine 20 mg daily reports persistent insomnia and anxiety.
The PMHNP considers adding a second agent. Which of the following
medications is most appropriate for augmentation in treatment-resistant
depression?
A. Quetiapine XR
B. Lorazepam
C. Ziprasidone
D. Trazodone
Answer: A. Quetiapine XR
Explanation: Quetiapine XR has FDA approval for augmentation in treatment-
resistant depression. Lorazepam and trazodone may help sleep but do not have
antidepressant augmentation efficacy. Ziprasidone is not approved for
augmentation in MDD .
, 4. The PMHNP is explaining the mechanism of action of aripiprazole to a
patient. Which of the following statements correctly describes aripiprazole's
unique mechanism?
A. It is a partial agonist at D2 and 5-HT1A receptors
B. It is a full antagonist at D2 receptors
C. It is a partial agonist at 5-HT2A receptors
D. It is a full agonist at dopamine receptors
Answer: A. It is a partial agonist at D2 and 5-HT1A receptors
Explanation: Aripiprazole is a partial agonist at dopamine D2 and serotonin 5-
HT1A receptors, making it unique among antipsychotics. It is also a potent
antagonist at 5-HT2A receptors .
5. A patient with schizophrenia has been on clozapine for 6 months. The PMHNP
should monitor for which potentially life-threatening side effect?
A. Weight gain
B. Agranulocytosis
C. Tardive dyskinesia
D. Hyperprolactinemia
Answer: B. Agranulocytosis
Explanation: Clozapine requires mandatory REMS monitoring due to the risk of
agranulocytosis (severe neutropenia). CBC must be checked weekly for the first 6
months, then biweekly, then monthly .
Questions with Answers & Detailed Explanations
for ANCC Psychiatric-Mental Health Nurse
Practitioner Certification |latest update this year
Download now and pass
first try!
Ace the LMR Georgette PMHNP Board Exam! 200 practice questions with verified
answers and detailed explanations covering psychopharmacology, CYP450,
pharmacogenomics, DSM-5-TR diagnosis, neurobiology, psychotherapy (CBT,
DBT), ethics, and cultural care. Aligned with ANCC PMHNP-BC blueprint. Pass first
try – download now!
Table of Contents:
Section 1: Scientific Foundation – Neurobiology & Psychopharmacology
(Questions 1–44)
Section 2: Advanced Practice Skills – Assessment & MSE (Questions 45–98)
Section 3: Diagnosis and Treatment – DSM-5 & Differential Diagnosis (Questions
99–142)
Section 4: Psychotherapy & Related Theories (Questions 143–164)
Section 5: Ethics, Legal Principles, and Cultural Care (Questions 165–200)
Includes: Answer Key with Detailed Explanations for Every Question
Covers: LMR Georgette PMHNP Board Exam, ANCC PMHNP-BC Blueprint,
Psychopharmacology, DSM-5, Psychotherapy, Ethics, and Clinical Management
Across the Lifespan
,Section 1: Scientific Foundation – Neurobiology & Psychopharmacology
(Questions 1-44)
1. A patient with major depressive disorder has failed two adequate trials of
SSRIs. Pharmacogenomic testing reveals a CYP2C19 poor metabolizer
phenotype. Which antidepressant selection is most appropriate based on this
result?
A. Escitalopram 10 mg daily, monitoring for increased side effects
B. Citalopram 40 mg daily, with dose reduction due to prolonged half-life
C. Sertraline 100 mg daily, as it is primarily metabolized by CYP3A4
D. Venlafaxine XR 75 mg daily, avoiding CYP2C19 metabolism
Answer: C. Sertraline 100 mg daily, as it is primarily metabolized by CYP3A4
Explanation: Sertraline is not significantly metabolized by CYP2C19; it uses CYP2B6
and CYP3A4. Escitalopram and citalopram are both metabolized by CYP2C19; in
poor metabolizers, they accumulate, increasing QTc risk (citalopram) or side
effects. Venlafaxine is metabolized by CYP2D6, not relevant. Therefore, sertraline
is a safe choice for this patient based on pharmacogenomic results .
2. A patient with bipolar disorder is started on lithium. The PMHNP orders
baseline labs before initiation. Which of the following is the most important lab
value to obtain before starting lithium therapy?
A. Complete blood count (CBC)
,B. Thyroid-stimulating hormone (TSH) and serum creatinine
C. Liver function tests (LFTs)
D. Serum magnesium level
Answer: B. Thyroid-stimulating hormone (TSH) and serum creatinine
Explanation: Lithium can cause hypothyroidism and nephrogenic diabetes
insipidus, so baseline TSH and creatinine are critical. CBC and LFTs are not
routinely indicated for lithium initiation .
3. A patient on fluoxetine 20 mg daily reports persistent insomnia and anxiety.
The PMHNP considers adding a second agent. Which of the following
medications is most appropriate for augmentation in treatment-resistant
depression?
A. Quetiapine XR
B. Lorazepam
C. Ziprasidone
D. Trazodone
Answer: A. Quetiapine XR
Explanation: Quetiapine XR has FDA approval for augmentation in treatment-
resistant depression. Lorazepam and trazodone may help sleep but do not have
antidepressant augmentation efficacy. Ziprasidone is not approved for
augmentation in MDD .
, 4. The PMHNP is explaining the mechanism of action of aripiprazole to a
patient. Which of the following statements correctly describes aripiprazole's
unique mechanism?
A. It is a partial agonist at D2 and 5-HT1A receptors
B. It is a full antagonist at D2 receptors
C. It is a partial agonist at 5-HT2A receptors
D. It is a full agonist at dopamine receptors
Answer: A. It is a partial agonist at D2 and 5-HT1A receptors
Explanation: Aripiprazole is a partial agonist at dopamine D2 and serotonin 5-
HT1A receptors, making it unique among antipsychotics. It is also a potent
antagonist at 5-HT2A receptors .
5. A patient with schizophrenia has been on clozapine for 6 months. The PMHNP
should monitor for which potentially life-threatening side effect?
A. Weight gain
B. Agranulocytosis
C. Tardive dyskinesia
D. Hyperprolactinemia
Answer: B. Agranulocytosis
Explanation: Clozapine requires mandatory REMS monitoring due to the risk of
agranulocytosis (severe neutropenia). CBC must be checked weekly for the first 6
months, then biweekly, then monthly .
