PMHNP-BC (ANCC) Exam Prep Question Bank: 200+ Practice
,Questions, Answers & Detailed Rationales
Psychiatric-Mental Health Nurse Practitioner Certification |
2025/2026 Edition
DOMAIN I: SCIENTIFIC FOUNDATION
1. The primary inhibitory neurotransmitter in the central
nervous system is:
A) Glutamate
B) Dopamine
C) GABA
D) Acetylcholine
Correct Answer: C
Rationale: GABA is the primary inhibitory neurotransmitter in
the CNS. Benzodiazepines enhance GABA-A receptor function,
producing anxiolytic, sedative, and anticonvulsant effects.
Glutamate is the primary excitatory neurotransmitter.
Dopamine is involved in reward and motivation. Acetylcholine
mediates memory and attention.
2. Excess dopamine in the mesolimbic pathway is implicated
in which symptoms of schizophrenia?
,A) Negative symptoms
B) Positive symptoms
C) Cognitive symptoms
D) Extrapyramidal symptoms
Correct Answer: B
Rationale: Dopamine excess in the mesolimbic pathway drives
positive symptoms (hallucinations, delusions). Dopamine
deficiency in the mesocortical pathway contributes to negative
and cognitive symptoms. Extrapyramidal symptoms result from
dopamine blockade in the nigrostriatal pathway.
3. Which brain region is hyperreactive in PTSD and responsible
for fear processing?
A) Hippocampus
B) Amygdala
C) Prefrontal cortex
D) Thalamus
Correct Answer: B
Rationale: The amygdala processes fear, threat detection, and
emotional salience. Amygdala hyperreactivity to threat cues
drives hyperarousal symptoms in PTSD. The hippocampus is
involved in memory consolidation. The prefrontal cortex
mediates executive function and emotion regulation.
, 4. Hippocampal volume reduction is documented in which
conditions?
A) Schizophrenia and bipolar disorder
B) PTSD, depression, and chronic stress
C) GAD and OCD
D) ADHD and ASD
Correct Answer: B
Rationale: Hippocampal volume reduction is documented in
PTSD, depression, and chronic stress due to cortisol
neurotoxicity from HPA axis dysregulation. Cortisol exerts
negative feedback on the hippocampus; this feedback loop is
impaired in melancholic depression.
5. The HPA axis in major depressive disorder shows:
A) Reduced activity
B) Hyperactivity with elevated cortisol and impaired negative
feedback
C) No change
D) Decreased cortisol levels
Correct Answer: B
Rationale: The HPA axis shows hyperactivity in depression,
leading to elevated cortisol and impaired negative feedback.
This dysregulation contributes to hippocampal atrophy and is a
core finding in major depressive disorder.
,Questions, Answers & Detailed Rationales
Psychiatric-Mental Health Nurse Practitioner Certification |
2025/2026 Edition
DOMAIN I: SCIENTIFIC FOUNDATION
1. The primary inhibitory neurotransmitter in the central
nervous system is:
A) Glutamate
B) Dopamine
C) GABA
D) Acetylcholine
Correct Answer: C
Rationale: GABA is the primary inhibitory neurotransmitter in
the CNS. Benzodiazepines enhance GABA-A receptor function,
producing anxiolytic, sedative, and anticonvulsant effects.
Glutamate is the primary excitatory neurotransmitter.
Dopamine is involved in reward and motivation. Acetylcholine
mediates memory and attention.
2. Excess dopamine in the mesolimbic pathway is implicated
in which symptoms of schizophrenia?
,A) Negative symptoms
B) Positive symptoms
C) Cognitive symptoms
D) Extrapyramidal symptoms
Correct Answer: B
Rationale: Dopamine excess in the mesolimbic pathway drives
positive symptoms (hallucinations, delusions). Dopamine
deficiency in the mesocortical pathway contributes to negative
and cognitive symptoms. Extrapyramidal symptoms result from
dopamine blockade in the nigrostriatal pathway.
3. Which brain region is hyperreactive in PTSD and responsible
for fear processing?
A) Hippocampus
B) Amygdala
C) Prefrontal cortex
D) Thalamus
Correct Answer: B
Rationale: The amygdala processes fear, threat detection, and
emotional salience. Amygdala hyperreactivity to threat cues
drives hyperarousal symptoms in PTSD. The hippocampus is
involved in memory consolidation. The prefrontal cortex
mediates executive function and emotion regulation.
, 4. Hippocampal volume reduction is documented in which
conditions?
A) Schizophrenia and bipolar disorder
B) PTSD, depression, and chronic stress
C) GAD and OCD
D) ADHD and ASD
Correct Answer: B
Rationale: Hippocampal volume reduction is documented in
PTSD, depression, and chronic stress due to cortisol
neurotoxicity from HPA axis dysregulation. Cortisol exerts
negative feedback on the hippocampus; this feedback loop is
impaired in melancholic depression.
5. The HPA axis in major depressive disorder shows:
A) Reduced activity
B) Hyperactivity with elevated cortisol and impaired negative
feedback
C) No change
D) Decreased cortisol levels
Correct Answer: B
Rationale: The HPA axis shows hyperactivity in depression,
leading to elevated cortisol and impaired negative feedback.
This dysregulation contributes to hippocampal atrophy and is a
core finding in major depressive disorder.
