AANP PMHNP Certification Exam Ultimate Study Bank:
200 High-Yield NGN Practice Questions with Detailed
Rationales Covering Psychopharmacology, DSM-5-TR
Criteria, and Clinical Best Practices for 2026/2027 Board
Success
Questions 1-10: Major Depressive Disorder &
Antidepressants
Q1. The first-line pharmacologic treatment for major
depressive disorder (MDD) is:
A. SSRI
B. MAOI
C. TCA
D. Benzodiazepine
Rationale: SSRIs (e.g., sertraline, escitalopram) have the
best safety, tolerability, and efficacy profiles for initial
MDD treatment.
Q2. A patient on an SSRI develops hyperreflexia, fever,
and myoclonus. This indicates:
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
,C. Anticholinergic toxicity
D. Opioid overdose
Rationale: Serotonin syndrome = neuromuscular
hyperactivity + autonomic instability + mental-status
change after serotonergic drugs.
Q3. The hallmark feature of generalized anxiety disorder
(GAD):
A. Excessive worry for ≥6 months
B. Panic attacks
C. Obsessions and compulsions
D. Social fear only
Rationale: GAD involves chronic, uncontrollable worry
about multiple domains for ≥6 months.
Q4. The black-box warning for antidepressants in
patients under 25 years is:
A. Increased risk of suicidal ideation
B. QT prolongation
C. Weight gain
D. Serotonin depletion
Rationale: FDA mandates monitoring for emerging
suicidality when starting or adjusting antidepressants in
young people.
,Q5. Which antidepressant is most associated with
seizures at high dose?
A. Bupropion
B. Paroxetine
C. Venlafaxine
D. Mirtazapine
Rationale: Bupropion lowers seizure threshold—avoid in
seizure or eating-disorder history.
Q6. A 32-year-old patient presents with a 2-week
history of depressed mood, anhedonia, sleep
disturbance, and fatigue. During the initial psychiatric
evaluation, which assessment is a priority?
A. Comprehensive risk assessment including suicide
and homicide
B. Immediate referral for genetic testing
C. Full neuropsychological testing battery
D. Electrocardiogram (ECG) to rule out cardiac causes
Rationale: A comprehensive risk assessment is a critical
component of the initial psychiatric evaluation, especially
when a patient presents with depressive symptoms. This
includes assessing for suicidal ideation, plan, intent,
access to means, and risk of harm to others.
, Q7. A patient with MDD has been on fluoxetine for 8
weeks with partial response. Which of the following is
an appropriate next step?
A. Increase the dose of fluoxetine
B. Add a benzodiazepine
C. Switch to a MAOI immediately
D. Discontinue all medications
Rationale: For partial response to an SSRI, increasing the
dose within the therapeutic range is a common and
appropriate next step before considering augmentation
or switching.
Q8. Which of the following is a common side effect of
SSRI antidepressants?
A. Sexual dysfunction
B. Hypertension
C. Sedation
D. Weight loss
Rationale: Sexual dysfunction (decreased libido,
anorgasmia, erectile dysfunction) is a common side effect
of SSRIs.
Q9. A patient on sertraline reports bruising easily. What
is the most likely cause?
200 High-Yield NGN Practice Questions with Detailed
Rationales Covering Psychopharmacology, DSM-5-TR
Criteria, and Clinical Best Practices for 2026/2027 Board
Success
Questions 1-10: Major Depressive Disorder &
Antidepressants
Q1. The first-line pharmacologic treatment for major
depressive disorder (MDD) is:
A. SSRI
B. MAOI
C. TCA
D. Benzodiazepine
Rationale: SSRIs (e.g., sertraline, escitalopram) have the
best safety, tolerability, and efficacy profiles for initial
MDD treatment.
Q2. A patient on an SSRI develops hyperreflexia, fever,
and myoclonus. This indicates:
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
,C. Anticholinergic toxicity
D. Opioid overdose
Rationale: Serotonin syndrome = neuromuscular
hyperactivity + autonomic instability + mental-status
change after serotonergic drugs.
Q3. The hallmark feature of generalized anxiety disorder
(GAD):
A. Excessive worry for ≥6 months
B. Panic attacks
C. Obsessions and compulsions
D. Social fear only
Rationale: GAD involves chronic, uncontrollable worry
about multiple domains for ≥6 months.
Q4. The black-box warning for antidepressants in
patients under 25 years is:
A. Increased risk of suicidal ideation
B. QT prolongation
C. Weight gain
D. Serotonin depletion
Rationale: FDA mandates monitoring for emerging
suicidality when starting or adjusting antidepressants in
young people.
,Q5. Which antidepressant is most associated with
seizures at high dose?
A. Bupropion
B. Paroxetine
C. Venlafaxine
D. Mirtazapine
Rationale: Bupropion lowers seizure threshold—avoid in
seizure or eating-disorder history.
Q6. A 32-year-old patient presents with a 2-week
history of depressed mood, anhedonia, sleep
disturbance, and fatigue. During the initial psychiatric
evaluation, which assessment is a priority?
A. Comprehensive risk assessment including suicide
and homicide
B. Immediate referral for genetic testing
C. Full neuropsychological testing battery
D. Electrocardiogram (ECG) to rule out cardiac causes
Rationale: A comprehensive risk assessment is a critical
component of the initial psychiatric evaluation, especially
when a patient presents with depressive symptoms. This
includes assessing for suicidal ideation, plan, intent,
access to means, and risk of harm to others.
, Q7. A patient with MDD has been on fluoxetine for 8
weeks with partial response. Which of the following is
an appropriate next step?
A. Increase the dose of fluoxetine
B. Add a benzodiazepine
C. Switch to a MAOI immediately
D. Discontinue all medications
Rationale: For partial response to an SSRI, increasing the
dose within the therapeutic range is a common and
appropriate next step before considering augmentation
or switching.
Q8. Which of the following is a common side effect of
SSRI antidepressants?
A. Sexual dysfunction
B. Hypertension
C. Sedation
D. Weight loss
Rationale: Sexual dysfunction (decreased libido,
anorgasmia, erectile dysfunction) is a common side effect
of SSRIs.
Q9. A patient on sertraline reports bruising easily. What
is the most likely cause?
