NURSING LICENSURE · PMHNP
LMR Georgette PMHNP Board Exam Review (2026/2027)
PDF | Board Review Materials 2026/2027
A+
Complete Domain Coverage · Board Review Materials
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
Section 1: Scientific Foundation
Section 2: Advanced Practice Skills
Section 3: Diagnosis and Treatment
Section 4: Psychotherapy and Related Theories
Section 5: Ethics, Legal Principles, and Cultural Care
STUVIAACTUALEXAM
, SECTION 1: Scientific Foundation
Q1.
A 34-year-old client with schizophrenia is started on a first-generation antipsychotic. Two weeks later the client develops muscle
rigidity, high fever, autonomic instability, and altered mental status. Which pathophysiologic mechanism best explains this
presentation?
A. Dopamine D2 receptor blockade in the nigrostriatal pathway precipitating neuroleptic malignant syndrome.
B. Excessive serotonin agonism at 5-HT2A receptors causing serotonin syndrome.
C. Sudden withdrawal of a GABA agonist leading to benzodiazepine withdrawal delirium.
D. Histamine H1 receptor antagonism producing only mild sedation without systemic signs.
Correct Answer: A
Rationale:
Neuroleptic malignant syndrome is associated with potent D2 blockade, especially in the nigrostriatal pathway, and presents with rigidity,
hyperthermia, and autonomic instability. Serotonin syndrome features hyperreflexia and clonus rather than lead-pipe rigidity.
Q2.
A PMHNP is reviewing the neurobiology of major depressive disorder. Which monoamine hypothesis statement is most consistent
with current evidence?
A. Depression involves dysregulation of serotonin, norepinephrine, and dopamine systems rather than a simple single-transmitter
deficiency.
B. Depression is caused solely by elevated dopamine in the mesolimbic pathway.
C. Only GABA deficiency accounts for the core symptoms of anhedonia and low energy.
D. Acetylcholine excess in the cortex is the primary driver of depressive symptoms.
Correct Answer: A
Rationale:
Contemporary understanding recognizes complex dysregulation across serotonin, norepinephrine, and dopamine circuits, along with
neurotrophic and inflammatory factors, rather than a pure monoamine deficit of one transmitter.
Q3.
A client is prescribed lithium for bipolar I disorder. The PMHNP orders baseline and ongoing laboratory monitoring. Which set of
tests is most appropriate for long-term lithium therapy?
A. Serum lithium level, renal function (BUN/creatinine), thyroid function (TSH), and electrolytes.
B. Only complete blood count every six months without metabolic monitoring.
C. Liver function tests exclusively because lithium is primarily hepatically cleared.
D. Serum lithium level alone without any organ-function surveillance.
Correct Answer: A
Rationale:
Lithium is renally cleared and can affect thyroid function; therefore regular monitoring of levels, renal function, thyroid status, and electrolytes is
required to detect toxicity and organ effects early.
Q4.
A 28-year-old client develops acute dystonia shortly after receiving an intramuscular dose of haloperidol. Which neurotransmitter
imbalance and anatomic pathway are primarily involved?
A. Relative dopamine deficiency in the nigrostriatal pathway leading to extrapyramidal symptoms.
B. Excess dopamine in the mesocortical pathway causing cognitive blunting.
C. Serotonin excess in the raphe nuclei producing only gastrointestinal distress.
D. Acetylcholine deficiency in the basal nucleus of Meynert causing memory loss.
Correct Answer: A
Rationale:
Acute dystonia results from abrupt D2 blockade in the nigrostriatal pathway, creating a relative cholinergic excess. Anticholinergic agents such
as benztropine are therefore used for rapid relief.
LMR Georgette PMHNP Board Exam Review (2026/2027)
PDF | Board Review Materials 2026/2027
A+
Complete Domain Coverage · Board Review Materials
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
Section 1: Scientific Foundation
Section 2: Advanced Practice Skills
Section 3: Diagnosis and Treatment
Section 4: Psychotherapy and Related Theories
Section 5: Ethics, Legal Principles, and Cultural Care
STUVIAACTUALEXAM
, SECTION 1: Scientific Foundation
Q1.
A 34-year-old client with schizophrenia is started on a first-generation antipsychotic. Two weeks later the client develops muscle
rigidity, high fever, autonomic instability, and altered mental status. Which pathophysiologic mechanism best explains this
presentation?
A. Dopamine D2 receptor blockade in the nigrostriatal pathway precipitating neuroleptic malignant syndrome.
B. Excessive serotonin agonism at 5-HT2A receptors causing serotonin syndrome.
C. Sudden withdrawal of a GABA agonist leading to benzodiazepine withdrawal delirium.
D. Histamine H1 receptor antagonism producing only mild sedation without systemic signs.
Correct Answer: A
Rationale:
Neuroleptic malignant syndrome is associated with potent D2 blockade, especially in the nigrostriatal pathway, and presents with rigidity,
hyperthermia, and autonomic instability. Serotonin syndrome features hyperreflexia and clonus rather than lead-pipe rigidity.
Q2.
A PMHNP is reviewing the neurobiology of major depressive disorder. Which monoamine hypothesis statement is most consistent
with current evidence?
A. Depression involves dysregulation of serotonin, norepinephrine, and dopamine systems rather than a simple single-transmitter
deficiency.
B. Depression is caused solely by elevated dopamine in the mesolimbic pathway.
C. Only GABA deficiency accounts for the core symptoms of anhedonia and low energy.
D. Acetylcholine excess in the cortex is the primary driver of depressive symptoms.
Correct Answer: A
Rationale:
Contemporary understanding recognizes complex dysregulation across serotonin, norepinephrine, and dopamine circuits, along with
neurotrophic and inflammatory factors, rather than a pure monoamine deficit of one transmitter.
Q3.
A client is prescribed lithium for bipolar I disorder. The PMHNP orders baseline and ongoing laboratory monitoring. Which set of
tests is most appropriate for long-term lithium therapy?
A. Serum lithium level, renal function (BUN/creatinine), thyroid function (TSH), and electrolytes.
B. Only complete blood count every six months without metabolic monitoring.
C. Liver function tests exclusively because lithium is primarily hepatically cleared.
D. Serum lithium level alone without any organ-function surveillance.
Correct Answer: A
Rationale:
Lithium is renally cleared and can affect thyroid function; therefore regular monitoring of levels, renal function, thyroid status, and electrolytes is
required to detect toxicity and organ effects early.
Q4.
A 28-year-old client develops acute dystonia shortly after receiving an intramuscular dose of haloperidol. Which neurotransmitter
imbalance and anatomic pathway are primarily involved?
A. Relative dopamine deficiency in the nigrostriatal pathway leading to extrapyramidal symptoms.
B. Excess dopamine in the mesocortical pathway causing cognitive blunting.
C. Serotonin excess in the raphe nuclei producing only gastrointestinal distress.
D. Acetylcholine deficiency in the basal nucleus of Meynert causing memory loss.
Correct Answer: A
Rationale:
Acute dystonia results from abrupt D2 blockade in the nigrostriatal pathway, creating a relative cholinergic excess. Anticholinergic agents such
as benztropine are therefore used for rapid relief.
