ANCC PMHNP PSYCH MENTAL HEALTH NP EXAM LATEST
VERSION 2026-2027 (TEST 1,2,3)100 QUESTION AND
ANSWERS WITH RATIONALES IN EACH VERSION.
TEST 1
A nurse is assessing a client who is receiving continuous enteral nutrition via a
nasogastric (NG) tube. The client has developed clinical manifestations consistent
with hyperosmolar dehydration. Which of the following actions should the nurse
take in response to these assessment findings?
a. Empty the client's ostomy pouch when it is half full.
b. Switch the client's enteral formula to a lactose-free preparation.
c. Increase the rate of the continuous enteral feeding infusion.
d. Administer a hypotonic intravenous fluid replacement as prescribed.
CORRECT ANS: B
EXPERT RATIONALE
Hyperosmolar dehydration in a client receiving enteral feeding often results from
the high osmotic load of the formula, which can draw fluid into the
gastrointestinal tract, leading to osmotic diarrhea and subsequent fluid and
electrolyte imbalances. Switching to a lactose-free formula can help reduce
osmotic diarrhea, particularly if the client has undiagnosed lactose intolerance,
which exacerbates fluid loss. Option A is irrelevant to the management of
hyperosmolar dehydration as it addresses ostomy care, not the underlying cause
,of the fluid imbalance. Option C would worsen the condition by increasing the
osmotic load. Option D is not a nursing action but a provider-prescribed
intervention; the nurse's immediate role is to address the cause of the
dehydration by modifying the formula.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
Your patient, whose wife died a few months ago, appears to be very unkempt and
apathetic. Although several months have passed since his wife's death, he has not
progressed at all through his grieving. You assess this condition as which of the
following?
A. Disenfranchised grief
B. Panic disorder
C. Complicated grief
D. Physiologic grief
CORRECT ANS: C
EXPERT RATIONALE
A person has uncomplicated grief when he or she has normal physical,
psychological, cognitive, and spiritual responses to the death of a significant other.
However, when the person shows persistent maladaptive behaviors such as not
taking care of personal hygiene and/or appearance and does not progress through
the mourning process, this is complicated grief. Option A, disenfranchised grief,
occurs when a loss is not socially recognized. Option B, panic disorder, is
characterized by recurrent unexpected panic attacks. Option D, physiologic grief, is
not a standard diagnostic term.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Psychiatric-Mental Health: Grief and Bereavement
MSC: NCLEX: Psychosocial Integrity
,If a patient has had a myocardial infarction, which of the following atypical
antidepressants should not be prescribed within the recovery phase?
A. Trazodone
B. Duloxetine
C. Bupropion
D. Desvenlafaxine
CORRECT ANS: A
EXPERT RATIONALE
If a patient has had a myocardial infarction, during the recovery phase, the patient
should not be prescribed trazodone (Desyrel). Trazodone can cause the patient to
develop orthostatic hypotension and priapism. Option B, duloxetine, is an SNRI.
Option C, bupropion, is an NDRI. Option D, desvenlafaxine, is an SNRI. These are
not contraindicated in the recovery phase of MI.
DIF: Cognitive Level: Apply (Application)
TOP: Psychopharmacology: Antidepressants
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
To get your teaching ideas and concepts across to a poor reader, which of the
following would be most appropriate?
A. Use longer sentences.
B. Use abstract concepts.
C. Discourage questioning.
D. Use examples and review.
CORRECT ANS: D
EXPERT RATIONALE
To get the idea across to a poor reader, use examples and review. The other
choices are not helpful. You should use short sentences and easy-to-read layouts;
be concrete rather than abstract; and teach them how to ask questions about
their health. Also, tell context first and use visual aids, common words, and
examples, and explain meaning. Option A is incorrect; longer sentences are not
, helpful. Option B is incorrect; abstract concepts are difficult for poor readers.
Option C is incorrect; questioning should be encouraged.
DIF: Cognitive Level: Apply (Application)
TOP: Patient Education: Health Literacy
MSC: NCLEX: Health Promotion and Maintenance
A 21-year-old woman presents with complaints of milky discharge from her
breasts. She doesn't have any other symptoms and is not pregnant, nor has been
before. She tells the nurse about each medication that she takes. Which of these
drugs may be implicated as the cause of the symptom?
A. Aspirin
B. Lamotrigine
C. Risperidone
D. Sertraline
CORRECT ANS: C
EXPERT RATIONALE
Risperidone can cause the greatest prolactin elevation among atypical
antipsychotics. A milky white discharge known as galactorrhea could be a sign of
an underlying condition. The fact that the woman takes risperidone, an atypical
antipsychotic, would likely point to the cause and should be switched with one
less likely to have that same side effect. Option A, aspirin, is not associated with
galactorrhea. Option B, lamotrigine, is a mood stabilizer with a low risk of
prolactin elevation. Option D, sertraline, is an SSRI that may cause
hyperprolactinemia but is less likely than risperidone.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Psychopharmacology: Antipsychotics
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
Which of the following would be considered one of the main things that is
responsible for about 2/3 of psychiatric hospital readmissions?
VERSION 2026-2027 (TEST 1,2,3)100 QUESTION AND
ANSWERS WITH RATIONALES IN EACH VERSION.
TEST 1
A nurse is assessing a client who is receiving continuous enteral nutrition via a
nasogastric (NG) tube. The client has developed clinical manifestations consistent
with hyperosmolar dehydration. Which of the following actions should the nurse
take in response to these assessment findings?
a. Empty the client's ostomy pouch when it is half full.
b. Switch the client's enteral formula to a lactose-free preparation.
c. Increase the rate of the continuous enteral feeding infusion.
d. Administer a hypotonic intravenous fluid replacement as prescribed.
CORRECT ANS: B
EXPERT RATIONALE
Hyperosmolar dehydration in a client receiving enteral feeding often results from
the high osmotic load of the formula, which can draw fluid into the
gastrointestinal tract, leading to osmotic diarrhea and subsequent fluid and
electrolyte imbalances. Switching to a lactose-free formula can help reduce
osmotic diarrhea, particularly if the client has undiagnosed lactose intolerance,
which exacerbates fluid loss. Option A is irrelevant to the management of
hyperosmolar dehydration as it addresses ostomy care, not the underlying cause
,of the fluid imbalance. Option C would worsen the condition by increasing the
osmotic load. Option D is not a nursing action but a provider-prescribed
intervention; the nurse's immediate role is to address the cause of the
dehydration by modifying the formula.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
Your patient, whose wife died a few months ago, appears to be very unkempt and
apathetic. Although several months have passed since his wife's death, he has not
progressed at all through his grieving. You assess this condition as which of the
following?
A. Disenfranchised grief
B. Panic disorder
C. Complicated grief
D. Physiologic grief
CORRECT ANS: C
EXPERT RATIONALE
A person has uncomplicated grief when he or she has normal physical,
psychological, cognitive, and spiritual responses to the death of a significant other.
However, when the person shows persistent maladaptive behaviors such as not
taking care of personal hygiene and/or appearance and does not progress through
the mourning process, this is complicated grief. Option A, disenfranchised grief,
occurs when a loss is not socially recognized. Option B, panic disorder, is
characterized by recurrent unexpected panic attacks. Option D, physiologic grief, is
not a standard diagnostic term.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Psychiatric-Mental Health: Grief and Bereavement
MSC: NCLEX: Psychosocial Integrity
,If a patient has had a myocardial infarction, which of the following atypical
antidepressants should not be prescribed within the recovery phase?
A. Trazodone
B. Duloxetine
C. Bupropion
D. Desvenlafaxine
CORRECT ANS: A
EXPERT RATIONALE
If a patient has had a myocardial infarction, during the recovery phase, the patient
should not be prescribed trazodone (Desyrel). Trazodone can cause the patient to
develop orthostatic hypotension and priapism. Option B, duloxetine, is an SNRI.
Option C, bupropion, is an NDRI. Option D, desvenlafaxine, is an SNRI. These are
not contraindicated in the recovery phase of MI.
DIF: Cognitive Level: Apply (Application)
TOP: Psychopharmacology: Antidepressants
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
To get your teaching ideas and concepts across to a poor reader, which of the
following would be most appropriate?
A. Use longer sentences.
B. Use abstract concepts.
C. Discourage questioning.
D. Use examples and review.
CORRECT ANS: D
EXPERT RATIONALE
To get the idea across to a poor reader, use examples and review. The other
choices are not helpful. You should use short sentences and easy-to-read layouts;
be concrete rather than abstract; and teach them how to ask questions about
their health. Also, tell context first and use visual aids, common words, and
examples, and explain meaning. Option A is incorrect; longer sentences are not
, helpful. Option B is incorrect; abstract concepts are difficult for poor readers.
Option C is incorrect; questioning should be encouraged.
DIF: Cognitive Level: Apply (Application)
TOP: Patient Education: Health Literacy
MSC: NCLEX: Health Promotion and Maintenance
A 21-year-old woman presents with complaints of milky discharge from her
breasts. She doesn't have any other symptoms and is not pregnant, nor has been
before. She tells the nurse about each medication that she takes. Which of these
drugs may be implicated as the cause of the symptom?
A. Aspirin
B. Lamotrigine
C. Risperidone
D. Sertraline
CORRECT ANS: C
EXPERT RATIONALE
Risperidone can cause the greatest prolactin elevation among atypical
antipsychotics. A milky white discharge known as galactorrhea could be a sign of
an underlying condition. The fact that the woman takes risperidone, an atypical
antipsychotic, would likely point to the cause and should be switched with one
less likely to have that same side effect. Option A, aspirin, is not associated with
galactorrhea. Option B, lamotrigine, is a mood stabilizer with a low risk of
prolactin elevation. Option D, sertraline, is an SSRI that may cause
hyperprolactinemia but is less likely than risperidone.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Psychopharmacology: Antipsychotics
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
Which of the following would be considered one of the main things that is
responsible for about 2/3 of psychiatric hospital readmissions?
