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PASS | LATEST EXAM UPDATE
Scientific Foundation
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Advanced Practice Skills
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Diagnosis and Treatment Planning
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Psychotherapy and Theoretical Frameworks
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Ethics, Legal, and Professional Standards
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Pharmacology and Pharmacokinetics
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, Population Health and Cultural Competence
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This examination is designed to rigorously evaluate the comprehensive clinical
competencies, advanced theoretical knowledge, and specialized decision-making skills
required of psychiatric-mental health nurse practitioners. The assessment rigorously
measures clinical proficiency across diverse mental health domains, ensuring candidates
possess the highest standards of diagnostic accuracy, psychopharmacological expertise,
and psychotherapeutic proficiency. Featuring a rigorous combination of multiple-choice and
complex scenario-based items, the test assesses real-world application, critical thinking,
and ethical judgment in complex clinical environments. Successful completion
demonstrates an advanced readiness for autonomous, safe, and evidence-based clinical
practice.
Section One: Questions 1–100
Question 1
A 34-year-old female presents with complaints of persistent, uncontrollable worry,
irritability, and muscle tension for the past eight months. She reports difficulty falling asleep
due to racing thoughts about her job and family responsibilities. Which of the following
neurotransmitters is primarily implicated in the pathophysiology of this disorder?
,A. Decreased serotonin and gamma-aminobutyric acid
B. Increased dopamine and norepinephrine
C. Decreased acetylcholine and glutamate
D. Increased serotonin and histamine
🟢 A. Decreased serotonin and gamma-aminobutyric acid
🔴 Explanation: Generalized anxiety disorder is closely linked to dysregulation within the
serotonergic and GABAergic systems, where deficiencies contribute to heightened anxiety
and hyperarousal.
Question 2
During an initial psychiatric evaluation, a patient states that television anchors are
speaking directly to them through hidden coded messages meant only for their eyes. This
phenomenon is best classified as which of the following?
A. Thought broadcasting
B. Delusion of reference
C. Idea of reference
D. Somatic delusion
🟢 B. Delusion of reference
🔴 Explanation: A delusion of reference involves the fixed, false belief that innocuous
events, objects, or public communications are specifically addressed to or meant for the
individual.
, Question 3
A 45-year-old male with a history of alcohol use disorder is admitted for medically
supervised withdrawal. On hospital day three, he develops tachycardia, hypertension,
diaphoresis, visual hallucinations, and disorientation. Which medication is the standard
first-line treatment for managing this acute condition?
A. Haloperidol
B. Lorazepam
C. Carbamazepine
D. Clonidine
🟢 B. Lorazepam
🔴 Explanation: Benzodiazepines such as lorazepam are the gold-standard first-line
agents for treating alcohol withdrawal delirium to prevent seizures and autonomic
instability.
Question 4
An advanced practice registered nurse is evaluating a patient taking lithium carbonate for
bipolar I disorder. The patient reports experiencing coarse hand tremors, ataxia, confusion,
and slurred speech. Laboratory results indicate a serum lithium level of 2.1 mEq/L. What is
the immediate priority action?
A. Administer a dose of benztropine immediately
B. Hold the lithium dose and notify the attending physician