PMH-BC PSYCHIATRIC NURSING CERTIFICATION EXAM 2026
MOST TESTED QUESTIONS & VERIFIED ANSWERS WITH DETAILED
ANSWERS | GRADED A+
DOMAIN I: ASSESSMENT AND DIAGNOSIS (Questions 1-50)
Question 1
A psychiatric-mental health nurse is conducting a mental status examination
(MSE)
on a newly admitted patient. Which component of the MSE assesses the patient's
ability to think abstractly?
A) Orientation
B) Memory
C) Judgment
D) Thought process
Answer: C
Rationale: Judgment assesses abstract thinking and reasoning ability. Orientation
refers to awareness of person, place, and time. Memory evaluates recall and
retention. Thought process examines the flow and organization of thoughts.
Question 2
The nurse is assessing a patient with suspected major depressive disorder. Which
finding is most consistent with this diagnosis?
A) Euphoria and grandiosity
B) Anhedonia and depressed mood for at least 2 weeks
C) Racing thoughts and decreased need for sleep
D) Hallucinations and delusions
Answer: B
Rationale: Major depressive disorder requires at least 2 weeks of depressed mood
or anhedonia along with other symptoms (sleep changes, appetite changes,
fatigue,
guilt, concentration issues). Options A and C describe mania; D describes
psychosis.
Question 3
1
,A patient with bipolar disorder is currently experiencing a manic episode. Which
assessment finding would the nurse expect?
A) Psychomotor retardation
B) Pressured speech and flight of ideas
C) Hypersomnia and hyperphagia
D) Anergia and avolition
Answer: B
Rationale: Manic episodes feature increased energy, pressured speech, flight of
ideas, decreased need for sleep, and grandiosity. Psychomotor retardation,
hypersomnia, hyperphagia, anergia, and avolition are characteristic of depressive
episodes.
Question 4
The nurse is assessing a patient who reports hearing voices that tell them they
are worthless. The nurse documents this as which type of symptom?
A) Delusion
B) Hallucination
C) Illusion
D) Obsession
Answer: B
Rationale: Auditory hallucinations are false sensory perceptions occurring
without external stimuli. Delusions are fixed false beliefs. Illusions are
misperceptions of real stimuli. Obsessions are intrusive thoughts.
Question 5
A patient with schizophrenia exhibits flat affect and social withdrawal. These
symptoms are classified as:
A) Positive symptoms
B) Negative symptoms
C) Cognitive symptoms
D) Affective symptoms
Answer: B
Rationale: Negative symptoms include flat affect, alogia, avolition, anhedonia,
and asociality. Positive symptoms include hallucinations, delusions, and
disorganized speech. Cognitive symptoms affect attention and memory.
2
,Question 6
The nurse is using the CAGE questionnaire to screen a patient for alcohol use
disorder. Which question is part of this screening tool?
A) "Have you ever felt you should cut down on your drinking?"
B) "How often do you drink alcohol?"
C) "Do you drink alcohol every day?"
D) "Has your drinking affected your job performance?"
Answer: A
Rationale: The CAGE questionnaire includes four questions: Cut down, Annoyed
by
criticism, Guilty feelings, and Eye-opener. The specific question about feeling
the need to cut down is the "C" in CAGE.
Question 7
Which assessment finding would the nurse expect in a patient with post-
traumatic
stress disorder (PTSD)?
A) Obsessive-compulsive rituals
B) Avoidance of trauma-related stimuli and hyperarousal
C) Paranoid ideation
D) Somatic complaints without medical cause
Answer: B
Rationale: PTSD is characterized by exposure to a traumatic event, intrusion
symptoms, avoidance of trauma-related stimuli, negative alterations in cognition
and mood, and hyperarousal. Options A, C, and D describe other disorders.
Question 8
The nurse is assessing a patient who exhibits significant weight loss, fatigue,
and a depressed mood that is worse in the morning. This pattern is most
consistent with:
A) Atypical depression
B) Melancholic depression
C) Seasonal affective disorder
D) Persistent depressive disorder
3
, Answer: B
Rationale: Melancholic features include early morning awakening, mood worse in
the morning, significant weight loss, psychomotor agitation or retardation, and
excessive guilt. Atypical depression features mood reactivity and increased
appetite/sleep.
Question 9
During the psychiatric assessment, the nurse notes that the patient makes up
answers to fill gaps in memory. This phenomenon is called:
A) Confabulation
B) Echolalia
C) Neologism
D) Circumstantiality
Answer: A
Rationale: Confabulation is the creation of false memories or stories to fill
memory gaps, often seen in dementia or Korsakoff syndrome. Echolalia is
repeating
others' words. Neologism is creating new words. Circumstantiality is speech that
includes unnecessary detail before reaching the point.
Question 10
The nurse is assessing suicide risk in a patient with depression. Which factor
represents the greatest immediate risk?
A) History of prior suicide attempts
B) Verbalizing a specific plan and intent
C) Family history of suicide
D) Social isolation
Answer: B
Rationale: While all options increase suicide risk, a specific plan with stated
intent represents the most immediate and acute risk requiring urgent
intervention.
This is a "red flag" that demands immediate safety measures.
Question 11
A patient with generalized anxiety disorder (GAD) reports excessive worry about
multiple topics. The nurse understands that this worry must be present for which
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MOST TESTED QUESTIONS & VERIFIED ANSWERS WITH DETAILED
ANSWERS | GRADED A+
DOMAIN I: ASSESSMENT AND DIAGNOSIS (Questions 1-50)
Question 1
A psychiatric-mental health nurse is conducting a mental status examination
(MSE)
on a newly admitted patient. Which component of the MSE assesses the patient's
ability to think abstractly?
A) Orientation
B) Memory
C) Judgment
D) Thought process
Answer: C
Rationale: Judgment assesses abstract thinking and reasoning ability. Orientation
refers to awareness of person, place, and time. Memory evaluates recall and
retention. Thought process examines the flow and organization of thoughts.
Question 2
The nurse is assessing a patient with suspected major depressive disorder. Which
finding is most consistent with this diagnosis?
A) Euphoria and grandiosity
B) Anhedonia and depressed mood for at least 2 weeks
C) Racing thoughts and decreased need for sleep
D) Hallucinations and delusions
Answer: B
Rationale: Major depressive disorder requires at least 2 weeks of depressed mood
or anhedonia along with other symptoms (sleep changes, appetite changes,
fatigue,
guilt, concentration issues). Options A and C describe mania; D describes
psychosis.
Question 3
1
,A patient with bipolar disorder is currently experiencing a manic episode. Which
assessment finding would the nurse expect?
A) Psychomotor retardation
B) Pressured speech and flight of ideas
C) Hypersomnia and hyperphagia
D) Anergia and avolition
Answer: B
Rationale: Manic episodes feature increased energy, pressured speech, flight of
ideas, decreased need for sleep, and grandiosity. Psychomotor retardation,
hypersomnia, hyperphagia, anergia, and avolition are characteristic of depressive
episodes.
Question 4
The nurse is assessing a patient who reports hearing voices that tell them they
are worthless. The nurse documents this as which type of symptom?
A) Delusion
B) Hallucination
C) Illusion
D) Obsession
Answer: B
Rationale: Auditory hallucinations are false sensory perceptions occurring
without external stimuli. Delusions are fixed false beliefs. Illusions are
misperceptions of real stimuli. Obsessions are intrusive thoughts.
Question 5
A patient with schizophrenia exhibits flat affect and social withdrawal. These
symptoms are classified as:
A) Positive symptoms
B) Negative symptoms
C) Cognitive symptoms
D) Affective symptoms
Answer: B
Rationale: Negative symptoms include flat affect, alogia, avolition, anhedonia,
and asociality. Positive symptoms include hallucinations, delusions, and
disorganized speech. Cognitive symptoms affect attention and memory.
2
,Question 6
The nurse is using the CAGE questionnaire to screen a patient for alcohol use
disorder. Which question is part of this screening tool?
A) "Have you ever felt you should cut down on your drinking?"
B) "How often do you drink alcohol?"
C) "Do you drink alcohol every day?"
D) "Has your drinking affected your job performance?"
Answer: A
Rationale: The CAGE questionnaire includes four questions: Cut down, Annoyed
by
criticism, Guilty feelings, and Eye-opener. The specific question about feeling
the need to cut down is the "C" in CAGE.
Question 7
Which assessment finding would the nurse expect in a patient with post-
traumatic
stress disorder (PTSD)?
A) Obsessive-compulsive rituals
B) Avoidance of trauma-related stimuli and hyperarousal
C) Paranoid ideation
D) Somatic complaints without medical cause
Answer: B
Rationale: PTSD is characterized by exposure to a traumatic event, intrusion
symptoms, avoidance of trauma-related stimuli, negative alterations in cognition
and mood, and hyperarousal. Options A, C, and D describe other disorders.
Question 8
The nurse is assessing a patient who exhibits significant weight loss, fatigue,
and a depressed mood that is worse in the morning. This pattern is most
consistent with:
A) Atypical depression
B) Melancholic depression
C) Seasonal affective disorder
D) Persistent depressive disorder
3
, Answer: B
Rationale: Melancholic features include early morning awakening, mood worse in
the morning, significant weight loss, psychomotor agitation or retardation, and
excessive guilt. Atypical depression features mood reactivity and increased
appetite/sleep.
Question 9
During the psychiatric assessment, the nurse notes that the patient makes up
answers to fill gaps in memory. This phenomenon is called:
A) Confabulation
B) Echolalia
C) Neologism
D) Circumstantiality
Answer: A
Rationale: Confabulation is the creation of false memories or stories to fill
memory gaps, often seen in dementia or Korsakoff syndrome. Echolalia is
repeating
others' words. Neologism is creating new words. Circumstantiality is speech that
includes unnecessary detail before reaching the point.
Question 10
The nurse is assessing suicide risk in a patient with depression. Which factor
represents the greatest immediate risk?
A) History of prior suicide attempts
B) Verbalizing a specific plan and intent
C) Family history of suicide
D) Social isolation
Answer: B
Rationale: While all options increase suicide risk, a specific plan with stated
intent represents the most immediate and acute risk requiring urgent
intervention.
This is a "red flag" that demands immediate safety measures.
Question 11
A patient with generalized anxiety disorder (GAD) reports excessive worry about
multiple topics. The nurse understands that this worry must be present for which
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