PMHNP-BC ANCC Exam ACTUAL EXAM 2026 || MOST RECENT
EXAM 2026|2027 ACTUAL COMPLETE REAL EXAM QUESTIONS
AND CORRECT ANSWERS (VERIFIED ANSWERS) ALREADY
GRADED A+ | GUARANTEED SUCCESS!! NEWEST EXAM |
JUST RELEASED!!
Which neurotransmitter is most strongly associated with the
pathophysiology of schizophrenia and the therapeutic action of
antipsychotic medications?
A. Acetylcholine
B. Dopamine
C. GABA
D. Glutamate
Answer: B. Dopamine
Rationale: Dopaminergic dysregulation is central to current models of
schizophrenia. Excess dopamine activity in the mesolimbic pathway is
associated with positive symptoms, whereas reduced dopamine activity
in the mesocortical pathway is associated with negative and cognitive
symptoms. Most antipsychotics exert their therapeutic effects primarily
through dopamine D2 receptor antagonism or partial agonism.
A patient taking lithium reports worsening hand tremor, vomiting,
diarrhea, and difficulty walking. What is the PMHNP's priority action?
A. Administer the next lithium dose with food
B. Increase the lithium dose
,C. Hold lithium and obtain an urgent serum lithium level
D. Reassure the patient that these are expected effects
Answer: C. Hold lithium and obtain an urgent serum lithium level
Rationale: Gastrointestinal symptoms, worsening tremor, ataxia, and
neurologic changes can indicate lithium toxicity. Lithium has a narrow
therapeutic index, so suspected toxicity requires prompt evaluation and
usually withholding further doses until the serum concentration and
clinical status are assessed.
Which finding is most characteristic of serotonin syndrome?
A. Lead-pipe rigidity with markedly elevated creatine kinase
B. Clonus, hyperreflexia, agitation, and hyperthermia
C. Bradycardia, hypothermia, and hyporeflexia
D. Isolated resting tremor
Answer: B. Clonus, hyperreflexia, agitation, and hyperthermia
Rationale: Serotonin syndrome results from excessive serotonergic
activity and commonly presents with mental-status changes, autonomic
instability, and neuromuscular abnormalities. Clonus and hyperreflexia
are particularly useful distinguishing features. Severe cases can
progress to hyperthermia, seizures, rhabdomyolysis, and organ failure.
A patient taking an antipsychotic develops sustained upward deviation
of the eyes and painful neck muscle contractions. Which medication is
most appropriate for acute treatment?
,A. Benztropine
B. Fluoxetine
C. Propranolol
D. Valproate
Answer: A. Benztropine
Rationale: The presentation is consistent with an acute dystonic
reaction, an extrapyramidal adverse effect of antipsychotic medications.
Anticholinergic agents such as benztropine or diphenhydramine are
effective treatments. Acute dystonia can be distressing and, in severe
cases, can compromise the airway.
Which symptom is most consistent with mania?
A. Decreased need for sleep without fatigue
B. Social withdrawal and anhedonia
C. Psychomotor retardation
D. Excessive guilt and hopelessness
Answer: A. Decreased need for sleep without fatigue
Rationale: Mania commonly includes elevated or irritable mood,
increased energy, decreased need for sleep, pressured speech, racing
thoughts, grandiosity, increased goal-directed activity, distractibility,
and potentially risky behavior. A decreased need for sleep differs from
insomnia because the manic patient may sleep very little yet report
feeling rested.
, A patient with major depressive disorder reports having a specific
suicide plan and access to the intended means. What is the priority
intervention?
A. Schedule routine psychotherapy in two weeks
B. Develop a safety plan and ensure immediate protection from lethal
means
C. Encourage the patient to exercise daily
D. Reassure the patient that symptoms will improve
Answer: B. Develop a safety plan and ensure immediate protection from
lethal means
Rationale: A specific suicide plan combined with access to lethal means
indicates elevated acute suicide risk. Immediate safety takes priority
over routine outpatient interventions. Depending on the overall
assessment, emergency psychiatric evaluation or hospitalization may be
necessary.
Which medication is commonly considered a first-line pharmacologic
treatment for generalized anxiety disorder?
A. Sertraline
B. Haloperidol
C. Carbamazepine
D. Benztropine
Answer: A. Sertraline
EXAM 2026|2027 ACTUAL COMPLETE REAL EXAM QUESTIONS
AND CORRECT ANSWERS (VERIFIED ANSWERS) ALREADY
GRADED A+ | GUARANTEED SUCCESS!! NEWEST EXAM |
JUST RELEASED!!
Which neurotransmitter is most strongly associated with the
pathophysiology of schizophrenia and the therapeutic action of
antipsychotic medications?
A. Acetylcholine
B. Dopamine
C. GABA
D. Glutamate
Answer: B. Dopamine
Rationale: Dopaminergic dysregulation is central to current models of
schizophrenia. Excess dopamine activity in the mesolimbic pathway is
associated with positive symptoms, whereas reduced dopamine activity
in the mesocortical pathway is associated with negative and cognitive
symptoms. Most antipsychotics exert their therapeutic effects primarily
through dopamine D2 receptor antagonism or partial agonism.
A patient taking lithium reports worsening hand tremor, vomiting,
diarrhea, and difficulty walking. What is the PMHNP's priority action?
A. Administer the next lithium dose with food
B. Increase the lithium dose
,C. Hold lithium and obtain an urgent serum lithium level
D. Reassure the patient that these are expected effects
Answer: C. Hold lithium and obtain an urgent serum lithium level
Rationale: Gastrointestinal symptoms, worsening tremor, ataxia, and
neurologic changes can indicate lithium toxicity. Lithium has a narrow
therapeutic index, so suspected toxicity requires prompt evaluation and
usually withholding further doses until the serum concentration and
clinical status are assessed.
Which finding is most characteristic of serotonin syndrome?
A. Lead-pipe rigidity with markedly elevated creatine kinase
B. Clonus, hyperreflexia, agitation, and hyperthermia
C. Bradycardia, hypothermia, and hyporeflexia
D. Isolated resting tremor
Answer: B. Clonus, hyperreflexia, agitation, and hyperthermia
Rationale: Serotonin syndrome results from excessive serotonergic
activity and commonly presents with mental-status changes, autonomic
instability, and neuromuscular abnormalities. Clonus and hyperreflexia
are particularly useful distinguishing features. Severe cases can
progress to hyperthermia, seizures, rhabdomyolysis, and organ failure.
A patient taking an antipsychotic develops sustained upward deviation
of the eyes and painful neck muscle contractions. Which medication is
most appropriate for acute treatment?
,A. Benztropine
B. Fluoxetine
C. Propranolol
D. Valproate
Answer: A. Benztropine
Rationale: The presentation is consistent with an acute dystonic
reaction, an extrapyramidal adverse effect of antipsychotic medications.
Anticholinergic agents such as benztropine or diphenhydramine are
effective treatments. Acute dystonia can be distressing and, in severe
cases, can compromise the airway.
Which symptom is most consistent with mania?
A. Decreased need for sleep without fatigue
B. Social withdrawal and anhedonia
C. Psychomotor retardation
D. Excessive guilt and hopelessness
Answer: A. Decreased need for sleep without fatigue
Rationale: Mania commonly includes elevated or irritable mood,
increased energy, decreased need for sleep, pressured speech, racing
thoughts, grandiosity, increased goal-directed activity, distractibility,
and potentially risky behavior. A decreased need for sleep differs from
insomnia because the manic patient may sleep very little yet report
feeling rested.
, A patient with major depressive disorder reports having a specific
suicide plan and access to the intended means. What is the priority
intervention?
A. Schedule routine psychotherapy in two weeks
B. Develop a safety plan and ensure immediate protection from lethal
means
C. Encourage the patient to exercise daily
D. Reassure the patient that symptoms will improve
Answer: B. Develop a safety plan and ensure immediate protection from
lethal means
Rationale: A specific suicide plan combined with access to lethal means
indicates elevated acute suicide risk. Immediate safety takes priority
over routine outpatient interventions. Depending on the overall
assessment, emergency psychiatric evaluation or hospitalization may be
necessary.
Which medication is commonly considered a first-line pharmacologic
treatment for generalized anxiety disorder?
A. Sertraline
B. Haloperidol
C. Carbamazepine
D. Benztropine
Answer: A. Sertraline
