• ANCC PMHNP Exam 09/11/2026
ANCC PMHNP Certification Exam 1 Questions and
Answers 2026/2027 | Complete Psychiatric
Mental Health NP Study Guide
.
A male client is admitted to the psychiatric unit with a medical diagnosis of paranoid schizophrenia. During the
admission procedure, the client looks up and states, "No, it's not MY fault. You can't blame me. I didn't kill him,
you did." What action is best for the nurse to take?
A) Reassure the client by telling him that his fear of the admission procedure is to be expected.
B) Tell the client that no one is accusing him of murder and remind him that the hospital is a safe place.
C) Assess the content of the hallucinations by asking the client what he is hearing.
D) Ignore the behavior and make no response at all to his delusional statements. –
Correct Answer :Further assessment is indicated (C). The nurse should obtain information about what the
client believes the voices are telling him--they may be telling him to kill the nurse! (A) is telling the client how he
feels (fearful). The nurse should leave communications open and seek more information. (B) is arguing with the
client's delusion, and the nurse should never argue with a client's hallucinations or delusions, also (B) is possibly
offering false reassurance. (D) is avoiding the situation and the client's needs.
P 1
, • ANCC PMHNP Exam 09/11/2026
Correct Answer(s): C
36.
A 27-year-old female client is admitted to the psychiatric hospital with a diagnosis of bipolar disorder, manic
phase. She is demanding and active. Which intervention should the nurse include in this client's plan of care?
A) Schedule her to attend various group activities.
B) Reinforce her ability to make her own decisions.
C) Encourage her to identify feelings of anger.
D) Provide a structured environment with little stimuli. –
Correct Answer :Clients in the manic phase of a bipolar disorder require decreased stimuli and a structured
environment (D). Plan noncompetitive activities that can be carried out alone. (A) is contraindicated; stimuli
should be reduced as much as possible. Impulsive decision-making is characteristic of clients with bipolar
disorder. To prevent future complications, the nurse should monitor these clients' decisions and assist them in
the decision-making process (B). (C) is more often associated with depression than with bipolar disorder.
Correct Answer(s): D
A 45-year-old male client tells the nurse that he used to believe that he was Jesus Christ, but now he knows he is
not. Which response is best for the nurse to make?
A) Did you really believe you were Jesus Christ?
B) I think you're getting well.
C) Others have had similar thoughts when under stress.
D) Why did you think you were Jesus Christ? –
Correct Answer :(C) offers support by assuring the client that others have suffered as he has (also the principle
on which Alcoholics Anonymous acts). (A) is belittling. (B) is making an inappropriate judgment. You may have
narrowed your choices to (C and D). However, you should eliminate (D) because it is a "why" question, and the
client does not know why!
Correct Answer(s): C
P 2
, • ANCC PMHNP Exam 09/11/2026
38.
The nurse is assessing the parents of a nuclear family who are attending a support group for parents of
adolescents. According to Erikson, these parents who are adapting to middle adulthood should exhibit which
characteristic?
A) Loss of independence.
B) Increased self-understanding.
C) Isolation from society.
D) Development of intimate relationships. –
Correct Answer :Middle adulthood is characterized by self-reflection, understanding, and acceptance (B), and
generativity or guidance of children. (A and C) are maladaptive behaviors in middle adulthood. Although middle-
aged adults may delay or re-establish intimate relationships, (D) is initially developed during young adulthood.
Correct Answer(s): B
39.
A 25-year-old female client has been particularly restless and the nurse finds her trying to leave the psychiatric
unit. She tells the nurse, "Please let me go! I must leave because the secret police are after me." Which response
is best for the nurse to make?
A) No one is after you, you're safe here.
B) You'll feel better after you have rested.
C) I know you must feel lonely and frightened.
D) Come with me to your room and I will sit with you. - Correct Answer :(D) is the best response because it
offers support without judgment or demands. (A) is arguing with the client's delusion. (B) is offering false
reassurance. (C) is a violation of therapeutic communication in that the nurse is telling the client how she feels
(frightened and lonely), rather than allowing the client to describe her own feelings. Hallucinating and/or
delusional clients are not capable of discussing their feelings, particularly when they perceive a crisis.
Correct Answer(s): D
40.
P 3
, • ANCC PMHNP Exam 09/11/2026
A female client with obsessive-compulsive disorder (OCD) is describing her obsessions and compulsions and asks
the nurse why these make her feel safer. What information should the nurse include in this client's teaching plan?
(Select all that apply.)
A) Compulsions relieve anxiety.
B) Anxiety is the key reason for OCD.
C) Obsessions cause compulsions.
D) Obsessive thoughts are linked to levels of neurochemicals.
E) Antidepressant medications increase serotonin levels.
- Correct Answer :Correct choices are (A, B, D, and E). To promote client understanding and compliance, the
teaching plan should include explanations about the origin and treatment options of OCD symptomology.
Compulsions are behaviors that help relieve anxiety (A), which is a vague feeling related to unknown fears, that
motivate behavior (B) to help the client cope and feel secure. All obsessions (C) do not result in compulsive
behavior. OCD is supported by the neurophysiology theory, which attributes a diminished level of
neurochemicals (D), particularly serotonin, and responds to selective serotonin reuptake inhibitors (SSRI).
Correct Answer(s): A, B, D, E
41.
A female client refuses to take an oral hypoglycemic agent because she believes that the drug is being
administered as part of an elaborate plan by the Mafia to harm her. Which nursing intervention is most important
to include in this client's plan of care?
A) Reassure the client that no one will harm her while she is in the hospital.
B) Ask the healthcare provider to give the client the medication.
C) Explain that the diabetic medication is important to take.
D) Reassess client's mental status for thought processes and content. –
Correct Answer :The most important intervention is to reassess the client's mental status (D) and to take
further action based on the findings of this assessment. Attempting to reassure the client (A) is in effect arguing
with the client's delusions and could escalate an already anxious situation. Collaborating about diabetic care (B
and C) is not likely to help change the client's false beliefs.
Correct Answer(s): D
P 4
ANCC PMHNP Certification Exam 1 Questions and
Answers 2026/2027 | Complete Psychiatric
Mental Health NP Study Guide
.
A male client is admitted to the psychiatric unit with a medical diagnosis of paranoid schizophrenia. During the
admission procedure, the client looks up and states, "No, it's not MY fault. You can't blame me. I didn't kill him,
you did." What action is best for the nurse to take?
A) Reassure the client by telling him that his fear of the admission procedure is to be expected.
B) Tell the client that no one is accusing him of murder and remind him that the hospital is a safe place.
C) Assess the content of the hallucinations by asking the client what he is hearing.
D) Ignore the behavior and make no response at all to his delusional statements. –
Correct Answer :Further assessment is indicated (C). The nurse should obtain information about what the
client believes the voices are telling him--they may be telling him to kill the nurse! (A) is telling the client how he
feels (fearful). The nurse should leave communications open and seek more information. (B) is arguing with the
client's delusion, and the nurse should never argue with a client's hallucinations or delusions, also (B) is possibly
offering false reassurance. (D) is avoiding the situation and the client's needs.
P 1
, • ANCC PMHNP Exam 09/11/2026
Correct Answer(s): C
36.
A 27-year-old female client is admitted to the psychiatric hospital with a diagnosis of bipolar disorder, manic
phase. She is demanding and active. Which intervention should the nurse include in this client's plan of care?
A) Schedule her to attend various group activities.
B) Reinforce her ability to make her own decisions.
C) Encourage her to identify feelings of anger.
D) Provide a structured environment with little stimuli. –
Correct Answer :Clients in the manic phase of a bipolar disorder require decreased stimuli and a structured
environment (D). Plan noncompetitive activities that can be carried out alone. (A) is contraindicated; stimuli
should be reduced as much as possible. Impulsive decision-making is characteristic of clients with bipolar
disorder. To prevent future complications, the nurse should monitor these clients' decisions and assist them in
the decision-making process (B). (C) is more often associated with depression than with bipolar disorder.
Correct Answer(s): D
A 45-year-old male client tells the nurse that he used to believe that he was Jesus Christ, but now he knows he is
not. Which response is best for the nurse to make?
A) Did you really believe you were Jesus Christ?
B) I think you're getting well.
C) Others have had similar thoughts when under stress.
D) Why did you think you were Jesus Christ? –
Correct Answer :(C) offers support by assuring the client that others have suffered as he has (also the principle
on which Alcoholics Anonymous acts). (A) is belittling. (B) is making an inappropriate judgment. You may have
narrowed your choices to (C and D). However, you should eliminate (D) because it is a "why" question, and the
client does not know why!
Correct Answer(s): C
P 2
, • ANCC PMHNP Exam 09/11/2026
38.
The nurse is assessing the parents of a nuclear family who are attending a support group for parents of
adolescents. According to Erikson, these parents who are adapting to middle adulthood should exhibit which
characteristic?
A) Loss of independence.
B) Increased self-understanding.
C) Isolation from society.
D) Development of intimate relationships. –
Correct Answer :Middle adulthood is characterized by self-reflection, understanding, and acceptance (B), and
generativity or guidance of children. (A and C) are maladaptive behaviors in middle adulthood. Although middle-
aged adults may delay or re-establish intimate relationships, (D) is initially developed during young adulthood.
Correct Answer(s): B
39.
A 25-year-old female client has been particularly restless and the nurse finds her trying to leave the psychiatric
unit. She tells the nurse, "Please let me go! I must leave because the secret police are after me." Which response
is best for the nurse to make?
A) No one is after you, you're safe here.
B) You'll feel better after you have rested.
C) I know you must feel lonely and frightened.
D) Come with me to your room and I will sit with you. - Correct Answer :(D) is the best response because it
offers support without judgment or demands. (A) is arguing with the client's delusion. (B) is offering false
reassurance. (C) is a violation of therapeutic communication in that the nurse is telling the client how she feels
(frightened and lonely), rather than allowing the client to describe her own feelings. Hallucinating and/or
delusional clients are not capable of discussing their feelings, particularly when they perceive a crisis.
Correct Answer(s): D
40.
P 3
, • ANCC PMHNP Exam 09/11/2026
A female client with obsessive-compulsive disorder (OCD) is describing her obsessions and compulsions and asks
the nurse why these make her feel safer. What information should the nurse include in this client's teaching plan?
(Select all that apply.)
A) Compulsions relieve anxiety.
B) Anxiety is the key reason for OCD.
C) Obsessions cause compulsions.
D) Obsessive thoughts are linked to levels of neurochemicals.
E) Antidepressant medications increase serotonin levels.
- Correct Answer :Correct choices are (A, B, D, and E). To promote client understanding and compliance, the
teaching plan should include explanations about the origin and treatment options of OCD symptomology.
Compulsions are behaviors that help relieve anxiety (A), which is a vague feeling related to unknown fears, that
motivate behavior (B) to help the client cope and feel secure. All obsessions (C) do not result in compulsive
behavior. OCD is supported by the neurophysiology theory, which attributes a diminished level of
neurochemicals (D), particularly serotonin, and responds to selective serotonin reuptake inhibitors (SSRI).
Correct Answer(s): A, B, D, E
41.
A female client refuses to take an oral hypoglycemic agent because she believes that the drug is being
administered as part of an elaborate plan by the Mafia to harm her. Which nursing intervention is most important
to include in this client's plan of care?
A) Reassure the client that no one will harm her while she is in the hospital.
B) Ask the healthcare provider to give the client the medication.
C) Explain that the diabetic medication is important to take.
D) Reassess client's mental status for thought processes and content. –
Correct Answer :The most important intervention is to reassess the client's mental status (D) and to take
further action based on the findings of this assessment. Attempting to reassure the client (A) is in effect arguing
with the client's delusions and could escalate an already anxious situation. Collaborating about diabetic care (B
and C) is not likely to help change the client's false beliefs.
Correct Answer(s): D
P 4
