• ANCC PMHNP Exam 09/11/2026
ANCC PMHNP Certification Exam 2 Questions and
Answers 2026/2027 | Complete Psychiatric
Mental Health NP Study Guide
.
A client receiving risperidone (Risperdal) is going on an all-day fishing outing with family members. It is important
that the nurse:
1
Encourage the client to use sunscreen.
2
Caution the client to avoid excessive activity.
3
Advise the client to bring an additional dose of medication to take after lunch.
4
Have the client take a blood pressure reading before leaving for the fishing outing. - Correct Answer
:1Risperidone (Risperdal) causes photosensitivity, which can be controlled with the use of sunscreens and
protective clothing. Cautioning the client to avoid excessive activity is not a necessary precaution with this
atypical antipsychotic drug; the client should be allowed to participate fully. The medication should be
P 1
, • ANCC PMHNP Exam 09/11/2026
administered as prescribed; additional doses should not be administered. Participating in an outing should not
affect the client's blood pressure.
A client recently admitted to the psychiatric unit is found to be experiencing command auditory hallucinations.
The nurse conducts an initial one-on-one session centered on the development of trust. What is the next
important nursing intervention?
1
Determining whether the command hallucinations are frightening to the client
2
Helping the client determine whether the voices are outside or inside the client's head
3
Determining the client's ability to refrain from listening to the messages from the voices
4
Identifying the content of the messages in the auditory hallucinations - Correct Answer :4During the acute
phase it is important to have the client describe the content of hallucinations so safety issues may be identified.
Determining whether the command hallucinations are frightening to the client is not the priority; most clients
find hallucinations frightening. Helping the client recognize whether the voices are outside or inside the client's
head is not the priority. Determining the client's ability to refrain from listening to the messages from the voices
is important, but it is not the priority at this time.
A client states, "I get down on myself when I make a mistake." In a cognitive therapy approach, which nursing
interventions are most appropriate? Select all that apply.
1
Teaching the client relaxation exercises to diminish stress
2
Exploring with the client past experiences that have caused distress
3
Providing the client with mastery experiences designed to boost self-esteem
4
Encouraging the client to replace these negative thoughts with positive thoughts
5
P 2
, • ANCC PMHNP Exam 09/11/2026
Helping the client modify the belief that anything less than perfection is unacceptable - Correct Answer
:45Cognitive therapy seeks to find underlying self-defeating beliefs and replace them with more reality-based
positive beliefs. It encourages the use of cognitive restructuring (cognitive reframing) through positive self-talk
and a rational mindset. Teaching the client relaxation exercises to diminish stress reflects a behavioral approach.
Exploring with the client past experiences that have caused distress is a psychoanalytical approach. Providing
the client with mastery experiences to boost self-esteem is a behavioral approach.
A client tells a mental health nurse about hearing a man speaking from the corner of the room. The client asks
whether the nurse hears him, too. What is the nurse's best response?
1
"What is he saying to you? Does it make any sense?"
2
"No one is in the corner of the room. Can't you see that?"
3
"Yes, I hear him, but I can't understand what he's saying."
4
"No, I don't hear him, but it probably upsets you to hear him." - Correct Answer :4
The statement "No, I don't hear him, but it probably upsets you to hear him" points out reality, recognizes the
client's feelings, and prevents the nurse from becoming involved in the client's hallucination. The response
"What is he saying to you? Does it make any sense?" is nontherapeutic; it supports and focuses on the
hallucination. The response "No one is in the corner of the room. Can't you see that?" is an attempt to argue the
client out of feelings by denying they exist. The response "Yes, I hear him, but I can't understand what he is
saying" is nontherapeutic; it supports and focuses on the hallucination.
A client tells a nurse, "I have been having trouble sleeping and feel wide awake as soon as I get into bed." Which
strategies should the nurse teach the client that will promote sleep? Select all that apply.
1
Leaving the bedroom shen he is unable to sleep
2
Eating a heavy snack near bedtime
3
Reading in bed before shutting out the light
4
P 3
, • ANCC PMHNP Exam 09/11/2026
Drinking a cup of warm tea with milk at bedtime
5
Exercising in the afternoon rather than in the evening
6
Counting backward from 100 to 0 when his mind is racing - Correct Answer :156
Lying in bed when one is unable to sleep increases frustration and anxiety and further impedes sleep; other
activities, such as reading or watching television, should not be conducted in bed. Exercise during the day
expends energy and promotes sleep at night; exercise too close to bedtime is stimulating and may interfere with
sleep. Counting backward requires minimal concentration but is enough to interfere with thoughts that distract
a person from falling asleep. A heavy meal exerts pressure against the diaphragm that may be uncomfortable,
and the body is expending energy to digest the food; a light, not heavy, snack is preferred before bedtime. The
bed should be used exclusively for sleep so the client's body expects sleep when the client gets into bed.
Although milk may promote sleep, tea contains caffeine, which is a stimulant that should be avoided after
midafternoon; otherwise, it may interfere with sleep.
A client tells the nurse in the mental health clinic that the practitioner said that the cornerstone of therapy used
in the clinic is cognitive therapy. The client asks what this therapy entails. What concept should the nurse explain
as the basis of cognitive therapy?
1
"Unconscious feelings influence actions."
2
"People can act their way into a new way of thinking."
3
"Maladaptive behaviors will continue as long as they are reinforced."
4
"Negative thoughts can precipitate anxiety." - Correct Answer :4
Cognitive therapy seeks to discover underlying thoughts that lead to feelings of depression and anxiety; also, it
teaches the client to replace these thoughts with more positive, realistic thinking. The response "Unconscious
feelings influence actions" reflects a psychoanalytical approach to treatment. The response "People can act their
way into a new way of thinking" reflects a behavioral approach to treatment. The response "Maladaptive
behaviors will continue as long as they are reinforced" reflects a behavioral approach to treatment.
A client undergoing alcohol detoxification asks about attending Alcoholics Anonymous (AA) meetings after
discharge. What is the nurse's best initial reply?
P 4
ANCC PMHNP Certification Exam 2 Questions and
Answers 2026/2027 | Complete Psychiatric
Mental Health NP Study Guide
.
A client receiving risperidone (Risperdal) is going on an all-day fishing outing with family members. It is important
that the nurse:
1
Encourage the client to use sunscreen.
2
Caution the client to avoid excessive activity.
3
Advise the client to bring an additional dose of medication to take after lunch.
4
Have the client take a blood pressure reading before leaving for the fishing outing. - Correct Answer
:1Risperidone (Risperdal) causes photosensitivity, which can be controlled with the use of sunscreens and
protective clothing. Cautioning the client to avoid excessive activity is not a necessary precaution with this
atypical antipsychotic drug; the client should be allowed to participate fully. The medication should be
P 1
, • ANCC PMHNP Exam 09/11/2026
administered as prescribed; additional doses should not be administered. Participating in an outing should not
affect the client's blood pressure.
A client recently admitted to the psychiatric unit is found to be experiencing command auditory hallucinations.
The nurse conducts an initial one-on-one session centered on the development of trust. What is the next
important nursing intervention?
1
Determining whether the command hallucinations are frightening to the client
2
Helping the client determine whether the voices are outside or inside the client's head
3
Determining the client's ability to refrain from listening to the messages from the voices
4
Identifying the content of the messages in the auditory hallucinations - Correct Answer :4During the acute
phase it is important to have the client describe the content of hallucinations so safety issues may be identified.
Determining whether the command hallucinations are frightening to the client is not the priority; most clients
find hallucinations frightening. Helping the client recognize whether the voices are outside or inside the client's
head is not the priority. Determining the client's ability to refrain from listening to the messages from the voices
is important, but it is not the priority at this time.
A client states, "I get down on myself when I make a mistake." In a cognitive therapy approach, which nursing
interventions are most appropriate? Select all that apply.
1
Teaching the client relaxation exercises to diminish stress
2
Exploring with the client past experiences that have caused distress
3
Providing the client with mastery experiences designed to boost self-esteem
4
Encouraging the client to replace these negative thoughts with positive thoughts
5
P 2
, • ANCC PMHNP Exam 09/11/2026
Helping the client modify the belief that anything less than perfection is unacceptable - Correct Answer
:45Cognitive therapy seeks to find underlying self-defeating beliefs and replace them with more reality-based
positive beliefs. It encourages the use of cognitive restructuring (cognitive reframing) through positive self-talk
and a rational mindset. Teaching the client relaxation exercises to diminish stress reflects a behavioral approach.
Exploring with the client past experiences that have caused distress is a psychoanalytical approach. Providing
the client with mastery experiences to boost self-esteem is a behavioral approach.
A client tells a mental health nurse about hearing a man speaking from the corner of the room. The client asks
whether the nurse hears him, too. What is the nurse's best response?
1
"What is he saying to you? Does it make any sense?"
2
"No one is in the corner of the room. Can't you see that?"
3
"Yes, I hear him, but I can't understand what he's saying."
4
"No, I don't hear him, but it probably upsets you to hear him." - Correct Answer :4
The statement "No, I don't hear him, but it probably upsets you to hear him" points out reality, recognizes the
client's feelings, and prevents the nurse from becoming involved in the client's hallucination. The response
"What is he saying to you? Does it make any sense?" is nontherapeutic; it supports and focuses on the
hallucination. The response "No one is in the corner of the room. Can't you see that?" is an attempt to argue the
client out of feelings by denying they exist. The response "Yes, I hear him, but I can't understand what he is
saying" is nontherapeutic; it supports and focuses on the hallucination.
A client tells a nurse, "I have been having trouble sleeping and feel wide awake as soon as I get into bed." Which
strategies should the nurse teach the client that will promote sleep? Select all that apply.
1
Leaving the bedroom shen he is unable to sleep
2
Eating a heavy snack near bedtime
3
Reading in bed before shutting out the light
4
P 3
, • ANCC PMHNP Exam 09/11/2026
Drinking a cup of warm tea with milk at bedtime
5
Exercising in the afternoon rather than in the evening
6
Counting backward from 100 to 0 when his mind is racing - Correct Answer :156
Lying in bed when one is unable to sleep increases frustration and anxiety and further impedes sleep; other
activities, such as reading or watching television, should not be conducted in bed. Exercise during the day
expends energy and promotes sleep at night; exercise too close to bedtime is stimulating and may interfere with
sleep. Counting backward requires minimal concentration but is enough to interfere with thoughts that distract
a person from falling asleep. A heavy meal exerts pressure against the diaphragm that may be uncomfortable,
and the body is expending energy to digest the food; a light, not heavy, snack is preferred before bedtime. The
bed should be used exclusively for sleep so the client's body expects sleep when the client gets into bed.
Although milk may promote sleep, tea contains caffeine, which is a stimulant that should be avoided after
midafternoon; otherwise, it may interfere with sleep.
A client tells the nurse in the mental health clinic that the practitioner said that the cornerstone of therapy used
in the clinic is cognitive therapy. The client asks what this therapy entails. What concept should the nurse explain
as the basis of cognitive therapy?
1
"Unconscious feelings influence actions."
2
"People can act their way into a new way of thinking."
3
"Maladaptive behaviors will continue as long as they are reinforced."
4
"Negative thoughts can precipitate anxiety." - Correct Answer :4
Cognitive therapy seeks to discover underlying thoughts that lead to feelings of depression and anxiety; also, it
teaches the client to replace these thoughts with more positive, realistic thinking. The response "Unconscious
feelings influence actions" reflects a psychoanalytical approach to treatment. The response "People can act their
way into a new way of thinking" reflects a behavioral approach to treatment. The response "Maladaptive
behaviors will continue as long as they are reinforced" reflects a behavioral approach to treatment.
A client undergoing alcohol detoxification asks about attending Alcoholics Anonymous (AA) meetings after
discharge. What is the nurse's best initial reply?
P 4
