ANCC PMHNP Certification Exam 5 Questions and
Answers 2026/2027 | Complete Psychiatric
Mental Health NP Study Guide
.
An anxious client expressing a fear of people and open places is admitted to the psychiatric unit. What is the
most effective way for the nurse to assist this client?
A) Plan an outing within the first week of admission.
B) Distract her whenever she expresses her discomfort about being with others.
C) Confront her fears and discuss the possible causes of these fears.
D) Accompany her outside for an increasing amount of time each day. –
Correct Answer :The process of gradual desensitization by controlled exposure to the situation which is feared
(D), is the treatment of choice in phobic reactions. (A and C) are far too aggressive for the initial treatment
period and could even be considered hostile. (B) promotes denial of the problem, and gives the client the
message that discussion of the phobia is not permitted.
Correct Answer(s): D
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48.
The nurse suspects child abuse when assessing a 3-year-old boy and noticing several small, round burns on his
legs and trunk that might be the result of cigarette burns. Which parental behavior provides the greatest
validation for such suspicions?
A) The parents' explanation of how the burns occurred is different from the child's explanation of how they
occurred.
B) The parents seem to dismiss the severity of the child's burns, saying they are very small and have not posed
any problem.
C) The parents become very anxious when the nurse suggests that the child may need to be admitted for further
evaluation.
D) The parents tell the nurse that the child was burned in a house fire which is incompatible with the nurse's
observation of the type of burn. –
Correct Answer :(D) provides the most validation. The parent's explanation (subjective data) is incompatible
with the objective data (small round burns on the legs and trunk). (A) provides only subjective data, and the
child's explanation could be influenced by factors such as age, fear, or imagination. The parent's apparent lack of
concern (B) is inconclusive, but the nurse's opinion of the parents' reaction is subjective and could be wrong. (C)
might provide a clue that child abuse occurred, but the nurse must remember that most parents are anxious
about their child being hospitalized.
Correct Answer(s): D
49.
The nurse is planning care for a 32-year-old male client diagnosed with HIV infection who has a history of chronic
depression. Recently, the client's viral load has begun to increase rather than decrease despite his adherence to
the HIV drug regimen. What should the nurse do first while taking the client's history upon admission to the
hospital?
A) Determine if the client attends a support group weekly.
B) Hold all antidepressant medications until further notice.
C) Ask the client if he takes St. John's Wort routinely.
D) Have the client describe any recent changes in mood. –
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Correct Answer :St. John's Wort, an herbal preparation, is an alternative (nonconventional) therapy for
depression, but it may adversely interact with medications used to treat HIV infection (C). The nurse's top
priority upon admission is to determine if the client has been taking this herb concurrently with HIV antiviral
drugs, which may explain the rise in the viral load. Asking about (A or D) may be helpful in gathering more data
about the client's depressive state, but these issues do not have the priority of (C). (B) may be harmful to the
client.
Correct Answer(s): C
50.
A client who is known to abuse drugs is admitted to the psychiatric unit. Which medication should the nurse
anticipate administering to a client who is exhibiting benzodiazepine withdrawal symptoms?
A) Perphenazine (Trilafon).
B) Diphenhydramine (Benadryl).
C) Chlordiazepoxide (Librium).
D) Isocarboxazid (Marplan). –
Correct Answer :Librium (C), an antianxiety drug, as well as other benzodiazepines, are used in titrated doses
to reduce the severity of abrupt benzodiazepine withdrawal. (A) is an antipsychotic agent. (B) is an
antihistamine and antianxiety drug. (D) is an MAO inhibitor.
Correct Answer(s): C
51.
A 35-year-old male client on the psychiatric ward of a general hospital believes that someone is trying to poison
him. The nurse understands that a client's delusions are most likely related to his
A) early childhood experiences involving authority issues.
B) anger about being hospitalized.
C) low self-esteem.
D) phobic fear of food. –
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Correct Answer :Psychotic clients have difficulty with trust and have low self-esteem (C). Nursing care should be
directed at building trust and promoting positive self-esteem. Activities with limited concentration and no
competition should be encouraged in order to build self-esteem. (A, B, and D) are not specifically related to the
development of delusions.
Correct Answer(s): C
A 40-year-old male client diagnosed with schizophrenia and alcohol dependence has not had any visitors or
phone calls since admission. He reports he has no family that cares about him and was living on the streets prior
to this admission. According to Erikson's theory of psychosocial development, which stage is the client in at this
time?
A) Isolation.
B) Stagnation.
C) Despair.
D) Role confusion. –
Correct Answer :The client is in Erikson's "Generativity vs. Stagnation" stage (age 24 to 45), and meeting the
task includes maintaining intimate relationships and moving toward developing a family (B). (A) occurs in young
adulthood (age 18 to 25), (C) occurs in maturity (age 45 to death), and (D) occurs in adolescence (age 12 to 20).
These are all stages that occur if individuals are not successfully coping with their psychosocial developmental
stage.
Correct Answer(s): B
The nurse plans to help an 18-year-old female mentally retarded client ambulate the first postoperative day after
an appendectomy. When the nurse tells the client it is time to get out of bed, the client becomes angry and tells
the nurse, "Get out of here! I'll get up when I'm ready!" Which response is best for the nurse to make?
A) Your healthcare provider has prescribed ambulation on the first postoperative day.
B) You must ambulate to avoid complications which could cause more discomfort than ambulating.
C) I know how you feel. You're angry about having to ambulate, but this will help you get well.
D) I'll be back in 30 minutes to help you get out of bed and walk around the room. –
Correct Answer :(D) provides a "cooling off" period, is firm, direct, non-threatening, and avoids arguing with
the client. (A) is avoiding responsibility by referring to the healthcare provider. (B) is trying to reason with a
mentally retarded client and is threatening the client with "complications." (C) is telling the client how she feels
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