• ANCC PMHNP Exam 09/11/2026
PMHNP ANCC EXAM ACTUAL EXAM 2 SCRIPT 2026
COMPLETE QUESTIONS AND SOLUTIONS GRADED
A+
A psychiatric nurse understands that a situational crisis usually resolves within:
1
1 to 4 days
2
2 to 3 weeks
3
1 to 2 months
4
2 to 6 months - Correct Answer :3
A situational crisis is a sudden, unexpected event with which the individual is unable to cope using past coping
behaviors; this time frame provides an opportunity for the individual to learn new coping behaviors. Two to 6
months is longer than the expected period within which a crisis should be resolved. One to 4 days and 2 to 3
weeks are both too short of periods for the individual to develop new, successful coping mechanisms.
For which adverse effect should the nurse continually assess a client who is receiving valproic acid (Depakene)?
P 1
, • ANCC PMHNP Exam 09/11/2026
1
Yellow sclerae
2
Motor restlessness
3
Ringing in the ears
4
Torsion of the neck - Correct Answer :1
Yellow sclerae are a sign of jaundice; pancreatitis and hepatic failure are life-threatening adverse effects of
valproic acid (Depakene). The client must have frequent liver function tests. Motor restlessness (akathisia) is
associated with antipsychotic drugs. Ringing or buzzing in the ears (tinnitus) is associated with aspirin. Torsion of
the neck (torticollis) due to contracted cervical muscles is associated with antipsychotic drugs.
Bupropion (Wellbutrin) has a unique side effect not shared by most other drugs of its class. The nurse should
assess the client for which unique possible side effect of this drug?
1
Heart failure
2
Breast tumors
3
Tardive dyskinesia
4
Generalized seizures - Correct Answer :4
Bupropion (Wellbutrin) inhibits the reuptake of dopamine, serotonin, and norepinephrine and may cause
seizures that can be life threatening; also, it may cause headaches, agitation, sedation, tremors, and confusion.
Heart failure is not a side effect of bupropion. Tardive dyskinesia can occur with the use of neuroleptics.
A client with a history of a short temper and physically abusive behavior becomes violent and is admitted to the
psychiatric service. At the time of admission the client is extremely anxious. What is the priority nursing action?
1
P 2
, • ANCC PMHNP Exam 09/11/2026
Sitting quietly with the client
2
Encouraging the client to play video games
3
Introducing the client to several other clients
4
Assigning a staff member to supervise the client - Correct Answer :4
Assigning a staff member to supervise the client will enable the staff member to respond quickly to any
escalation in the client's mood or behavior. Sitting quietly with the client may put the nurse at risk because it may
actually make the client more anxious and precipitate violence. The client is too anxious to concentrate on a
game or to interact with other people.
A female client's stream of consciousness is occupied exclusively with thoughts of her mother's death. The nurse
plans to help the client through this stage of grieving, which is known as:
1
Resolving the loss
2
Shock and disbelief
3
Developing awareness
4
Restitution and recover - Correct Answer :1
Resolving a loss is a slow, painful, continuous process until a mental image of the dead person, almost devoid of
negative or undesirable features, emerges. The shock-and-disbelief stage is usually dominated by a refusal to
accept or comprehend the fact that a loved one has died. The reality of the death and its meaning as a loss, plus
anger, dominate this stage. The various rituals of the funeral help to initiate the recovery or restitution stage.
A client with a history of chronic alcoholism is admitted to the mental health unit. What does the nurse identify
as the cause of a client's use of confabulation?
1
Ideas of grandeur
2
P 3
, • ANCC PMHNP Exam 09/11/2026
Need to get attention
3
Marked loss of memory
4
Difficulty accepting the truth - Correct Answer :3
Alcoholic clients have loss of memory and adapt to this by unconsciously filling in with false information areas
that cannot be remembered. Ideas of grandeur do not occur in this disease. A need to get attention is unrelated
to confabulation. These individuals are not purposely lying but instead are trying to cover memory losses.
When working with a client who is in an alcohol detoxification program, it is most important for the nurse to:
1
Support the client's need for nurture.
2
Address the client's holistic needs.
3
Discuss with the client the negative effects of alcohol.
4
Promote the client's compliance with the program through gentle prodding. - Correct Answer :2
Clients who abuse alcohol characteristically have multiple nursing care needs, among them physiological,
psychological, social and occupational. Although nurture is important, this client must learn self-reliance.
Discussing with the client the negative effects of alcohol is probably an old story to this client and will have a
minimal positive effect. Promoting the client's compliance with the program through gentle prodding will not
provide an atmosphere that can help the client withstand the stress of the detoxification program.
A client with schizophrenia is admitted to a psychiatric unit. The client is talking while walking in the hall, is
unkempt, and obviously has not washed in several days. What should the nurse say when trying to help this
client shower?
1
"Would you like a shower?"
2
"I'll help you take your shower now."
3
P 4
PMHNP ANCC EXAM ACTUAL EXAM 2 SCRIPT 2026
COMPLETE QUESTIONS AND SOLUTIONS GRADED
A+
A psychiatric nurse understands that a situational crisis usually resolves within:
1
1 to 4 days
2
2 to 3 weeks
3
1 to 2 months
4
2 to 6 months - Correct Answer :3
A situational crisis is a sudden, unexpected event with which the individual is unable to cope using past coping
behaviors; this time frame provides an opportunity for the individual to learn new coping behaviors. Two to 6
months is longer than the expected period within which a crisis should be resolved. One to 4 days and 2 to 3
weeks are both too short of periods for the individual to develop new, successful coping mechanisms.
For which adverse effect should the nurse continually assess a client who is receiving valproic acid (Depakene)?
P 1
, • ANCC PMHNP Exam 09/11/2026
1
Yellow sclerae
2
Motor restlessness
3
Ringing in the ears
4
Torsion of the neck - Correct Answer :1
Yellow sclerae are a sign of jaundice; pancreatitis and hepatic failure are life-threatening adverse effects of
valproic acid (Depakene). The client must have frequent liver function tests. Motor restlessness (akathisia) is
associated with antipsychotic drugs. Ringing or buzzing in the ears (tinnitus) is associated with aspirin. Torsion of
the neck (torticollis) due to contracted cervical muscles is associated with antipsychotic drugs.
Bupropion (Wellbutrin) has a unique side effect not shared by most other drugs of its class. The nurse should
assess the client for which unique possible side effect of this drug?
1
Heart failure
2
Breast tumors
3
Tardive dyskinesia
4
Generalized seizures - Correct Answer :4
Bupropion (Wellbutrin) inhibits the reuptake of dopamine, serotonin, and norepinephrine and may cause
seizures that can be life threatening; also, it may cause headaches, agitation, sedation, tremors, and confusion.
Heart failure is not a side effect of bupropion. Tardive dyskinesia can occur with the use of neuroleptics.
A client with a history of a short temper and physically abusive behavior becomes violent and is admitted to the
psychiatric service. At the time of admission the client is extremely anxious. What is the priority nursing action?
1
P 2
, • ANCC PMHNP Exam 09/11/2026
Sitting quietly with the client
2
Encouraging the client to play video games
3
Introducing the client to several other clients
4
Assigning a staff member to supervise the client - Correct Answer :4
Assigning a staff member to supervise the client will enable the staff member to respond quickly to any
escalation in the client's mood or behavior. Sitting quietly with the client may put the nurse at risk because it may
actually make the client more anxious and precipitate violence. The client is too anxious to concentrate on a
game or to interact with other people.
A female client's stream of consciousness is occupied exclusively with thoughts of her mother's death. The nurse
plans to help the client through this stage of grieving, which is known as:
1
Resolving the loss
2
Shock and disbelief
3
Developing awareness
4
Restitution and recover - Correct Answer :1
Resolving a loss is a slow, painful, continuous process until a mental image of the dead person, almost devoid of
negative or undesirable features, emerges. The shock-and-disbelief stage is usually dominated by a refusal to
accept or comprehend the fact that a loved one has died. The reality of the death and its meaning as a loss, plus
anger, dominate this stage. The various rituals of the funeral help to initiate the recovery or restitution stage.
A client with a history of chronic alcoholism is admitted to the mental health unit. What does the nurse identify
as the cause of a client's use of confabulation?
1
Ideas of grandeur
2
P 3
, • ANCC PMHNP Exam 09/11/2026
Need to get attention
3
Marked loss of memory
4
Difficulty accepting the truth - Correct Answer :3
Alcoholic clients have loss of memory and adapt to this by unconsciously filling in with false information areas
that cannot be remembered. Ideas of grandeur do not occur in this disease. A need to get attention is unrelated
to confabulation. These individuals are not purposely lying but instead are trying to cover memory losses.
When working with a client who is in an alcohol detoxification program, it is most important for the nurse to:
1
Support the client's need for nurture.
2
Address the client's holistic needs.
3
Discuss with the client the negative effects of alcohol.
4
Promote the client's compliance with the program through gentle prodding. - Correct Answer :2
Clients who abuse alcohol characteristically have multiple nursing care needs, among them physiological,
psychological, social and occupational. Although nurture is important, this client must learn self-reliance.
Discussing with the client the negative effects of alcohol is probably an old story to this client and will have a
minimal positive effect. Promoting the client's compliance with the program through gentle prodding will not
provide an atmosphere that can help the client withstand the stress of the detoxification program.
A client with schizophrenia is admitted to a psychiatric unit. The client is talking while walking in the hall, is
unkempt, and obviously has not washed in several days. What should the nurse say when trying to help this
client shower?
1
"Would you like a shower?"
2
"I'll help you take your shower now."
3
P 4
