1
APEA PMHNP EXAM AND PRACTICE EXAM NEWEST 2026
TEST BANK| APEA PSYCHIATRIC-MENTAL HEALTH NURSE
PRACTITIONER (PMHNP) EXAM PREP WITH COMPLETE 200
REAL EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+ (MOST RECENT!!)
SECTION 1: DEPRESSION AND MOOD DISORDERS
Question 1
A patient scores 16 on the Hamilton-D scale and is started on Lexapro 10 mg.
At a 10-week follow-up, the score is 18. What is the most appropriate
adjustment?
A. Discontinue Lexapro and switch to a different class
B. Increase the Lexapro dose
C. Maintain the current dose and reassess in 4 weeks
D. Add an adjunctive antipsychotic
Answer: B
Rationale: The score increased from 16 to 18 after 10 weeks, indicating
inadequate response. Dose optimization is the recommended next step
before switching medications. Ten weeks is an adequate trial at the current
dose.
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Question 2
A patient scores 19 on the Beck Depression Inventory. They are started on
Lexapro 10 mg and return 8 weeks later with a score of 29. What adjustment
should be made?
A. Discontinue Lexapro immediately
B. Increase the Lexapro dose
C. Maintain the current dose
D. Switch to a different SSRI
Answer: B
Rationale: Worsening depression after 8 weeks indicates the current dose is
insufficient. Increasing the dose is appropriate before considering a switch.
Eight weeks is enough time to assess response.
Question 3
A patient scores 2 on the GAD scale and has been on Lexapro for 5 months.
What adjustment is needed?
A. Increase the dose
B. Decrease the dose
C. No adjustment
D. Add buspirone
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Answer: C
Rationale: A GAD score of 2 indicates minimal anxiety. The patient is
responding well. No change is needed; continue monitoring.
Question 4
A 72-year-old female presents with increasing forgetfulness, insomnia,
decreased activity, and decreased appetite for 2 months. She has
hypertension on lisinopril. Exam is normal. MMSE is 24 but she declines to
answer some questions and needs urging. What is the most likely diagnosis?
A. Alzheimer's dementia
B. Delirium
C. Depression
D. Vascular dementia
Answer: C
Rationale: The patient shows poor effort on cognitive testing and prominent
mood symptoms. Depression in the elderly often presents with cognitive
complaints and reluctance to participate, unlike dementia where patients
typically try to answer.
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Question 5
A patient with MDD has been on sertraline 50 mg for 4 weeks with no
improvement. What is the next step?
A. Continue same dose for another 4 weeks
B. Increase to 100 mg
C. Switch to another antidepressant
D. Add psychotherapy
Answer: B
Rationale: After 4 weeks at 50 mg with no response, increasing to 100 mg is
appropriate. Four weeks is an adequate trial at the initial dose. Reassess in 2
to 4 weeks.
Question 6
A 28-year-old female with MDD and no history of mania starts fluoxetine.
Three weeks later she has increased energy, decreased need for sleep, and
racing thoughts. What is the most likely explanation?
A. Serotonin syndrome
B. Bipolar disorder unmasked by antidepressant
C. Akathisia
D. Treatment-emergent mania
APEA PMHNP EXAM AND PRACTICE EXAM NEWEST 2026
TEST BANK| APEA PSYCHIATRIC-MENTAL HEALTH NURSE
PRACTITIONER (PMHNP) EXAM PREP WITH COMPLETE 200
REAL EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+ (MOST RECENT!!)
SECTION 1: DEPRESSION AND MOOD DISORDERS
Question 1
A patient scores 16 on the Hamilton-D scale and is started on Lexapro 10 mg.
At a 10-week follow-up, the score is 18. What is the most appropriate
adjustment?
A. Discontinue Lexapro and switch to a different class
B. Increase the Lexapro dose
C. Maintain the current dose and reassess in 4 weeks
D. Add an adjunctive antipsychotic
Answer: B
Rationale: The score increased from 16 to 18 after 10 weeks, indicating
inadequate response. Dose optimization is the recommended next step
before switching medications. Ten weeks is an adequate trial at the current
dose.
,2
Question 2
A patient scores 19 on the Beck Depression Inventory. They are started on
Lexapro 10 mg and return 8 weeks later with a score of 29. What adjustment
should be made?
A. Discontinue Lexapro immediately
B. Increase the Lexapro dose
C. Maintain the current dose
D. Switch to a different SSRI
Answer: B
Rationale: Worsening depression after 8 weeks indicates the current dose is
insufficient. Increasing the dose is appropriate before considering a switch.
Eight weeks is enough time to assess response.
Question 3
A patient scores 2 on the GAD scale and has been on Lexapro for 5 months.
What adjustment is needed?
A. Increase the dose
B. Decrease the dose
C. No adjustment
D. Add buspirone
,3
Answer: C
Rationale: A GAD score of 2 indicates minimal anxiety. The patient is
responding well. No change is needed; continue monitoring.
Question 4
A 72-year-old female presents with increasing forgetfulness, insomnia,
decreased activity, and decreased appetite for 2 months. She has
hypertension on lisinopril. Exam is normal. MMSE is 24 but she declines to
answer some questions and needs urging. What is the most likely diagnosis?
A. Alzheimer's dementia
B. Delirium
C. Depression
D. Vascular dementia
Answer: C
Rationale: The patient shows poor effort on cognitive testing and prominent
mood symptoms. Depression in the elderly often presents with cognitive
complaints and reluctance to participate, unlike dementia where patients
typically try to answer.
, 4
Question 5
A patient with MDD has been on sertraline 50 mg for 4 weeks with no
improvement. What is the next step?
A. Continue same dose for another 4 weeks
B. Increase to 100 mg
C. Switch to another antidepressant
D. Add psychotherapy
Answer: B
Rationale: After 4 weeks at 50 mg with no response, increasing to 100 mg is
appropriate. Four weeks is an adequate trial at the initial dose. Reassess in 2
to 4 weeks.
Question 6
A 28-year-old female with MDD and no history of mania starts fluoxetine.
Three weeks later she has increased energy, decreased need for sleep, and
racing thoughts. What is the most likely explanation?
A. Serotonin syndrome
B. Bipolar disorder unmasked by antidepressant
C. Akathisia
D. Treatment-emergent mania
