APEA PMHNP Exam Prep 2026/2027 PDF – 200 Practice Questions with Answers & Detailed Rationales | Psychiatric Mental Health NP Board Review | DSM-5-TR, Psychopharmacology & Clinical Scenarios | Instant Download

APEA PMHNP Exam Prep 2026/2027: 200
Practice Questions with Answers and
Rationales
Psychiatric Mental Health Nurse Practitioner
Board Review | DSM-5-TR |
Psychopharmacology | Clinical Scenarios

SECTION 1: ADVANCED PSYCHIATRIC ASSESSMENT (Questions 1-40)
Question 1
A 28-year-old patient presents with depressed mood, anhedonia, fatigue, and
suicidal ideation persisting for 3 weeks. The patient reports no history of manic or
hypomanic episodes. Which screening tool is most appropriate for initial
assessment?
A) GAD-7
B) PHQ-9
C) AUDIT
D) CAGE Questionnaire
Answer: B) PHQ-9
Rationale: The Patient Health Questionnaire-9 (PHQ-9) is a validated screening
tool specifically designed to assess depression severity and monitor treatment
response. It evaluates the nine DSM-5 criteria for major depressive disorder. The
GAD-7 screens for anxiety, while AUDIT and CAGE assess alcohol use disorders.
Given the presenting symptoms of depressed mood, anhedonia, fatigue, and
suicidal ideation, the PHQ-9 is the most appropriate initial screening instrument .


Question 2

,A 45-year-old patient with no prior psychiatric history presents with a first episode
of psychotic symptoms lasting 3 weeks, including delusions of persecution and
auditory hallucinations. The patient maintains baseline functioning in other
domains. Which diagnosis should be considered?
A) Schizophrenia
B) Schizophreniform disorder
C) Brief psychotic disorder
D) Delusional disorder
Answer: B) Schizophreniform disorder
Rationale: Schizophreniform disorder is diagnosed when psychotic symptoms
(delusions, hallucinations, disorganized speech, catatonic behavior, or negative
symptoms) last at least 1 month but less than 6 months. Unlike schizophrenia,
which requires 6 months of symptoms, schizophreniform disorder is distinguished
by duration. Brief psychotic disorder lasts 1 day to 1 month. Delusional disorder
involves non-bizarre delusions without other prominent psychotic symptoms .


Question 3
A 32-year-old patient is brought to the emergency department by police after being
found wandering in traffic, speaking incoherently about receiving messages from
satellites. The patient is disheveled and appears to be responding to internal
stimuli. Which initial assessment priority is most important?
A) Neuroimaging
B) Determination of capacity to consent to treatment
C) Collateral information regarding psychiatric history
D) Immediate safety assessment and stabilization
Answer: D) Immediate safety assessment and stabilization
Rationale: In emergency psychiatry, the priority is safety—both for the patient and
others. This includes assessing for imminent risk of harm, agitation level, and
medical stability before proceeding with diagnostic evaluation. Safety assessment
must precede neuroimaging, capacity determination, or history gathering in acute
presentations .

,Question 4
A 16-year-old patient presents with excessive worry about school performance,
difficulty concentrating, sleep disturbance, and physical symptoms including
muscle tension and fatigue. Symptoms have been present for 8 months. Which
diagnosis is most consistent with this presentation?
A) Major depressive disorder
B) Generalized anxiety disorder
C) Social anxiety disorder
D) Panic disorder
Answer: B) Generalized anxiety disorder
Rationale: Generalized anxiety disorder (GAD) is characterized by excessive
anxiety and worry occurring more days than not for at least 6 months, associated
with difficulty controlling worry and at least three of the following: restlessness,
fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbance.
The duration of 8 months and multiple physical symptoms align with GAD
criteria .


Question 5
A 24-year-old patient presents with difficulty sustaining attention, frequent careless
mistakes, fidgeting, interrupting others, and impulsive decision-making. Symptoms
have been present since elementary school. Which assessment is most important
for confirming the diagnosis?
A) Symptom onset prior to age 12
B) Symptom onset in adulthood
C) Absence of hyperactivity
D) Presence of anxiety symptoms
Answer: A) Symptom onset prior to age 12
Rationale: DSM-5-TR diagnostic criteria for ADHD require several inattentive or
hyperactive-impulsive symptoms present before age 12 years. Retrospective

, assessment of childhood symptoms is essential for differentiating adult-onset
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symptoms that may be attributable to other conditions .
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Question 6 k




A 55-year-old patient presents with progressive memory loss, difficulty performing
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familiar tasks, and personality changes over the past 2 years. The patient's spouse
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reports the patient sometimes cannot remember the names of grandchildren. Which
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assessment tool would be most appropriate?
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A) PHQ-9
B) Mini-Mental State Examination (MMSE) k k k




C) GAD-7
D) AUDIT
Answer: B) Mini-Mental State Examination (MMSE)
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Rationale: The MMSE is a screening tool for cognitive impairment assessing
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orientation, registration, attention, recall, and language. Given the progressive
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memory loss, difficulty with familiar tasks, and personality changes, cognitive
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screening is indicated to evaluate for neurocognitive disorders such as Alzheimer's
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disease or other dementias .
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Question 7 k




A patient reports persistent low mood, loss of interest in previously enjoyed
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activities, and fatigue for over two months. No medical cause has been identified. Which
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diagnosis is most consistent with these symptoms?
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A) Bipolar I disorder k k




B) Generalized anxiety disorder k k




C) Major depressive disorder
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D) Schizophrenia
Answer: C) Major depressive disorder
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