ANCC PMHNP Certification Exam
PRACTICE QUESTIONS |ORIGINAL
QUESTIONS & ANSWERS |DETAILED
RATIONALES |HINTED COMPLETE
EXAM PREP GRADED A+*INSTANT
DOWNLOAD PDF
1. A patient with major depressive disorder reports depressed mood,
anhedonia, fatigue, and insomnia for 3 weeks. Which additional
symptom would most strongly support the diagnosis?
A. Increased goal-directed activity
B. Grandiosity
C. Feelings of worthlessness
D. Decreased need for sleep
Answer: C. Feelings of worthlessness
Worthlessness is a common depressive symptom and contributes to
the diagnostic picture of major depressive disorder.
2. Which neurotransmitter is most closely associated with the
reward pathway and psychosis when dysregulated?
A. Acetylcholine
B. Dopamine
C. GABA
D. Glutamate
Answer: B. Dopamine
Dopaminergic dysfunction, particularly excessive dopamine signaling
in certain pathways, is associated with psychotic symptoms and
reward processing.
,3. During a psychiatric interview, which question is most appropriate
for assessing suicidal ideation?
A. "You aren't thinking about suicide, are you?"
B. "Why would you want to die?"
C. "Have you had thoughts of killing yourself?"
D. "Do you feel better today?"
Answer: C. "Have you had thoughts of killing yourself?"
Direct, clear questioning about suicide does not increase suicidal
behavior and allows accurate risk assessment.
4. Which finding represents a positive symptom of schizophrenia?
A. Avolition
B. Anhedonia
C. Alogia
D. Auditory hallucinations
Answer: D. Auditory hallucinations
Positive symptoms include hallucinations, delusions, and disorganized
speech or behavior.
5. A patient reports hearing a voice when no external speaker is
present. This is best described as:
A. Illusion
B. Hallucination
C. Delusion
D. Derealization
Answer: B. Hallucination
A hallucination is a sensory perception occurring without an external
stimulus.
6. A fixed false belief that remains despite contradictory evidence is
a:
A. Hallucination
B. Delusion
,C. Compulsion
D. Confabulation
Answer: B. Delusion
A delusion is a fixed false belief that is not consistent with reality or
cultural expectations.
7. Which component of the mental status examination assesses the
patient's awareness of illness?
A. Affect
B. Insight
C. Attention
D. Thought process
Answer: B. Insight
Insight refers to the patient's recognition and understanding of their
condition and need for treatment.
8. A patient says, "The FBI implanted a tracking device in my tooth."
This is most consistent with which type of delusion?
A. Grandiose
B. Somatic
C. Persecutory
D. Erotomanic
Answer: C. Persecutory
Persecutory delusions involve beliefs that one is being harmed,
followed, watched, or persecuted.
9. Which finding is most characteristic of mania?
A. Psychomotor retardation
B. Decreased energy
C. Decreased need for sleep
D. Social withdrawal
Answer: C. Decreased need for sleep
Mania commonly involves decreased need for sleep, elevated or
, irritable mood, increased energy, and increased goal-directed
activity.
10. A patient with mania is speaking rapidly and moving from one
topic to another with understandable but loosely connected
associations. This is:
A. Thought blocking
B. Flight of ideas
C. Neologism
D. Echolalia
Answer: B. Flight of ideas
Flight of ideas is rapid shifting between topics with understandable
associations, commonly occurring during mania.
11. Which question best assesses orientation?
A. "What do you think caused your symptoms?"
B. "Do you hear voices?"
C. "Can you tell me where you are and today's date?"
D. "How do you feel about your family?"
Answer: C. "Can you tell me where you are and today's date?"
Orientation commonly assesses person, place, time, and sometimes
situation.
12. Which finding is most concerning for delirium rather than a
primary psychotic disorder?
A. Chronic auditory hallucinations
B. Fluctuating level of consciousness
C. Fixed persecutory delusions
D. Long-standing social withdrawal
Answer: B. Fluctuating level of consciousness
Delirium is characterized by acute onset, fluctuating attention and
awareness, and often an underlying medical cause.
PRACTICE QUESTIONS |ORIGINAL
QUESTIONS & ANSWERS |DETAILED
RATIONALES |HINTED COMPLETE
EXAM PREP GRADED A+*INSTANT
DOWNLOAD PDF
1. A patient with major depressive disorder reports depressed mood,
anhedonia, fatigue, and insomnia for 3 weeks. Which additional
symptom would most strongly support the diagnosis?
A. Increased goal-directed activity
B. Grandiosity
C. Feelings of worthlessness
D. Decreased need for sleep
Answer: C. Feelings of worthlessness
Worthlessness is a common depressive symptom and contributes to
the diagnostic picture of major depressive disorder.
2. Which neurotransmitter is most closely associated with the
reward pathway and psychosis when dysregulated?
A. Acetylcholine
B. Dopamine
C. GABA
D. Glutamate
Answer: B. Dopamine
Dopaminergic dysfunction, particularly excessive dopamine signaling
in certain pathways, is associated with psychotic symptoms and
reward processing.
,3. During a psychiatric interview, which question is most appropriate
for assessing suicidal ideation?
A. "You aren't thinking about suicide, are you?"
B. "Why would you want to die?"
C. "Have you had thoughts of killing yourself?"
D. "Do you feel better today?"
Answer: C. "Have you had thoughts of killing yourself?"
Direct, clear questioning about suicide does not increase suicidal
behavior and allows accurate risk assessment.
4. Which finding represents a positive symptom of schizophrenia?
A. Avolition
B. Anhedonia
C. Alogia
D. Auditory hallucinations
Answer: D. Auditory hallucinations
Positive symptoms include hallucinations, delusions, and disorganized
speech or behavior.
5. A patient reports hearing a voice when no external speaker is
present. This is best described as:
A. Illusion
B. Hallucination
C. Delusion
D. Derealization
Answer: B. Hallucination
A hallucination is a sensory perception occurring without an external
stimulus.
6. A fixed false belief that remains despite contradictory evidence is
a:
A. Hallucination
B. Delusion
,C. Compulsion
D. Confabulation
Answer: B. Delusion
A delusion is a fixed false belief that is not consistent with reality or
cultural expectations.
7. Which component of the mental status examination assesses the
patient's awareness of illness?
A. Affect
B. Insight
C. Attention
D. Thought process
Answer: B. Insight
Insight refers to the patient's recognition and understanding of their
condition and need for treatment.
8. A patient says, "The FBI implanted a tracking device in my tooth."
This is most consistent with which type of delusion?
A. Grandiose
B. Somatic
C. Persecutory
D. Erotomanic
Answer: C. Persecutory
Persecutory delusions involve beliefs that one is being harmed,
followed, watched, or persecuted.
9. Which finding is most characteristic of mania?
A. Psychomotor retardation
B. Decreased energy
C. Decreased need for sleep
D. Social withdrawal
Answer: C. Decreased need for sleep
Mania commonly involves decreased need for sleep, elevated or
, irritable mood, increased energy, and increased goal-directed
activity.
10. A patient with mania is speaking rapidly and moving from one
topic to another with understandable but loosely connected
associations. This is:
A. Thought blocking
B. Flight of ideas
C. Neologism
D. Echolalia
Answer: B. Flight of ideas
Flight of ideas is rapid shifting between topics with understandable
associations, commonly occurring during mania.
11. Which question best assesses orientation?
A. "What do you think caused your symptoms?"
B. "Do you hear voices?"
C. "Can you tell me where you are and today's date?"
D. "How do you feel about your family?"
Answer: C. "Can you tell me where you are and today's date?"
Orientation commonly assesses person, place, time, and sometimes
situation.
12. Which finding is most concerning for delirium rather than a
primary psychotic disorder?
A. Chronic auditory hallucinations
B. Fluctuating level of consciousness
C. Fixed persecutory delusions
D. Long-standing social withdrawal
Answer: B. Fluctuating level of consciousness
Delirium is characterized by acute onset, fluctuating attention and
awareness, and often an underlying medical cause.
