PMHNP ANCC ACTUAL QUESTIONS AND VERIFIED
ANSWERS 2026-2027 PMHNP I - EXAM VERIFIED
ANSWER GRADED A+
Mrs. French has been in individual therapy for 3 months. She has shown much growth and
improvement in her functioning and insight and is to discontinue services within the next few
weeks. In the next session, after you discuss service termination, she suddenly begins to
demonstrate the original symptoms that had brought her to treatment initially. She is now
hesitant to discharge, wants to continue services, and is displaying an increase in regressive
defense mechanisms. What is the best explanation for ms. French's behavior?
A. An exacerbation of her symptoms related to stress
B. The normal cyclic nature of chronic mental health symptoms
C. A sign of normal resistance to termination seen in the termination phase of therapy
D. A sign of pathological attachment to the therapist that must be addressed
Ans: c. Clients frequently display resistance and regression at the termination of a meaningful
therapeutic process. The pmhnp is responsible for planning an effective termination and
monitoring clients during the termination period.
,A client is displaying low self-esteem, poor self-control, self-doubt, and a high level of
dependency. These behaviors indicate developmental failure of which of the following stages
of development:
A. Infancy
B. Early childhood
C. Late childhood
D. School age
Ans: b. These signs indicate developmental failure of early childhood.
Mr. Thompson has been forgetful lately, for example, forgetting where he has placed his keys
or what time appointments are scheduled, and he has stated that he thinks these are just
random behaviors that have no particular meaning. Which freudian-based psychodynamic
principle assumes that all behavior and actions are purposeful?
A. Pleasure principle
B. Psychic determinism principle
C. Reality principle
D. Unconsciousness principle
Ans: b. The psychic determinism principle states that all behavior has purpose and meaning,
often unconscious in nature, and that no behaviors occur randomly or by coincidence.
An example of a mature, healthy defense mechanism is
A. Denial
B. Rationalization
C. Repression
D. Suppression
Ans: d. Suppression is the only defense mechanism listed in which the client channels
conflicting energies into growth-promoting activities.
,Mr. Johnson is a 54-year-old client you have been seeing for several weeks in therapy. While
discussing his current concerns of marital stress, he lies on the floor and assumes the fetal
position. This is most likely an example of
A. Immature regressive defense mechanism
B. Denial of reality
C. Immature fantasy defense mechanism
D. Repressive behavior
Ans: a. Immature regressive defense mechanism is a return to a behavior common to an earlier
stage of development.
Defense mechanisms are best viewed as a function of the ego
A. To alert us to harm and danger
B. To alert us to problems
C. Used to resolve a conflict
D. Used to protect the id
Ans: c. Defense mechanisms are a function of the ego used to resolve a conflict.
One of the health care changes that has occurred as a result of the affordable care act (aca) is
that doctors/hospitals/clinic groups or health systems are coming together and assuming the
responsibility for quality care to large groups of individuals insured by medicare. The health
care clinics/systems doctors or hospitals that join together are called which of the following?
A. Health maintenance organization (hmo)
B. Preferred provider network (ppo)
C. Accountable care organization (aco)
D. Individual health plan (ihp)
Ans: c. Aco's are groups of doctors or other health care providers who voluntarily come
together and assume the care provided to medicare patients.
, Health care economics is concerned with making decisions so the benefits outweigh the cost of
resource utilization. What are two concepts that healthcare economics is concerned with in
regard to fair distribution of resources and allocation?
A. Equity and efficiency
B. Cost and benefits
C. Opportunity and waste
D. Affordable and quality
Ans: a. Health care efficiency is making risk and benefit decision about how care resources are
allocated and equity is ensuring that there is a fair distribution of the resources.
What four elements need to be present for a malpractice lawsuit to be filed?
A. Beneficence, non-maleficence, truthfulness, and justice
B. Duty of care, breach of standard of care, injury, and injury must be related to breach of the
standard of care
C. Abandonment, breach of care, violation of ethics, and reimbursement for poor care
D. Breach of standard of care, injury, deceit, and malpractice
Ans: b. The four elements that must be satisfied for malpractice to have occurred are a duty of
care between clinician and patient, breach of standard of care, an injury to the patient, and the
patient's injury must be related to the clinician's breach of care.
Mary is a psychiatric-mental health nurse practitioner (pmhnp) who is working in a hospitalist
role. Mary has encountered over five incidences in which attending psychiatrists and medical
residents have been demeaning to nursing staff and not answering calls in the middle of the
night or telling the nursing staff to write orders and the md would sign off in the a.m. Mary is
concerned about errors and wants to improve quality, reduce errors to promote safety. What
concept is mary employing?
A. Bullying
B. Abuse
C. Civil disobedience
D. Just culture
ANSWERS 2026-2027 PMHNP I - EXAM VERIFIED
ANSWER GRADED A+
Mrs. French has been in individual therapy for 3 months. She has shown much growth and
improvement in her functioning and insight and is to discontinue services within the next few
weeks. In the next session, after you discuss service termination, she suddenly begins to
demonstrate the original symptoms that had brought her to treatment initially. She is now
hesitant to discharge, wants to continue services, and is displaying an increase in regressive
defense mechanisms. What is the best explanation for ms. French's behavior?
A. An exacerbation of her symptoms related to stress
B. The normal cyclic nature of chronic mental health symptoms
C. A sign of normal resistance to termination seen in the termination phase of therapy
D. A sign of pathological attachment to the therapist that must be addressed
Ans: c. Clients frequently display resistance and regression at the termination of a meaningful
therapeutic process. The pmhnp is responsible for planning an effective termination and
monitoring clients during the termination period.
,A client is displaying low self-esteem, poor self-control, self-doubt, and a high level of
dependency. These behaviors indicate developmental failure of which of the following stages
of development:
A. Infancy
B. Early childhood
C. Late childhood
D. School age
Ans: b. These signs indicate developmental failure of early childhood.
Mr. Thompson has been forgetful lately, for example, forgetting where he has placed his keys
or what time appointments are scheduled, and he has stated that he thinks these are just
random behaviors that have no particular meaning. Which freudian-based psychodynamic
principle assumes that all behavior and actions are purposeful?
A. Pleasure principle
B. Psychic determinism principle
C. Reality principle
D. Unconsciousness principle
Ans: b. The psychic determinism principle states that all behavior has purpose and meaning,
often unconscious in nature, and that no behaviors occur randomly or by coincidence.
An example of a mature, healthy defense mechanism is
A. Denial
B. Rationalization
C. Repression
D. Suppression
Ans: d. Suppression is the only defense mechanism listed in which the client channels
conflicting energies into growth-promoting activities.
,Mr. Johnson is a 54-year-old client you have been seeing for several weeks in therapy. While
discussing his current concerns of marital stress, he lies on the floor and assumes the fetal
position. This is most likely an example of
A. Immature regressive defense mechanism
B. Denial of reality
C. Immature fantasy defense mechanism
D. Repressive behavior
Ans: a. Immature regressive defense mechanism is a return to a behavior common to an earlier
stage of development.
Defense mechanisms are best viewed as a function of the ego
A. To alert us to harm and danger
B. To alert us to problems
C. Used to resolve a conflict
D. Used to protect the id
Ans: c. Defense mechanisms are a function of the ego used to resolve a conflict.
One of the health care changes that has occurred as a result of the affordable care act (aca) is
that doctors/hospitals/clinic groups or health systems are coming together and assuming the
responsibility for quality care to large groups of individuals insured by medicare. The health
care clinics/systems doctors or hospitals that join together are called which of the following?
A. Health maintenance organization (hmo)
B. Preferred provider network (ppo)
C. Accountable care organization (aco)
D. Individual health plan (ihp)
Ans: c. Aco's are groups of doctors or other health care providers who voluntarily come
together and assume the care provided to medicare patients.
, Health care economics is concerned with making decisions so the benefits outweigh the cost of
resource utilization. What are two concepts that healthcare economics is concerned with in
regard to fair distribution of resources and allocation?
A. Equity and efficiency
B. Cost and benefits
C. Opportunity and waste
D. Affordable and quality
Ans: a. Health care efficiency is making risk and benefit decision about how care resources are
allocated and equity is ensuring that there is a fair distribution of the resources.
What four elements need to be present for a malpractice lawsuit to be filed?
A. Beneficence, non-maleficence, truthfulness, and justice
B. Duty of care, breach of standard of care, injury, and injury must be related to breach of the
standard of care
C. Abandonment, breach of care, violation of ethics, and reimbursement for poor care
D. Breach of standard of care, injury, deceit, and malpractice
Ans: b. The four elements that must be satisfied for malpractice to have occurred are a duty of
care between clinician and patient, breach of standard of care, an injury to the patient, and the
patient's injury must be related to the clinician's breach of care.
Mary is a psychiatric-mental health nurse practitioner (pmhnp) who is working in a hospitalist
role. Mary has encountered over five incidences in which attending psychiatrists and medical
residents have been demeaning to nursing staff and not answering calls in the middle of the
night or telling the nursing staff to write orders and the md would sign off in the a.m. Mary is
concerned about errors and wants to improve quality, reduce errors to promote safety. What
concept is mary employing?
A. Bullying
B. Abuse
C. Civil disobedience
D. Just culture
