LMR PMHNP MID EXAM 2025
QUESTIONS WITH CORRECT
HIGHLIGHTED ANSWERS
A 17-year-old presents with irritability, withdrawal from school activities, and difficulty sleeping after his
parents' recent divorce. Symptoms began within three weeks of the divorce and are causing significant
distress. What is the most likely diagnosis?
A. Major Depressive Disorder
B. Adjustment Disorder
C. Generalized Anxiety Disorder
D. Persistent Depressive Disorder
B. Adjustment Disorder
A 13-year-old presents with sleep disturbances, sad mood, loss of interest in usual activities,
and increased irritability following the death of a pet one month ago. The child has also been arguing
with teachers and refusing to attend school. Based on DSM-5 criteria, what is the most appropriate
diagnosis?
A. Major Depressive Disorder
B. Adjustment Disorder with mixed disturbance of emotions and conduct
C. Oppositional Defiant Disorder
D. Generalized Anxiety Disorder
B. Adjustment Disorder with mixed disturbance of emotions and conduct
Which of the following best differentiates Adjustment Disorder from Major Depressive Disorder (MDD)?
A. Adjustment disorder includes psychotic symptoms
B. MDD requires symptoms to occur within 3 months of a stressor
C. Adjustment disorder involves an identifiable external stressor, while MDD can occur without one
LMR PMHNP MID EXAM 2025
,D. MDD resolves more quickly than adjustment disorder
C. Adjustment disorder involves an identifiable external stressor, while MDD can occur without one
A 9-year-old presents with frequent blinking, shoulder shrugging, and grunting sounds that have
persisted for over a year. The parent reports these behaviors began around age 7 and tend to wax and
wane in severity. There is no evidence of substance use or another medical condition. What is the most
likely diagnosis?
A. Persistent Motor Tic Disorder
B. Tourette Syndrome (Tourette’s Disorder)
C. Transient Tic Disorder
D. Autism Spectrum Disorder
B. Tourette Syndrome (Tourette's Disorder)
Which of the following medications are FDA-approved for the treatment of Tourette Syndrome, and
which are commonly used to help manage impulse control and rage symptoms?
A. Fluoxetine and sertraline; useful for vocal tics and aggression
B. Haloperidol, Pimozide, Aripiprazole for tics; Clonidine and Guanfacine for impulse control and rage
attacks
C. Lithium and carbamazepine; helpful for tic suppression
D. Methylphenidate and amphetamine; reduce tics and aggression
B. Haloperidol, Pimozide, Aripiprazole for tics; Clonidine and Guanfacine for impulse control and rage
attacks
Which of the following neurotransmitters are most commonly associated with the development
of Tourette Syndrome, and what is a common pharmacologic treatment strategy?
A. Acetylcholine and histamine; treated with SSRIs
B. Dopamine, norepinephrine, serotonin, glutamate, and GABA; treated with antipsychotics and alpBha-
2 agonists
C. GABA and endorphins; treated with benzodiazepines
D. Serotonin and melatonin; treated with stimulants
B. Dopamine, norepinephrine, serotonin, glutamate, and GABA; treated with antipsychotics and alpBha-
2 agonists
LMR PMHNP MID EXAM 2025
,Why is Guanfacine often preferred over Clonidine when treating children with ADHD and/or tic
disorders?
A. Clonidine has fewer sedating effects and a longer half-life
B. Guanfacine causes less sedation, has a longer half-life, and is dosed once daily
C. Guanfacine is a stimulant and acts faster than Clonidine
D. Clonidine is FDA-approved for ADHD and Guanfacine is not
B. Guanfacine causes less sedation, has a longer half-life, and is dosed once daily
Which of the following is a key reason Guanfacine is preferred over Clonidine for treating ADHD or tic
disorders in children?
A. Guanfacine has a stronger sedative effect than Clonidine
B. Guanfacine works faster due to a shorter half-life
C. Guanfacine has a longer half-life, allowing for once-daily dosing and improved medication adherence
D. Guanfacine is more effective in adults than in children
C. Guanfacine has a longer half-life, allowing for once-daily dosing and improved medication adherence
A PMHNP is deciding between Clonidine and Guanfacine to treat a 9-year-old child with ADHD and
impulsivity. The family is concerned about daytime sedation and tolerability. Which of the following best
supports the choice of Guanfacine over Clonidine?
A. Clonidine is less likely to cause fatigue or dry mouth
B. Guanfacine is only used for sleep, not ADHD
C. Guanfacine causes fewer sedative effects, has better tolerability, and is less disruptive to daily
functioning
D. Clonidine is a stimulant and should be avoided in children
C. Guanfacine causes fewer sedative effects, has better tolerability, and is less disruptive to daily
functioning
A 25-year-old woman presents to the clinic three weeks after surviving a car accident. She
reports intense fear, nightmares about the crash, difficulty sleeping, poor concentration, and avoids
driving or thinking about the event. These symptoms began a few days after the accident. What is the
most likely diagnosis?
A. Adjustment Disorder
LMR PMHNP MID EXAM 2025
, B. Post-Traumatic Stress Disorder (PTSD)
C. Acute Stress Disorder
D. Generalized Anxiety Disorder
C. Acute Stress Disorder
Which of the following best distinguishes Post-Traumatic Stress Disorder (PTSD) from Acute Stress
Disorder (ASD)?
A. PTSD symptoms resolve within 2 weeks while ASD persists for months
B. PTSD occurs only after natural disasters, while ASD occurs after any trauma
C. PTSD symptoms must persist for at least one month, while ASD symptoms occur within 3 days to 4
weeks of the trauma
D. ASD includes hallucinations and delusions, while PTSD does not
C. PTSD symptoms must persist for at least one month, while ASD symptoms occur within 3 days to 4
weeks of the trauma
A 30-year-old male presents to the clinic 10 days after witnessing a violent robbery. He
reports nightmares, hypervigilance, difficulty sleeping, and avoidance of the crime scene. Symptoms
began within 48 hours of the event. What is the most appropriate diagnosis?
A. Adjustment Disorder
B. Acute Stress Disorder
C. Post-Traumatic Stress Disorder (PTSD)
D. Panic Disorder
B. Acute Stress Disorder
A 24-year-old woman continues to experience intrusive memories, emotional numbness, flashbacks,
and insomnia six weeks after surviving a serious car crash. She reports symptoms began a few days after
the event and have not resolved. What is the most likely diagnosis?
A. Acute Stress Disorder
B. Post-Traumatic Stress Disorder (PTSD)
C. Generalized Anxiety Disorder
D. Panic Disorder
LMR PMHNP MID EXAM 2025
QUESTIONS WITH CORRECT
HIGHLIGHTED ANSWERS
A 17-year-old presents with irritability, withdrawal from school activities, and difficulty sleeping after his
parents' recent divorce. Symptoms began within three weeks of the divorce and are causing significant
distress. What is the most likely diagnosis?
A. Major Depressive Disorder
B. Adjustment Disorder
C. Generalized Anxiety Disorder
D. Persistent Depressive Disorder
B. Adjustment Disorder
A 13-year-old presents with sleep disturbances, sad mood, loss of interest in usual activities,
and increased irritability following the death of a pet one month ago. The child has also been arguing
with teachers and refusing to attend school. Based on DSM-5 criteria, what is the most appropriate
diagnosis?
A. Major Depressive Disorder
B. Adjustment Disorder with mixed disturbance of emotions and conduct
C. Oppositional Defiant Disorder
D. Generalized Anxiety Disorder
B. Adjustment Disorder with mixed disturbance of emotions and conduct
Which of the following best differentiates Adjustment Disorder from Major Depressive Disorder (MDD)?
A. Adjustment disorder includes psychotic symptoms
B. MDD requires symptoms to occur within 3 months of a stressor
C. Adjustment disorder involves an identifiable external stressor, while MDD can occur without one
LMR PMHNP MID EXAM 2025
,D. MDD resolves more quickly than adjustment disorder
C. Adjustment disorder involves an identifiable external stressor, while MDD can occur without one
A 9-year-old presents with frequent blinking, shoulder shrugging, and grunting sounds that have
persisted for over a year. The parent reports these behaviors began around age 7 and tend to wax and
wane in severity. There is no evidence of substance use or another medical condition. What is the most
likely diagnosis?
A. Persistent Motor Tic Disorder
B. Tourette Syndrome (Tourette’s Disorder)
C. Transient Tic Disorder
D. Autism Spectrum Disorder
B. Tourette Syndrome (Tourette's Disorder)
Which of the following medications are FDA-approved for the treatment of Tourette Syndrome, and
which are commonly used to help manage impulse control and rage symptoms?
A. Fluoxetine and sertraline; useful for vocal tics and aggression
B. Haloperidol, Pimozide, Aripiprazole for tics; Clonidine and Guanfacine for impulse control and rage
attacks
C. Lithium and carbamazepine; helpful for tic suppression
D. Methylphenidate and amphetamine; reduce tics and aggression
B. Haloperidol, Pimozide, Aripiprazole for tics; Clonidine and Guanfacine for impulse control and rage
attacks
Which of the following neurotransmitters are most commonly associated with the development
of Tourette Syndrome, and what is a common pharmacologic treatment strategy?
A. Acetylcholine and histamine; treated with SSRIs
B. Dopamine, norepinephrine, serotonin, glutamate, and GABA; treated with antipsychotics and alpBha-
2 agonists
C. GABA and endorphins; treated with benzodiazepines
D. Serotonin and melatonin; treated with stimulants
B. Dopamine, norepinephrine, serotonin, glutamate, and GABA; treated with antipsychotics and alpBha-
2 agonists
LMR PMHNP MID EXAM 2025
,Why is Guanfacine often preferred over Clonidine when treating children with ADHD and/or tic
disorders?
A. Clonidine has fewer sedating effects and a longer half-life
B. Guanfacine causes less sedation, has a longer half-life, and is dosed once daily
C. Guanfacine is a stimulant and acts faster than Clonidine
D. Clonidine is FDA-approved for ADHD and Guanfacine is not
B. Guanfacine causes less sedation, has a longer half-life, and is dosed once daily
Which of the following is a key reason Guanfacine is preferred over Clonidine for treating ADHD or tic
disorders in children?
A. Guanfacine has a stronger sedative effect than Clonidine
B. Guanfacine works faster due to a shorter half-life
C. Guanfacine has a longer half-life, allowing for once-daily dosing and improved medication adherence
D. Guanfacine is more effective in adults than in children
C. Guanfacine has a longer half-life, allowing for once-daily dosing and improved medication adherence
A PMHNP is deciding between Clonidine and Guanfacine to treat a 9-year-old child with ADHD and
impulsivity. The family is concerned about daytime sedation and tolerability. Which of the following best
supports the choice of Guanfacine over Clonidine?
A. Clonidine is less likely to cause fatigue or dry mouth
B. Guanfacine is only used for sleep, not ADHD
C. Guanfacine causes fewer sedative effects, has better tolerability, and is less disruptive to daily
functioning
D. Clonidine is a stimulant and should be avoided in children
C. Guanfacine causes fewer sedative effects, has better tolerability, and is less disruptive to daily
functioning
A 25-year-old woman presents to the clinic three weeks after surviving a car accident. She
reports intense fear, nightmares about the crash, difficulty sleeping, poor concentration, and avoids
driving or thinking about the event. These symptoms began a few days after the accident. What is the
most likely diagnosis?
A. Adjustment Disorder
LMR PMHNP MID EXAM 2025
, B. Post-Traumatic Stress Disorder (PTSD)
C. Acute Stress Disorder
D. Generalized Anxiety Disorder
C. Acute Stress Disorder
Which of the following best distinguishes Post-Traumatic Stress Disorder (PTSD) from Acute Stress
Disorder (ASD)?
A. PTSD symptoms resolve within 2 weeks while ASD persists for months
B. PTSD occurs only after natural disasters, while ASD occurs after any trauma
C. PTSD symptoms must persist for at least one month, while ASD symptoms occur within 3 days to 4
weeks of the trauma
D. ASD includes hallucinations and delusions, while PTSD does not
C. PTSD symptoms must persist for at least one month, while ASD symptoms occur within 3 days to 4
weeks of the trauma
A 30-year-old male presents to the clinic 10 days after witnessing a violent robbery. He
reports nightmares, hypervigilance, difficulty sleeping, and avoidance of the crime scene. Symptoms
began within 48 hours of the event. What is the most appropriate diagnosis?
A. Adjustment Disorder
B. Acute Stress Disorder
C. Post-Traumatic Stress Disorder (PTSD)
D. Panic Disorder
B. Acute Stress Disorder
A 24-year-old woman continues to experience intrusive memories, emotional numbness, flashbacks,
and insomnia six weeks after surviving a serious car crash. She reports symptoms began a few days after
the event and have not resolved. What is the most likely diagnosis?
A. Acute Stress Disorder
B. Post-Traumatic Stress Disorder (PTSD)
C. Generalized Anxiety Disorder
D. Panic Disorder
LMR PMHNP MID EXAM 2025
