PMHNP CERTIFICATION EXAM 450 QUESTIONS AND DETAILED ANSWERS |NEW 2025/2026 VERSION

Example A patient is being treated for schizophrenia with olanzapine. Which
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of the following is the most common side effect of olanzapine?
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A. Increased waist circumference
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B. EPS (not as common in atypical antipsychotics d/t 5HT2A)-receptor
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mantagonism

C. Increased Lipids
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D. Metabolic Syndrome
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Which patient is at highest risk for SI
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A. 30y/o married AA female with previous SI attempt *1 risk factor
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B. 35 y/o single Asian male with previous SI attempt *3 risk factors
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C. 38 y/o single AA male who is a manager of a bank *2 risk factors
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D. 68 y/o single white male with depression *5 risk factors (age, male,
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mwhite, depression) m




D. 68 y/o single white male with depression *5 risk factors (age, male, white,
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mdepression)



Which antipsychotics have the least weight gain?
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Latuda, Abilify, (also least sedating), Geodon-if patient has metabolic
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msyndrome consider switching to one of the medications above. Or if the
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mpatient is overly sedated try switching to ABILIFY
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,Which mood stabilizer have the least weight gain?
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m Lamictal

-But remember all mood stabilizers cause some weight gain
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When presented with a question about typical vs atypical antipsychotic the
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answer is usually to start of aatypical
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A client presents with complains of changes in appetite, feeling fatigued,
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problems with sleep-rest cycle, and changes in libido. What is the
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neuroanatomical area of the brain that is responsible for the normal
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regulation of these functions?
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A. Thalamus m




B. Hypothalamus
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C. Limbic System
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D. Hippocampus
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Count the risk factorsCOWS scale components
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· Opioid W/D
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How long do you wait when switching between an SSRI to an MAOI?
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2 weeks m




How long do you wait when switching between Prozac and MAOI?
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5-6 weeks wash out period
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,What is the first line treatment for depression and why?
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SSRI-First line treatment for depression due to less risk of injury from
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OVERDOSE
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If a cancer patient has depression what should you consider?
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Treating with a medication with minimal drug/drug side effects like
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Lexapro
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Patient with depression worries about sexual dysfunction what would be the
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medication of choice? m m




Wellbutrin

Primary symptoms of depression include fatigue and low energy what med
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would you chose?
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Wellbutrin

Wellbutrin is contraindicated in patients with
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m Seizures and anorexia (bulimia also)
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Which medications are best for neuropathic pain?
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m SNRI

Gabapentin

TCA
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Secondary to the black box warning providers caring for patients on
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antidepressants should assess for? m m m




Suicidality, frequency, and severity at EVERY appointment
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m Which meds have the worse serotonin discontinuation syndrome
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m Those with short half lives such as Zoloft; TCA's
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, Symptoms of discontinuation syndrome m m m




flu like symptoms (fatigue, lethargy, myalgia, decreased concentration), n/v,
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impaired memory, paresthesia, irritability, anxiety, insomnia, crying w/o
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reason, dizziness, and vertigoTx w/periactin
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Ages of onset for schizophrenia in males vs females
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-MALES 18-25 years m m




-FEMALE 25-35 years m m




What nationality is most suseptible of getting steven johnson?
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Asians

When treating asians with tegretol screen for?
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HLAB-1502 Allele m




What two medications cause agranulocytosis?
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Clozaril & Tegretol m m




Agranulocytosis when to discontinue medication m m m m




Less than 1000
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When monitoring for agranulocytosis in patients look for s/s of what?
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m Infection

-Fever, sore throat, fatigue, chills
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Before starting any mood stabilizer in a female of childbearing age be sure
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to check?
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