ANCC Psychiatric Mental Health Nursing (PMH-BC)
Certification Exam New 2026 Version with All
Questions, Answers and Rationale
Section 1: Foundations of Psychiatric-Mental Health Nursing (Questions 1–13)
1. A nurse is using therapeutic communication with a patient experiencing anxiety. What
technique is most appropriate?
A) Reflecting the patient's feelings back to them.
B) Giving advice on how to manage anxiety.
C) Changing the subject to distract the patient.
D) Telling the patient to calm down. Correct Answer: A) Reflecting the patient's feelings
back to them.
Rationale: Reflecting promotes empathy and self-awareness. ANCC Domain 1:
Therapeutic communication techniques.
2. A patient with schizophrenia reports hallucinations. What theoretical model guides the
nurse's approach?
A) Biopsychosocial model.
B) Biomedical model only.
C) Behavioral model.
D) No model needed. Correct Answer: A) Biopsychosocial model.
Rationale: Addresses biological, psychological, and social factors in mental health.
ANCC Domain 1: Theoretical foundations.
3. In an ethical dilemma involving patient confidentiality, what is the nurse's priority?
A) Disclose information only with patient consent or legal mandate.
B) Share with family without consent.
C) Ignore confidentiality.
D) Disclose to all staff. Correct Answer: A) Disclose information only with patient
consent or legal mandate.
Rationale: Upholds HIPAA and ethical principles. ANCC Domain 1: Ethical and legal
issues.
4. A nurse is assessing a patient's readiness for discharge. What legal consideration?
A) Ensure patient understands risks of self-harm.
B) Discharge without assessment.
C) No legal consideration.
D) Ignore risks. Correct Answer: A) Ensure patient understands risks of self-harm.
Rationale: Liability for patient safety. ANCC Domain 1: Legal aspects in discharge
planning.
5. A patient from a cultural background where mental illness is stigmatized. What
approach?
A) Use culturally sensitive language to reduce stigma.
B) Ignore culture.
C) Force disclosure.
D) No approach. Correct Answer: A) Use culturally sensitive language to reduce stigma.
Rationale: Builds trust. ANCC Domain 1: Cultural competence in foundations.
,6. A nurse applies the recovery model. What key principle?
A) Patient empowerment and hope.
B) Cure only.
C) Medication focus.
D) No principle. Correct Answer: A) Patient empowerment and hope.
Rationale: SAMHSA recovery model. ANCC Domain 1: Theoretical models.
7. A patient refuses psychotropic medication. What ethical response?
A) Respect autonomy if competent.
B) Force medication.
C) Ignore refusal.
D) Discharge. Correct Answer: A) Respect autonomy if competent.
Rationale: Principle of autonomy. ANCC Domain 1: Ethical issues in medication refusal.
8. A nurse uses active listening. What example?
A) Paraphrasing the patient's statements.
B) Interrupting to give advice.
C) No listening.
D) Changing topic. Correct Answer: A) Paraphrasing the patient's statements.
Rationale: Demonstrates understanding. ANCC Domain 1: Therapeutic communication.
9. In scope of practice, a nurse encounters a patient in crisis. What action?
A) Follow state laws and collaborate with team.
B) Handle alone.
C) Ignore scope.
D) No collaboration. Correct Answer: A) Follow state laws and collaborate with team.
Rationale: Ensures safe practice. ANCC Domain 1: Scope of practice.
10. A patient with PTSD relives trauma. What model guides care?
A) Trauma-informed care model.
B) Biomedical model.
C) No model.
D) Behavioral model. Correct Answer: A) Trauma-informed care model.
Rationale: SAMHSA model for PTSD. ANCC Domain 1: Theoretical models for trauma.
11. A nurse faces a legal issue with involuntary commitment. What priority?
A) Ensure due process and patient rights.
B) Commit without process.
C) No legal priority.
D) Ignore rights. Correct Answer: A) Ensure due process and patient rights.
Rationale: Protects civil liberties. ANCC Domain 1: Legal aspects in psychiatric care.
12. A nurse advocates for a patient with stigma. What action?
A) Educate community to reduce stigma.
B) No advocacy.
C) Ignore stigma.
D) Discharge. Correct Answer: A) Educate community to reduce stigma.
Rationale: Promotes mental health acceptance. ANCC Domain 1: Advocacy.
13. A nurse collaborates with a social worker for a patient. What goal?
A) Address social determinants of health.
B) No collaboration.
C) Nurse alone.
, D) Ignore social work. Correct Answer: A) Address social determinants of health.
Rationale: Holistic care. ANCC Domain 1: Collaboration.
Section 2: Assessment and Diagnosis (Questions 14–37)
14. A 35-year-old patient reports auditory hallucinations. What assessment?
A) Mental status exam for delusions.
B) No exam.
C) Physical only.
D) Labs. Correct Answer: A) Mental status exam for delusions.
Rationale: Evaluates psychotic symptoms. ANCC Domain 2: Psychosis assessment.
15. A 65-year-old with depression. What screening tool?
A) Geriatric Depression Scale (GDS).
B) No tool.
C) PHQ-9 for adults.
D) Ignore screening. Correct Answer: A) Geriatric Depression Scale (GDS).
Rationale: Age-appropriate for elderly. ANCC Domain 2: Depression diagnosis in
geriatrics.
16. A patient with anxiety has panic attacks. What diagnosis?
A) Panic disorder.
B) Generalized anxiety.
C) PTSD.
D) All possible. Correct Answer: A) Panic disorder.
Rationale: Recurrent unexpected attacks. ANCC Domain 2: Anxiety diagnosis.
17. A 25-year-old with mood swings and impulsivity. What diagnosis?
A) Bipolar disorder.
B) Depression.
C) Schizophrenia.
D) All possible. Correct Answer: A) Bipolar disorder.
Rationale: Manic episodes with depression. ANCC Domain 2: Mood disorder diagnosis.
18. A patient with PTSD has flashbacks. What assessment?
A) PTSD Checklist (PCL-5).
B) No tool.
C) MMSE.
D) Ignore flashbacks. Correct Answer: A) PTSD Checklist (PCL-5).
Rationale: Screens for PTSD symptoms. ANCC Domain 2: Trauma diagnosis.
19. A 45-year-old with sleep disturbance and irritability. What diagnosis?
A) Major depressive disorder.
B) Adjustment disorder.
C) Bipolar.
D) All possible. Correct Answer: D) All possible.
Rationale: Differential for mood changes. ANCC Domain 2: Differential diagnosis.
20. A 30-year-old with social withdrawal and anhedonia. What diagnosis?
A) Schizophrenia.
B) Depression.
C) Anxiety.
D) All possible. Correct Answer: D) All possible.
Rationale: Overlapping symptoms. ANCC Domain 2: Psychosis vs. depression diagnosis.
Certification Exam New 2026 Version with All
Questions, Answers and Rationale
Section 1: Foundations of Psychiatric-Mental Health Nursing (Questions 1–13)
1. A nurse is using therapeutic communication with a patient experiencing anxiety. What
technique is most appropriate?
A) Reflecting the patient's feelings back to them.
B) Giving advice on how to manage anxiety.
C) Changing the subject to distract the patient.
D) Telling the patient to calm down. Correct Answer: A) Reflecting the patient's feelings
back to them.
Rationale: Reflecting promotes empathy and self-awareness. ANCC Domain 1:
Therapeutic communication techniques.
2. A patient with schizophrenia reports hallucinations. What theoretical model guides the
nurse's approach?
A) Biopsychosocial model.
B) Biomedical model only.
C) Behavioral model.
D) No model needed. Correct Answer: A) Biopsychosocial model.
Rationale: Addresses biological, psychological, and social factors in mental health.
ANCC Domain 1: Theoretical foundations.
3. In an ethical dilemma involving patient confidentiality, what is the nurse's priority?
A) Disclose information only with patient consent or legal mandate.
B) Share with family without consent.
C) Ignore confidentiality.
D) Disclose to all staff. Correct Answer: A) Disclose information only with patient
consent or legal mandate.
Rationale: Upholds HIPAA and ethical principles. ANCC Domain 1: Ethical and legal
issues.
4. A nurse is assessing a patient's readiness for discharge. What legal consideration?
A) Ensure patient understands risks of self-harm.
B) Discharge without assessment.
C) No legal consideration.
D) Ignore risks. Correct Answer: A) Ensure patient understands risks of self-harm.
Rationale: Liability for patient safety. ANCC Domain 1: Legal aspects in discharge
planning.
5. A patient from a cultural background where mental illness is stigmatized. What
approach?
A) Use culturally sensitive language to reduce stigma.
B) Ignore culture.
C) Force disclosure.
D) No approach. Correct Answer: A) Use culturally sensitive language to reduce stigma.
Rationale: Builds trust. ANCC Domain 1: Cultural competence in foundations.
,6. A nurse applies the recovery model. What key principle?
A) Patient empowerment and hope.
B) Cure only.
C) Medication focus.
D) No principle. Correct Answer: A) Patient empowerment and hope.
Rationale: SAMHSA recovery model. ANCC Domain 1: Theoretical models.
7. A patient refuses psychotropic medication. What ethical response?
A) Respect autonomy if competent.
B) Force medication.
C) Ignore refusal.
D) Discharge. Correct Answer: A) Respect autonomy if competent.
Rationale: Principle of autonomy. ANCC Domain 1: Ethical issues in medication refusal.
8. A nurse uses active listening. What example?
A) Paraphrasing the patient's statements.
B) Interrupting to give advice.
C) No listening.
D) Changing topic. Correct Answer: A) Paraphrasing the patient's statements.
Rationale: Demonstrates understanding. ANCC Domain 1: Therapeutic communication.
9. In scope of practice, a nurse encounters a patient in crisis. What action?
A) Follow state laws and collaborate with team.
B) Handle alone.
C) Ignore scope.
D) No collaboration. Correct Answer: A) Follow state laws and collaborate with team.
Rationale: Ensures safe practice. ANCC Domain 1: Scope of practice.
10. A patient with PTSD relives trauma. What model guides care?
A) Trauma-informed care model.
B) Biomedical model.
C) No model.
D) Behavioral model. Correct Answer: A) Trauma-informed care model.
Rationale: SAMHSA model for PTSD. ANCC Domain 1: Theoretical models for trauma.
11. A nurse faces a legal issue with involuntary commitment. What priority?
A) Ensure due process and patient rights.
B) Commit without process.
C) No legal priority.
D) Ignore rights. Correct Answer: A) Ensure due process and patient rights.
Rationale: Protects civil liberties. ANCC Domain 1: Legal aspects in psychiatric care.
12. A nurse advocates for a patient with stigma. What action?
A) Educate community to reduce stigma.
B) No advocacy.
C) Ignore stigma.
D) Discharge. Correct Answer: A) Educate community to reduce stigma.
Rationale: Promotes mental health acceptance. ANCC Domain 1: Advocacy.
13. A nurse collaborates with a social worker for a patient. What goal?
A) Address social determinants of health.
B) No collaboration.
C) Nurse alone.
, D) Ignore social work. Correct Answer: A) Address social determinants of health.
Rationale: Holistic care. ANCC Domain 1: Collaboration.
Section 2: Assessment and Diagnosis (Questions 14–37)
14. A 35-year-old patient reports auditory hallucinations. What assessment?
A) Mental status exam for delusions.
B) No exam.
C) Physical only.
D) Labs. Correct Answer: A) Mental status exam for delusions.
Rationale: Evaluates psychotic symptoms. ANCC Domain 2: Psychosis assessment.
15. A 65-year-old with depression. What screening tool?
A) Geriatric Depression Scale (GDS).
B) No tool.
C) PHQ-9 for adults.
D) Ignore screening. Correct Answer: A) Geriatric Depression Scale (GDS).
Rationale: Age-appropriate for elderly. ANCC Domain 2: Depression diagnosis in
geriatrics.
16. A patient with anxiety has panic attacks. What diagnosis?
A) Panic disorder.
B) Generalized anxiety.
C) PTSD.
D) All possible. Correct Answer: A) Panic disorder.
Rationale: Recurrent unexpected attacks. ANCC Domain 2: Anxiety diagnosis.
17. A 25-year-old with mood swings and impulsivity. What diagnosis?
A) Bipolar disorder.
B) Depression.
C) Schizophrenia.
D) All possible. Correct Answer: A) Bipolar disorder.
Rationale: Manic episodes with depression. ANCC Domain 2: Mood disorder diagnosis.
18. A patient with PTSD has flashbacks. What assessment?
A) PTSD Checklist (PCL-5).
B) No tool.
C) MMSE.
D) Ignore flashbacks. Correct Answer: A) PTSD Checklist (PCL-5).
Rationale: Screens for PTSD symptoms. ANCC Domain 2: Trauma diagnosis.
19. A 45-year-old with sleep disturbance and irritability. What diagnosis?
A) Major depressive disorder.
B) Adjustment disorder.
C) Bipolar.
D) All possible. Correct Answer: D) All possible.
Rationale: Differential for mood changes. ANCC Domain 2: Differential diagnosis.
20. A 30-year-old with social withdrawal and anhedonia. What diagnosis?
A) Schizophrenia.
B) Depression.
C) Anxiety.
D) All possible. Correct Answer: D) All possible.
Rationale: Overlapping symptoms. ANCC Domain 2: Psychosis vs. depression diagnosis.
