GEORGETTE’S LMR PMHNP ACTUAL EXAM –
VERSION 2: COMPLETE 100-QUESTION STUDY
GUIDE WITH VERIFIED ANSWERS AND
RATIONALES
Overview:
This comprehensive study guide is designed for psychiatric-mental health nurse practitioner
(PMHNP) certification exam preparation. It includes 100 high-yield, evidence-based questions
covering core PMHNP concepts, including:
Psychopharmacology – Antidepressants, antipsychotics, mood stabilizers, anxiolytics,
ADHD medications, and special considerations for pregnancy, elderly, and comorbid
conditions.
Psychotherapy – CBT, DBT, IPT, trauma-focused therapy, and other evidence-based
modalities.
Psychiatric Disorders – Depression, anxiety disorders, PTSD, OCD, schizophrenia,
bipolar disorders, personality disorders, ADHD, and substance use disorders.
Assessment and Diagnosis – DSM-5 criteria, symptom recognition, lab and safety
monitoring, and differential diagnosis.
Clinical Decision-Making – First-line treatments, risk management, and medication
monitoring.
Each question includes:
The correct answer in bold
Rationale explaining why it is correct
This guide is intended to maximize exam readiness, reinforce critical concepts, and provide a
structured, test-like experience to help PMHNP candidates confidently prepare for the
certification exam.
81. First-line treatment for acute agitation in psychosis:
A. Fluoxetine
B. Haloperidol or lorazepam
C. Lithium
D. Valproate
Rationale: Rapid sedation is achieved with antipsychotics (haloperidol) or benzodiazepines
(lorazepam).
,82. Which therapy is evidence-based for chronic insomnia?
A. Psychoanalysis
B. Hypnosis
C. DBT
D. CBT-I
Rationale: CBT-I targets maladaptive sleep behaviors and cognitive distortions.
83. First-line pharmacologic treatment for bipolar II depression:
A. SSRI monotherapy
B. Lithium or lamotrigine
C. Antipsychotic monotherapy
D. Benzodiazepines
Rationale: Mood stabilizers prevent hypomanic switches; SSRIs alone risk triggering mania.
84. Which antidepressant is safest for cardiac patients?
A. TCAs
B. SSRIs
C. MAOIs
D. SNRIs
Rationale: SSRIs have a safer cardiac profile; TCAs can cause arrhythmias.
85. First-line treatment for generalized anxiety disorder in adults:
A. Benzodiazepines only
B. Antipsychotics
C. SSRIs/SNRIs
D. Mood stabilizers
Rationale: SSRIs/SNRIs are preferred for long-term efficacy and safety.
86. Which therapy is best for grief and role transitions in depression?
A. CBT
B. DBT
C. IPT
D. Psychoanalysis
Rationale: IPT targets interpersonal issues contributing to depressive symptoms.
87. Which personality disorder is marked by attention-seeking and dramatic behavior?
A. Borderline
B. Narcissistic
C. Histrionic
D. Antisocial
Rationale: Histrionic personality disorder involves exaggerated emotionality and attention-
seeking.
88. First-line therapy for PTSD:
A. Benzodiazepines
B. Trauma-focused CBT
, C. SSRIs only
D. Antipsychotics
Rationale: Trauma-focused CBT reduces symptoms and risk of chronic PTSD; SSRIs can be
adjunctive.
89. Which neurotransmitter is primarily implicated in depression?
A. Dopamine excess
B. Serotonin and norepinephrine deficiency
C. GABA excess
D. Acetylcholine deficiency
Rationale: Reduced serotonergic and noradrenergic activity contributes to depressive symptoms.
90. Which antipsychotic carries the highest risk of agranulocytosis?
A. Risperidone
B. Clozapine
C. Olanzapine
D. Quetiapine
Rationale: Clozapine requires frequent CBC monitoring due to life-threatening leukopenia risk.
91. First-line treatment for adult ADHD:
A. Atomoxetine
B. Stimulants (methylphenidate or amphetamines)
C. Bupropion
D. SSRIs
Rationale: Stimulants are first-line; atomoxetine is second-line or adjunctive.
92. Which therapy teaches skills for emotional regulation and interpersonal effectiveness?
A. CBT
B. DBT
C. IPT
D. Psychoanalysis
Rationale: DBT includes mindfulness, distress tolerance, and interpersonal effectiveness skills.
93. Which lab is critical to monitor with valproate therapy?
A. Electrolytes only
B. CBC and LFTs
C. Thyroid function
D. Renal function
Rationale: Valproate can cause hepatotoxicity and thrombocytopenia; LFTs and CBC are
essential.
94. First-line pharmacologic treatment for OCD:
A. Benzodiazepines
B. Antipsychotics
C. SSRIs (high-dose)
D. Mood stabilizers
VERSION 2: COMPLETE 100-QUESTION STUDY
GUIDE WITH VERIFIED ANSWERS AND
RATIONALES
Overview:
This comprehensive study guide is designed for psychiatric-mental health nurse practitioner
(PMHNP) certification exam preparation. It includes 100 high-yield, evidence-based questions
covering core PMHNP concepts, including:
Psychopharmacology – Antidepressants, antipsychotics, mood stabilizers, anxiolytics,
ADHD medications, and special considerations for pregnancy, elderly, and comorbid
conditions.
Psychotherapy – CBT, DBT, IPT, trauma-focused therapy, and other evidence-based
modalities.
Psychiatric Disorders – Depression, anxiety disorders, PTSD, OCD, schizophrenia,
bipolar disorders, personality disorders, ADHD, and substance use disorders.
Assessment and Diagnosis – DSM-5 criteria, symptom recognition, lab and safety
monitoring, and differential diagnosis.
Clinical Decision-Making – First-line treatments, risk management, and medication
monitoring.
Each question includes:
The correct answer in bold
Rationale explaining why it is correct
This guide is intended to maximize exam readiness, reinforce critical concepts, and provide a
structured, test-like experience to help PMHNP candidates confidently prepare for the
certification exam.
81. First-line treatment for acute agitation in psychosis:
A. Fluoxetine
B. Haloperidol or lorazepam
C. Lithium
D. Valproate
Rationale: Rapid sedation is achieved with antipsychotics (haloperidol) or benzodiazepines
(lorazepam).
,82. Which therapy is evidence-based for chronic insomnia?
A. Psychoanalysis
B. Hypnosis
C. DBT
D. CBT-I
Rationale: CBT-I targets maladaptive sleep behaviors and cognitive distortions.
83. First-line pharmacologic treatment for bipolar II depression:
A. SSRI monotherapy
B. Lithium or lamotrigine
C. Antipsychotic monotherapy
D. Benzodiazepines
Rationale: Mood stabilizers prevent hypomanic switches; SSRIs alone risk triggering mania.
84. Which antidepressant is safest for cardiac patients?
A. TCAs
B. SSRIs
C. MAOIs
D. SNRIs
Rationale: SSRIs have a safer cardiac profile; TCAs can cause arrhythmias.
85. First-line treatment for generalized anxiety disorder in adults:
A. Benzodiazepines only
B. Antipsychotics
C. SSRIs/SNRIs
D. Mood stabilizers
Rationale: SSRIs/SNRIs are preferred for long-term efficacy and safety.
86. Which therapy is best for grief and role transitions in depression?
A. CBT
B. DBT
C. IPT
D. Psychoanalysis
Rationale: IPT targets interpersonal issues contributing to depressive symptoms.
87. Which personality disorder is marked by attention-seeking and dramatic behavior?
A. Borderline
B. Narcissistic
C. Histrionic
D. Antisocial
Rationale: Histrionic personality disorder involves exaggerated emotionality and attention-
seeking.
88. First-line therapy for PTSD:
A. Benzodiazepines
B. Trauma-focused CBT
, C. SSRIs only
D. Antipsychotics
Rationale: Trauma-focused CBT reduces symptoms and risk of chronic PTSD; SSRIs can be
adjunctive.
89. Which neurotransmitter is primarily implicated in depression?
A. Dopamine excess
B. Serotonin and norepinephrine deficiency
C. GABA excess
D. Acetylcholine deficiency
Rationale: Reduced serotonergic and noradrenergic activity contributes to depressive symptoms.
90. Which antipsychotic carries the highest risk of agranulocytosis?
A. Risperidone
B. Clozapine
C. Olanzapine
D. Quetiapine
Rationale: Clozapine requires frequent CBC monitoring due to life-threatening leukopenia risk.
91. First-line treatment for adult ADHD:
A. Atomoxetine
B. Stimulants (methylphenidate or amphetamines)
C. Bupropion
D. SSRIs
Rationale: Stimulants are first-line; atomoxetine is second-line or adjunctive.
92. Which therapy teaches skills for emotional regulation and interpersonal effectiveness?
A. CBT
B. DBT
C. IPT
D. Psychoanalysis
Rationale: DBT includes mindfulness, distress tolerance, and interpersonal effectiveness skills.
93. Which lab is critical to monitor with valproate therapy?
A. Electrolytes only
B. CBC and LFTs
C. Thyroid function
D. Renal function
Rationale: Valproate can cause hepatotoxicity and thrombocytopenia; LFTs and CBC are
essential.
94. First-line pharmacologic treatment for OCD:
A. Benzodiazepines
B. Antipsychotics
C. SSRIs (high-dose)
D. Mood stabilizers
