Psychiatric-Mental Health Nurse
Practitioner (PMHNP) Certification Exam
Practice Test Questions And Correct
Answers (Verified Answers) Plus Rationales
2026 Q&A | Instant Download Pdf
1. A 28-year-old patient presents with recurrent panic attacks and persistent
worry about future episodes. What is the first-line pharmacological
treatment?
A. Buspirone
B. Selective serotonin reuptake inhibitor (SSRI)
C. Benzodiazepine
D. Beta-blocker
Rationale: SSRIs are first-line agents for panic disorder due to their efficacy
and safety profile compared to benzodiazepines, which are reserved for
short-term relief.
,2. Which of the following neurotransmitters is primarily associated with
schizophrenia?
A. Norepinephrine
B. Serotonin
C. Dopamine
D. Acetylcholine
Rationale: Excessive dopamine activity, especially in the mesolimbic
pathway, is linked to positive symptoms of schizophrenia.
3. Which symptom best characterizes major depressive disorder (MDD)?
A. Elevated mood
B. Anhedonia
C. Euphoria
D. Increased energy
Rationale: Anhedonia, or loss of interest or pleasure in activities, is a
hallmark of major depressive disorder.
4. When prescribing lithium, which lab test should be obtained regularly?
A. Liver function tests
B. Serum creatinine and thyroid function tests
C. CBC with differential
D. Vitamin D level
,Rationale: Lithium can affect renal and thyroid function, necessitating
periodic monitoring.
5. A patient on clozapine presents with fever and sore throat. What is the
next best step?
A. Continue medication and observe
B. Obtain WBC and absolute neutrophil count (ANC)
C. Stop medication immediately without labs
D. Prescribe antibiotics
Rationale: Clozapine may cause agranulocytosis; checking WBC/ANC is
essential to confirm.
6. A 10-year-old boy is hyperactive, impulsive, and inattentive. Which
medication is most appropriate?
A. Atomoxetine
B. Methylphenidate
C. Bupropion
D. Clonidine
Rationale: Methylphenidate, a stimulant, is first-line for ADHD and improves
attention and impulse control.
, 7. A client with bipolar I disorder presents in a manic episode. Which
medication should be initiated?
A. Fluoxetine
B. Valproic acid
C. Buspirone
D. Trazodone
Rationale: Valproic acid is effective for acute mania and mood stabilization.
8. Which of the following side effects is associated with second-generation
antipsychotics?
A. Bradycardia
B. Metabolic syndrome
C. Nephrotoxicity
D. Hyperthyroidism
Rationale: Atypical antipsychotics often cause weight gain, dyslipidemia,
and glucose intolerance.
9. A client reports auditory hallucinations. This is an example of which type
of symptom in schizophrenia?
A. Negative symptom
B. Cognitive symptom
C. Positive symptom
D. Affective symptom
Practitioner (PMHNP) Certification Exam
Practice Test Questions And Correct
Answers (Verified Answers) Plus Rationales
2026 Q&A | Instant Download Pdf
1. A 28-year-old patient presents with recurrent panic attacks and persistent
worry about future episodes. What is the first-line pharmacological
treatment?
A. Buspirone
B. Selective serotonin reuptake inhibitor (SSRI)
C. Benzodiazepine
D. Beta-blocker
Rationale: SSRIs are first-line agents for panic disorder due to their efficacy
and safety profile compared to benzodiazepines, which are reserved for
short-term relief.
,2. Which of the following neurotransmitters is primarily associated with
schizophrenia?
A. Norepinephrine
B. Serotonin
C. Dopamine
D. Acetylcholine
Rationale: Excessive dopamine activity, especially in the mesolimbic
pathway, is linked to positive symptoms of schizophrenia.
3. Which symptom best characterizes major depressive disorder (MDD)?
A. Elevated mood
B. Anhedonia
C. Euphoria
D. Increased energy
Rationale: Anhedonia, or loss of interest or pleasure in activities, is a
hallmark of major depressive disorder.
4. When prescribing lithium, which lab test should be obtained regularly?
A. Liver function tests
B. Serum creatinine and thyroid function tests
C. CBC with differential
D. Vitamin D level
,Rationale: Lithium can affect renal and thyroid function, necessitating
periodic monitoring.
5. A patient on clozapine presents with fever and sore throat. What is the
next best step?
A. Continue medication and observe
B. Obtain WBC and absolute neutrophil count (ANC)
C. Stop medication immediately without labs
D. Prescribe antibiotics
Rationale: Clozapine may cause agranulocytosis; checking WBC/ANC is
essential to confirm.
6. A 10-year-old boy is hyperactive, impulsive, and inattentive. Which
medication is most appropriate?
A. Atomoxetine
B. Methylphenidate
C. Bupropion
D. Clonidine
Rationale: Methylphenidate, a stimulant, is first-line for ADHD and improves
attention and impulse control.
, 7. A client with bipolar I disorder presents in a manic episode. Which
medication should be initiated?
A. Fluoxetine
B. Valproic acid
C. Buspirone
D. Trazodone
Rationale: Valproic acid is effective for acute mania and mood stabilization.
8. Which of the following side effects is associated with second-generation
antipsychotics?
A. Bradycardia
B. Metabolic syndrome
C. Nephrotoxicity
D. Hyperthyroidism
Rationale: Atypical antipsychotics often cause weight gain, dyslipidemia,
and glucose intolerance.
9. A client reports auditory hallucinations. This is an example of which type
of symptom in schizophrenia?
A. Negative symptom
B. Cognitive symptom
C. Positive symptom
D. Affective symptom
