PMHNP Certification Exam Review Guide 2025/2026
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PMHNP CERTIFICATION EXAM REVIEW GUIDE (2025/2026)
Complete Question Bank - 100 Questions with Answers
SECTION 1: NEUROSCIENCE & PSYCHOPHARMACOLOGY (20 Questions)
1. Which neurotransmitter is primarily implicated in the pathophysiology of schizophrenia's
positive symptoms?
A) Serotonin
B) GABA
C) Dopamine ✓
D) Norepinephrine
2. A patient on an SSRI develops agitation, hyperthermia, and myoclonus. What is the most
likely diagnosis?
A) Neuroleptic malignant syndrome
B) Serotonin syndrome ✓
C) Anticholinergic toxicity
D) Akathisia
3. Which medication requires regular monitoring of serum levels due to its narrow
therapeutic window?
A) Sertraline
B) Lithium ✓
C) Quetiapine
D) Bupropion
4. Which receptor antagonism is primarily responsible for antipsychotic-induced weight gain?
A) D2 dopamine receptor
B) H1 histamine receptor ✓
C) Alpha-1 adrenergic receptor
D) Muscarinic cholinergic receptor
5. What is the mechanism of action of lamotrigine in bipolar disorder?
A) Sodium channel modulation ✓
B) GABA enhancement
,C) Dopamine blockade
D) NMDA antagonism
6. Which medication combination poses the highest risk for serotonin syndrome?
A) Fluoxetine + trazodone
B) Sertraline + buspirone
C) Fluoxetine + MAOI ✓
D) Escitalopram + mirtazapine
7. The therapeutic effect of benzodiazepines is primarily mediated through which receptor
system?
A) NMDA glutamate receptors
B) GABA-A receptors ✓
C) Serotonin 5-HT2A receptors
D) Dopamine D2 receptors
8. Which antipsychotic has the highest risk of QT prolongation?
A) Haloperidol
B) Risperidone
C) Thioridazine ✓
D) Olanzapine
9. What is the primary mechanism of stimulant medications in ADHD?
A) Blockade of dopamine reuptake
B) Enhancement of norepinephrine and dopamine activity ✓
C) Serotonin receptor agonism
D) GABAergic enhancement
10. Which of the following is NOT a cytochrome P450 enzyme inhibitor?
A) Fluoxetine
B) Paroxetine
C) Sertraline ✓
D) Fluvoxamine
11. Clozapine requires monitoring for which potentially fatal side effect?
A) Agranulocytosis ✓
B) Hepatotoxicity
C) Pancreatitis
D) Nephrotoxicity
, 12. Which antidepressant has the most significant effect on REM sleep suppression?
A) Trazodone
B) Mirtazapine
C) Venlafaxine
D) Tricyclic antidepressants ✓
13. What is the recommended first-line pharmacotherapy for panic disorder?
A) Benzodiazepines
B) Atypical antipsychotics
C) SSRIs ✓
D) Beta-blockers
14. Which medication class has the highest risk of anticholinergic side effects?
A) SSRIs
B) SNRIs
C) Tricyclic antidepressants ✓
D) MAOIs
15. Tardive dyskinesia is primarily associated with blockade of which receptors?
A) D2 dopamine receptors ✓
B) 5-HT2A receptors
C) Alpha-1 adrenergic receptors
D) H1 histamine receptors
16. Which mood stabilizer is most associated with neural tube defects in pregnancy?
A) Lithium
B) Valproate ✓
C) Lamotrigine
D) Carbamazepine
17. The "kindling hypothesis" is most relevant to which disorder?
A) Schizophrenia
B) Bipolar disorder ✓
C) Major depressive disorder
D) OCD
18. Which test is mandatory before initiating treatment with carbamazepine?
A) HLA-B*1502 screening ✓
B) CYP2D6 genotyping
create the 100 questions and answers well structured and well used right tick to mark correct
answer PMHNP Certification Exam – Complete Review & Questions (Latest 2025/2026) –
Download to Score A+
,I'll create a well-structured PMHNP certification exam review with 100 questions and answers.
Since this is a comprehensive exam, I'll organize it by major content domains with proper
formatting for the correct answers.
PMHNP CERTIFICATION EXAM REVIEW GUIDE (2025/2026)
Complete Question Bank - 100 Questions with Answers
SECTION 1: NEUROSCIENCE & PSYCHOPHARMACOLOGY (20 Questions)
1. Which neurotransmitter is primarily implicated in the pathophysiology of schizophrenia's
positive symptoms?
A) Serotonin
B) GABA
C) Dopamine ✓
D) Norepinephrine
2. A patient on an SSRI develops agitation, hyperthermia, and myoclonus. What is the most
likely diagnosis?
A) Neuroleptic malignant syndrome
B) Serotonin syndrome ✓
C) Anticholinergic toxicity
D) Akathisia
3. Which medication requires regular monitoring of serum levels due to its narrow
therapeutic window?
A) Sertraline
B) Lithium ✓
C) Quetiapine
D) Bupropion
4. Which receptor antagonism is primarily responsible for antipsychotic-induced weight gain?
A) D2 dopamine receptor
B) H1 histamine receptor ✓
C) Alpha-1 adrenergic receptor
D) Muscarinic cholinergic receptor
5. What is the mechanism of action of lamotrigine in bipolar disorder?
A) Sodium channel modulation ✓
B) GABA enhancement
,C) Dopamine blockade
D) NMDA antagonism
6. Which medication combination poses the highest risk for serotonin syndrome?
A) Fluoxetine + trazodone
B) Sertraline + buspirone
C) Fluoxetine + MAOI ✓
D) Escitalopram + mirtazapine
7. The therapeutic effect of benzodiazepines is primarily mediated through which receptor
system?
A) NMDA glutamate receptors
B) GABA-A receptors ✓
C) Serotonin 5-HT2A receptors
D) Dopamine D2 receptors
8. Which antipsychotic has the highest risk of QT prolongation?
A) Haloperidol
B) Risperidone
C) Thioridazine ✓
D) Olanzapine
9. What is the primary mechanism of stimulant medications in ADHD?
A) Blockade of dopamine reuptake
B) Enhancement of norepinephrine and dopamine activity ✓
C) Serotonin receptor agonism
D) GABAergic enhancement
10. Which of the following is NOT a cytochrome P450 enzyme inhibitor?
A) Fluoxetine
B) Paroxetine
C) Sertraline ✓
D) Fluvoxamine
11. Clozapine requires monitoring for which potentially fatal side effect?
A) Agranulocytosis ✓
B) Hepatotoxicity
C) Pancreatitis
D) Nephrotoxicity
, 12. Which antidepressant has the most significant effect on REM sleep suppression?
A) Trazodone
B) Mirtazapine
C) Venlafaxine
D) Tricyclic antidepressants ✓
13. What is the recommended first-line pharmacotherapy for panic disorder?
A) Benzodiazepines
B) Atypical antipsychotics
C) SSRIs ✓
D) Beta-blockers
14. Which medication class has the highest risk of anticholinergic side effects?
A) SSRIs
B) SNRIs
C) Tricyclic antidepressants ✓
D) MAOIs
15. Tardive dyskinesia is primarily associated with blockade of which receptors?
A) D2 dopamine receptors ✓
B) 5-HT2A receptors
C) Alpha-1 adrenergic receptors
D) H1 histamine receptors
16. Which mood stabilizer is most associated with neural tube defects in pregnancy?
A) Lithium
B) Valproate ✓
C) Lamotrigine
D) Carbamazepine
17. The "kindling hypothesis" is most relevant to which disorder?
A) Schizophrenia
B) Bipolar disorder ✓
C) Major depressive disorder
D) OCD
18. Which test is mandatory before initiating treatment with carbamazepine?
A) HLA-B*1502 screening ✓
B) CYP2D6 genotyping
