PMHNP ANCC ACTUAL EXAM PAPER 2026
QUESTIONS WITH SOLUTIONS GRADED A+
◍ The trend in legal rulings on cases involving mental illness over the
past 25 years has been to
a. Encourage juries to find defendants not guilty by reason of insanity
b. Protect the person's freedoms or rights when he or she is committed
to a mental hospital
c. Place increasing trust in mental health professionals to make good
and ethical decisions
d. Decrease the "red tape" associated with commitments so that
commitments are faster and easier. Answer: B. Identifies the trend of
ensuring the protection of individual civil liberties for psychiatric
clients.
◍ Mr. Smithers, an involuntarily hospitalized patient experiencing
psychotic symptoms, refuses to take any of his ordered medication
because he believes "Jesus Christ told me I am the prophet and must
fast for a year." Your actions should be based on your knowledge of
which of the following?
a. Psychiatric clients cannot refuse treatment
b. Psychiatric clients do not always know what is good for them
c. Psychiatric clients can refuse treatment
d. Psychiatric clients cannot be trusted to make good healthcare
decisions and, therefore, the nurse's best clinical judgment should
guide actions. Answer: C. As with any client, psychiatric clients can
,refuse treatment unless a legal process resulting in involuntary
commitment or mandatory court order for treatment has been
obtained.
◍ Which of the following statements best reflects the difference
between the nurse-client (N-C) relationship and a social relationship?
a. In the N-C relationship, the primary focus is on the client and the
client's needs.
b. Goals in the N-C relationship are deliberately left vague and
unspoken so that the client can work on any issue.
c. In the N-C relationship, the nurse is solely responsible for making
the relationship work.
d. In the N-C relationship, there is no place for social interaction..
Answer: A. Social relationships are mutual interpersonal relationships
in which the needs of both parties are addressed. The N-C relationship
is most concerned with meeting the needs of the client.
◍ A community has an unusually high incidence of depression and
drug use among the teenage population. The public health nurses
decide to address this problem, in part, by modifying the environment
and strengthening the capacities of families to prevent the
development of new cases of depression and drug use. What is this is
an example of?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
,d. Protective factorial prevention. Answer: A. This action focuses on
interventions designed to reduce the incidence of new cases of
disease.
◍ Mrs. Kemp is voluntarily admitted to the hospital. After 24 hours,
she states she wishes to leave because "this place can't help me." The
best nursing action that reflects the legal right of this client is
a. Discharge the client
b. Explain that the client cannot leave until you can complete further
assessment
c. Allow the client to leave but have her sign forms stating she is
leaving against medical advice
d. Immediately start the paperwork to commit the client and to allow
you to treat her against her wishes. Answer: B. Almost every state
allows for a brief for a period detainment to assess a client for
dangerousness to self or others before allowing the client to leave a
hospital setting, even if the admission was voluntary.
◍ In forming a therapeutic relationship with clients, the PMHNP
must consider developing many characteristics that are known to be
helpful in relationship-building. Which of the following is an essential
part of building a therapeutic relationship?
a. Collecting a family history
b. Like-mindedness
c. Authenticity
d. Accuracy in assessment. Answer: C. Authenticity. Being genuine,
honest, and respectful are essential elements in establishing a working
relationship with any client. Like-mindedness is not a part of the
, therapeutic relationship. Although an important aspect of the PMHNP
role, collecting a family history and accuracy in assessment does not
in and of itself facilitate relationship building.
◍ According to the DSM-5, which of the following is true? (Ch. 3)
a. A mental disorder is equivalent to the need for treatment.
b. Diagnostic criteria are used to inform clinical judgment.
c. Socially deviant behavior is considered a mental disorder.
d. A culturally expected response to a stressor is not a mental
disorder.. Answer: D. All DSM-5 disorders need to be made taking a
person's culture into account. A cultural expression of a response to
grief, loss, or stress is not considered a DSM-5 diagnosis.
◍ Mrs. French has been in individual therapy for 3 months. She has
shown much growth and improvement in her functioning and insight
and is to discontinue services within the next few weeks. In the next
session, after you discuss service termination, she suddenly begins to
demonstrate the original symptoms that had brought her to treatment
initially. She is now hesitant to discharge, wants to continue services,
and is displaying an increase in regressive defense mechanisms. What
is the best explanation for Ms. French's behavior?
a. An exacerbation of her symptoms related to stress
b. The normal cyclic nature of chronic mental health symptoms
c. A sign of normal resistance to termination seen in the termination
phase of therapy
d. A sign of pathological attachment to the therapist that must be
addressed. Answer: C. Clients frequently display resistance and
regression at the termination of a meaningful therapeutic process. The
QUESTIONS WITH SOLUTIONS GRADED A+
◍ The trend in legal rulings on cases involving mental illness over the
past 25 years has been to
a. Encourage juries to find defendants not guilty by reason of insanity
b. Protect the person's freedoms or rights when he or she is committed
to a mental hospital
c. Place increasing trust in mental health professionals to make good
and ethical decisions
d. Decrease the "red tape" associated with commitments so that
commitments are faster and easier. Answer: B. Identifies the trend of
ensuring the protection of individual civil liberties for psychiatric
clients.
◍ Mr. Smithers, an involuntarily hospitalized patient experiencing
psychotic symptoms, refuses to take any of his ordered medication
because he believes "Jesus Christ told me I am the prophet and must
fast for a year." Your actions should be based on your knowledge of
which of the following?
a. Psychiatric clients cannot refuse treatment
b. Psychiatric clients do not always know what is good for them
c. Psychiatric clients can refuse treatment
d. Psychiatric clients cannot be trusted to make good healthcare
decisions and, therefore, the nurse's best clinical judgment should
guide actions. Answer: C. As with any client, psychiatric clients can
,refuse treatment unless a legal process resulting in involuntary
commitment or mandatory court order for treatment has been
obtained.
◍ Which of the following statements best reflects the difference
between the nurse-client (N-C) relationship and a social relationship?
a. In the N-C relationship, the primary focus is on the client and the
client's needs.
b. Goals in the N-C relationship are deliberately left vague and
unspoken so that the client can work on any issue.
c. In the N-C relationship, the nurse is solely responsible for making
the relationship work.
d. In the N-C relationship, there is no place for social interaction..
Answer: A. Social relationships are mutual interpersonal relationships
in which the needs of both parties are addressed. The N-C relationship
is most concerned with meeting the needs of the client.
◍ A community has an unusually high incidence of depression and
drug use among the teenage population. The public health nurses
decide to address this problem, in part, by modifying the environment
and strengthening the capacities of families to prevent the
development of new cases of depression and drug use. What is this is
an example of?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
,d. Protective factorial prevention. Answer: A. This action focuses on
interventions designed to reduce the incidence of new cases of
disease.
◍ Mrs. Kemp is voluntarily admitted to the hospital. After 24 hours,
she states she wishes to leave because "this place can't help me." The
best nursing action that reflects the legal right of this client is
a. Discharge the client
b. Explain that the client cannot leave until you can complete further
assessment
c. Allow the client to leave but have her sign forms stating she is
leaving against medical advice
d. Immediately start the paperwork to commit the client and to allow
you to treat her against her wishes. Answer: B. Almost every state
allows for a brief for a period detainment to assess a client for
dangerousness to self or others before allowing the client to leave a
hospital setting, even if the admission was voluntary.
◍ In forming a therapeutic relationship with clients, the PMHNP
must consider developing many characteristics that are known to be
helpful in relationship-building. Which of the following is an essential
part of building a therapeutic relationship?
a. Collecting a family history
b. Like-mindedness
c. Authenticity
d. Accuracy in assessment. Answer: C. Authenticity. Being genuine,
honest, and respectful are essential elements in establishing a working
relationship with any client. Like-mindedness is not a part of the
, therapeutic relationship. Although an important aspect of the PMHNP
role, collecting a family history and accuracy in assessment does not
in and of itself facilitate relationship building.
◍ According to the DSM-5, which of the following is true? (Ch. 3)
a. A mental disorder is equivalent to the need for treatment.
b. Diagnostic criteria are used to inform clinical judgment.
c. Socially deviant behavior is considered a mental disorder.
d. A culturally expected response to a stressor is not a mental
disorder.. Answer: D. All DSM-5 disorders need to be made taking a
person's culture into account. A cultural expression of a response to
grief, loss, or stress is not considered a DSM-5 diagnosis.
◍ Mrs. French has been in individual therapy for 3 months. She has
shown much growth and improvement in her functioning and insight
and is to discontinue services within the next few weeks. In the next
session, after you discuss service termination, she suddenly begins to
demonstrate the original symptoms that had brought her to treatment
initially. She is now hesitant to discharge, wants to continue services,
and is displaying an increase in regressive defense mechanisms. What
is the best explanation for Ms. French's behavior?
a. An exacerbation of her symptoms related to stress
b. The normal cyclic nature of chronic mental health symptoms
c. A sign of normal resistance to termination seen in the termination
phase of therapy
d. A sign of pathological attachment to the therapist that must be
addressed. Answer: C. Clients frequently display resistance and
regression at the termination of a meaningful therapeutic process. The
