WGU D345 PMHNP ANCC
OBJECTIVE ASSESSMENT Comprehensive
Resource To Help You Ace 2026-2027 Includes
Frequently Tested Questions With ELABORATED
100% Correct COMPLETE SOLUTIONS
Guaranteed Pass First Attempt!!
Current Update!!
1. The PMHNP is planning to work with a client using an individual therapy model of care.
During the first session, the client makes the following statement: "This is the third time
my son has run away. I've grounded him, taken away his bike, even tried cutting off his
allowance and confining him to his room. What should I do now?" The most therapeutic
response for the PMHNP to make is
a. "I wonder if confining him to his room was abusive?"
b. "Maybe that depends on what you are trying to accomplish."
c. "Perhaps talking to his friends and teachers would help."
d. Remain silent - Correct Answer: B. This response will be the most therapeutic in moving
forward with the client.
2. A client says to the PMHNP, "Some days life is just not worth it. All my wife and I ever do is
fight and scream. Things at home would be calmer and simpler if I just wasn't there anymore."
The most therapeutic response for the PMHNP to make is
a. "Do you mean that you are thinking about leaving your wife and moving out?"
b. "Tell me what you mean by 'it would be simpler if you just weren't there anymore.'"
c. "So you are thinking suicide might be an option for you?"
d. Remain silent - Correct Answer: B. This response is the most therapeutic, allowing the
client to further clarify and express feelings.
,3. Mrs. Shea has come to the mental health center seeking treatment for depression. She has a
history of a suicide attempt by overdose 1 month ago. She was started on imipramine (tricyclic
antidepressant [TCA]) after that event but stopped taking the medication 1 week later because
it "did no good." The PMHNP meets with Mrs. Shea to plan care with her. Which of the
following is the most appropriate initial action?
a. Asking Mrs. Shea how to help her
b. Providing client teaching about the long time frame for TCAs to work
c. Contracting with Mrs. Shea for 6 sessions of individual therapy
d. Providing Mrs. Shea with feedback about how suicide might affect her family - Correct
Answer: A. Asking the client how to help is an aspect of assessment—all other answers are
aspects of interventions, which are not initial actions of the PMHNP.
4. In completing the PMHNP assessment for the Mrs. Shea, the most appropriate lab test for
the PMHNP to order at this time is
a. CBC
b. TSH
c. Liver function tests
d. Electrolyte panel - Correct Answer: C. Client overdosed and then was placed on a
medication that affects the liver. The PMHNP needs to assess the client's liver function as an
aspect of care planning for her.
5. A client comes into the clinic with a longstanding history of depression and chronic renal
failure. He is on an antidepressant and a diuretic and complains of increased depression, mild
confusion, irritability, and overall apathy from being too tired to do anything. The best initial
PMHNP action to take at this time is
a. Increase his dose of antidepressant medication to better capture symptoms
b. Change him to another antidepressant for better symptom control
c. Augment his antidepressant with an atypical antipsychotic medication
,d. Order a comprehensive metabolic panel - Correct Answer: D. Client symptoms are
consistent with electrolyte imbalance and a physical cause of his symptoms must be ruled out
first.
6. Sarah presents for her initial intake appointment with complaints of depression. She is being
treated for hypertension and asthma by her primary care provider. Knowing that certain
medications can cause or exacerbate depression, you obtain a complete medication history.
Which of the following medications is known to exacerbate or cause depression?
a. Omeprazole
b. Propranolol
c. Levothyroxine
d. Clarithromycin - Correct Answer: B. Beta blockers can cause or exacerbate depression.
7. When treating older adults, you should keep in mind that they are more sensitive to issues of
drug toxicity because of which of the following reasons?
a. Decreased body fat
b. Increased liver capacity
c. Decreased protein binding
d. Increased muscle concentration - Correct Answer: C. Older adults usually have decreased
protein levels. Most psychotropic medications are highly protein-bound. It is the unbound (free)
concentration of the drug that is active; the bound concentration of the drug is inert. Thus, with
decreased protein available for binding, more free (active) drug remains in the body, which then
predisposes older adults to toxicity.
8. Which known teratogenic effects can be caused by the common psychotropic medications
divalproex and lithium?
a. Divalproex—Epstein anomaly; lithium—cleft palate
b. Divalproex—spina bifida; lithium—Epstein anomaly
c. Divalproex—limb malformations; lithium—seizure disorder
, d. Divalproex—mental retardation; lithium—spina bifida - Correct Answer: B. Divalproex can
cause spina bifida and lithium can cause Epstein's anomaly.
9. The study of what the body does to drugs is called
a. Pharmacodynamics
b. Pharmacology
c. Pharmacokinetics
d. Distribution - Correct Answer: C. Pharmacokinetics is the study of what the body does to
drugs.
10. Your client Sam is being treated for panic disorder with agoraphobia. He currently is being
prescribed paroxetine (Paxil CR, 37.5 mg q.d.) and clonazepam (Klonopin, 0.5 mg q.d., p.r.n.). He
has been on clonazepam for 2 years and admits to needing 4 pills to achieve the same effect
that 1 pill initially produced. This is possibly an example of which process?
a. Kindling
b. Addiction
c. Tolerance
d. Potency - Correct Answer: C. Tolerance means needing more to achieve the same effect.
11. Why is group therapy beneficial?
a. It assists the client to focus on self
b. It lacks theoretical frameworks
c. It enables participants to acquire therapeutic factors
d. It is always time limited - Correct Answer: D. Group therapy is beneficial because it
increases social skills, is cost-effective, and enables participants to acquire the curative factors.
12. Which of the following is the best rationale for using cognitive behavioral therapy?
a. Recognize and change his or her automatic thoughts
OBJECTIVE ASSESSMENT Comprehensive
Resource To Help You Ace 2026-2027 Includes
Frequently Tested Questions With ELABORATED
100% Correct COMPLETE SOLUTIONS
Guaranteed Pass First Attempt!!
Current Update!!
1. The PMHNP is planning to work with a client using an individual therapy model of care.
During the first session, the client makes the following statement: "This is the third time
my son has run away. I've grounded him, taken away his bike, even tried cutting off his
allowance and confining him to his room. What should I do now?" The most therapeutic
response for the PMHNP to make is
a. "I wonder if confining him to his room was abusive?"
b. "Maybe that depends on what you are trying to accomplish."
c. "Perhaps talking to his friends and teachers would help."
d. Remain silent - Correct Answer: B. This response will be the most therapeutic in moving
forward with the client.
2. A client says to the PMHNP, "Some days life is just not worth it. All my wife and I ever do is
fight and scream. Things at home would be calmer and simpler if I just wasn't there anymore."
The most therapeutic response for the PMHNP to make is
a. "Do you mean that you are thinking about leaving your wife and moving out?"
b. "Tell me what you mean by 'it would be simpler if you just weren't there anymore.'"
c. "So you are thinking suicide might be an option for you?"
d. Remain silent - Correct Answer: B. This response is the most therapeutic, allowing the
client to further clarify and express feelings.
,3. Mrs. Shea has come to the mental health center seeking treatment for depression. She has a
history of a suicide attempt by overdose 1 month ago. She was started on imipramine (tricyclic
antidepressant [TCA]) after that event but stopped taking the medication 1 week later because
it "did no good." The PMHNP meets with Mrs. Shea to plan care with her. Which of the
following is the most appropriate initial action?
a. Asking Mrs. Shea how to help her
b. Providing client teaching about the long time frame for TCAs to work
c. Contracting with Mrs. Shea for 6 sessions of individual therapy
d. Providing Mrs. Shea with feedback about how suicide might affect her family - Correct
Answer: A. Asking the client how to help is an aspect of assessment—all other answers are
aspects of interventions, which are not initial actions of the PMHNP.
4. In completing the PMHNP assessment for the Mrs. Shea, the most appropriate lab test for
the PMHNP to order at this time is
a. CBC
b. TSH
c. Liver function tests
d. Electrolyte panel - Correct Answer: C. Client overdosed and then was placed on a
medication that affects the liver. The PMHNP needs to assess the client's liver function as an
aspect of care planning for her.
5. A client comes into the clinic with a longstanding history of depression and chronic renal
failure. He is on an antidepressant and a diuretic and complains of increased depression, mild
confusion, irritability, and overall apathy from being too tired to do anything. The best initial
PMHNP action to take at this time is
a. Increase his dose of antidepressant medication to better capture symptoms
b. Change him to another antidepressant for better symptom control
c. Augment his antidepressant with an atypical antipsychotic medication
,d. Order a comprehensive metabolic panel - Correct Answer: D. Client symptoms are
consistent with electrolyte imbalance and a physical cause of his symptoms must be ruled out
first.
6. Sarah presents for her initial intake appointment with complaints of depression. She is being
treated for hypertension and asthma by her primary care provider. Knowing that certain
medications can cause or exacerbate depression, you obtain a complete medication history.
Which of the following medications is known to exacerbate or cause depression?
a. Omeprazole
b. Propranolol
c. Levothyroxine
d. Clarithromycin - Correct Answer: B. Beta blockers can cause or exacerbate depression.
7. When treating older adults, you should keep in mind that they are more sensitive to issues of
drug toxicity because of which of the following reasons?
a. Decreased body fat
b. Increased liver capacity
c. Decreased protein binding
d. Increased muscle concentration - Correct Answer: C. Older adults usually have decreased
protein levels. Most psychotropic medications are highly protein-bound. It is the unbound (free)
concentration of the drug that is active; the bound concentration of the drug is inert. Thus, with
decreased protein available for binding, more free (active) drug remains in the body, which then
predisposes older adults to toxicity.
8. Which known teratogenic effects can be caused by the common psychotropic medications
divalproex and lithium?
a. Divalproex—Epstein anomaly; lithium—cleft palate
b. Divalproex—spina bifida; lithium—Epstein anomaly
c. Divalproex—limb malformations; lithium—seizure disorder
, d. Divalproex—mental retardation; lithium—spina bifida - Correct Answer: B. Divalproex can
cause spina bifida and lithium can cause Epstein's anomaly.
9. The study of what the body does to drugs is called
a. Pharmacodynamics
b. Pharmacology
c. Pharmacokinetics
d. Distribution - Correct Answer: C. Pharmacokinetics is the study of what the body does to
drugs.
10. Your client Sam is being treated for panic disorder with agoraphobia. He currently is being
prescribed paroxetine (Paxil CR, 37.5 mg q.d.) and clonazepam (Klonopin, 0.5 mg q.d., p.r.n.). He
has been on clonazepam for 2 years and admits to needing 4 pills to achieve the same effect
that 1 pill initially produced. This is possibly an example of which process?
a. Kindling
b. Addiction
c. Tolerance
d. Potency - Correct Answer: C. Tolerance means needing more to achieve the same effect.
11. Why is group therapy beneficial?
a. It assists the client to focus on self
b. It lacks theoretical frameworks
c. It enables participants to acquire therapeutic factors
d. It is always time limited - Correct Answer: D. Group therapy is beneficial because it
increases social skills, is cost-effective, and enables participants to acquire the curative factors.
12. Which of the following is the best rationale for using cognitive behavioral therapy?
a. Recognize and change his or her automatic thoughts
