APEA PMHNP Exam | Latest Update 2026/2027 | 200 Practice
Questions & Verified Answers | PsychiatricMental Health NP
Certification | A+ Graded
1. A charge nurse is discussing mental status exams with a newly licensed nurse. Which statement by the
newly licensed nurse indicates an understanding of the teaching? (Select all that apply)
A) "To assess cognitive ability, I should ask the client to count backward by sevens."
B) "To assess affect, I should observe the client's facial expression."
C) "To assess language ability, I should instruct the client to write a sentence."
D) "To assess remote memory, I should have the client repeat a list of objects."
E) "To assess the client's abstract thinking, I should ask the client to identify our most recent presidents."
Answer: A, B, C
Explanation: Cognitive ability is assessed via serial 7s or spelling "world" backward. Affect is observed via
facial expression. Language is assessed by writing, reading, and comprehension tasks. Remote memory
involves longterm recall (e.g., childhood events), while repeating objects tests immediate memory.
Abstract thinking is tested by interpreting proverbs or similarities, not by identifying presidents (which
tests fund of knowledge).
2. A nurse is told during changeofshift report that a client is stuporous. When assessing the client, which
finding should the nurse expect?
A) The client arouses briefly in response to a sternal rub.
B) The client has a Glasgow Coma Scale score less than 7.
C) The client exhibits decorticate rigidity.
D) The client is alert but disoriented to time and place.
Answer: A
,Explanation: Stupor is a state of unresponsiveness from which the patient can be aroused only by
vigorous and repeated stimuli (e.g., sternal rub). Once the stimulus stops, the patient returns to an
unresponsive state. A GCS <7 indicates coma.
3. A nurse is planning care for a client who has a mental health disorder. Which action should the nurse
include as a psychobiological intervention?
A) Assist the client with systematic desensitization therapy.
B) Teach the client appropriate coping mechanisms.
C) Assess the client for comorbid health conditions.
D) Monitor the client for adverse effects of medications.
Answer: D
Explanation: Psychobiological interventions address the biological and physiological aspects of mental
health disorders, including medication management and monitoring for adverse effects. Systematic
desensitization is a behavioral therapy, coping mechanisms are psychological interventions, and
assessing comorbidities is part of comprehensive assessment.
4. A 34yearold woman presents with a 2month history of depressed mood, fatigue, poor concentration,
insomnia, and unintentional weight loss of 10 pounds. She denies suicidal ideation. She reports difficulty
functioning at work due to low energy. What is the most appropriate initial pharmacologic treatment?
A) Bupropion
B) Fluoxetine
C) Mirtazapine
D) Lithium
Answer: C
Explanation: Mirtazapine is ideal in patients with depression accompanied by insomnia and weight loss
because it promotes sleep and appetite due to its potent antihistaminergic properties.
,5. A patient is brought to the emergency department after taking multiple serotonergic medications.
Which findings are consistent with serotonin syndrome? (Select all that apply)
A) Hyperreflexia
B) Clonus
C) Diaphoresis
D) Bradykinesia
E) Agitation
F) Hypothermia
Answer: A, B, C, E
Explanation: Serotonin syndrome presents with neuromuscular hyperactivity (clonus, hyperreflexia,
tremor), autonomic instability (diaphoresis, hyperthermia, tachycardia), and altered mental status
(agitation, confusion). Bradykinesia and hypothermia are not characteristic; hyperthermia is more
common.
6. A 58yearold patient with bipolar disorder presents with nausea, vomiting, tremors, and confusion. He
has been taking lithium for 5 years. His family reports recent dehydration due to a gastrointestinal
illness. What is the priority action?
A) Administer the next dose of lithium.
B) Start an antipsychotic.
C) Hold lithium and check serum levels.
D) Administer IV fluids and continue lithium.
Answer: C
Explanation: The patient is showing signs of lithium toxicity (nausea, vomiting, tremors, confusion),
which can be precipitated by dehydration. The priority is to hold the lithium and check serum levels.
Continuing lithium or administering IV fluids without holding the medication could worsen toxicity.
, 7. A patient is experiencing opioid withdrawal. Which symptoms would you expect? (Select all that
apply)
A) Yawning
B) Lacrimation
C) Constipation
D) Diarrhea
E) Piloerection (goosebumps)
F) Respiratory depression
Answer: A, B, D, E
Explanation: Opioid withdrawal causes flulike symptoms including yawning, lacrimation (tearing),
rhinorrhea, diarrhea, piloerection (goosebumps), mydriasis, and muscle aches. Constipation and
respiratory depression are effects of opioid intoxication, not withdrawal.
8. A 45yearold male with a history of alcohol use disorder presents with confusion, ataxia, and
ophthalmoplegia. Which vitamin deficiency is most likely responsible?
A) Vitamin B12
B) Thiamine (Vitamin B1)
C) Folate
D) Vitamin D
Answer: B
Explanation: The classic triad of confusion, ataxia, and ophthalmoplegia is Wernicke's encephalopathy,
caused by thiamine (vitamin B1) deficiency, commonly seen in chronic alcohol use disorder. Immediate
thiamine replacement is essential.
Questions & Verified Answers | PsychiatricMental Health NP
Certification | A+ Graded
1. A charge nurse is discussing mental status exams with a newly licensed nurse. Which statement by the
newly licensed nurse indicates an understanding of the teaching? (Select all that apply)
A) "To assess cognitive ability, I should ask the client to count backward by sevens."
B) "To assess affect, I should observe the client's facial expression."
C) "To assess language ability, I should instruct the client to write a sentence."
D) "To assess remote memory, I should have the client repeat a list of objects."
E) "To assess the client's abstract thinking, I should ask the client to identify our most recent presidents."
Answer: A, B, C
Explanation: Cognitive ability is assessed via serial 7s or spelling "world" backward. Affect is observed via
facial expression. Language is assessed by writing, reading, and comprehension tasks. Remote memory
involves longterm recall (e.g., childhood events), while repeating objects tests immediate memory.
Abstract thinking is tested by interpreting proverbs or similarities, not by identifying presidents (which
tests fund of knowledge).
2. A nurse is told during changeofshift report that a client is stuporous. When assessing the client, which
finding should the nurse expect?
A) The client arouses briefly in response to a sternal rub.
B) The client has a Glasgow Coma Scale score less than 7.
C) The client exhibits decorticate rigidity.
D) The client is alert but disoriented to time and place.
Answer: A
,Explanation: Stupor is a state of unresponsiveness from which the patient can be aroused only by
vigorous and repeated stimuli (e.g., sternal rub). Once the stimulus stops, the patient returns to an
unresponsive state. A GCS <7 indicates coma.
3. A nurse is planning care for a client who has a mental health disorder. Which action should the nurse
include as a psychobiological intervention?
A) Assist the client with systematic desensitization therapy.
B) Teach the client appropriate coping mechanisms.
C) Assess the client for comorbid health conditions.
D) Monitor the client for adverse effects of medications.
Answer: D
Explanation: Psychobiological interventions address the biological and physiological aspects of mental
health disorders, including medication management and monitoring for adverse effects. Systematic
desensitization is a behavioral therapy, coping mechanisms are psychological interventions, and
assessing comorbidities is part of comprehensive assessment.
4. A 34yearold woman presents with a 2month history of depressed mood, fatigue, poor concentration,
insomnia, and unintentional weight loss of 10 pounds. She denies suicidal ideation. She reports difficulty
functioning at work due to low energy. What is the most appropriate initial pharmacologic treatment?
A) Bupropion
B) Fluoxetine
C) Mirtazapine
D) Lithium
Answer: C
Explanation: Mirtazapine is ideal in patients with depression accompanied by insomnia and weight loss
because it promotes sleep and appetite due to its potent antihistaminergic properties.
,5. A patient is brought to the emergency department after taking multiple serotonergic medications.
Which findings are consistent with serotonin syndrome? (Select all that apply)
A) Hyperreflexia
B) Clonus
C) Diaphoresis
D) Bradykinesia
E) Agitation
F) Hypothermia
Answer: A, B, C, E
Explanation: Serotonin syndrome presents with neuromuscular hyperactivity (clonus, hyperreflexia,
tremor), autonomic instability (diaphoresis, hyperthermia, tachycardia), and altered mental status
(agitation, confusion). Bradykinesia and hypothermia are not characteristic; hyperthermia is more
common.
6. A 58yearold patient with bipolar disorder presents with nausea, vomiting, tremors, and confusion. He
has been taking lithium for 5 years. His family reports recent dehydration due to a gastrointestinal
illness. What is the priority action?
A) Administer the next dose of lithium.
B) Start an antipsychotic.
C) Hold lithium and check serum levels.
D) Administer IV fluids and continue lithium.
Answer: C
Explanation: The patient is showing signs of lithium toxicity (nausea, vomiting, tremors, confusion),
which can be precipitated by dehydration. The priority is to hold the lithium and check serum levels.
Continuing lithium or administering IV fluids without holding the medication could worsen toxicity.
, 7. A patient is experiencing opioid withdrawal. Which symptoms would you expect? (Select all that
apply)
A) Yawning
B) Lacrimation
C) Constipation
D) Diarrhea
E) Piloerection (goosebumps)
F) Respiratory depression
Answer: A, B, D, E
Explanation: Opioid withdrawal causes flulike symptoms including yawning, lacrimation (tearing),
rhinorrhea, diarrhea, piloerection (goosebumps), mydriasis, and muscle aches. Constipation and
respiratory depression are effects of opioid intoxication, not withdrawal.
8. A 45yearold male with a history of alcohol use disorder presents with confusion, ataxia, and
ophthalmoplegia. Which vitamin deficiency is most likely responsible?
A) Vitamin B12
B) Thiamine (Vitamin B1)
C) Folate
D) Vitamin D
Answer: B
Explanation: The classic triad of confusion, ataxia, and ophthalmoplegia is Wernicke's encephalopathy,
caused by thiamine (vitamin B1) deficiency, commonly seen in chronic alcohol use disorder. Immediate
thiamine replacement is essential.
