PMHNP BOARD EXAM QUESTIONS AND ANSWERS
GRADED A+!!
Which of the following patients is at a higher risk of suicide?
a. A 30-year-old married African-American female with a previous suicide
attempt.
b. A 35-year-old single Asian male with a previous suicide attempt.
c. A 38-year-old single African male who is a manager of a bank.
d. A 68-year-old single Caucasian male with depression answer >>>>>>D. A 68-
year-old single Caucasian male with depression
A 72-year-old female is brought in by her husband with increasing forgetfulness,
insomnia, decreased activity, and decreased appetite for 2 months. She has a
history of hypertension and is being treated with Lisinopril. The exam is normal,
and the mini-mental status exam provides a score of 24 but she declines to
answer some questions and needs to be urged to participate in the assessment.
What is the most likely diagnosis?
a. Alzheimer's disease (2 months is too short)
b. Vascular dementia
c. Depression
d. Delirium answer >>>>>>C. Depression
,PMHNP
A new female patient has recently been diagnosed with bipolar disorder. The
PMHNP and the patient agreed to start Lithium. The PMHNP reviews the benefits
and risks of taking lithium with the patient, and the PMHNP sends the order to
the pharmacy. Which of the following patient rights was violated in this case?
a. Beneficence
b. Informed consent
c. Non-maleficence
d. Confidentiality answer >>>>>>D. Confidentiality
1. In treating a 47-year-old male patient with a history of asthma who presents
with sudden onset symptoms of tachycardia, elevated blood pressure, sweating,
shaking, agitation, and anxiety, the PMHNP prescribes:
a. 0.5 mg of Xanax IV
b. 2 mg of lorazepam IM
c. 10 mg of propranolol IM
d. 50 mg of hydroxyzine IM answer >>>>>>D. 50mg of Hydroxyzine IM
1. A 46-year-old hex bipolar comes for a regular follow-up appointment w/
PMHNP and presents w/complains of severe vomiting, diarrhea, muscle
weakness, blurred vision, and ataxia. The patient is currently taking 900 mg of
lithium daily. The psychiatric nurse practitioner identifies these symptoms as signs
of lithium toxicity. What is the priority action of the PMHNP?
a. Maintains education regimen and monitors the symptoms
b. Tells the pt. to stop taking the lithium and orders a serum lithium level
,PMHNP
c. Orders an electrocardiogram
d. Take the patient's vital signs answer >>>>>>b. Tells the pt. to stop taking the
lithium and orders a serum lithium level
For 12 years, a 65-year-old pt. with bipolar affective disorder has been treated
with lithium Escalate 900 mg daily. When oral hydrochlorothiazide (HCTZ) 12.5 mg
daily is added for hypertension, the patient develops nausea, vomiting ataxia, and
muscle weakness. The patient's serum lithium level is 2.0 me/L. The interaction of
the lithium and the thiazide diuretic has induced:
a. Hypokalemia
b. Hyponatremia
c. Increased renal clearance of lithium
d. Reduced renal clearance of lithium answer >>>>>>D. Reduced Renal Clearance
of Lithium
Mary a 45 yr. old African American female has been treated on isocarboxazid
(Mar plan) for over 6 years. Mary is going in for a surgical procedure. Which
medication is strictly contraindicated w/isocarboxazid?
a. Morphine
b. NSAIDs
c. Methylphenidate
d. Acetaminophen answer >>>>>>c. Methylphenidate - (this causes a risk of HTN
Crisis)
, PMHNP
1. The PMHNP is aware of the following signs to watch out for pts taking clozapine
(Clairol)?
a. Nosebleeds, bleeding gums, and skin rash
b. Mutism, muscle rigidity, and hyperthermia
c. Fever, sore throats, and chills
d. Ataxia, confusion, hypothyroidism answer >>>>>>c. Fever, sore throats, and
chills -- due to leukocytopenia
A new Rx of carbamazepine (Tigerton) is given to a pt. whose baseline WBC is
5000 and absolute neutrophil count (ANC) is 4000. Laboratory tests show that the
pts WBC count has decreased to 2500 and ANC has decreased to 750 after 2
weeks of therapy. Similar outcomes are obtained when the laboratory studies are
repeated. The pt. does not present w/ s/s of infection. What is the next action?
a. Continues the pt. on Tigerton and monitors pt. for s/s infection
b. Tell the pt. to stop taking Tigerton and recheck the ANC and WBC
c. Continues the pt. on Tigerton since the WBC is within normal limits
d. Refer the pt. to a primary care provider. (if there is something you can do
before referring to another provider then you should do it) answer >>>>>>B. Tells
the pt. to stop taking Tigerton and recheck the ANC and WBC
If given during pregnancy, sodium valproate (Depakote) can cause which if the
following medical problems in the baby?
a. Steven Johnson syndrome
b. Epstein’s anomaly
c. Spine bifida
d. Cleft palate answer >>>>>>C. Spine Bifida