• ANCC PMHNP Exam 09/11/2026
ANCC PMHNP Certification Exam 4 Questions
and Answers 2026/2027 | Complete Psychiatric
Mental Health NP Study Guide
.
A 40-year-old male client diagnosed with schizophrenia and alcohol dependence has not had any visitors or
phone calls since admission. He reports he has no family that cares about him and was living on the streets prior
to this admission. According to Erikson's theory of psychosocial development, which stage is the client in at this
time?
A) Isolation.
B) Stagnation.
C) Despair.
D) Role confusion. –
Correct Answer :The client is in Erikson's "Generativity vs. Stagnation" stage (age 24 to 45), and meeting the
task includes maintaining intimate relationships and moving toward developing a family (B). (A) occurs in young
adulthood (age 18 to 25), (C) occurs in maturity (age 45 to death), and (D) occurs in adolescence (age 12 to 20).
These are all stages that occur if individuals are not successfully coping with their psychosocial developmental
stage.
P 1
, • ANCC PMHNP Exam 09/11/2026
Correct Answer(s): B
The nurse plans to help an 18-year-old female mentally retarded client ambulate the first postoperative day after
an appendectomy. When the nurse tells the client it is time to get out of bed, the client becomes angry and tells
the nurse, "Get out of here! I'll get up when I'm ready!" Which response is best for the nurse to make?
A) Your healthcare provider has prescribed ambulation on the first postoperative day.
B) You must ambulate to avoid complications which could cause more discomfort than ambulating.
C) I know how you feel. You're angry about having to ambulate, but this will help you get well.
D) I'll be back in 30 minutes to help you get out of bed and walk around the room. –
Correct Answer :(D) provides a "cooling off" period, is firm, direct, non-threatening, and avoids arguing with
the client. (A) is avoiding responsibility by referring to the healthcare provider. (B) is trying to reason with a
mentally retarded client and is threatening the client with "complications." (C) is telling the client how she feels
(angry), and the nurse does not really "know" how this client feels, unless the nurse is mentally retarded and has
just had an appendectomy!
Correct Answer(s): D
A client is admitted with a diagnosis of depression. The nurse knows that which characteristic is most indicative
of depression?
A) Grandiose ideation.
B) Self-destructive thoughts.
C) Suspiciousness of others.
D) A negative view of self and the future. –
Correct Answer :Negative self-image and feelings of hopelessness about the future (D) are specific indicators
for depression. (A and/or C) occurs with paranoia or paranoid ideation. (B) may be seen in depressed clients, but
are not always present, so (D) is a better answer than (B).
Correct Answer(s): D
P 2
, • ANCC PMHNP Exam 09/11/2026
.A woman brings her 48-year-old husband to the outpatient psychiatric unit and describes his behavior to the
admitting nurse. She states that he has been sleepwalking, cannot remember who he is, and exhibits multiple
personalities. The nurse knows that these behaviors are often associated with
A) dissociative disorder.
B) obsessive-compulsive disorder.
C) panic disorder.
D) post-traumatic stress syndrome. –
Correct Answer :Sleepwalking, amnesia, and multiple personalities are examples of detaching emotional
conflict from one's consciousness, which is the definition of a dissociative disorder (A). (B) is characterized by
persistent, recurrent intrusive thoughts or urges (obsessions) that are unwilled and cannot be ignored, and
provoke impulsive acts (compulsions) such as handwashing. (C) is an acute attack of anxiety characterized by
personality disorganization. (D) is re-experiencing a psychologically terrifying or distressing event that is outside
the usual range of human experience, such as war, rape, etc.
Correct Answer(s): A
A 65-year-old female client complains to the nurse that recently she has been hearing voices. What question
should the nurse ask this client first?
A) Do you have problems with hallucinations?
B) Are you ever alone when you hear the voices?
C) Has anyone in your family had hearing problems?
D) Do you see things that others cannot see?
- Correct Answer :Determining if the client is alone when she hears voices (B) will assist in differentiating
between hallucinations and hearing loss; this is especially important in the aging population. If the client is
experiencing hallucinations, the voices will be real to her, and it is unlikely that (A) would provide accurate
information. (C and D) might be good follow-up questions, but would not have the priority of (B).
Correct Answer(s): B
56.
P 3
, • ANCC PMHNP Exam 09/11/2026
When preparing a teaching plan for a client who is to be discharged with a prescription for lithium carbonate
(Lithonate), it is most important for the nurse to include which instruction?
A) It may take 3 to 4 weeks to achieve therapeutic effects.
B) Keep your dietary salt intake consistent.
C) Avoid eating aged cheese and chicken liver.
D) Eat foods high in fiber such as whole grain breads. –
Correct Answer :Lithium's effectiveness is influenced by salt intake (B). Too much salt causes more lithium to
be excreted, thereby decreasing the effectiveness of the drug. Too little salt causes less lithium to be excreted,
potentially resulting in toxicity. (A, C, and D) are not specific instructions pertinent to teaching about lithium
carbonate (Lithonate).
Correct Answer(s): B
Over a period of several weeks, one male participant of a socialization group at a community day care center for
the elderly monopolizes most of the group's time and interrupts others when they are talking. What is the best
action for the nurse to take in this situation?
A) Talk to the client outside the group about his behavior during group meetings.
B) Remind the client to allow others in the group a chance to talk.
C) Allow the group to handle the problem.
D) Ask the client to join another group.
- Correct Answer :After several weeks, the group is in the working phase and the group members should be
allowed to determine the direction of the group. The nurse should ignore the client's comments and allow the
group to handle the situation (C). A good leader should not have separate meetings with group members (A), as
such behavior is manipulative on the part of the leader. (B) is dictatorial and is not in keeping with good
leadership skills. (D) is avoiding the problem. Remember, identify what phase the group is in--initial, working, or
termination--this will help determine communication style.
Correct Answer(s): C
58.
P 4
ANCC PMHNP Certification Exam 4 Questions
and Answers 2026/2027 | Complete Psychiatric
Mental Health NP Study Guide
.
A 40-year-old male client diagnosed with schizophrenia and alcohol dependence has not had any visitors or
phone calls since admission. He reports he has no family that cares about him and was living on the streets prior
to this admission. According to Erikson's theory of psychosocial development, which stage is the client in at this
time?
A) Isolation.
B) Stagnation.
C) Despair.
D) Role confusion. –
Correct Answer :The client is in Erikson's "Generativity vs. Stagnation" stage (age 24 to 45), and meeting the
task includes maintaining intimate relationships and moving toward developing a family (B). (A) occurs in young
adulthood (age 18 to 25), (C) occurs in maturity (age 45 to death), and (D) occurs in adolescence (age 12 to 20).
These are all stages that occur if individuals are not successfully coping with their psychosocial developmental
stage.
P 1
, • ANCC PMHNP Exam 09/11/2026
Correct Answer(s): B
The nurse plans to help an 18-year-old female mentally retarded client ambulate the first postoperative day after
an appendectomy. When the nurse tells the client it is time to get out of bed, the client becomes angry and tells
the nurse, "Get out of here! I'll get up when I'm ready!" Which response is best for the nurse to make?
A) Your healthcare provider has prescribed ambulation on the first postoperative day.
B) You must ambulate to avoid complications which could cause more discomfort than ambulating.
C) I know how you feel. You're angry about having to ambulate, but this will help you get well.
D) I'll be back in 30 minutes to help you get out of bed and walk around the room. –
Correct Answer :(D) provides a "cooling off" period, is firm, direct, non-threatening, and avoids arguing with
the client. (A) is avoiding responsibility by referring to the healthcare provider. (B) is trying to reason with a
mentally retarded client and is threatening the client with "complications." (C) is telling the client how she feels
(angry), and the nurse does not really "know" how this client feels, unless the nurse is mentally retarded and has
just had an appendectomy!
Correct Answer(s): D
A client is admitted with a diagnosis of depression. The nurse knows that which characteristic is most indicative
of depression?
A) Grandiose ideation.
B) Self-destructive thoughts.
C) Suspiciousness of others.
D) A negative view of self and the future. –
Correct Answer :Negative self-image and feelings of hopelessness about the future (D) are specific indicators
for depression. (A and/or C) occurs with paranoia or paranoid ideation. (B) may be seen in depressed clients, but
are not always present, so (D) is a better answer than (B).
Correct Answer(s): D
P 2
, • ANCC PMHNP Exam 09/11/2026
.A woman brings her 48-year-old husband to the outpatient psychiatric unit and describes his behavior to the
admitting nurse. She states that he has been sleepwalking, cannot remember who he is, and exhibits multiple
personalities. The nurse knows that these behaviors are often associated with
A) dissociative disorder.
B) obsessive-compulsive disorder.
C) panic disorder.
D) post-traumatic stress syndrome. –
Correct Answer :Sleepwalking, amnesia, and multiple personalities are examples of detaching emotional
conflict from one's consciousness, which is the definition of a dissociative disorder (A). (B) is characterized by
persistent, recurrent intrusive thoughts or urges (obsessions) that are unwilled and cannot be ignored, and
provoke impulsive acts (compulsions) such as handwashing. (C) is an acute attack of anxiety characterized by
personality disorganization. (D) is re-experiencing a psychologically terrifying or distressing event that is outside
the usual range of human experience, such as war, rape, etc.
Correct Answer(s): A
A 65-year-old female client complains to the nurse that recently she has been hearing voices. What question
should the nurse ask this client first?
A) Do you have problems with hallucinations?
B) Are you ever alone when you hear the voices?
C) Has anyone in your family had hearing problems?
D) Do you see things that others cannot see?
- Correct Answer :Determining if the client is alone when she hears voices (B) will assist in differentiating
between hallucinations and hearing loss; this is especially important in the aging population. If the client is
experiencing hallucinations, the voices will be real to her, and it is unlikely that (A) would provide accurate
information. (C and D) might be good follow-up questions, but would not have the priority of (B).
Correct Answer(s): B
56.
P 3
, • ANCC PMHNP Exam 09/11/2026
When preparing a teaching plan for a client who is to be discharged with a prescription for lithium carbonate
(Lithonate), it is most important for the nurse to include which instruction?
A) It may take 3 to 4 weeks to achieve therapeutic effects.
B) Keep your dietary salt intake consistent.
C) Avoid eating aged cheese and chicken liver.
D) Eat foods high in fiber such as whole grain breads. –
Correct Answer :Lithium's effectiveness is influenced by salt intake (B). Too much salt causes more lithium to
be excreted, thereby decreasing the effectiveness of the drug. Too little salt causes less lithium to be excreted,
potentially resulting in toxicity. (A, C, and D) are not specific instructions pertinent to teaching about lithium
carbonate (Lithonate).
Correct Answer(s): B
Over a period of several weeks, one male participant of a socialization group at a community day care center for
the elderly monopolizes most of the group's time and interrupts others when they are talking. What is the best
action for the nurse to take in this situation?
A) Talk to the client outside the group about his behavior during group meetings.
B) Remind the client to allow others in the group a chance to talk.
C) Allow the group to handle the problem.
D) Ask the client to join another group.
- Correct Answer :After several weeks, the group is in the working phase and the group members should be
allowed to determine the direction of the group. The nurse should ignore the client's comments and allow the
group to handle the situation (C). A good leader should not have separate meetings with group members (A), as
such behavior is manipulative on the part of the leader. (B) is dictatorial and is not in keeping with good
leadership skills. (D) is avoiding the problem. Remember, identify what phase the group is in--initial, working, or
termination--this will help determine communication style.
Correct Answer(s): C
58.
P 4
