Purple Book PMHNP 100 multiple choice
questions w/answers ANCC NEWEST
2025/2026 100% PASS
1. The purpose of the American Nurses Association's Psychiatric-Mental Health Nursing: Scope
II! II! II! II! II! II! II! II! II! II! II!
and Standards of Practice is to
II! II! II! II! II! II!
A. Define the role and actions for the NP
II! II! II! II! II! II! II! II!
Establish the legal authority for the prescription of psychotropic
II! II! II! II! II! II! II! II! II!
B. medications
II!
C. Define the legal statutes of the role of the PMHNP
II! II! II! II! II! II! II! II! II! II!
D. Define the differences between the physician role and the NP role - Correct Answers Correct
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
Answer: A. The ANA's Psychiatric-Mental Health Nursing: Scope and Standards of Practice defines
II! II! II! II! II! II! II! II! II! II! II! II! II!
the role and actions of the nurse practitioner.
II! II! II! II! II! II! II! II!
II! 2) Primary prevention care practices are an essential aspect of the PMHNP role. Which of the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! following is the best example of a primary prevention care strategy for community behavioral
II! II! II! II! II! II! II! II! II! II! II! II! II!
II! health?
a) Aftercare program for chronically mentally ill clients recently discharged from the hospital
II! II! II! II! II! II! II! II! II! II! II! II!
b) Court-ordered counseling for abusive parents
II! II! II! II! II!
c) 24-hour crisis hotlines
II! II! II!
d) Parenting skills classes for pregnant adolescents - Correct Answers Correct Answer: D.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
Information reduces incidence of disease.
II! II! II! II! II!
II! 3
The trend in legal rulings on cases involving mental illness over the past 25 years has been to
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
a) Encourage juries to find defendants not guilty by reason of insanity
II! II! II! II! II! II! II! II! II! II! II!
b) Protect the person's freedoms or rights when he or she is committed to a mental hospital
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
,c) Place increasing trust in mental health professionals to make good and ethical decisions
II! II! II! II! II! II! II! II! II! II! II! II! II!
d) Decrease the "red tape" associated with commitments so that commitments are faster and
II! II! II! II! II! II! II! II! II! II! II! II! II!
easier - Correct Answers B. Identifies the trend of ensuring the protection of individual civil
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
liberties for psychiatric clients.
II! II! II! II!
II! 4
II! Mr. Smithers, an involuntarily hospitalized patient experiencing psychotic symptoms, refuses to
II! II! II! II! II! II! II! II! II! II!
II! take any of his ordered medication because he believes "Jesus Christ told me I am the prophet
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! and must fast for a year." Your actions should be based on your knowledge of which of the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! following?
a) Psychiatric clients cannot refuse treatment
II! II! II! II! II!
b) Psychiatric clients do not always know what is good for them
II! II! II! II! II! II! II! II! II! II! II!
c) Psychiatric clients can refuse treatment
II! II! II! II! II!
d) Psychiatric clients cannot be trusted to make good healthcare decisions and, therefore, the
II! II! II! II! II! II! II! II! II! II! II! II! II!
nurse's best clinical judgment should guide actions - Correct Answers C. As with any client,
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
psychiatric clients can refuse treatment un- less a legal process resulting in involuntary
II! II! II! II! II! II! II! II! II! II! II! II! II!
commitment or mandatory court order for treatment has been obtained.
II! II! II! II! II! II! II! II! II! II!
II! 5. Which of the following statements best reflects the difference between the nurse-client (N-C)
II! II! II! II! II! II! II! II! II! II! II! II! II!
II! relationship and a social relationship? II! II! II! II!
a) In the N-C relationship, the primary focus is on the client and the client's needs.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
b) Goals in the N-C relationship are deliberately left vague and unspoken so that the client can
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
work on any issue.
II! II! II! II!
c) In the N-C relationship, the nurse is solely responsible for making the relationship work.
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
d) In the N-C relationship, there is no place for social interaction. - Correct Answers A. Social
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
relationships are mutual interpersonal relationships in which the needs of both parties are
II! II! II! II! II! II! II! II! II! II! II! II! II!
addressed. The N-C relationship is most con- cerned with meeting the needs of the client.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! 6. A community has an unusually high incidence of depression and drug use among the teen- age
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! population. The public health nurses decide to address this problem, in part, by modifying theII! II! II! II! II! II! II! II! II! II! II! II! II! II!
,II! environment and strengthening the capacities of families to prevent the development of new II! II! II! II! II! II! II! II! II! II! II! II!
II! cases of depression and drug use. What is this is an example of?
II! II! II! II! II! II! II! II! II! II! II! II!
a) Primary prevention
II! II!
b) Secondary prevention
II! II!
c) Tertiary prevention
II! II!
d) Protective factorial prevention - Correct Answers A. This action focuses on interventions
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
designed to reduce the incidence of new cases of disease.
II! II! II! II! II! II! II! II! II! II!
II! 7
Mrs. Kemp is voluntarily admitted to the hospital. After 24 hours, she states she wishes to leave
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
because "this place can't help me." The best nursing action that reflects the legal right of this
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
client is
II! II!
a) Discharge the client
II! II! II!
b) Explain that the client cannot leave until you can complete further assessment
II! II! II! II! II! II! II! II! II! II! II! II!
c) Allow the client to leave but have her sign forms stating she is leaving against medical advice
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
d) Immediately start the paperwork to commit the client and to allow you to treat her against her
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
wishes - Correct Answers Correct Answer: B. Almost every state allows for a brief period of
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
detainment to as- sess a client for dangerousness to self or others before allowing the client to
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
leave a hospital setting, even if the admission was voluntary.
II! II! II! II! II! II! II! II! II! II!
II! 8
In many characteristics that are known to be helpful in relationship-building. Which of the fol-
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
lowing is an essential part of building a therapeutic relationship? forming a therapeutic
II! II! II! II! II! II! II! II! II! II! II! II! II!
relationship with clients, the PMHNP must consider developing
II! II! II! II! II! II! II! II!
a) Collecting a family history
II! II! II! II!
b) Like-mindedness
II!
c) Authenticity
II!
d) Accuracy in assessment - Correct Answers C. Authenticity. Being genuine, honest, and
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
respectful are essential elements in establishing a working relationship with any client. Like-
II! II! II! II! II! II! II! II! II! II! II! II! II!
, mindednessis not a part of the therapeutic relationship. Although an important aspect of the II! II! II! II! II! II! II! II! II! II! II! II! II!
PMHNP role, collecting a family history and accuracy in assessment does not in and of itself
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
facilitate relationship-building.
II! II!
II! 9
According to the DSM-5, which of the following is true? (Ch. 3) II! II! II! II! II! II! II! II! II! II! II!
a) A mental disorder is equivalent to the need for treatment.
II! II! II! II! II! II! II! II! II! II!
b) Diagnostic criteria are used to inform clinical judgment.
II! II! II! II! II! II! II! II!
c) Socially deviant behavior is considered a mental disorder.
II! II! II! II! II! II! II! II!
d) A culturally expected response to a stressor is not a mental disorder. - Correct Answers
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
Correct Answer: D. All DSM-5 disorders need to be made taking a person's culture into account. A
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
cultural expression of a response to grief, loss, or stress is not con- sidered a DSM-5 diagnosis.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! 10
Mrs. French has been in individual therapy for 3 months. She has shown much growth and
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
improvement in her functioning and insight and is to discontinue services within the next few
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
weeks. In the next session, after you discuss service termination, she suddenly begins to
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
demonstrate the original symptoms that had brought her to treatment initially. She is now
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
hesitant to discharge, wants to continue services, and is displaying an increase in regressive
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
defense mechanisms. What is the best explanation for Ms. French's behavior?
II! II! II! II! II! II! II! II! II! II! II!
a) An exacerbation of her symptoms related to stress
II! II! II! II! II! II! II! II!
b) The normal cyclic nature of chronic mental health symptoms
II! II! II! II! II! II! II! II! II!
c) A sign of normal resistance to termination seen in the termination phase of therapy
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
d) A sign of pathological attachment to the therapist that must be addressed - Correct Answers
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
C. Clients frequently display resistance and regression at the termination of a meaningful
II! II! II! II! II! II! II! II! II! II! II! II! II!
therapeutic process. The PMHNP is responsible for planning an effective termination and
II! II! II! II! II! II! II! II! II! II! II! II!
monitoring clients during the termination period.
II! II! II! II! II! II!
II! 11 II!
questions w/answers ANCC NEWEST
2025/2026 100% PASS
1. The purpose of the American Nurses Association's Psychiatric-Mental Health Nursing: Scope
II! II! II! II! II! II! II! II! II! II! II!
and Standards of Practice is to
II! II! II! II! II! II!
A. Define the role and actions for the NP
II! II! II! II! II! II! II! II!
Establish the legal authority for the prescription of psychotropic
II! II! II! II! II! II! II! II! II!
B. medications
II!
C. Define the legal statutes of the role of the PMHNP
II! II! II! II! II! II! II! II! II! II!
D. Define the differences between the physician role and the NP role - Correct Answers Correct
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
Answer: A. The ANA's Psychiatric-Mental Health Nursing: Scope and Standards of Practice defines
II! II! II! II! II! II! II! II! II! II! II! II! II!
the role and actions of the nurse practitioner.
II! II! II! II! II! II! II! II!
II! 2) Primary prevention care practices are an essential aspect of the PMHNP role. Which of the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! following is the best example of a primary prevention care strategy for community behavioral
II! II! II! II! II! II! II! II! II! II! II! II! II!
II! health?
a) Aftercare program for chronically mentally ill clients recently discharged from the hospital
II! II! II! II! II! II! II! II! II! II! II! II!
b) Court-ordered counseling for abusive parents
II! II! II! II! II!
c) 24-hour crisis hotlines
II! II! II!
d) Parenting skills classes for pregnant adolescents - Correct Answers Correct Answer: D.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
Information reduces incidence of disease.
II! II! II! II! II!
II! 3
The trend in legal rulings on cases involving mental illness over the past 25 years has been to
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
a) Encourage juries to find defendants not guilty by reason of insanity
II! II! II! II! II! II! II! II! II! II! II!
b) Protect the person's freedoms or rights when he or she is committed to a mental hospital
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
,c) Place increasing trust in mental health professionals to make good and ethical decisions
II! II! II! II! II! II! II! II! II! II! II! II! II!
d) Decrease the "red tape" associated with commitments so that commitments are faster and
II! II! II! II! II! II! II! II! II! II! II! II! II!
easier - Correct Answers B. Identifies the trend of ensuring the protection of individual civil
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
liberties for psychiatric clients.
II! II! II! II!
II! 4
II! Mr. Smithers, an involuntarily hospitalized patient experiencing psychotic symptoms, refuses to
II! II! II! II! II! II! II! II! II! II!
II! take any of his ordered medication because he believes "Jesus Christ told me I am the prophet
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! and must fast for a year." Your actions should be based on your knowledge of which of the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! following?
a) Psychiatric clients cannot refuse treatment
II! II! II! II! II!
b) Psychiatric clients do not always know what is good for them
II! II! II! II! II! II! II! II! II! II! II!
c) Psychiatric clients can refuse treatment
II! II! II! II! II!
d) Psychiatric clients cannot be trusted to make good healthcare decisions and, therefore, the
II! II! II! II! II! II! II! II! II! II! II! II! II!
nurse's best clinical judgment should guide actions - Correct Answers C. As with any client,
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
psychiatric clients can refuse treatment un- less a legal process resulting in involuntary
II! II! II! II! II! II! II! II! II! II! II! II! II!
commitment or mandatory court order for treatment has been obtained.
II! II! II! II! II! II! II! II! II! II!
II! 5. Which of the following statements best reflects the difference between the nurse-client (N-C)
II! II! II! II! II! II! II! II! II! II! II! II! II!
II! relationship and a social relationship? II! II! II! II!
a) In the N-C relationship, the primary focus is on the client and the client's needs.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
b) Goals in the N-C relationship are deliberately left vague and unspoken so that the client can
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
work on any issue.
II! II! II! II!
c) In the N-C relationship, the nurse is solely responsible for making the relationship work.
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
d) In the N-C relationship, there is no place for social interaction. - Correct Answers A. Social
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
relationships are mutual interpersonal relationships in which the needs of both parties are
II! II! II! II! II! II! II! II! II! II! II! II! II!
addressed. The N-C relationship is most con- cerned with meeting the needs of the client.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! 6. A community has an unusually high incidence of depression and drug use among the teen- age
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! population. The public health nurses decide to address this problem, in part, by modifying theII! II! II! II! II! II! II! II! II! II! II! II! II! II!
,II! environment and strengthening the capacities of families to prevent the development of new II! II! II! II! II! II! II! II! II! II! II! II!
II! cases of depression and drug use. What is this is an example of?
II! II! II! II! II! II! II! II! II! II! II! II!
a) Primary prevention
II! II!
b) Secondary prevention
II! II!
c) Tertiary prevention
II! II!
d) Protective factorial prevention - Correct Answers A. This action focuses on interventions
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
designed to reduce the incidence of new cases of disease.
II! II! II! II! II! II! II! II! II! II!
II! 7
Mrs. Kemp is voluntarily admitted to the hospital. After 24 hours, she states she wishes to leave
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
because "this place can't help me." The best nursing action that reflects the legal right of this
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
client is
II! II!
a) Discharge the client
II! II! II!
b) Explain that the client cannot leave until you can complete further assessment
II! II! II! II! II! II! II! II! II! II! II! II!
c) Allow the client to leave but have her sign forms stating she is leaving against medical advice
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
d) Immediately start the paperwork to commit the client and to allow you to treat her against her
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
wishes - Correct Answers Correct Answer: B. Almost every state allows for a brief period of
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
detainment to as- sess a client for dangerousness to self or others before allowing the client to
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
leave a hospital setting, even if the admission was voluntary.
II! II! II! II! II! II! II! II! II! II!
II! 8
In many characteristics that are known to be helpful in relationship-building. Which of the fol-
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
lowing is an essential part of building a therapeutic relationship? forming a therapeutic
II! II! II! II! II! II! II! II! II! II! II! II! II!
relationship with clients, the PMHNP must consider developing
II! II! II! II! II! II! II! II!
a) Collecting a family history
II! II! II! II!
b) Like-mindedness
II!
c) Authenticity
II!
d) Accuracy in assessment - Correct Answers C. Authenticity. Being genuine, honest, and
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
respectful are essential elements in establishing a working relationship with any client. Like-
II! II! II! II! II! II! II! II! II! II! II! II! II!
, mindednessis not a part of the therapeutic relationship. Although an important aspect of the II! II! II! II! II! II! II! II! II! II! II! II! II!
PMHNP role, collecting a family history and accuracy in assessment does not in and of itself
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
facilitate relationship-building.
II! II!
II! 9
According to the DSM-5, which of the following is true? (Ch. 3) II! II! II! II! II! II! II! II! II! II! II!
a) A mental disorder is equivalent to the need for treatment.
II! II! II! II! II! II! II! II! II! II!
b) Diagnostic criteria are used to inform clinical judgment.
II! II! II! II! II! II! II! II!
c) Socially deviant behavior is considered a mental disorder.
II! II! II! II! II! II! II! II!
d) A culturally expected response to a stressor is not a mental disorder. - Correct Answers
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
Correct Answer: D. All DSM-5 disorders need to be made taking a person's culture into account. A
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
cultural expression of a response to grief, loss, or stress is not con- sidered a DSM-5 diagnosis.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! 10
Mrs. French has been in individual therapy for 3 months. She has shown much growth and
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
improvement in her functioning and insight and is to discontinue services within the next few
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
weeks. In the next session, after you discuss service termination, she suddenly begins to
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
demonstrate the original symptoms that had brought her to treatment initially. She is now
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
hesitant to discharge, wants to continue services, and is displaying an increase in regressive
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
defense mechanisms. What is the best explanation for Ms. French's behavior?
II! II! II! II! II! II! II! II! II! II! II!
a) An exacerbation of her symptoms related to stress
II! II! II! II! II! II! II! II!
b) The normal cyclic nature of chronic mental health symptoms
II! II! II! II! II! II! II! II! II!
c) A sign of normal resistance to termination seen in the termination phase of therapy
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
d) A sign of pathological attachment to the therapist that must be addressed - Correct Answers
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
C. Clients frequently display resistance and regression at the termination of a meaningful
II! II! II! II! II! II! II! II! II! II! II! II! II!
therapeutic process. The PMHNP is responsible for planning an effective termination and
II! II! II! II! II! II! II! II! II! II! II! II!
monitoring clients during the termination period.
II! II! II! II! II! II!
II! 11 II!
