PMHN-BC (Psychiatric-Mental Health Nurse Practitioner
Certification) Practice Exam With Real Questions And
Correct Answer/Guaranteed Pass/Instant Download Pdf
1. Which neurotransmitter is primarily implicated in the pathophysiology of schizophrenia?
A. Dopamine
B. Serotonin
C. Glutamate
D. Acetylcholine
Correct Answer: C
Rationale: Glutamate dysfunction, particularly NMDA receptor hypofunction, is strongly implicated in
schizophrenia alongside dopaminergic abnormalities.
2. A patient with major depressive disorder presents with hypersomnia and increased appetite. This
presentation is most consistent with:
A. Melancholic depression
B. Atypical depression
C. Psychotic depression
D. Catatonic depression
Correct Answer: B
Rationale: Atypical depression is characterized by mood reactivity, hypersomnia, increased appetite, and
leaden paralysis.
3. Which medication is considered first-line for treatment-resistant depression in adults?
A. Fluoxetine
B. Esketamine
C. Bupropion
D. Sertraline
Correct Answer: B
Rationale: Esketamine nasal spray is indicated for treatment-resistant depression after failure of
standard antidepressants.
4. Which psychotherapy is most effective for borderline personality disorder?
A. Cognitive Behavioral Therapy (CBT)
B. Interpersonal Therapy (IPT)
C. Dialectical Behavior Therapy (DBT)
D. Psychoanalysis
Correct Answer: C
,Rationale: DBT is specifically designed to treat borderline personality disorder, focusing on emotion
regulation, distress tolerance, and interpersonal effectiveness.
5. The best initial treatment for acute mania in bipolar I disorder is:
A. Fluoxetine
B. Lithium
C. Lorazepam
D. Haloperidol
Correct Answer: B
Rationale: Lithium is a first-line mood stabilizer for acute mania; antipsychotics may also be used
depending on severity.
6. Which of the following is a hallmark symptom of post-traumatic stress disorder (PTSD)?
A. Hallucinations
B. Re-experiencing the trauma through flashbacks or nightmares
C. Obsessive thoughts
D. Social withdrawal only
Correct Answer: B
Rationale: Re-experiencing symptoms are a core criterion for PTSD diagnosis.
7. A patient reports hearing voices that command self-harm. The NP should:
A. Document and monitor
B. Assess for immediate risk and initiate safety measures
C. Encourage journaling
D. Refer to primary care
Correct Answer: B
Rationale: Command hallucinations, especially involving self-harm, require immediate safety assessment
and intervention.
8. First-line pharmacotherapy for generalized anxiety disorder (GAD) includes:
A. Benzodiazepines long-term
B. SSRIs or SNRIs
C. Typical antipsychotics
D. Beta-blockers only
Correct Answer: B
Rationale: SSRIs and SNRIs are considered first-line for GAD due to efficacy and safety profile;
benzodiazepines are short-term adjuncts.
9. The primary risk factor for suicide in patients with major depression is:
A. Age over 60
B. Social support
C. Previous suicide attempts
D. Female gender
, Correct Answer: C
Rationale: A history of previous suicide attempts is the strongest predictor of future suicidal behavior.
10. Clozapine is reserved for which type of schizophrenia?
A. First-episode schizophrenia
B. Treatment-resistant schizophrenia
C. Acute psychotic episode
D. Mild schizophrenia
Correct Answer: B
Rationale: Clozapine is reserved for patients who do not respond to at least two other antipsychotics due
to its risk of agranulocytosis.
11. Which symptom differentiates bipolar I from bipolar II disorder?
A. Hypomania
B. Full-blown mania
C. Depressive episodes
D. Rapid cycling
Correct Answer: B
Rationale: Bipolar I is defined by the presence of at least one manic episode, whereas bipolar II involves
hypomania and depression without full mania.
12. In ADHD, which neurotransmitter is primarily targeted by stimulant medications?
A. Serotonin
B. Acetylcholine
C. Dopamine and norepinephrine
D. GABA
Correct Answer: C
Rationale: Stimulants increase dopamine and norepinephrine in the prefrontal cortex, improving
attention and impulse control.
13. Which is the first-line treatment for obsessive-compulsive disorder (OCD)?
A. Benzodiazepines
B. Mood stabilizers
C. SSRIs
D. Antipsychotics
Correct Answer: C
Rationale: SSRIs are first-line pharmacotherapy for OCD; higher doses may be required than for
depression.
14. A patient presents with persistent sadness, poor concentration, and low energy for 3 weeks. The
best initial NP action is:
A. Diagnose major depression immediately
B. Conduct a thorough assessment including psychosocial and medical factors
Certification) Practice Exam With Real Questions And
Correct Answer/Guaranteed Pass/Instant Download Pdf
1. Which neurotransmitter is primarily implicated in the pathophysiology of schizophrenia?
A. Dopamine
B. Serotonin
C. Glutamate
D. Acetylcholine
Correct Answer: C
Rationale: Glutamate dysfunction, particularly NMDA receptor hypofunction, is strongly implicated in
schizophrenia alongside dopaminergic abnormalities.
2. A patient with major depressive disorder presents with hypersomnia and increased appetite. This
presentation is most consistent with:
A. Melancholic depression
B. Atypical depression
C. Psychotic depression
D. Catatonic depression
Correct Answer: B
Rationale: Atypical depression is characterized by mood reactivity, hypersomnia, increased appetite, and
leaden paralysis.
3. Which medication is considered first-line for treatment-resistant depression in adults?
A. Fluoxetine
B. Esketamine
C. Bupropion
D. Sertraline
Correct Answer: B
Rationale: Esketamine nasal spray is indicated for treatment-resistant depression after failure of
standard antidepressants.
4. Which psychotherapy is most effective for borderline personality disorder?
A. Cognitive Behavioral Therapy (CBT)
B. Interpersonal Therapy (IPT)
C. Dialectical Behavior Therapy (DBT)
D. Psychoanalysis
Correct Answer: C
,Rationale: DBT is specifically designed to treat borderline personality disorder, focusing on emotion
regulation, distress tolerance, and interpersonal effectiveness.
5. The best initial treatment for acute mania in bipolar I disorder is:
A. Fluoxetine
B. Lithium
C. Lorazepam
D. Haloperidol
Correct Answer: B
Rationale: Lithium is a first-line mood stabilizer for acute mania; antipsychotics may also be used
depending on severity.
6. Which of the following is a hallmark symptom of post-traumatic stress disorder (PTSD)?
A. Hallucinations
B. Re-experiencing the trauma through flashbacks or nightmares
C. Obsessive thoughts
D. Social withdrawal only
Correct Answer: B
Rationale: Re-experiencing symptoms are a core criterion for PTSD diagnosis.
7. A patient reports hearing voices that command self-harm. The NP should:
A. Document and monitor
B. Assess for immediate risk and initiate safety measures
C. Encourage journaling
D. Refer to primary care
Correct Answer: B
Rationale: Command hallucinations, especially involving self-harm, require immediate safety assessment
and intervention.
8. First-line pharmacotherapy for generalized anxiety disorder (GAD) includes:
A. Benzodiazepines long-term
B. SSRIs or SNRIs
C. Typical antipsychotics
D. Beta-blockers only
Correct Answer: B
Rationale: SSRIs and SNRIs are considered first-line for GAD due to efficacy and safety profile;
benzodiazepines are short-term adjuncts.
9. The primary risk factor for suicide in patients with major depression is:
A. Age over 60
B. Social support
C. Previous suicide attempts
D. Female gender
, Correct Answer: C
Rationale: A history of previous suicide attempts is the strongest predictor of future suicidal behavior.
10. Clozapine is reserved for which type of schizophrenia?
A. First-episode schizophrenia
B. Treatment-resistant schizophrenia
C. Acute psychotic episode
D. Mild schizophrenia
Correct Answer: B
Rationale: Clozapine is reserved for patients who do not respond to at least two other antipsychotics due
to its risk of agranulocytosis.
11. Which symptom differentiates bipolar I from bipolar II disorder?
A. Hypomania
B. Full-blown mania
C. Depressive episodes
D. Rapid cycling
Correct Answer: B
Rationale: Bipolar I is defined by the presence of at least one manic episode, whereas bipolar II involves
hypomania and depression without full mania.
12. In ADHD, which neurotransmitter is primarily targeted by stimulant medications?
A. Serotonin
B. Acetylcholine
C. Dopamine and norepinephrine
D. GABA
Correct Answer: C
Rationale: Stimulants increase dopamine and norepinephrine in the prefrontal cortex, improving
attention and impulse control.
13. Which is the first-line treatment for obsessive-compulsive disorder (OCD)?
A. Benzodiazepines
B. Mood stabilizers
C. SSRIs
D. Antipsychotics
Correct Answer: C
Rationale: SSRIs are first-line pharmacotherapy for OCD; higher doses may be required than for
depression.
14. A patient presents with persistent sadness, poor concentration, and low energy for 3 weeks. The
best initial NP action is:
A. Diagnose major depression immediately
B. Conduct a thorough assessment including psychosocial and medical factors
