QUESTION BANK FOR PMHNP BOARDS 2026
ACTUAL EXAMINATION TEST COMPLETE
QUESTIONS AND SOLUTIONS GRADED A+
◉ Medicare Part A Eligibility. Answer: >65 in social security
automatic enrollment
◉ Medicare Part A Cost. Answer: No cost if automatically qualified.
30-39 work quarters: ~$250/mo <30 work quarters: ~$450/mo
◉ Medicare Part B Coverage. Answer: Supplemental medical
insurance. Outpatient services, care, physical/speech therapy, some
home health care, medical equipment
◉ Medicare Part B Eligibility. Answer: Voluntary if >65
◉ Medicare Part B Cost. Answer: Deducted from monthly social
security check. *Enroll 3 months before 65th birthday or 4 months
after, otherwise increased costs to enroll*
◉ Medicare Part C. Answer: Medicare Advantage. Get all their
medical services through that plan.
,◉ Medicare Part D coverage. Answer: Prescription drug coverage
◉ Medicare Part D Cost. Answer: Varies depending on how extensive
drug benefit is. Different plans have different benefits.
◉ Medigap Plans. Answer: Fill gaps in coverage that occur with
Medicare
◉ Medicare Advantage Plan. Answer: Will likely eliminate need for
medigap insurance?
◉ Medicaid Eligibility. Answer: Automatic coverage not guaranteed
except for poor pregnant women and children. States can refuse to
cover adults/head of households who lose Temporary Assistance to
Needy Families d/t refusal to work. Generally covers poor people.
◉ Medicaid funding. Answer: Federal + state. States determine how
much they want to pay in, different states have different qualities of
Medicaid
◉ HMO. Answer: Four components: Enrolled population,
prepayment of premiums, coverage of comprehensive medical svcs,
centralization of medical and hospital svcs
,◉ Closed-panel HMO. Answer: Specific providers identified by plan
to provide the medical services to members. Staff can be salaried by
HMO or an agency/group contracted by the HMO.
◉ Open-panel HMO. Answer: Network HMO, Individual Practice
Association, Point of Service Plans
◉ Network HMO. Answer: HMO contracts with more than one group
of practices
◉ Individual Practice Association. Answer: Insurance coverage.
Contract with an association of physicians to provide services to
members
◉ Point of Service (POS) and Preferred Provider Organizations
(PPOs). Answer: Insurance coverage. Patients allowed to self-refer to
specialist but pay higher premium to do so. POS requires PCP is
gatekeeper but pt can see a provider outside of HMO for more $$.
PPOs contract to a selected group of participating providers and give
discount for using a selected group of providers. Financial risk held
by insurer in PPO, held by providers in POS
◉ Managed indemnity. Answer: Traditional model insurance
coverage.. Pre-certification, catastrophic case management, minimal
contract arrangement with providers. Provider groups and health
plans can use quality control, utilization review, bundling of services,
, incentives for health behaviors. MUST seek National Committee on
Quality Assurance (NCQA) accreditation
◉ Licensure. Answer: Member of profession is granted ability to
practice
◉ Accreditation. Answer: Formal review and approval by a
recognized agency of
educational degree or certification programs in nursing or nursing-
related programs.
◉ Certification. Answer: Tests knowledge, skills, abilities for entry
into practice. Formal recognition of the knowledge, skills, and
experience
demonstrated by the achievement of standards identified by the
profession
◉ Education. Answer: Formal preparation of APRNs in graduate
degree-granting or postgraduate
certificate programs
◉ Factors facilitating NP growth. Answer: Demand for svcs,
acceptance of role, emphasis on integrated healthcare svcs,
emergence of PMHNP and decreasing stigmatization
ACTUAL EXAMINATION TEST COMPLETE
QUESTIONS AND SOLUTIONS GRADED A+
◉ Medicare Part A Eligibility. Answer: >65 in social security
automatic enrollment
◉ Medicare Part A Cost. Answer: No cost if automatically qualified.
30-39 work quarters: ~$250/mo <30 work quarters: ~$450/mo
◉ Medicare Part B Coverage. Answer: Supplemental medical
insurance. Outpatient services, care, physical/speech therapy, some
home health care, medical equipment
◉ Medicare Part B Eligibility. Answer: Voluntary if >65
◉ Medicare Part B Cost. Answer: Deducted from monthly social
security check. *Enroll 3 months before 65th birthday or 4 months
after, otherwise increased costs to enroll*
◉ Medicare Part C. Answer: Medicare Advantage. Get all their
medical services through that plan.
,◉ Medicare Part D coverage. Answer: Prescription drug coverage
◉ Medicare Part D Cost. Answer: Varies depending on how extensive
drug benefit is. Different plans have different benefits.
◉ Medigap Plans. Answer: Fill gaps in coverage that occur with
Medicare
◉ Medicare Advantage Plan. Answer: Will likely eliminate need for
medigap insurance?
◉ Medicaid Eligibility. Answer: Automatic coverage not guaranteed
except for poor pregnant women and children. States can refuse to
cover adults/head of households who lose Temporary Assistance to
Needy Families d/t refusal to work. Generally covers poor people.
◉ Medicaid funding. Answer: Federal + state. States determine how
much they want to pay in, different states have different qualities of
Medicaid
◉ HMO. Answer: Four components: Enrolled population,
prepayment of premiums, coverage of comprehensive medical svcs,
centralization of medical and hospital svcs
,◉ Closed-panel HMO. Answer: Specific providers identified by plan
to provide the medical services to members. Staff can be salaried by
HMO or an agency/group contracted by the HMO.
◉ Open-panel HMO. Answer: Network HMO, Individual Practice
Association, Point of Service Plans
◉ Network HMO. Answer: HMO contracts with more than one group
of practices
◉ Individual Practice Association. Answer: Insurance coverage.
Contract with an association of physicians to provide services to
members
◉ Point of Service (POS) and Preferred Provider Organizations
(PPOs). Answer: Insurance coverage. Patients allowed to self-refer to
specialist but pay higher premium to do so. POS requires PCP is
gatekeeper but pt can see a provider outside of HMO for more $$.
PPOs contract to a selected group of participating providers and give
discount for using a selected group of providers. Financial risk held
by insurer in PPO, held by providers in POS
◉ Managed indemnity. Answer: Traditional model insurance
coverage.. Pre-certification, catastrophic case management, minimal
contract arrangement with providers. Provider groups and health
plans can use quality control, utilization review, bundling of services,
, incentives for health behaviors. MUST seek National Committee on
Quality Assurance (NCQA) accreditation
◉ Licensure. Answer: Member of profession is granted ability to
practice
◉ Accreditation. Answer: Formal review and approval by a
recognized agency of
educational degree or certification programs in nursing or nursing-
related programs.
◉ Certification. Answer: Tests knowledge, skills, abilities for entry
into practice. Formal recognition of the knowledge, skills, and
experience
demonstrated by the achievement of standards identified by the
profession
◉ Education. Answer: Formal preparation of APRNs in graduate
degree-granting or postgraduate
certificate programs
◉ Factors facilitating NP growth. Answer: Demand for svcs,
acceptance of role, emphasis on integrated healthcare svcs,
emergence of PMHNP and decreasing stigmatization
