Page 1 of 250
“PMHNP REVIEW (GEORGETTE) EXAM 2026 ”LATEST
EXAM 2026 – 2027 SOLVED QUESTIONS & ANSWERS
VERIFIED 100% GRADED A+ (LATEST VERSION) WELL
REVISED 100% GUARANTEE PASS
PMHNP ANCC Review Questions
A 48-year-old obese woman experiences excessive daytime sleepiness,
fatigue, anhedonia, and apathy. Her husband reports that she snores loudly
when sleeping and often will wake up drenched in sweat. The patient has no
prior psychiatric history and denies substance abuse. Which of the following
is the most likely cause of her symptoms?
A. airway obstruction
B. major depression
C. perimenopause
D. narcolepsy
A. airway obstruction
A 52-year-old obese man with type 2 diabetes reports dozing off while driving,
watching TV, or reading with increased apathy and fatigue. The PMHNP
ordered a sleep study which revealed 10 episodes of apnea lasting 15-20
seconds each per hour of sleep. Based on these findings what should the
PMHNP prescribe for this condition?
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A. antidepressant medications
B. referral to otolaryngology for uvuloplasty
C. referral to otolaryngology for rhinoplasty
D. continuous positive airway pressure
D. continuous positive airway pressure
A father brings his 6-year-old son to you because he is worried about him. He
states that the son sits up in bed shortly after falling asleep and screams. He
says he is inconsolable and unable to be awakened during these episodes but
eventually he falls back asleep. The father states he is not able to fall back
asleep after those episodes and is exhausted and falling asleep at work during
the day. The child is energetic and playful during the day and has no memory
of the episodes. What is the most appropriate response?
A. "are you worried you are doing something wrong?"
B. "I can see you're upset but really you are overreacting."
C. "I can see this is upsetting for you."
D. "Tell me why you can't fall back asleep after your son does?"
C. "I can see this is upsetting for you."
The PMHNP is providing psycho-education and anticipatory guidance to the
concerned parent regarding night terrors. At which stage of sleep is most
likely to occur?
A. any stage of sleep
B. stage 1
C. stage 2
D. stage 3-4
D. stage 3-4
Stage 3-4 is when night terrors and parasomnia occur (usually within 3 hours of
falling asleep).
Sam is 11 years old without past psychiatric history. He was born by normal
spontaneous vaginal delivery with normal APGAR scores. He has met all of his
developmental milestones. He began 6th grade this year and has had
increased trouble falling asleep. He has always had bedtime rituals but lately
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they're extending in complexity and length. Most of his time in the evening is
spent checking that the lights are turned off and the windows are locked. As a
result, he is only getting 5 hours of sleep and has excessive daytime
sleepiness with decreased interest in socialization and failing grades. Which of
the following infectious diseases may contribute to this clinical presentation?
A. treponema
B. HIV
C. streptococcus
D. congenital herpes simplex virus
C. streptococcus
Streptococcus infection has been associated with severe OCD and PANDAS
The PMHNP is covering for the vacationing psychiatrist and is conducting a
follow up visit for a 24-year-old man diagnosed with MDD. Which type of sleep
disturbance is most consistent with this diagnosis?
A. early morning awakening
B. sleeping too deeply
C. easily awakened/sleeping too lightly
D. decreased effect of trazodone
A. early morning awakening
Early morning wakening is most consistently associated with MDD
Sleeping too deeply is associated with oversedation
Easily awakened/sleeping too lightly is associated with hypervigilance in the setting
of PTSD
A patient with MDD and early morning wakening is likely to have which of the
following hormonal states accounting for his symptoms?
A. elevated testosterone
B. elevated cortisol
C. elevated catecholamine
D. decreased cortisol
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B. elevated cortisol
A 30-year-old man has been started on sertraline 50mg daily for MDD 1 week
ago. He presents for followup. Which of the following sleep patterns is he
expected to report?
A. no change in sleep pattern
B. increased sleep latency
C. decreased sleep latency
D. increased sleepiness earlier in the evening
B. increased sleep latency
Increased sleep latency (difficulty falling asleep) is a common adverse effect of
SSRIs and is especially pronounced during the initiation and titration phase.
A 56-year-old woman with depressed mood reports a decrease in weight,
libido, and ability to sleep. In addition, she reports intermittent episodes of
constipation. Which neurovegetative symptom should be targeted first when
prescribing a psychopharmacological agent?
A. constipation
B. sleep
C. weight loss
D. depressed mood
B. sleep
Sleep should be the first symptom targeted and a primary sleep disorder should be
ruled out as it can account for many of the symptoms associated with MDD.
The PMHNP is consulting on a 79-year-old female in a long-term care facility
with history of hypertension, coronary artery disease, and atrial fibrillation.
The patient is having difficulty sleeping and was started on lorazepam 2mg at
bedtime. The patient has become increasingly agitated and wandering and has
been further prescribed lorazepam 2mg Q6hours. The patient is also
prescribed hydrochlorothiazide 25mg daily, digoxin 0.125mg every other day,
diltiazem sustained release 360mg daily, and isosorbide 30mg daily. What
should the PMHNP do first?
“PMHNP REVIEW (GEORGETTE) EXAM 2026 ”LATEST
EXAM 2026 – 2027 SOLVED QUESTIONS & ANSWERS
VERIFIED 100% GRADED A+ (LATEST VERSION) WELL
REVISED 100% GUARANTEE PASS
PMHNP ANCC Review Questions
A 48-year-old obese woman experiences excessive daytime sleepiness,
fatigue, anhedonia, and apathy. Her husband reports that she snores loudly
when sleeping and often will wake up drenched in sweat. The patient has no
prior psychiatric history and denies substance abuse. Which of the following
is the most likely cause of her symptoms?
A. airway obstruction
B. major depression
C. perimenopause
D. narcolepsy
A. airway obstruction
A 52-year-old obese man with type 2 diabetes reports dozing off while driving,
watching TV, or reading with increased apathy and fatigue. The PMHNP
ordered a sleep study which revealed 10 episodes of apnea lasting 15-20
seconds each per hour of sleep. Based on these findings what should the
PMHNP prescribe for this condition?
, Page 2 of 250
A. antidepressant medications
B. referral to otolaryngology for uvuloplasty
C. referral to otolaryngology for rhinoplasty
D. continuous positive airway pressure
D. continuous positive airway pressure
A father brings his 6-year-old son to you because he is worried about him. He
states that the son sits up in bed shortly after falling asleep and screams. He
says he is inconsolable and unable to be awakened during these episodes but
eventually he falls back asleep. The father states he is not able to fall back
asleep after those episodes and is exhausted and falling asleep at work during
the day. The child is energetic and playful during the day and has no memory
of the episodes. What is the most appropriate response?
A. "are you worried you are doing something wrong?"
B. "I can see you're upset but really you are overreacting."
C. "I can see this is upsetting for you."
D. "Tell me why you can't fall back asleep after your son does?"
C. "I can see this is upsetting for you."
The PMHNP is providing psycho-education and anticipatory guidance to the
concerned parent regarding night terrors. At which stage of sleep is most
likely to occur?
A. any stage of sleep
B. stage 1
C. stage 2
D. stage 3-4
D. stage 3-4
Stage 3-4 is when night terrors and parasomnia occur (usually within 3 hours of
falling asleep).
Sam is 11 years old without past psychiatric history. He was born by normal
spontaneous vaginal delivery with normal APGAR scores. He has met all of his
developmental milestones. He began 6th grade this year and has had
increased trouble falling asleep. He has always had bedtime rituals but lately
, Page 3 of 250
they're extending in complexity and length. Most of his time in the evening is
spent checking that the lights are turned off and the windows are locked. As a
result, he is only getting 5 hours of sleep and has excessive daytime
sleepiness with decreased interest in socialization and failing grades. Which of
the following infectious diseases may contribute to this clinical presentation?
A. treponema
B. HIV
C. streptococcus
D. congenital herpes simplex virus
C. streptococcus
Streptococcus infection has been associated with severe OCD and PANDAS
The PMHNP is covering for the vacationing psychiatrist and is conducting a
follow up visit for a 24-year-old man diagnosed with MDD. Which type of sleep
disturbance is most consistent with this diagnosis?
A. early morning awakening
B. sleeping too deeply
C. easily awakened/sleeping too lightly
D. decreased effect of trazodone
A. early morning awakening
Early morning wakening is most consistently associated with MDD
Sleeping too deeply is associated with oversedation
Easily awakened/sleeping too lightly is associated with hypervigilance in the setting
of PTSD
A patient with MDD and early morning wakening is likely to have which of the
following hormonal states accounting for his symptoms?
A. elevated testosterone
B. elevated cortisol
C. elevated catecholamine
D. decreased cortisol
, Page 4 of 250
B. elevated cortisol
A 30-year-old man has been started on sertraline 50mg daily for MDD 1 week
ago. He presents for followup. Which of the following sleep patterns is he
expected to report?
A. no change in sleep pattern
B. increased sleep latency
C. decreased sleep latency
D. increased sleepiness earlier in the evening
B. increased sleep latency
Increased sleep latency (difficulty falling asleep) is a common adverse effect of
SSRIs and is especially pronounced during the initiation and titration phase.
A 56-year-old woman with depressed mood reports a decrease in weight,
libido, and ability to sleep. In addition, she reports intermittent episodes of
constipation. Which neurovegetative symptom should be targeted first when
prescribing a psychopharmacological agent?
A. constipation
B. sleep
C. weight loss
D. depressed mood
B. sleep
Sleep should be the first symptom targeted and a primary sleep disorder should be
ruled out as it can account for many of the symptoms associated with MDD.
The PMHNP is consulting on a 79-year-old female in a long-term care facility
with history of hypertension, coronary artery disease, and atrial fibrillation.
The patient is having difficulty sleeping and was started on lorazepam 2mg at
bedtime. The patient has become increasingly agitated and wandering and has
been further prescribed lorazepam 2mg Q6hours. The patient is also
prescribed hydrochlorothiazide 25mg daily, digoxin 0.125mg every other day,
diltiazem sustained release 360mg daily, and isosorbide 30mg daily. What
should the PMHNP do first?
