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AANP PMHNP Board Exam Q&A 1-400 |
2026 Updated Practice Questions with
Correct Answers & Clinical Rationales –
Pass Your Psychiatric Mental Health Nurse
Practitioner Certification on the First Try
Question 1
A 28-year-old female with panic disorder reports sudden episodes of palpitations,
sweating, and fear of dying. Which medication is first-line?
A) Alprazolam
B) Sertraline
C) Propranolol
D) Buspirone
Answer: B) Sertraline
Rationale: SSRIs like sertraline are first-line for panic disorder; benzodiazepines are
adjunctive due to abuse potential.
Question 2
Which antipsychotic is most associated with QT prolongation?
A) Aripiprazole
B) Ziprasidone
C) Quetiapine
D) Risperidone
Answer: B) Ziprasidone
Rationale: Ziprasidone has the highest risk of QTc prolongation among atypical
antipsychotics.
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Question 3
A patient on phenelzine reports headache and neck stiffness after eating aged
cheese. What is the diagnosis?
A) Serotonin syndrome
B) Hypertensive crisis
C) Neuroleptic malignant syndrome
D) Anticholinergic toxicity
Answer: B) Hypertensive crisis
Rationale: Tyramine-rich foods with MAOIs cause hypertensive crisis; headache and
neck stiffness are early signs.
Question 4
What lab test is required before starting clozapine?
A) CBC with differential
B) Serum creatinine
C) TSH
D) Liver function tests
Answer: A) CBC with differential
Rationale: Clozapine causes agranulocytosis; baseline and serial CBCs are mandatory.
Question 5
A patient with bipolar I disorder presents with mania. Which medication has the
fastest onset?
A) Lithium
B) Valproate
C) Olanzapine
D) Lamotrigine
Answer: C) Olanzapine
Rationale: Atypical antipsychotics like olanzapine have rapid onset for acute mania.
Question 6
Which SSRI has the longest half-life?
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A) Sertraline
B) Paroxetine
C) Fluoxetine
D) Escitalopram
Answer: C) Fluoxetine
Rationale: Fluoxetine has a half-life of 4–6 days; its active metabolite, norfluoxetine,
has a half-life of 7–15 days.
Question 7
A patient on lithium has a level of 1.9 mEq/L and reports confusion and ataxia. Next
step?
A) Increase fluids
B) Hold lithium and check renal function
C) Add propranolol
D) Continue and monitor
Answer: B) Hold lithium and check renal function
Rationale: Level >1.5 is toxic; hold lithium and assess renal function.
Question 8
Which is a negative symptom of schizophrenia?
A) Hallucinations
B) Delusions
C) Anhedonia
D) Disorganized speech
Answer: C) Anhedonia
Rationale: Negative symptoms include anhedonia, avolition, alogia, and affective
blunting.
Question 9
A patient with GAD and insomnia is started on which medication?
A) Fluoxetine
B) Trazodone
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C) Bupropion
D) Duloxetine
Answer: B) Trazodone
Rationale: Trazodone is sedating and treats both anxiety and insomnia.
Question 10
Which medication is FDA-approved for binge eating disorder?
A) Fluoxetine
B) Sertraline
C) Lisdexamfetamine
D) Topiramate
Answer: C) Lisdexamfetamine
Rationale: Lisdexamfetamine is FDA-approved for moderate to severe binge eating
disorder.
Question 11
A patient on valproate should be monitored for:
A) Pancreatitis
B) Hyperammonemia
C) Thrombocytopenia
D) All of the above
Answer: D) All of the above
Rationale: Valproate affects multiple organ systems; monitor all.
Question 12
Which is the antidote for anticholinergic toxicity?
A) Naloxone
B) Flumazenil
C) Physostigmine
D) Atropine
AANP PMHNP Board Exam Q&A 1-400 |
2026 Updated Practice Questions with
Correct Answers & Clinical Rationales –
Pass Your Psychiatric Mental Health Nurse
Practitioner Certification on the First Try
Question 1
A 28-year-old female with panic disorder reports sudden episodes of palpitations,
sweating, and fear of dying. Which medication is first-line?
A) Alprazolam
B) Sertraline
C) Propranolol
D) Buspirone
Answer: B) Sertraline
Rationale: SSRIs like sertraline are first-line for panic disorder; benzodiazepines are
adjunctive due to abuse potential.
Question 2
Which antipsychotic is most associated with QT prolongation?
A) Aripiprazole
B) Ziprasidone
C) Quetiapine
D) Risperidone
Answer: B) Ziprasidone
Rationale: Ziprasidone has the highest risk of QTc prolongation among atypical
antipsychotics.
,2|Page
Question 3
A patient on phenelzine reports headache and neck stiffness after eating aged
cheese. What is the diagnosis?
A) Serotonin syndrome
B) Hypertensive crisis
C) Neuroleptic malignant syndrome
D) Anticholinergic toxicity
Answer: B) Hypertensive crisis
Rationale: Tyramine-rich foods with MAOIs cause hypertensive crisis; headache and
neck stiffness are early signs.
Question 4
What lab test is required before starting clozapine?
A) CBC with differential
B) Serum creatinine
C) TSH
D) Liver function tests
Answer: A) CBC with differential
Rationale: Clozapine causes agranulocytosis; baseline and serial CBCs are mandatory.
Question 5
A patient with bipolar I disorder presents with mania. Which medication has the
fastest onset?
A) Lithium
B) Valproate
C) Olanzapine
D) Lamotrigine
Answer: C) Olanzapine
Rationale: Atypical antipsychotics like olanzapine have rapid onset for acute mania.
Question 6
Which SSRI has the longest half-life?
,3|Page
A) Sertraline
B) Paroxetine
C) Fluoxetine
D) Escitalopram
Answer: C) Fluoxetine
Rationale: Fluoxetine has a half-life of 4–6 days; its active metabolite, norfluoxetine,
has a half-life of 7–15 days.
Question 7
A patient on lithium has a level of 1.9 mEq/L and reports confusion and ataxia. Next
step?
A) Increase fluids
B) Hold lithium and check renal function
C) Add propranolol
D) Continue and monitor
Answer: B) Hold lithium and check renal function
Rationale: Level >1.5 is toxic; hold lithium and assess renal function.
Question 8
Which is a negative symptom of schizophrenia?
A) Hallucinations
B) Delusions
C) Anhedonia
D) Disorganized speech
Answer: C) Anhedonia
Rationale: Negative symptoms include anhedonia, avolition, alogia, and affective
blunting.
Question 9
A patient with GAD and insomnia is started on which medication?
A) Fluoxetine
B) Trazodone
, 4|Page
C) Bupropion
D) Duloxetine
Answer: B) Trazodone
Rationale: Trazodone is sedating and treats both anxiety and insomnia.
Question 10
Which medication is FDA-approved for binge eating disorder?
A) Fluoxetine
B) Sertraline
C) Lisdexamfetamine
D) Topiramate
Answer: C) Lisdexamfetamine
Rationale: Lisdexamfetamine is FDA-approved for moderate to severe binge eating
disorder.
Question 11
A patient on valproate should be monitored for:
A) Pancreatitis
B) Hyperammonemia
C) Thrombocytopenia
D) All of the above
Answer: D) All of the above
Rationale: Valproate affects multiple organ systems; monitor all.
Question 12
Which is the antidote for anticholinergic toxicity?
A) Naloxone
B) Flumazenil
C) Physostigmine
D) Atropine
