PMHNP CERTIFICATION EXAM
QUESTIONS AND ANSWERS 2026
(ACTUAL TEST VERIFIED A+)
1. Which patient is at highest risk for SI
A. 30y/o married AA female with previous SI attempt *1 risk factor
B. 35 y/o single Asian male with previous SI attempt *3 risk factors
C. 38 y/o single AA male who is a manager of a bank *2 risk factors
D. 68 y/o single white male with depression *5 risk factors (age,
male, white, depression): D. 68 y/o single white male with depression
*5 risk factors (age, male, white, depression)
Count the risk factors
2. When interview teenagers (16 y/o) that arrive with
their parents what should you do?: interview them
separately from parents.
-This helps Build therapeutic rapport with teens by telling them the info is
confiden- tial. Parents may be upset but remember you are advocating for
the child.
3. Which Ethnic group has the highest rate of suicide?: Native
Americans
4. Example A patient is being treated for schizophrenia with
olanzapine. Which of the following is the most common
side effect of olanzapine?
A. Increased waist circumference
B. EPS (not as common in atypical antipsychotics d/t
5HT2A)-receptor an- tagonism
C. Increased Lipids
D. Metabolic Syndrome: D. Metabolic Syndrome (UMBRELLA ANSWER)
5. Which antipsychotics have the least weight gain?: Latuda,
Abilify, (also least sedating), Geodon-if patient has metabolic syndrome
consider switching to one of the medications above. Or if the patient is
overly sedated try switching to ABILIFY
6. Which mood stabilizer have the least weight gain?: Lamictal
-But remember all mood stabilizers cause some weight gain
7. When presented with a question about typical
vs atypical antipsychotic the answer is usually to
1/
38
,start of a: atypical
8. A client presents with complains of changes in appetite,
feeling fatigued, problems with sleep-rest cycle, and changes
in libido. What is
2/
38
,the neu- roanatomical area of the brain that is responsible for the
normal regulation of these functions?
A. Thalamus
B. Hypothalamus
C. Limbic System
D. Hippocampus: Hypothalamus
A, B, & D are all part of the limbic system so you can rule that out
3/
38
, 9. When a patient is hesitant to participate in treatment
you should encour- age?: Bring a support person like a
husband
10. Thyroid-Stimulating hormone normal level: 0.5-5.0 Mu/L
11. When T4 and T3 are high and TSH is low what is the
diagnosis: HY- PERTHYROIDISM, TSH secretion decreases: TSH
LOW à key symptoms HEAT INTOLERANCE
12. Key symptoms of Heat Intolerance: Hyperthyroidism
13. When T4 and T3 are Low and TSH is high what is the
diagnosis: (HY- POTHYROIDISM) TSH secretion increased: TSH
HIGH à COLD INTERANCE
14. Key symptoms of Cold Intolerance: Hypothyroidism
15. Hyperthyroid can mimic: Mania
16. Hypothyroid can mimic: Depression
17. A patient on depakote complains of RUQ pain
and has reddish/brown urine: Hepatoxicity
-Check LFTs
18. Signs of Depakote toxicity: Disorientation, confusion, lethargy
19. You suspect depakote toxicity what do you do?: Check
-LFT
-Ammonia
-Depakote Level
20. What herbal supplement can cause hepatoxicity?: Kava Kava
21. When taking Kava Kava in combinations with other
medications you should caution about: Risk of Hepatoxicity
and Sedation
22. TCAs carry a risk of: Hepatotoxicity
23. Signs of Stevens-Johnson Syndrome: -fever, mouth pain,
swelling, burning eyes, blisters, skin pain
24. two psychotropics known to cause steven johnson syndrome:
lamictal and tegretol
25. What nationality is most suseptible of getting steven johnson?:
Asians
26. When treating asians with tegretal screen for?: HLAB-1502 Allele
27. What two medications cause agranulocytosis?: Clozaril & Tegretal
28. Agranulocytosis when to discontinue medication: Less than 1000
4/
38
QUESTIONS AND ANSWERS 2026
(ACTUAL TEST VERIFIED A+)
1. Which patient is at highest risk for SI
A. 30y/o married AA female with previous SI attempt *1 risk factor
B. 35 y/o single Asian male with previous SI attempt *3 risk factors
C. 38 y/o single AA male who is a manager of a bank *2 risk factors
D. 68 y/o single white male with depression *5 risk factors (age,
male, white, depression): D. 68 y/o single white male with depression
*5 risk factors (age, male, white, depression)
Count the risk factors
2. When interview teenagers (16 y/o) that arrive with
their parents what should you do?: interview them
separately from parents.
-This helps Build therapeutic rapport with teens by telling them the info is
confiden- tial. Parents may be upset but remember you are advocating for
the child.
3. Which Ethnic group has the highest rate of suicide?: Native
Americans
4. Example A patient is being treated for schizophrenia with
olanzapine. Which of the following is the most common
side effect of olanzapine?
A. Increased waist circumference
B. EPS (not as common in atypical antipsychotics d/t
5HT2A)-receptor an- tagonism
C. Increased Lipids
D. Metabolic Syndrome: D. Metabolic Syndrome (UMBRELLA ANSWER)
5. Which antipsychotics have the least weight gain?: Latuda,
Abilify, (also least sedating), Geodon-if patient has metabolic syndrome
consider switching to one of the medications above. Or if the patient is
overly sedated try switching to ABILIFY
6. Which mood stabilizer have the least weight gain?: Lamictal
-But remember all mood stabilizers cause some weight gain
7. When presented with a question about typical
vs atypical antipsychotic the answer is usually to
1/
38
,start of a: atypical
8. A client presents with complains of changes in appetite,
feeling fatigued, problems with sleep-rest cycle, and changes
in libido. What is
2/
38
,the neu- roanatomical area of the brain that is responsible for the
normal regulation of these functions?
A. Thalamus
B. Hypothalamus
C. Limbic System
D. Hippocampus: Hypothalamus
A, B, & D are all part of the limbic system so you can rule that out
3/
38
, 9. When a patient is hesitant to participate in treatment
you should encour- age?: Bring a support person like a
husband
10. Thyroid-Stimulating hormone normal level: 0.5-5.0 Mu/L
11. When T4 and T3 are high and TSH is low what is the
diagnosis: HY- PERTHYROIDISM, TSH secretion decreases: TSH
LOW à key symptoms HEAT INTOLERANCE
12. Key symptoms of Heat Intolerance: Hyperthyroidism
13. When T4 and T3 are Low and TSH is high what is the
diagnosis: (HY- POTHYROIDISM) TSH secretion increased: TSH
HIGH à COLD INTERANCE
14. Key symptoms of Cold Intolerance: Hypothyroidism
15. Hyperthyroid can mimic: Mania
16. Hypothyroid can mimic: Depression
17. A patient on depakote complains of RUQ pain
and has reddish/brown urine: Hepatoxicity
-Check LFTs
18. Signs of Depakote toxicity: Disorientation, confusion, lethargy
19. You suspect depakote toxicity what do you do?: Check
-LFT
-Ammonia
-Depakote Level
20. What herbal supplement can cause hepatoxicity?: Kava Kava
21. When taking Kava Kava in combinations with other
medications you should caution about: Risk of Hepatoxicity
and Sedation
22. TCAs carry a risk of: Hepatotoxicity
23. Signs of Stevens-Johnson Syndrome: -fever, mouth pain,
swelling, burning eyes, blisters, skin pain
24. two psychotropics known to cause steven johnson syndrome:
lamictal and tegretol
25. What nationality is most suseptible of getting steven johnson?:
Asians
26. When treating asians with tegretal screen for?: HLAB-1502 Allele
27. What two medications cause agranulocytosis?: Clozaril & Tegretal
28. Agranulocytosis when to discontinue medication: Less than 1000
4/
38
