AANC PMHNP (PSYCHIATRIC-MENTAL HEALTH NURSE
PRACTITIONER) CERTIFICATION | QUESTIONS AND ANSWERS
| VERIFIED ANSWERS PLUS RATIONALES | EXAM ALREADY
GRADED A+ | LATEST EXAM
1. A 32-year-old patient presents with persistent sadness, anhedonia, and fatigue for the past
6 months. Which of the following is the most likely diagnosis?
A. Dysthymia
B. Major Depressive Disorder
C. Bipolar I Disorder
D. Adjustment Disorder
Answer: B
Rationale: Major Depressive Disorder requires at least 2 weeks of depressed mood or
anhedonia with associated symptoms, and the presentation here exceeds that duration.
2. A patient with schizophrenia reports hearing voices telling him to harm himself. What is
the nurse practitioner’s immediate priority?
A. Adjust antipsychotic medication
B. Ensure patient safety
C. Schedule psychotherapy
D. Document the hallucinations
Answer: B
Rationale: Safety is always the top priority in patients experiencing command
hallucinations.
3. Which neurotransmitter is most associated with the pathophysiology of Parkinson’s
disease?
A. Serotonin
B. Dopamine
C. GABA
D. Norepinephrine
Answer: B
Rationale: Dopamine deficiency in the substantia nigra leads to the motor symptoms of
Parkinson’s disease.
4. A patient with generalized anxiety disorder is prescribed an SSRI. What is the most
important teaching point?
A. Immediate relief of anxiety is expected
B. Avoid driving for 6 weeks
C. Therapeutic effects may take 4–6 weeks
D. Increase dose if anxiety persists after 1 day
Answer: C
Rationale: SSRIs often take several weeks to achieve therapeutic effect; patients should
be counseled to continue medication and monitor side effects.
5. Which of the following is a first-line treatment for adult ADHD?
A. Lithium
B. Methylphenidate
, C. Risperidone
D. Buspirone
Answer: B
Rationale: Stimulants like methylphenidate are considered first-line therapy for ADHD in
adults due to efficacy in improving attention and reducing hyperactivity.
6. A patient with bipolar disorder is experiencing a manic episode. Which medication is
considered a mood stabilizer?
A. Fluoxetine
B. Lithium
C. Lorazepam
D. Haloperidol
Answer: B
Rationale: Lithium is a gold-standard mood stabilizer for both acute mania and
maintenance therapy in bipolar disorder.
7. Which of the following is a key symptom of PTSD?
A. Obsessions
B. Re-experiencing traumatic events
C. Hallucinations
D. Compulsions
Answer: B
Rationale: PTSD is characterized by re-experiencing, avoidance, negative cognitions,
and hyperarousal following a traumatic event.
8. A 16-year-old presents with binge eating episodes followed by purging. What is the most
likely diagnosis?
A. Anorexia nervosa
B. Bulimia nervosa
C. Binge-eating disorder
D. Avoidant/restrictive food intake disorder
Answer: B
Rationale: Bulimia nervosa is defined by recurrent binge eating with compensatory
behaviors such as vomiting, fasting, or excessive exercise.
9. Which lab should be monitored in patients taking lithium?
A. CBC
B. Thyroid function tests
C. Liver function tests
D. Fasting glucose
Answer: B
Rationale: Lithium can affect thyroid function, and baseline and periodic monitoring of
TSH is recommended.
10. A patient presents with severe agitation and paranoia. Which antipsychotic is most
appropriate for rapid tranquilization?
A. Olanzapine IM
B. Fluoxetine PO
C. Lorazepam PO
D. Buspirone PO
Answer: A
, Rationale: IM olanzapine is effective for acute agitation in psychosis and can be
administered rapidly.
11. Which psychotherapy is considered first-line for borderline personality disorder?
A. Cognitive Behavioral Therapy
B. Dialectical Behavior Therapy
C. Psychodynamic Therapy
D. Exposure Therapy
Answer: B
Rationale: DBT is evidence-based therapy specifically designed for emotion regulation
and reducing self-harm in borderline personality disorder.
12. Which of the following is a positive symptom of schizophrenia?
A. Flat affect
B. Hallucinations
C. Social withdrawal
D. Anhedonia
Answer: B
Rationale: Positive symptoms include hallucinations, delusions, and thought disorders;
negative symptoms include affective flattening and social withdrawal.
13. A patient with major depressive disorder is started on an SSRI and reports nausea and
insomnia. What is the most appropriate action?
A. Immediately discontinue SSRI
B. Educate patient that side effects often improve over time
C. Switch to MAOI
D. Add antipsychotic
Answer: B
Rationale: Early SSRI side effects are common and usually transient; patient education
and monitoring are appropriate.
14. Which of the following is the most common side effect of atypical antipsychotics?
A. Extrapyramidal symptoms
B. Weight gain and metabolic syndrome
C. Bradycardia
D. Hypotension
Answer: B
Rationale: Atypical antipsychotics like olanzapine and clozapine are associated with
metabolic side effects including weight gain, hyperlipidemia, and diabetes risk.
15. A patient presents with excessive worry for at least 6 months, difficulty concentrating,
and muscle tension. Which is the best diagnosis?
A. Panic Disorder
B. Generalized Anxiety Disorder
C. Social Anxiety Disorder
D. Obsessive-Compulsive Disorder
Answer: B
Rationale: Generalized anxiety disorder is characterized by excessive anxiety and worry
more days than not for at least 6 months.
16. Which of the following is an absolute contraindication to electroconvulsive therapy
(ECT)?
, A. Severe depression
B. Recent myocardial infarction
C. Treatment-resistant schizophrenia
D. Catatonia
Answer: B
Rationale: Recent MI or unstable cardiovascular conditions are relative or absolute
contraindications due to increased risk of complications.
17. A patient on paroxetine reports sexual dysfunction. Which intervention is appropriate?
A. Discontinue therapy abruptly
B. Switch to bupropion
C. Add benzodiazepine
D. Increase dose
Answer: B
Rationale: Bupropion has a lower risk of sexual side effects and can be used when SSRI-
induced sexual dysfunction occurs.
18. Which of the following is a hallmark feature of ADHD in adults?
A. Memory loss
B. Inattention and distractibility
C. Mood swings
D. Hallucinations
Answer: B
Rationale: Adult ADHD commonly presents with inattention, distractibility, and
executive function difficulties.
19. A patient presents with tremor, agitation, diaphoresis, and autonomic instability after
starting an MAOI. What is the likely diagnosis?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Lithium toxicity
D. Panic attack
Answer: A
Rationale: Serotonin syndrome results from excess serotonergic activity and presents
with neuromuscular, autonomic, and mental status changes.
20. Which of the following is considered a first-line treatment for panic disorder?
A. Benzodiazepines only
B. SSRIs and CBT
C. MAOIs
D. Antipsychotics
Answer: B
Rationale: Evidence-based treatment includes SSRIs and cognitive behavioral therapy;
benzodiazepines may be adjunctive for acute symptoms.
21. A 70-year-old patient presents with depression and cognitive decline. Which of the
following should be screened first?
A. Schizophrenia
B. Hypothyroidism
C. Bipolar disorder
D. ADHD
PRACTITIONER) CERTIFICATION | QUESTIONS AND ANSWERS
| VERIFIED ANSWERS PLUS RATIONALES | EXAM ALREADY
GRADED A+ | LATEST EXAM
1. A 32-year-old patient presents with persistent sadness, anhedonia, and fatigue for the past
6 months. Which of the following is the most likely diagnosis?
A. Dysthymia
B. Major Depressive Disorder
C. Bipolar I Disorder
D. Adjustment Disorder
Answer: B
Rationale: Major Depressive Disorder requires at least 2 weeks of depressed mood or
anhedonia with associated symptoms, and the presentation here exceeds that duration.
2. A patient with schizophrenia reports hearing voices telling him to harm himself. What is
the nurse practitioner’s immediate priority?
A. Adjust antipsychotic medication
B. Ensure patient safety
C. Schedule psychotherapy
D. Document the hallucinations
Answer: B
Rationale: Safety is always the top priority in patients experiencing command
hallucinations.
3. Which neurotransmitter is most associated with the pathophysiology of Parkinson’s
disease?
A. Serotonin
B. Dopamine
C. GABA
D. Norepinephrine
Answer: B
Rationale: Dopamine deficiency in the substantia nigra leads to the motor symptoms of
Parkinson’s disease.
4. A patient with generalized anxiety disorder is prescribed an SSRI. What is the most
important teaching point?
A. Immediate relief of anxiety is expected
B. Avoid driving for 6 weeks
C. Therapeutic effects may take 4–6 weeks
D. Increase dose if anxiety persists after 1 day
Answer: C
Rationale: SSRIs often take several weeks to achieve therapeutic effect; patients should
be counseled to continue medication and monitor side effects.
5. Which of the following is a first-line treatment for adult ADHD?
A. Lithium
B. Methylphenidate
, C. Risperidone
D. Buspirone
Answer: B
Rationale: Stimulants like methylphenidate are considered first-line therapy for ADHD in
adults due to efficacy in improving attention and reducing hyperactivity.
6. A patient with bipolar disorder is experiencing a manic episode. Which medication is
considered a mood stabilizer?
A. Fluoxetine
B. Lithium
C. Lorazepam
D. Haloperidol
Answer: B
Rationale: Lithium is a gold-standard mood stabilizer for both acute mania and
maintenance therapy in bipolar disorder.
7. Which of the following is a key symptom of PTSD?
A. Obsessions
B. Re-experiencing traumatic events
C. Hallucinations
D. Compulsions
Answer: B
Rationale: PTSD is characterized by re-experiencing, avoidance, negative cognitions,
and hyperarousal following a traumatic event.
8. A 16-year-old presents with binge eating episodes followed by purging. What is the most
likely diagnosis?
A. Anorexia nervosa
B. Bulimia nervosa
C. Binge-eating disorder
D. Avoidant/restrictive food intake disorder
Answer: B
Rationale: Bulimia nervosa is defined by recurrent binge eating with compensatory
behaviors such as vomiting, fasting, or excessive exercise.
9. Which lab should be monitored in patients taking lithium?
A. CBC
B. Thyroid function tests
C. Liver function tests
D. Fasting glucose
Answer: B
Rationale: Lithium can affect thyroid function, and baseline and periodic monitoring of
TSH is recommended.
10. A patient presents with severe agitation and paranoia. Which antipsychotic is most
appropriate for rapid tranquilization?
A. Olanzapine IM
B. Fluoxetine PO
C. Lorazepam PO
D. Buspirone PO
Answer: A
, Rationale: IM olanzapine is effective for acute agitation in psychosis and can be
administered rapidly.
11. Which psychotherapy is considered first-line for borderline personality disorder?
A. Cognitive Behavioral Therapy
B. Dialectical Behavior Therapy
C. Psychodynamic Therapy
D. Exposure Therapy
Answer: B
Rationale: DBT is evidence-based therapy specifically designed for emotion regulation
and reducing self-harm in borderline personality disorder.
12. Which of the following is a positive symptom of schizophrenia?
A. Flat affect
B. Hallucinations
C. Social withdrawal
D. Anhedonia
Answer: B
Rationale: Positive symptoms include hallucinations, delusions, and thought disorders;
negative symptoms include affective flattening and social withdrawal.
13. A patient with major depressive disorder is started on an SSRI and reports nausea and
insomnia. What is the most appropriate action?
A. Immediately discontinue SSRI
B. Educate patient that side effects often improve over time
C. Switch to MAOI
D. Add antipsychotic
Answer: B
Rationale: Early SSRI side effects are common and usually transient; patient education
and monitoring are appropriate.
14. Which of the following is the most common side effect of atypical antipsychotics?
A. Extrapyramidal symptoms
B. Weight gain and metabolic syndrome
C. Bradycardia
D. Hypotension
Answer: B
Rationale: Atypical antipsychotics like olanzapine and clozapine are associated with
metabolic side effects including weight gain, hyperlipidemia, and diabetes risk.
15. A patient presents with excessive worry for at least 6 months, difficulty concentrating,
and muscle tension. Which is the best diagnosis?
A. Panic Disorder
B. Generalized Anxiety Disorder
C. Social Anxiety Disorder
D. Obsessive-Compulsive Disorder
Answer: B
Rationale: Generalized anxiety disorder is characterized by excessive anxiety and worry
more days than not for at least 6 months.
16. Which of the following is an absolute contraindication to electroconvulsive therapy
(ECT)?
, A. Severe depression
B. Recent myocardial infarction
C. Treatment-resistant schizophrenia
D. Catatonia
Answer: B
Rationale: Recent MI or unstable cardiovascular conditions are relative or absolute
contraindications due to increased risk of complications.
17. A patient on paroxetine reports sexual dysfunction. Which intervention is appropriate?
A. Discontinue therapy abruptly
B. Switch to bupropion
C. Add benzodiazepine
D. Increase dose
Answer: B
Rationale: Bupropion has a lower risk of sexual side effects and can be used when SSRI-
induced sexual dysfunction occurs.
18. Which of the following is a hallmark feature of ADHD in adults?
A. Memory loss
B. Inattention and distractibility
C. Mood swings
D. Hallucinations
Answer: B
Rationale: Adult ADHD commonly presents with inattention, distractibility, and
executive function difficulties.
19. A patient presents with tremor, agitation, diaphoresis, and autonomic instability after
starting an MAOI. What is the likely diagnosis?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Lithium toxicity
D. Panic attack
Answer: A
Rationale: Serotonin syndrome results from excess serotonergic activity and presents
with neuromuscular, autonomic, and mental status changes.
20. Which of the following is considered a first-line treatment for panic disorder?
A. Benzodiazepines only
B. SSRIs and CBT
C. MAOIs
D. Antipsychotics
Answer: B
Rationale: Evidence-based treatment includes SSRIs and cognitive behavioral therapy;
benzodiazepines may be adjunctive for acute symptoms.
21. A 70-year-old patient presents with depression and cognitive decline. Which of the
following should be screened first?
A. Schizophrenia
B. Hypothyroidism
C. Bipolar disorder
D. ADHD
