PMHS Pediatric Primary Care Mental Health
Specialist Exam 2025 – Practice Questions &
Answers Verified Study Guide
• This practice guide contains 200 verified multiple-choice questions designed to
prepare you for the PMHS Pediatric Primary Care Mental Health Specialist
certification exam — study actively by attempting each question before revealing
the answer.
• Each question includes 5 options (A–E), a clearly highlighted correct answer with
EXPERT EXPERT RATIONALE, and covers the full breadth of PMHS exam domains
including assessment, diagnosis, psychopharmacology, therapy, ethics, and care
coordination.
1. Which screening tool is most commonly recommended for depression in
adolescents in a primary care setting?
A. GAD-7
B. CRAFFT
C. SCARED
D. PHQ-A (Patient Health Questionnaire for Adolescents)
E. CSSRS
Correct Answer: D. PHQ-A (Patient Health Questionnaire for Adolescents)
EXPERT EXPERT RATIONALE: The PHQ-A is a validated, adolescent-specific
version of the PHQ-9 adapted for use in primary care settings. It screens for major
depressive disorder in adolescents aged 11–17 and is widely endorsed by the AAP
and USPSTF.
2. A 7-year-old presents with difficulty sustaining attention, frequent careless
mistakes, and trouble organizing tasks lasting more than 6 months. What is
the most likely diagnosis?
A. Autism Spectrum Disorder
,B. Generalized Anxiety Disorder
C. Oppositional Defiant Disorder
D. Learning Disability
E. ADHD, Predominantly Inattentive Presentation
Correct Answer: E. ADHD, Predominantly Inattentive Presentation
EXPERT EXPERT RATIONALE: DSM-5 criteria for ADHD require symptoms
present for ≥6 months in two or more settings. Inattentive symptoms such as
careless mistakes, difficulty sustaining attention, and disorganization without
hyperactivity-impulsivity point to the inattentive presentation.
3. Which medication is FDA-approved as a first-line treatment for ADHD in
children aged 6 and older?
A. Risperidone
B. Atomoxetine
C. Clonidine
D. Methylphenidate
E. Sertraline
Correct Answer: D. Methylphenidate
EXPERT EXPERT RATIONALE: Methylphenidate is a stimulant medication FDA-
approved for ADHD in children ≥6 years. It is considered a first-line pharmacological
treatment alongside amphetamine-based agents, with strong evidence supporting
its efficacy.
4. Which of the following best describes the role of the PMHS in pediatric
primary care?
A. Prescribing psychiatric medications independently
,B. Replacing the child psychiatrist in all clinical decisions
C. Conducting inpatient psychiatric evaluations
D. Providing long-term psychotherapy only
E. Integrating mental health assessment and care coordination into primary
care settings
Correct Answer: E. Integrating mental health assessment and care coordination
into primary care settings
EXPERT EXPERT RATIONALE: The PMHS serves as a bridge between primary
care and mental health specialty services, focusing on early identification, care
coordination, brief interventions, and collaboration with the primary care team.
5. A mother reports her 4-year-old has intense tantrums, defies rules
constantly, and argues with adults daily for the past 8 months. The most
appropriate diagnosis to consider is:
A. Conduct Disorder
B. Intermittent Explosive Disorder
C. Bipolar Disorder
D. Oppositional Defiant Disorder
E. ADHD
Correct Answer: D. Oppositional Defiant Disorder
EXPERT EXPERT RATIONALE: ODD is characterized by a pattern of
angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at
least 6 months. It is common in preschool-age children and must be distinguished
from age-appropriate defiance.
6. The CRAFFT screening tool is used to assess:
A. Autism spectrum symptoms
, B. Anxiety in school-age children
C. Depression severity in adolescents
D. Substance use in adolescents
E. ADHD in teenagers
Correct Answer: D. Substance use in adolescents
EXPERT EXPERT RATIONALE: CRAFFT (Car, Relax, Alone, Forget, Friends,
Trouble) is a validated brief screening tool for alcohol and drug use among
adolescents aged 12–21, recommended by SAMHSA and the AAP.
7. Which of the following is the most appropriate first-line pharmacological
treatment for pediatric generalized anxiety disorder?
A. Lorazepam
B. Bupropion
C. Lithium
D. Risperidone
E. Sertraline
Correct Answer: E. Sertraline
EXPERT EXPERT RATIONALE: SSRIs, particularly sertraline and fluoxetine, are
considered first-line pharmacological agents for pediatric anxiety disorders based
on evidence from the CAMS trial and other studies. Benzodiazepines are generally
avoided in children.
8. According to the DSM-5, how many inattentive or hyperactive-impulsive
symptoms are required to diagnose ADHD in children under 17?
A. 3
B. 4
Specialist Exam 2025 – Practice Questions &
Answers Verified Study Guide
• This practice guide contains 200 verified multiple-choice questions designed to
prepare you for the PMHS Pediatric Primary Care Mental Health Specialist
certification exam — study actively by attempting each question before revealing
the answer.
• Each question includes 5 options (A–E), a clearly highlighted correct answer with
EXPERT EXPERT RATIONALE, and covers the full breadth of PMHS exam domains
including assessment, diagnosis, psychopharmacology, therapy, ethics, and care
coordination.
1. Which screening tool is most commonly recommended for depression in
adolescents in a primary care setting?
A. GAD-7
B. CRAFFT
C. SCARED
D. PHQ-A (Patient Health Questionnaire for Adolescents)
E. CSSRS
Correct Answer: D. PHQ-A (Patient Health Questionnaire for Adolescents)
EXPERT EXPERT RATIONALE: The PHQ-A is a validated, adolescent-specific
version of the PHQ-9 adapted for use in primary care settings. It screens for major
depressive disorder in adolescents aged 11–17 and is widely endorsed by the AAP
and USPSTF.
2. A 7-year-old presents with difficulty sustaining attention, frequent careless
mistakes, and trouble organizing tasks lasting more than 6 months. What is
the most likely diagnosis?
A. Autism Spectrum Disorder
,B. Generalized Anxiety Disorder
C. Oppositional Defiant Disorder
D. Learning Disability
E. ADHD, Predominantly Inattentive Presentation
Correct Answer: E. ADHD, Predominantly Inattentive Presentation
EXPERT EXPERT RATIONALE: DSM-5 criteria for ADHD require symptoms
present for ≥6 months in two or more settings. Inattentive symptoms such as
careless mistakes, difficulty sustaining attention, and disorganization without
hyperactivity-impulsivity point to the inattentive presentation.
3. Which medication is FDA-approved as a first-line treatment for ADHD in
children aged 6 and older?
A. Risperidone
B. Atomoxetine
C. Clonidine
D. Methylphenidate
E. Sertraline
Correct Answer: D. Methylphenidate
EXPERT EXPERT RATIONALE: Methylphenidate is a stimulant medication FDA-
approved for ADHD in children ≥6 years. It is considered a first-line pharmacological
treatment alongside amphetamine-based agents, with strong evidence supporting
its efficacy.
4. Which of the following best describes the role of the PMHS in pediatric
primary care?
A. Prescribing psychiatric medications independently
,B. Replacing the child psychiatrist in all clinical decisions
C. Conducting inpatient psychiatric evaluations
D. Providing long-term psychotherapy only
E. Integrating mental health assessment and care coordination into primary
care settings
Correct Answer: E. Integrating mental health assessment and care coordination
into primary care settings
EXPERT EXPERT RATIONALE: The PMHS serves as a bridge between primary
care and mental health specialty services, focusing on early identification, care
coordination, brief interventions, and collaboration with the primary care team.
5. A mother reports her 4-year-old has intense tantrums, defies rules
constantly, and argues with adults daily for the past 8 months. The most
appropriate diagnosis to consider is:
A. Conduct Disorder
B. Intermittent Explosive Disorder
C. Bipolar Disorder
D. Oppositional Defiant Disorder
E. ADHD
Correct Answer: D. Oppositional Defiant Disorder
EXPERT EXPERT RATIONALE: ODD is characterized by a pattern of
angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at
least 6 months. It is common in preschool-age children and must be distinguished
from age-appropriate defiance.
6. The CRAFFT screening tool is used to assess:
A. Autism spectrum symptoms
, B. Anxiety in school-age children
C. Depression severity in adolescents
D. Substance use in adolescents
E. ADHD in teenagers
Correct Answer: D. Substance use in adolescents
EXPERT EXPERT RATIONALE: CRAFFT (Car, Relax, Alone, Forget, Friends,
Trouble) is a validated brief screening tool for alcohol and drug use among
adolescents aged 12–21, recommended by SAMHSA and the AAP.
7. Which of the following is the most appropriate first-line pharmacological
treatment for pediatric generalized anxiety disorder?
A. Lorazepam
B. Bupropion
C. Lithium
D. Risperidone
E. Sertraline
Correct Answer: E. Sertraline
EXPERT EXPERT RATIONALE: SSRIs, particularly sertraline and fluoxetine, are
considered first-line pharmacological agents for pediatric anxiety disorders based
on evidence from the CAMS trial and other studies. Benzodiazepines are generally
avoided in children.
8. According to the DSM-5, how many inattentive or hyperactive-impulsive
symptoms are required to diagnose ADHD in children under 17?
A. 3
B. 4
