PMH-BC (PSYCHIATRIC-MENTAL HEALTH) –QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
CORE DOMAINS
Assessment and Diagnosis
Planning and Implementation
Evaluation of Care
Pharmacological and Integrative Therapies
Therapeutic Communication and Relationships
Professional Role and Policy
Quality Improvement and Safety
Legal and Ethical Practice
INTRODUCTION
The purpose of this assessment is to evaluate the clinical proficiency and theoretical knowledge required for the
Psychiatric-Mental Health Nursing Board Certification. This exam assesses the candidate's ability to integrate
advanced nursing concepts with psychiatric principles to provide holistic care. The exam consists of multiple-
choice and scenario-based questions designed to mirror real-world clinical challenges. Candidates are tested
on their decision-making skills, understanding of psychopharmacology, therapeutic modalities, and adherence
to legal and ethical standards. Emphasis is placed on the application of evidence-based practice to improve
patient outcomes in diverse mental health settings.
SECTION ONE: QUESTIONS 1–100
1. A patient with schizophrenia reports hearing voices telling him to "strike out." Which nursing intervention is
the highest priority?
,A. Assist the patient in identifying triggers for the hallucinations.
B. Encourage the patient to listen to loud music to drown out the voices.
🟢 C. Ask the patient specifically what the voices are commanding him to do.
D. Administer an ordered PRN dose of an antipsychotic medication.
🔴 RATIONALE: Assessment of command hallucinations is the priority to ensure safety and determine the risk
of violence toward self or others.
2. Which neurotransmitter is primarily implicated in the pathophysiology of Alzheimer's disease?
🟢 A. Acetylcholine
B. Dopamine
C. Norepinephrine
D. Serotonin
🔴 RATIONALE: A deficit in acetylcholine is a hallmark of Alzheimer's disease, leading to the cognitive decline
and memory loss associated with the condition.
3. A nurse is caring for a client who is experiencing a hypertensive crisis while taking a Monoamine Oxidase
Inhibitor (MAOI). Which food item likely contributed to this event?
A. Fresh cottage cheese
B. Whole grain bread
C. Grilled chicken breast
🟢 D. Smoked salami
🔴 RATIONALE: Smoked meats like salami are high in tyramine, which can trigger a hypertensive crisis in
patients taking MAOIs.
4. According to Peplau’s Theory of Interpersonal Relations, in which phase does the patient begin to feel a
sense of belonging and participate in their care?
,A. Orientation phase
🟢 B. Identification phase
C. Exploitation phase
D. Resolution phase
🔴 RATIONALE: In the identification phase, the patient identifies with those who can help them and begins to
participate actively in their treatment plan.
5. A client is admitted with a blood alcohol level of 0.20%. What is the most critical assessment for the nurse
to perform within the first 6 to 24 hours of admission?
A. Assessing for liver cirrhosis signs
B. Monitoring for nutritional deficiencies
🟢 C. Monitoring for tremors and agitation
D. Assessing for long-term memory loss
🔴 RATIONALE: Alcohol withdrawal symptoms, including tremors and agitation, typically begin within 6 to 24
hours after the last drink and can progress to life-threatening seizures or delirium tremens.
6. A 24-year-old female patient with Borderline Personality Disorder (BPD) tells the day-shift nurse, "You are
the only one who cares; the night-shift nurse is incompetent." This is an example of:
A. Projection
B. Sublimation
🟢 C. Splitting
D. Rationalization
🔴 RATIONALE: Splitting is a common defense mechanism in BPD where individuals perceive others as all
good or all bad to manage internal anxiety.
7. Which legal principle is violated if a nurse threatens to place a competent patient in mechanical restraints
against their will?
, 🟢 A. Assault
B. Battery
C. False Imprisonment
D. Defamation
🔴 RATIONALE: Assault is an act that results in a person’s apprehension of being touched in an offensive or
harmful manner without consent.
8. When treating a patient with Lithium for Bipolar Disorder, which laboratory value requires immediate
follow-up?
A. Sodium 138 mEq/L
B. BUN 15 mg/dL
🟢 C. Lithium level 1.8 mEq/L
D. Creatinine 1.0 mg/dL
🔴 RATIONALE: A lithium level of 1.8 mEq/L is above the therapeutic range (0.6-1.2 mEq/L) and indicates
toxicity, requiring immediate intervention.
9. A patient is exhibiting repetitive, involuntary movements of the tongue and jaw after years of taking
Haloperidol. This condition is known as:
A. Akathisia
B. Dystonia
🟢 C. Tardive Dyskinesia
D. Pseudoparkinsonism
🔴 RATIONALE: Tardive Dyskinesia is a late-onset extrapyramidal side effect characterized by involuntary
movements resulting from long-term antipsychotic use.
10. In a group therapy session, a patient states, "I've been through this before, and it helped me realize I'm
not alone." This represents which of Yalom's curative factors?
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
CORE DOMAINS
Assessment and Diagnosis
Planning and Implementation
Evaluation of Care
Pharmacological and Integrative Therapies
Therapeutic Communication and Relationships
Professional Role and Policy
Quality Improvement and Safety
Legal and Ethical Practice
INTRODUCTION
The purpose of this assessment is to evaluate the clinical proficiency and theoretical knowledge required for the
Psychiatric-Mental Health Nursing Board Certification. This exam assesses the candidate's ability to integrate
advanced nursing concepts with psychiatric principles to provide holistic care. The exam consists of multiple-
choice and scenario-based questions designed to mirror real-world clinical challenges. Candidates are tested
on their decision-making skills, understanding of psychopharmacology, therapeutic modalities, and adherence
to legal and ethical standards. Emphasis is placed on the application of evidence-based practice to improve
patient outcomes in diverse mental health settings.
SECTION ONE: QUESTIONS 1–100
1. A patient with schizophrenia reports hearing voices telling him to "strike out." Which nursing intervention is
the highest priority?
,A. Assist the patient in identifying triggers for the hallucinations.
B. Encourage the patient to listen to loud music to drown out the voices.
🟢 C. Ask the patient specifically what the voices are commanding him to do.
D. Administer an ordered PRN dose of an antipsychotic medication.
🔴 RATIONALE: Assessment of command hallucinations is the priority to ensure safety and determine the risk
of violence toward self or others.
2. Which neurotransmitter is primarily implicated in the pathophysiology of Alzheimer's disease?
🟢 A. Acetylcholine
B. Dopamine
C. Norepinephrine
D. Serotonin
🔴 RATIONALE: A deficit in acetylcholine is a hallmark of Alzheimer's disease, leading to the cognitive decline
and memory loss associated with the condition.
3. A nurse is caring for a client who is experiencing a hypertensive crisis while taking a Monoamine Oxidase
Inhibitor (MAOI). Which food item likely contributed to this event?
A. Fresh cottage cheese
B. Whole grain bread
C. Grilled chicken breast
🟢 D. Smoked salami
🔴 RATIONALE: Smoked meats like salami are high in tyramine, which can trigger a hypertensive crisis in
patients taking MAOIs.
4. According to Peplau’s Theory of Interpersonal Relations, in which phase does the patient begin to feel a
sense of belonging and participate in their care?
,A. Orientation phase
🟢 B. Identification phase
C. Exploitation phase
D. Resolution phase
🔴 RATIONALE: In the identification phase, the patient identifies with those who can help them and begins to
participate actively in their treatment plan.
5. A client is admitted with a blood alcohol level of 0.20%. What is the most critical assessment for the nurse
to perform within the first 6 to 24 hours of admission?
A. Assessing for liver cirrhosis signs
B. Monitoring for nutritional deficiencies
🟢 C. Monitoring for tremors and agitation
D. Assessing for long-term memory loss
🔴 RATIONALE: Alcohol withdrawal symptoms, including tremors and agitation, typically begin within 6 to 24
hours after the last drink and can progress to life-threatening seizures or delirium tremens.
6. A 24-year-old female patient with Borderline Personality Disorder (BPD) tells the day-shift nurse, "You are
the only one who cares; the night-shift nurse is incompetent." This is an example of:
A. Projection
B. Sublimation
🟢 C. Splitting
D. Rationalization
🔴 RATIONALE: Splitting is a common defense mechanism in BPD where individuals perceive others as all
good or all bad to manage internal anxiety.
7. Which legal principle is violated if a nurse threatens to place a competent patient in mechanical restraints
against their will?
, 🟢 A. Assault
B. Battery
C. False Imprisonment
D. Defamation
🔴 RATIONALE: Assault is an act that results in a person’s apprehension of being touched in an offensive or
harmful manner without consent.
8. When treating a patient with Lithium for Bipolar Disorder, which laboratory value requires immediate
follow-up?
A. Sodium 138 mEq/L
B. BUN 15 mg/dL
🟢 C. Lithium level 1.8 mEq/L
D. Creatinine 1.0 mg/dL
🔴 RATIONALE: A lithium level of 1.8 mEq/L is above the therapeutic range (0.6-1.2 mEq/L) and indicates
toxicity, requiring immediate intervention.
9. A patient is exhibiting repetitive, involuntary movements of the tongue and jaw after years of taking
Haloperidol. This condition is known as:
A. Akathisia
B. Dystonia
🟢 C. Tardive Dyskinesia
D. Pseudoparkinsonism
🔴 RATIONALE: Tardive Dyskinesia is a late-onset extrapyramidal side effect characterized by involuntary
movements resulting from long-term antipsychotic use.
10. In a group therapy session, a patient states, "I've been through this before, and it helped me realize I'm
not alone." This represents which of Yalom's curative factors?
