Psychiatric Mental Health Nursing Certification
PMH-BC ACTUAL EXAM 2026/2027 | PMH-BC
ANCC Certification | Verified Q&A | Pass
Guaranteed - A+ Graded
Domain 1: Assessment (Questions 1–30)
Q1: A PMH-BC nurse is assessing a 42-year-old patient with a history of major depressive disorder. The
patient states, "I don't want to be a burden anymore. Everyone would be better off without me." Which
assessment question is the priority?
A. "How long have you felt this way?"
B. "Do you have a plan to end your life?" [CORRECT]
C. "Have you ever seen a therapist before?"
D. "What medications are you currently taking?"
Correct Answer: B
Rationale: Directly asking about suicidal plan (method, means, timing) is the priority to determine
imminent risk and guide immediate safety interventions such as one-to-one observation or
hospitalization.
Q2: A 68-year-old patient is brought to the emergency department by family for sudden onset of
confusion, hallucinations, and agitation that began yesterday. The patient has no prior psychiatric
history. What is the most likely cause?
A. Late-onset schizophrenia
B. Delirium due to a medical condition [CORRECT]
C. Major depressive disorder with psychotic features
D. Bipolar disorder with mixed features
Correct Answer: B
Rationale: Sudden onset, fluctuating course, altered consciousness, and new confusion in an older adult
without psychiatric history is hallmark of delirium, which requires immediate medical workup for
underlying causes (infection, metabolic, medication).
,Q3: Which medication requires regular monitoring of absolute neutrophil count (ANC) due to risk of
agranulocytosis?
A. Quetiapine
B. Aripiprazole
C. Clozapine [CORRECT]
D. Risperidone
Correct Answer: C
Rationale: Clozapine carries a black box warning for severe neutropenia/agranulocytosis requiring
regular ANC monitoring through the REMS program (weekly then biweekly then monthly).
Q4: A PMH-BC nurse is conducting a mental status examination. The patient demonstrates rapid,
pressured speech with frequent topic changes. This finding is best described as:
A. Flight of ideas [CORRECT]
B. Thought blocking
C. Circumstantiality
D. Tangentiality
Correct Answer: A
Rationale: Flight of ideas is characterized by rapid, continuous speech with abrupt shifts between topics,
often seen in manic episodes; it reflects accelerated thought processes and racing thoughts.
Q5: A patient with borderline personality disorder is admitted after a suicide attempt. Which protective
factor should the nurse document?
A. History of multiple previous attempts
B. Strong religious beliefs that oppose suicide [CORRECT]
C. Access to lethal means
D. Chronic substance use
Correct Answer: B
Rationale: Protective factors against suicide include strong religious/spiritual beliefs, social support,
responsibility to children, and positive therapeutic relationships; these factors reduce imminent risk and
inform safety planning.
,Q6: A 55-year-old patient presents with depressed mood, fatigue, constipation, and dry skin. TSH is
elevated. What is the priority nursing action?
A. Start an SSRI for depression
B. Refer for thyroid function evaluation and treatment [CORRECT]
C. Begin cognitive behavioral therapy
D. Assess for bipolar disorder
Correct Answer: B
Rationale: Hypothyroidism commonly mimics depression with fatigue, constipation, and dry skin; ruling
out and treating medical causes before diagnosing primary depression is essential for appropriate care.
Q7: The PMH-BC nurse is assessing a patient for alcohol use disorder. Which screening tool is most
appropriate for identifying hazardous drinking?
A. PHQ-9
B. AUDIT (Alcohol Use Disorders Identification Test) [CORRECT]
C. GAD-7
D. MMSE
Correct Answer: B
Rationale: The AUDIT is a 10-item WHO-validated screening tool that identifies hazardous drinking,
harmful alcohol use, and dependence; it is superior to CAGE for detecting at-risk drinking across
populations.
Q8: A patient with schizophrenia reports hearing voices commanding them to "hurt the nurse." What is
the priority nursing assessment?
A. Ask the patient to describe the voices and assess command hallucination compliance [CORRECT]
B. Ignore the hallucinations to avoid reinforcing them
C. Immediately restrain the patient
D. Tell the patient the voices are not real
Correct Answer: A
Rationale: Assessing the content of command hallucinations and the patient's relationship with the
voices (resistance vs. compliance) determines imminent violence risk and guides safety interventions.
, Q9: A trauma-informed assessment approach emphasizes which principle?
A. Focus on past trauma details immediately
B. Safety, trustworthiness, choice, collaboration, and empowerment [CORRECT]
C. Confront the patient about substance use
D. Require the patient to discuss trauma before other concerns
Correct Answer: B
Rationale: The six principles of trauma-informed care (SAMHSA) are safety,
trustworthiness/transparency, peer support, collaboration, empowerment, and
cultural/historical/gender issues; these create a safe environment for disclosure.
Q10: A patient presents with agitation, diaphoresis, tremors, and hallucinations 48 hours after their last
drink. What is the most likely diagnosis?
A. Alcohol intoxication
B. Alcohol withdrawal delirium (delirium tremens) [CORRECT]
C. Wernicke encephalopathy
D. Korsakoff syndrome
Correct Answer: B
Rationale: Alcohol withdrawal delirium presents 48-96 hours after last drink with autonomic
hyperactivity (tachycardia, hypertension, diaphoresis), agitation, and visual hallucinations; it is a medical
emergency with mortality up to 15% without treatment.
Q11: A PMH-BC nurse is assessing a child for ADHD. Which assessment tool is most appropriate?
A. PHQ-9
B. Conners Rating Scales [CORRECT]
C. GAD-7
D. MoCA
Correct Answer: B
Rationale: The Conners Rating Scales (parent and teacher versions) are validated ADHD assessment tools
that evaluate inattention, hyperactivity, and impulsivity across settings; multi-informant data is required
for accurate diagnosis.
PMH-BC ACTUAL EXAM 2026/2027 | PMH-BC
ANCC Certification | Verified Q&A | Pass
Guaranteed - A+ Graded
Domain 1: Assessment (Questions 1–30)
Q1: A PMH-BC nurse is assessing a 42-year-old patient with a history of major depressive disorder. The
patient states, "I don't want to be a burden anymore. Everyone would be better off without me." Which
assessment question is the priority?
A. "How long have you felt this way?"
B. "Do you have a plan to end your life?" [CORRECT]
C. "Have you ever seen a therapist before?"
D. "What medications are you currently taking?"
Correct Answer: B
Rationale: Directly asking about suicidal plan (method, means, timing) is the priority to determine
imminent risk and guide immediate safety interventions such as one-to-one observation or
hospitalization.
Q2: A 68-year-old patient is brought to the emergency department by family for sudden onset of
confusion, hallucinations, and agitation that began yesterday. The patient has no prior psychiatric
history. What is the most likely cause?
A. Late-onset schizophrenia
B. Delirium due to a medical condition [CORRECT]
C. Major depressive disorder with psychotic features
D. Bipolar disorder with mixed features
Correct Answer: B
Rationale: Sudden onset, fluctuating course, altered consciousness, and new confusion in an older adult
without psychiatric history is hallmark of delirium, which requires immediate medical workup for
underlying causes (infection, metabolic, medication).
,Q3: Which medication requires regular monitoring of absolute neutrophil count (ANC) due to risk of
agranulocytosis?
A. Quetiapine
B. Aripiprazole
C. Clozapine [CORRECT]
D. Risperidone
Correct Answer: C
Rationale: Clozapine carries a black box warning for severe neutropenia/agranulocytosis requiring
regular ANC monitoring through the REMS program (weekly then biweekly then monthly).
Q4: A PMH-BC nurse is conducting a mental status examination. The patient demonstrates rapid,
pressured speech with frequent topic changes. This finding is best described as:
A. Flight of ideas [CORRECT]
B. Thought blocking
C. Circumstantiality
D. Tangentiality
Correct Answer: A
Rationale: Flight of ideas is characterized by rapid, continuous speech with abrupt shifts between topics,
often seen in manic episodes; it reflects accelerated thought processes and racing thoughts.
Q5: A patient with borderline personality disorder is admitted after a suicide attempt. Which protective
factor should the nurse document?
A. History of multiple previous attempts
B. Strong religious beliefs that oppose suicide [CORRECT]
C. Access to lethal means
D. Chronic substance use
Correct Answer: B
Rationale: Protective factors against suicide include strong religious/spiritual beliefs, social support,
responsibility to children, and positive therapeutic relationships; these factors reduce imminent risk and
inform safety planning.
,Q6: A 55-year-old patient presents with depressed mood, fatigue, constipation, and dry skin. TSH is
elevated. What is the priority nursing action?
A. Start an SSRI for depression
B. Refer for thyroid function evaluation and treatment [CORRECT]
C. Begin cognitive behavioral therapy
D. Assess for bipolar disorder
Correct Answer: B
Rationale: Hypothyroidism commonly mimics depression with fatigue, constipation, and dry skin; ruling
out and treating medical causes before diagnosing primary depression is essential for appropriate care.
Q7: The PMH-BC nurse is assessing a patient for alcohol use disorder. Which screening tool is most
appropriate for identifying hazardous drinking?
A. PHQ-9
B. AUDIT (Alcohol Use Disorders Identification Test) [CORRECT]
C. GAD-7
D. MMSE
Correct Answer: B
Rationale: The AUDIT is a 10-item WHO-validated screening tool that identifies hazardous drinking,
harmful alcohol use, and dependence; it is superior to CAGE for detecting at-risk drinking across
populations.
Q8: A patient with schizophrenia reports hearing voices commanding them to "hurt the nurse." What is
the priority nursing assessment?
A. Ask the patient to describe the voices and assess command hallucination compliance [CORRECT]
B. Ignore the hallucinations to avoid reinforcing them
C. Immediately restrain the patient
D. Tell the patient the voices are not real
Correct Answer: A
Rationale: Assessing the content of command hallucinations and the patient's relationship with the
voices (resistance vs. compliance) determines imminent violence risk and guides safety interventions.
, Q9: A trauma-informed assessment approach emphasizes which principle?
A. Focus on past trauma details immediately
B. Safety, trustworthiness, choice, collaboration, and empowerment [CORRECT]
C. Confront the patient about substance use
D. Require the patient to discuss trauma before other concerns
Correct Answer: B
Rationale: The six principles of trauma-informed care (SAMHSA) are safety,
trustworthiness/transparency, peer support, collaboration, empowerment, and
cultural/historical/gender issues; these create a safe environment for disclosure.
Q10: A patient presents with agitation, diaphoresis, tremors, and hallucinations 48 hours after their last
drink. What is the most likely diagnosis?
A. Alcohol intoxication
B. Alcohol withdrawal delirium (delirium tremens) [CORRECT]
C. Wernicke encephalopathy
D. Korsakoff syndrome
Correct Answer: B
Rationale: Alcohol withdrawal delirium presents 48-96 hours after last drink with autonomic
hyperactivity (tachycardia, hypertension, diaphoresis), agitation, and visual hallucinations; it is a medical
emergency with mortality up to 15% without treatment.
Q11: A PMH-BC nurse is assessing a child for ADHD. Which assessment tool is most appropriate?
A. PHQ-9
B. Conners Rating Scales [CORRECT]
C. GAD-7
D. MoCA
Correct Answer: B
Rationale: The Conners Rating Scales (parent and teacher versions) are validated ADHD assessment tools
that evaluate inattention, hyperactivity, and impulsivity across settings; multi-informant data is required
for accurate diagnosis.
