APEA EXAM zm
Exam Solution zm
PMHNP post test 2026 A+ GRADE ASSURED COMPLETE zm zm zm zm zm zm zm zm
SOLUTIONS AND VERIFIED ANSWERS (670CA) zm zm zm zm
QUESTION 1 zm
A 37-year-
zm
old man with bipolar disorder is being evaluated following a suicide attempt. He is cu
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
rrently taking quetiapine for bipolar maintenance therapy. The PMHNP considers the
zm zm zm zm zm zm zm zm zm zm zm
addition of: Perphenazine. Clomipramine. Bupropion. Lithium.
zm zm zm zm zm
ANSWER
Lithium. The addition of another antipsychotic would not be recommended (A). Antidepressants such
zm zm zm zm zm zm zm zm zm zm zm zm
as clomipramine (
zm zm zm
B) and bupropion (
zm zm zm
C) are not recommended in the management of bipolar disorder.
zm zm zm zm zm zm zm zm zm
QUESTION 2 zm
When initiating lithium therapy for mood stabilization, the PMHNP recommends check
zm zm zm zm zm zm zm zm zm zm
ing serum lithium level: In 2 days. In 5 days. In 14 days. Only when adverse effects ar
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
e reported.
zm
ANSWER
In 5 days Testing after 2 days of initiating lithium treatment would not allow enough time to get an
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm z
madequate assessment of the steady- zm zm zm zm
state lithium level (A). Waiting until 14 days or longer after initiating therapy is too long and would
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm z
mnot allow timely dose adjustment to ensure a safe and effective level is attained (D). Lithium levels
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
should be routinely monitored and not limited to only when adverse effects are reported (D).
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
QUESTION 3 zm
A 27-year-
zm
old woman is being treated with a SSRI for generalized anxiety disorder. She mention
zm zm zm zm zm zm zm zm zm zm zm zm zm
s that she is experiencing migraines about once per week and asks what she can take
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm z
mto treat an acute migraine. The PMHNP recommends: Ibuprofen. Sumatriptan. Topira
zm zm zm zm zm zm zm zm zm zm
mate. Propranolol. zm
,ANSWER
Ibuprofen. Ibuprofen or acetaminophen are appropriate choices to treat an acute migraine episode f
zm zm zm zm zm zm zm zm zm zm zm zm zm
or this patient. (A). These pain relievers are safe to use in patients taking a SSRI agent.
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
QUESTION 4 zm
Deb is a 41-year- zm zm zm
old female with a history of bipolar I disorder who stopped taking her mood stabilize
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
r because of a lapse in her health insurance. At a follow-
zm zm zm zm zm zm zm zm zm zm zm
up visit, she presents with signs of moderate-to-
zm zm zm zm zm zm zm
severe depression. The PMHNP realizes which of the following is FDA approved for th
zm zm zm zm zm zm zm zm zm zm zm zm zm
e treatment of bipolar depression? Divalproex sodium Risperidone Citalopram Lurasid
zm zm zm zm zm zm zm zm zm
one
ANSWER
Lurasidone SSRIs are not recommended for bipolar depression alone as this can trigger a manic epis
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
ode (C). The anticonvulsant divalproex sodium and the second-
zm zm zm zm zm zm zm zm
generation antipsychotic risperidone are indicated for the treatment of acute mania but not bipolar
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
depression (A, B). zm zm
QUESTION 5 zm
Lanugo is a condition most often associated with which of the following mental health
zm zm zm zm zm zm zm zm zm zm zm zm zm z
disorders? Binge-eating disorder Schizophrenia Anorexia Alzheimer's dementia
m zm zm zm zm zm zm
ANSWER
Anorexia Lanugo associated with malnutrition is not an expected finding among those with binge-
zm zm zm zm zm zm zm zm zm zm zm zm zm
eating disorder (A), schizophrenia (B), or Alzheimer's dementia (D).
zm zm zm zm zm zm zm zm
QUESTION 6 zm
Which of the following individuals with depression would be the best candidate for fl
zm zm zm zm zm zm zm zm zm zm zm zm zm
uoxetine therapy? An 81-year-old with multiple comorbid conditions A 48-year-
zm zm zm zm zm zm zm zm zm
old with a long history of alcohol abuse A 25-year-old with insomnia A 35-year-
zm zm zm zm zm zm zm zm zm zm zm zm zm
old with a history of poor medication adherence
zm zm zm zm zm zm zm
ANSWER
A 35-year-old with a history of poor medication adherence Given the prolonged half-
zm zm zm zm zm zm zm zm zm zm zm zm
life, fluoxetine is not recommended for those with decreased metabolism of the drug as this can incr
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
ease drug exposure. This can include the elderly (
zm zm zm zm zm zm zm zm
A) as well as those with decreased hepatic function (B). This agent is also energizing and can help e
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
xacerbate symptoms of insomnia (C). zm zm zm zm
QUESTION 7 zm
, Jessica is a 33-year- zm zm zm
old woman with bipolar I disorder who will initiate lithium for mood stabilization. Th
zm zm zm zm zm zm zm zm zm zm zm zm zm
e PMHNP counsels Jessica that an anticipated adverse effect of lithium therapy is: Nau
zm zm zm zm zm zm zm zm zm zm zm zm zm
sea and vomiting. Hyperirritability of muscles. Coarse hand tremor. Sedation.
zm zm zm zm zm zm zm zm zm
ANSWER
Nausea and vomiting. Lithium is an inexpensive and effective drug that is often used for mood stabil
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
ization. However, lithium toxicity can be a life-
zm zm zm zm zm zm zm
threatening condition and, thus, routine drug level monitoring is needed to ensure a therapeutic leve
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
l is maintained. Common adverse effects of lithium include nausea, vomiting, and thirst, and these ar
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
e not necessarily a sign of toxicity (A).
zm zm zm zm zm zm zm
QUESTION 8 zm
Jessica returns about two weeks later and reports some improvement in symptoms. H
zm zm zm zm zm zm zm zm zm zm zm zm
er lithium level is 0.4 mEq/L and she does not report any unusual signs or symptoms
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
other than mild thirst. The PMHNP will advise: This is within the normal therapeutic
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
range. The dose should be increased. The dose should be decreased. She should disco
zm zm zm zm zm zm zm zm zm zm zm zm zm
ntinue therapy immediately. zm zm
ANSWER
The dose should be increased. As the expected lithium level should be in the range of 0.6 to 1.0 mE
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
q/L, her dose should be titrated higher rather than decreased or continued at the same dose (A, B).
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm z
There is no need to stop therapy as there is no report of a serious adverse effect (D).
m zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
QUESTION 9 zm
A 44-year-
zm
old woman is being evaluated for panic disorder. When asked to describe what she ex
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
periences during a panic attack, which of the following is least likely to be mentioned
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
? Chest pain Profuse sweating Vertigo Shortness of breath
zm zm zm zm zm zm zm zm
ANSWER
Vertigo Panic disorder is characterized by an abrupt surge of intense fear or discomfort and can incl
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
ude a number of symptoms including palpitations, pounding heart, sweating (B), trembling or shakin
zm zm zm zm zm zm zm zm zm zm zm zm zm
g, sensation of shortness of breath (D), chest pain (A), nausea, and dizziness, among others. Those w
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
ith panic disorder will adapt their behavior to avoid panic attacks or avoid unfamiliar surroundings
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
in case a panic attack occurs.
zm zm zm zm zm
QUESTION 10 zm
When making a diagnosis of depression, the DSM-
zm zm zm zm zm zm zm
5 criteria require a finding of either depressed mood and/or a finding of: Recurring t
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
houghts of death. Diminished self-worth. Loss of interest or pleasure. Fatigue.
zm zm zm zm zm zm zm zm zm zm
ANSWER
Exam Solution zm
PMHNP post test 2026 A+ GRADE ASSURED COMPLETE zm zm zm zm zm zm zm zm
SOLUTIONS AND VERIFIED ANSWERS (670CA) zm zm zm zm
QUESTION 1 zm
A 37-year-
zm
old man with bipolar disorder is being evaluated following a suicide attempt. He is cu
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
rrently taking quetiapine for bipolar maintenance therapy. The PMHNP considers the
zm zm zm zm zm zm zm zm zm zm zm
addition of: Perphenazine. Clomipramine. Bupropion. Lithium.
zm zm zm zm zm
ANSWER
Lithium. The addition of another antipsychotic would not be recommended (A). Antidepressants such
zm zm zm zm zm zm zm zm zm zm zm zm
as clomipramine (
zm zm zm
B) and bupropion (
zm zm zm
C) are not recommended in the management of bipolar disorder.
zm zm zm zm zm zm zm zm zm
QUESTION 2 zm
When initiating lithium therapy for mood stabilization, the PMHNP recommends check
zm zm zm zm zm zm zm zm zm zm
ing serum lithium level: In 2 days. In 5 days. In 14 days. Only when adverse effects ar
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
e reported.
zm
ANSWER
In 5 days Testing after 2 days of initiating lithium treatment would not allow enough time to get an
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm z
madequate assessment of the steady- zm zm zm zm
state lithium level (A). Waiting until 14 days or longer after initiating therapy is too long and would
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm z
mnot allow timely dose adjustment to ensure a safe and effective level is attained (D). Lithium levels
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
should be routinely monitored and not limited to only when adverse effects are reported (D).
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
QUESTION 3 zm
A 27-year-
zm
old woman is being treated with a SSRI for generalized anxiety disorder. She mention
zm zm zm zm zm zm zm zm zm zm zm zm zm
s that she is experiencing migraines about once per week and asks what she can take
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm z
mto treat an acute migraine. The PMHNP recommends: Ibuprofen. Sumatriptan. Topira
zm zm zm zm zm zm zm zm zm zm
mate. Propranolol. zm
,ANSWER
Ibuprofen. Ibuprofen or acetaminophen are appropriate choices to treat an acute migraine episode f
zm zm zm zm zm zm zm zm zm zm zm zm zm
or this patient. (A). These pain relievers are safe to use in patients taking a SSRI agent.
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
QUESTION 4 zm
Deb is a 41-year- zm zm zm
old female with a history of bipolar I disorder who stopped taking her mood stabilize
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
r because of a lapse in her health insurance. At a follow-
zm zm zm zm zm zm zm zm zm zm zm
up visit, she presents with signs of moderate-to-
zm zm zm zm zm zm zm
severe depression. The PMHNP realizes which of the following is FDA approved for th
zm zm zm zm zm zm zm zm zm zm zm zm zm
e treatment of bipolar depression? Divalproex sodium Risperidone Citalopram Lurasid
zm zm zm zm zm zm zm zm zm
one
ANSWER
Lurasidone SSRIs are not recommended for bipolar depression alone as this can trigger a manic epis
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
ode (C). The anticonvulsant divalproex sodium and the second-
zm zm zm zm zm zm zm zm
generation antipsychotic risperidone are indicated for the treatment of acute mania but not bipolar
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
depression (A, B). zm zm
QUESTION 5 zm
Lanugo is a condition most often associated with which of the following mental health
zm zm zm zm zm zm zm zm zm zm zm zm zm z
disorders? Binge-eating disorder Schizophrenia Anorexia Alzheimer's dementia
m zm zm zm zm zm zm
ANSWER
Anorexia Lanugo associated with malnutrition is not an expected finding among those with binge-
zm zm zm zm zm zm zm zm zm zm zm zm zm
eating disorder (A), schizophrenia (B), or Alzheimer's dementia (D).
zm zm zm zm zm zm zm zm
QUESTION 6 zm
Which of the following individuals with depression would be the best candidate for fl
zm zm zm zm zm zm zm zm zm zm zm zm zm
uoxetine therapy? An 81-year-old with multiple comorbid conditions A 48-year-
zm zm zm zm zm zm zm zm zm
old with a long history of alcohol abuse A 25-year-old with insomnia A 35-year-
zm zm zm zm zm zm zm zm zm zm zm zm zm
old with a history of poor medication adherence
zm zm zm zm zm zm zm
ANSWER
A 35-year-old with a history of poor medication adherence Given the prolonged half-
zm zm zm zm zm zm zm zm zm zm zm zm
life, fluoxetine is not recommended for those with decreased metabolism of the drug as this can incr
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
ease drug exposure. This can include the elderly (
zm zm zm zm zm zm zm zm
A) as well as those with decreased hepatic function (B). This agent is also energizing and can help e
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
xacerbate symptoms of insomnia (C). zm zm zm zm
QUESTION 7 zm
, Jessica is a 33-year- zm zm zm
old woman with bipolar I disorder who will initiate lithium for mood stabilization. Th
zm zm zm zm zm zm zm zm zm zm zm zm zm
e PMHNP counsels Jessica that an anticipated adverse effect of lithium therapy is: Nau
zm zm zm zm zm zm zm zm zm zm zm zm zm
sea and vomiting. Hyperirritability of muscles. Coarse hand tremor. Sedation.
zm zm zm zm zm zm zm zm zm
ANSWER
Nausea and vomiting. Lithium is an inexpensive and effective drug that is often used for mood stabil
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
ization. However, lithium toxicity can be a life-
zm zm zm zm zm zm zm
threatening condition and, thus, routine drug level monitoring is needed to ensure a therapeutic leve
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
l is maintained. Common adverse effects of lithium include nausea, vomiting, and thirst, and these ar
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
e not necessarily a sign of toxicity (A).
zm zm zm zm zm zm zm
QUESTION 8 zm
Jessica returns about two weeks later and reports some improvement in symptoms. H
zm zm zm zm zm zm zm zm zm zm zm zm
er lithium level is 0.4 mEq/L and she does not report any unusual signs or symptoms
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
other than mild thirst. The PMHNP will advise: This is within the normal therapeutic
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
range. The dose should be increased. The dose should be decreased. She should disco
zm zm zm zm zm zm zm zm zm zm zm zm zm
ntinue therapy immediately. zm zm
ANSWER
The dose should be increased. As the expected lithium level should be in the range of 0.6 to 1.0 mE
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
q/L, her dose should be titrated higher rather than decreased or continued at the same dose (A, B).
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm z
There is no need to stop therapy as there is no report of a serious adverse effect (D).
m zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
QUESTION 9 zm
A 44-year-
zm
old woman is being evaluated for panic disorder. When asked to describe what she ex
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
periences during a panic attack, which of the following is least likely to be mentioned
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
? Chest pain Profuse sweating Vertigo Shortness of breath
zm zm zm zm zm zm zm zm
ANSWER
Vertigo Panic disorder is characterized by an abrupt surge of intense fear or discomfort and can incl
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
ude a number of symptoms including palpitations, pounding heart, sweating (B), trembling or shakin
zm zm zm zm zm zm zm zm zm zm zm zm zm
g, sensation of shortness of breath (D), chest pain (A), nausea, and dizziness, among others. Those w
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
ith panic disorder will adapt their behavior to avoid panic attacks or avoid unfamiliar surroundings
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
in case a panic attack occurs.
zm zm zm zm zm
QUESTION 10 zm
When making a diagnosis of depression, the DSM-
zm zm zm zm zm zm zm
5 criteria require a finding of either depressed mood and/or a finding of: Recurring t
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
houghts of death. Diminished self-worth. Loss of interest or pleasure. Fatigue.
zm zm zm zm zm zm zm zm zm zm
ANSWER
