Page 1 of 148
ANCC Psychiatric–Mental Health Nurse Practitioner
(PMHNP) EXAM REVIEW VERSION WITH ALL 300
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES JUST RELEASED THIS YEAR
TITLE:
ANCC Psychiatric–Mental Health Nurse Practitioner (PMHNP) Practice Examination Review
ORGANIZATION:
American Nurses Credentialing Center
PROGRAM:
Psychiatric–Mental Health Nurse Practitioner (PMHNP) Certification
EDITION:
Latest Version
YEAR:
2026–2027
TOTAL QUESTIONS:
300 Randomized Questions
TYPE OF QUESTIONS:
• Multiple Choice Questions (MCQs)
• Scenario-based psychiatric case questions
• Clinical judgment and advanced practice items
EXAM FORMAT:
• Computer-based or paper-based practice exam
• Four-option multiple choice format (A–D)
• Includes correct answers and summarized rationales
• Randomized question order
1
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EXAM DESCRIPTION:
This comprehensive PMHNP practice exam evaluates advanced psychiatric nursing knowledge
related to mental health assessment, diagnosis, psychotherapy, psychopharmacology, ethical
and legal principles, and advanced practice nursing responsibilities.
INSTRUCTIONS:
• Read each question carefully
• Select the most appropriate clinical response
• Apply evidence-based psychiatric nursing principles
• Use clinical judgment and therapeutic communication skills
• No negative marking
PAGE 2: EXAM COVERAGE (BRIEF SUMMARY)
Topics Covered:
• Psychiatric assessment and diagnosis
• DSM-5 mental health disorders
• Therapeutic communication techniques
• Individual, group, and family psychotherapy
• Psychopharmacology and medication management
• Mood, anxiety, psychotic, and personality disorders
• Substance use and addiction disorders
• Crisis intervention and suicide risk assessment
• Child, adolescent, adult, and geriatric psychiatry
• Ethical and legal issues in psychiatric care
• Cultural competence and trauma-informed care
• Advanced practice nursing roles and leadership
• Patient education and interdisciplinary collaboration
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• Evidence-based psychiatric treatment planning
1. A patient reports feeling “empty,” having no interest in hobbies, and sleeping 12 hours a day
without feeling rested. Which screening tool is most appropriate first step?
A) GAD-7
B) C-SSRS
C) PHQ-9
D) AUDIT
Answer: C
PHQ-9 screens for major depression; anhedonia and hypersomnia are core depressive
symptoms.
2. A 22-year-old with no psychiatric history presents with 3 days of rapid speech, decreased
need for sleep, grandiose plans, and reckless spending. She is irritable when interrupted. Most
likely diagnosis?
A) Major depressive episode
B) Manic episode
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C) Panic disorder
D) Schizophreniform disorder
Answer: B
*Mania requires ≥1 week of elevated/irritable mood plus increased goal-directed activity or
energy.*
3. A patient taking fluoxetine 40 mg/day for 6 weeks reports no improvement. What is the best
next step?
A) Increase to 60 mg/day
B) Add a second antidepressant
C) Switch to venlafaxine
D) Assess adherence and consider dose optimization within range
Answer: D
Fluoxetine 40 mg is often subtherapeutic; first assess adherence, then consider increasing to
max 80 mg before switching.
4. During a mental status exam, the patient says, “The CIA is controlling my thoughts with
satellites.” This is an example of?
A) Illusion
4
SUCCESS!
ANCC Psychiatric–Mental Health Nurse Practitioner
(PMHNP) EXAM REVIEW VERSION WITH ALL 300
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES JUST RELEASED THIS YEAR
TITLE:
ANCC Psychiatric–Mental Health Nurse Practitioner (PMHNP) Practice Examination Review
ORGANIZATION:
American Nurses Credentialing Center
PROGRAM:
Psychiatric–Mental Health Nurse Practitioner (PMHNP) Certification
EDITION:
Latest Version
YEAR:
2026–2027
TOTAL QUESTIONS:
300 Randomized Questions
TYPE OF QUESTIONS:
• Multiple Choice Questions (MCQs)
• Scenario-based psychiatric case questions
• Clinical judgment and advanced practice items
EXAM FORMAT:
• Computer-based or paper-based practice exam
• Four-option multiple choice format (A–D)
• Includes correct answers and summarized rationales
• Randomized question order
1
SUCCESS!
,Page 2 of 148
EXAM DESCRIPTION:
This comprehensive PMHNP practice exam evaluates advanced psychiatric nursing knowledge
related to mental health assessment, diagnosis, psychotherapy, psychopharmacology, ethical
and legal principles, and advanced practice nursing responsibilities.
INSTRUCTIONS:
• Read each question carefully
• Select the most appropriate clinical response
• Apply evidence-based psychiatric nursing principles
• Use clinical judgment and therapeutic communication skills
• No negative marking
PAGE 2: EXAM COVERAGE (BRIEF SUMMARY)
Topics Covered:
• Psychiatric assessment and diagnosis
• DSM-5 mental health disorders
• Therapeutic communication techniques
• Individual, group, and family psychotherapy
• Psychopharmacology and medication management
• Mood, anxiety, psychotic, and personality disorders
• Substance use and addiction disorders
• Crisis intervention and suicide risk assessment
• Child, adolescent, adult, and geriatric psychiatry
• Ethical and legal issues in psychiatric care
• Cultural competence and trauma-informed care
• Advanced practice nursing roles and leadership
• Patient education and interdisciplinary collaboration
2
SUCCESS!
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• Evidence-based psychiatric treatment planning
1. A patient reports feeling “empty,” having no interest in hobbies, and sleeping 12 hours a day
without feeling rested. Which screening tool is most appropriate first step?
A) GAD-7
B) C-SSRS
C) PHQ-9
D) AUDIT
Answer: C
PHQ-9 screens for major depression; anhedonia and hypersomnia are core depressive
symptoms.
2. A 22-year-old with no psychiatric history presents with 3 days of rapid speech, decreased
need for sleep, grandiose plans, and reckless spending. She is irritable when interrupted. Most
likely diagnosis?
A) Major depressive episode
B) Manic episode
3
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C) Panic disorder
D) Schizophreniform disorder
Answer: B
*Mania requires ≥1 week of elevated/irritable mood plus increased goal-directed activity or
energy.*
3. A patient taking fluoxetine 40 mg/day for 6 weeks reports no improvement. What is the best
next step?
A) Increase to 60 mg/day
B) Add a second antidepressant
C) Switch to venlafaxine
D) Assess adherence and consider dose optimization within range
Answer: D
Fluoxetine 40 mg is often subtherapeutic; first assess adherence, then consider increasing to
max 80 mg before switching.
4. During a mental status exam, the patient says, “The CIA is controlling my thoughts with
satellites.” This is an example of?
A) Illusion
4
SUCCESS!
