PMHN-BC — Psychiatric Mental Health
Nursing Board Certified WITH CORRECT
ACTUAL QUESTIONS AND CORRECTLY
WELL DEFINED ANSWERS LATEST ALREADY
GRADED A+ (2025/2026)
Domain I: Assessment and Diagnosis (Questions 1-33)
Question 1
Which component of the Mental Status Examination assesses the
patient's ability to maintain appropriate eye contact, posture, and motor
activity?
A) Speech
B) Behavior
C) Thought process
D) Insight
Correct ,,,,Answer,,,,: B) Behavior ✅
Rationale: The "Behavior" portion of the MSE includes observations of eye
contact, posture, gait, psychomotor activity (retardation or agitation), and
level of cooperation .
,Question 2
A 68-year-old man with a history of hypertension presents with sudden
confusion, agitation, and visual hallucinations. Which laboratory finding
would most likely support a diagnosis of delirium?
A) Elevated thyroid-stimulating hormone (TSH)
B) Low serum glucose
C) Positive urine drug screen for amphetamines
D) Elevated serum ammonia
Correct ,,,,Answer,,,,: D) Elevated serum ammonia ✅
Rationale: Hyperammonemia from hepatic dysfunction can precipitate
acute encephalopathy and delirium, producing sudden confusion,
agitation, and visual hallucinations .
Question 3
In schizophrenia, which dopamine pathway is most implicated in the
development of positive symptoms such as hallucinations and delusions?
A) Mesolimbic pathway
B) Nigrostriatal pathway
C) Mesocortical pathway
D) Tuberoinfundibular pathway
Correct ,,,,Answer,,,,: A) Mesolimbic pathway ✅
Rationale: Hyperactivity of dopamine in the mesolimbic pathway (VTA →
nucleus accumbens) is linked to positive psychotic symptoms.
Hypoactivity in the mesocortical pathway is associated with negative
symptoms .
,Question 4
Which of the following is the most appropriate initial screening tool for
suicide risk in an adult psychiatric outpatient?
A) PHQ-9 item 9
B) GAD-7
C) CAGE questionnaire
D) MMSE
Correct ,,,,Answer,,,,: A) PHQ-9 item 9 ✅
Rationale: The ninth item of the PHQ-9 specifically asks about thoughts of
self-harm ("thoughts that you would be better off dead or of hurting
yourself") and is widely used as an initial suicide risk screen .
Question 5
A client with bipolar I disorder is currently in a manic episode with
agitation and psychosis. Which medication class is considered FIRST-
LINE for acute mania?
A) Selective serotonin reuptake inhibitors (SSRIs)
B) Lithium
C) Atypical antipsychotics
D) Benzodiazepines alone
Correct ,,,,Answer,,,,: C) Atypical antipsychotics ✅
, Rationale: Atypical antipsychotics (risperidone, olanzapine, quetiapine)
are first-line for rapid control of acute mania, especially with agitation or
psychosis. Lithium is effective but requires slower titration .
Question 6
Which neurotransmitter deficiency is most closely associated with major
depressive disorder and underlies the mechanism of SSRIs?
A) Dopamine
B) Serotonin
C) GABA
D) Acetylcholine
Correct ,,,,Answer,,,,: B) Serotonin ✅
Rationale: Reduced serotonergic activity is a primary hypothesis in the
pathophysiology of depression and underlies the efficacy of SSRIs, which
increase synaptic serotonin by blocking reuptake .
Question 7
Which of the following is the most reliable indicator of lithium toxicity
requiring immediate intervention?
A) Fine hand tremor
B) Diarrhea and nausea
C) Serum lithium level >1.5 mEq/L
D) Polyuria
Nursing Board Certified WITH CORRECT
ACTUAL QUESTIONS AND CORRECTLY
WELL DEFINED ANSWERS LATEST ALREADY
GRADED A+ (2025/2026)
Domain I: Assessment and Diagnosis (Questions 1-33)
Question 1
Which component of the Mental Status Examination assesses the
patient's ability to maintain appropriate eye contact, posture, and motor
activity?
A) Speech
B) Behavior
C) Thought process
D) Insight
Correct ,,,,Answer,,,,: B) Behavior ✅
Rationale: The "Behavior" portion of the MSE includes observations of eye
contact, posture, gait, psychomotor activity (retardation or agitation), and
level of cooperation .
,Question 2
A 68-year-old man with a history of hypertension presents with sudden
confusion, agitation, and visual hallucinations. Which laboratory finding
would most likely support a diagnosis of delirium?
A) Elevated thyroid-stimulating hormone (TSH)
B) Low serum glucose
C) Positive urine drug screen for amphetamines
D) Elevated serum ammonia
Correct ,,,,Answer,,,,: D) Elevated serum ammonia ✅
Rationale: Hyperammonemia from hepatic dysfunction can precipitate
acute encephalopathy and delirium, producing sudden confusion,
agitation, and visual hallucinations .
Question 3
In schizophrenia, which dopamine pathway is most implicated in the
development of positive symptoms such as hallucinations and delusions?
A) Mesolimbic pathway
B) Nigrostriatal pathway
C) Mesocortical pathway
D) Tuberoinfundibular pathway
Correct ,,,,Answer,,,,: A) Mesolimbic pathway ✅
Rationale: Hyperactivity of dopamine in the mesolimbic pathway (VTA →
nucleus accumbens) is linked to positive psychotic symptoms.
Hypoactivity in the mesocortical pathway is associated with negative
symptoms .
,Question 4
Which of the following is the most appropriate initial screening tool for
suicide risk in an adult psychiatric outpatient?
A) PHQ-9 item 9
B) GAD-7
C) CAGE questionnaire
D) MMSE
Correct ,,,,Answer,,,,: A) PHQ-9 item 9 ✅
Rationale: The ninth item of the PHQ-9 specifically asks about thoughts of
self-harm ("thoughts that you would be better off dead or of hurting
yourself") and is widely used as an initial suicide risk screen .
Question 5
A client with bipolar I disorder is currently in a manic episode with
agitation and psychosis. Which medication class is considered FIRST-
LINE for acute mania?
A) Selective serotonin reuptake inhibitors (SSRIs)
B) Lithium
C) Atypical antipsychotics
D) Benzodiazepines alone
Correct ,,,,Answer,,,,: C) Atypical antipsychotics ✅
, Rationale: Atypical antipsychotics (risperidone, olanzapine, quetiapine)
are first-line for rapid control of acute mania, especially with agitation or
psychosis. Lithium is effective but requires slower titration .
Question 6
Which neurotransmitter deficiency is most closely associated with major
depressive disorder and underlies the mechanism of SSRIs?
A) Dopamine
B) Serotonin
C) GABA
D) Acetylcholine
Correct ,,,,Answer,,,,: B) Serotonin ✅
Rationale: Reduced serotonergic activity is a primary hypothesis in the
pathophysiology of depression and underlies the efficacy of SSRIs, which
increase synaptic serotonin by blocking reuptake .
Question 7
Which of the following is the most reliable indicator of lithium toxicity
requiring immediate intervention?
A) Fine hand tremor
B) Diarrhea and nausea
C) Serum lithium level >1.5 mEq/L
D) Polyuria
