PMHNP Certification Exam Questions
and Answers
1. Which patient is at highest risk for SI
A. 30y/o married AA female with previous SI attempt *1 risk factor
B. 35 y/o single Asian male with previous SI attempt *3 risk factors
C. 38 y/o single AA male who is a manager of a bank *2 risk factors
D. 68 y/o single white male with depression *5 risk factors (age,
male, white, depression): D. 68 y/o single white male with depression *5 risk factors (age,
male, white, depression)
Count the risk factors
2. COWS scale components: · Opioid W/D
Pulse, sweating, restlessness, pupil size- dilation (if pinpoint= opioid intoxication, not w/d), body aches,
Rhinorrhea (running nose), Lacrimation (eye tearing), GI upset (N/V/D), yawning, tremors, anxiety/irritability,
Piloerection (goose- flesh skin), insomnia
3. What does COWS stand for?: Clinical Opiate Withdrawal Scale
4. What does CIWA stand for?: Clinical Institute Withdrawal Assessment
,5. What does CIWA assess for?: --used to determine likelihood of ETOH withdrawal or DTs
--usually occur within the first 24-72 hours after cessation
o used to determine when to administer medications for ETOH withdrawal
6. What does CIWA NOT test for?: Alcohol Use Disorder
7. What are the CIWA scale components?: · N/V, tremor, paroxysmal sweats, anxiety,
agitation, tactile disturbances, auditory disturbances, visual disturbances, H/A, orientation
Each component is scored from 0(none)-7(severe) except orientation wh/ is (0 (AA0x4)-4 (disoriented)
Score:
<10: Very mild Start PRN meds at score of 8
>10 to 15: Mild scheduled + PRN meds
>16 to 20: Moderate
>21: Severe Diazepam, Librium, Ativan
8. When interview teenagers (16 y/o) that arrive with their parents
what should you do?: interview them separately from parents.
-This helps Build therapeutic rapport with teens by telling them the info is confidential. Parents may be
upset but remember you are advocating for the child.
9. Which Ethnic group has the highest rate of suicide?: Native Americans
,10. Example A patient is being treated for schizophrenia with
olanzapine. Which of the following is the most common side effect of
olanzapine?
A. Increased waist circumference
B. EPS (not as common in atypical antipsychotics d/t 5HT2A)-
receptor antago- nism
C. Increased Lipids
D. Metabolic Syndrome: D. Metabolic Syndrome (UMBRELLA ANSWER)
11. Which antipsychotics have the least weight gain?: Latuda, Abilify, (also
least sedating), Geodon-if patient has metabolic syndrome consider switching to one of the
medications above. Or if the patient is overly sedated try switching to ABILIFY
12. Which mood stabilizer have the least weight gain?: Lamictal
-But remember all mood stabilizers cause some weight gain
13. When presented with a question about typical vs atypical
antipsychotic the answer is usually to start of a: atypical
14. A client presents with complains of changes in appetite,
feeling fatigued, problems with sleep-rest cycle, and changes in
libido. What is the neu- roanatomical area of the brain that is
responsible for the normal regulation of these functions?
A. Thalamus
, B. Hypothalamus
C. Limbic System
D. Hippocampus: Hypothalamus
A, B, & D are all part of the limbic system so you can rule that out
15. When a patient is hesitant to participate in treatment you
should encour- age?: Bring a support person like a husband
16. Thyroid-Stimulating hormone normal level: 0.5-5.0 Mu/L
17. When T4 and T3 are high and TSH is low what is the diagnosis:
HYPERTHYROIDISM, TSH secretion decreases: TSH LOW à key symptoms HEAT INTOLERANCE
18. Key symptoms of Heat Intolerance: Hyperthyroidism
19. When T4 and T3 are Low and TSH is high what is the diagnosis:
(HYPOTHYROIDISM) TSH secretion increased: TSH HIGH à COLD INTERANCE
20. Key symptoms of Cold Intolerance: Hypothyroidism
21. Hyperthyroid can mimic: Mania
22. Hypothyroid can mimic: Depression
23. A patient on depakote complains of RUQ pain and has
reddish/brown urine-
and Answers
1. Which patient is at highest risk for SI
A. 30y/o married AA female with previous SI attempt *1 risk factor
B. 35 y/o single Asian male with previous SI attempt *3 risk factors
C. 38 y/o single AA male who is a manager of a bank *2 risk factors
D. 68 y/o single white male with depression *5 risk factors (age,
male, white, depression): D. 68 y/o single white male with depression *5 risk factors (age,
male, white, depression)
Count the risk factors
2. COWS scale components: · Opioid W/D
Pulse, sweating, restlessness, pupil size- dilation (if pinpoint= opioid intoxication, not w/d), body aches,
Rhinorrhea (running nose), Lacrimation (eye tearing), GI upset (N/V/D), yawning, tremors, anxiety/irritability,
Piloerection (goose- flesh skin), insomnia
3. What does COWS stand for?: Clinical Opiate Withdrawal Scale
4. What does CIWA stand for?: Clinical Institute Withdrawal Assessment
,5. What does CIWA assess for?: --used to determine likelihood of ETOH withdrawal or DTs
--usually occur within the first 24-72 hours after cessation
o used to determine when to administer medications for ETOH withdrawal
6. What does CIWA NOT test for?: Alcohol Use Disorder
7. What are the CIWA scale components?: · N/V, tremor, paroxysmal sweats, anxiety,
agitation, tactile disturbances, auditory disturbances, visual disturbances, H/A, orientation
Each component is scored from 0(none)-7(severe) except orientation wh/ is (0 (AA0x4)-4 (disoriented)
Score:
<10: Very mild Start PRN meds at score of 8
>10 to 15: Mild scheduled + PRN meds
>16 to 20: Moderate
>21: Severe Diazepam, Librium, Ativan
8. When interview teenagers (16 y/o) that arrive with their parents
what should you do?: interview them separately from parents.
-This helps Build therapeutic rapport with teens by telling them the info is confidential. Parents may be
upset but remember you are advocating for the child.
9. Which Ethnic group has the highest rate of suicide?: Native Americans
,10. Example A patient is being treated for schizophrenia with
olanzapine. Which of the following is the most common side effect of
olanzapine?
A. Increased waist circumference
B. EPS (not as common in atypical antipsychotics d/t 5HT2A)-
receptor antago- nism
C. Increased Lipids
D. Metabolic Syndrome: D. Metabolic Syndrome (UMBRELLA ANSWER)
11. Which antipsychotics have the least weight gain?: Latuda, Abilify, (also
least sedating), Geodon-if patient has metabolic syndrome consider switching to one of the
medications above. Or if the patient is overly sedated try switching to ABILIFY
12. Which mood stabilizer have the least weight gain?: Lamictal
-But remember all mood stabilizers cause some weight gain
13. When presented with a question about typical vs atypical
antipsychotic the answer is usually to start of a: atypical
14. A client presents with complains of changes in appetite,
feeling fatigued, problems with sleep-rest cycle, and changes in
libido. What is the neu- roanatomical area of the brain that is
responsible for the normal regulation of these functions?
A. Thalamus
, B. Hypothalamus
C. Limbic System
D. Hippocampus: Hypothalamus
A, B, & D are all part of the limbic system so you can rule that out
15. When a patient is hesitant to participate in treatment you
should encour- age?: Bring a support person like a husband
16. Thyroid-Stimulating hormone normal level: 0.5-5.0 Mu/L
17. When T4 and T3 are high and TSH is low what is the diagnosis:
HYPERTHYROIDISM, TSH secretion decreases: TSH LOW à key symptoms HEAT INTOLERANCE
18. Key symptoms of Heat Intolerance: Hyperthyroidism
19. When T4 and T3 are Low and TSH is high what is the diagnosis:
(HYPOTHYROIDISM) TSH secretion increased: TSH HIGH à COLD INTERANCE
20. Key symptoms of Cold Intolerance: Hypothyroidism
21. Hyperthyroid can mimic: Mania
22. Hypothyroid can mimic: Depression
23. A patient on depakote complains of RUQ pain and has
reddish/brown urine-
