PMHNP Certification Exam KM Questions and Correct
Answers 2026 /2027 Graded A+|Brand New!!!
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
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.
Which Ethnic group has the highest rate of suicide?
Native Americans
Example A patient is being treated for schizophrenia with olanzapine. Which of the following
is the most common side effect of olanzapine?
D. Metabolic Syndrome UMBRELLA ANSWER
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
Which mood stabilizer have the least weight gain?
Lamictal
-But remember all mood stabilizers cause some weight gain
1|Page
,When presented with a question about typical vs atypical antipsychotic the answer is usually
to start of a
atypical
A client presents with complains of changes in appetite, feeling fatigued, problems with sleep-
rest cycle, and changes in libido. What is the neuroanatomical 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
When a patient is hesitant to participate in treatment you should encourage?
Bring a support person like a husband
Thyroid-Stimulating hormone normal level
0.5-5.0 Mu/L
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
Key symptoms of Heat Intolerance
Hyperthyroidism
When T4 and T3 are Low and TSH is high what is the diagnosis
(HYPOTHYROIDISM) TSH secretion increased: TSH HIGH à COLD INTERANCE
Key symptoms of Cold Intolerance
Hypothyroidism
Hyperthyroid can mimic
Mania
Hypothyroid can mimic
2|Page
,Depression
A patient on depakote complains of RUQ pain and has reddish/brown urine
Hepatoxicity
-Check LFTs
Signs of Depakote toxicity
Disorientation, confusion, lethargy
You suspect depakote toxicity what do you do?
Check
-LFT
-Ammonia
-Depakote Level
What herbal supplement can cause hepatoxicity?
Kava Kava
When taking Kava Kava in combinations with other medications you should caution about
Risk of Hepatoxicity and Sedation
TCAs carry a risk of
Hepatotoxicity
Signs of Stevens-Johnson Syndrome
-fever, mouth pain, swelling, burning eyes, blisters, skin pain
two psychotropics known to cause steven johnson syndrome
lamictal and tegretol
What nationality is most suseptible of getting steven johnson?
Asians
When treating asians with tegretal screen for?
HLAB-1502 Allele
What two medications cause agranulocytosis?
Clozaril & Tegretal
3|Page
, Agranulocytosis when to discontinue medication
Less than 1000
When monitoring for agranulocytosis in patients look for s/s of what?
Infection
-Fever, sore throat, fatigue, chills
Before starting any mood stabilizer in a female of childbearing age be sure to check?
HCG
Which two medications may decrease the risk of suicide?
clozaril and lithium
Medications that increase lithium level
NSAID-ibuprofen, INDOCIN
THIAZIDES-hydrochlorithiazide ACE INHIBITORS-lisinopril
Ace inhibitors are treatment of choice for?
Heart Failure
Certain medications are known to increase lithium level, but HOW?
by reducing renal clearance
When educating a patient about lithium teach them about
Hyponatremia
Dehydration-hot days, exercise
Normal Lithium Level
0.6-1.2
Lithium Toxicity
1.5 or above
Discontinue and re-order lithium level
Lithium level of 1.4
Monitor for toxicity
Labs before starting lithium
4|Page
Answers 2026 /2027 Graded A+|Brand New!!!
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
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.
Which Ethnic group has the highest rate of suicide?
Native Americans
Example A patient is being treated for schizophrenia with olanzapine. Which of the following
is the most common side effect of olanzapine?
D. Metabolic Syndrome UMBRELLA ANSWER
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
Which mood stabilizer have the least weight gain?
Lamictal
-But remember all mood stabilizers cause some weight gain
1|Page
,When presented with a question about typical vs atypical antipsychotic the answer is usually
to start of a
atypical
A client presents with complains of changes in appetite, feeling fatigued, problems with sleep-
rest cycle, and changes in libido. What is the neuroanatomical 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
When a patient is hesitant to participate in treatment you should encourage?
Bring a support person like a husband
Thyroid-Stimulating hormone normal level
0.5-5.0 Mu/L
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
Key symptoms of Heat Intolerance
Hyperthyroidism
When T4 and T3 are Low and TSH is high what is the diagnosis
(HYPOTHYROIDISM) TSH secretion increased: TSH HIGH à COLD INTERANCE
Key symptoms of Cold Intolerance
Hypothyroidism
Hyperthyroid can mimic
Mania
Hypothyroid can mimic
2|Page
,Depression
A patient on depakote complains of RUQ pain and has reddish/brown urine
Hepatoxicity
-Check LFTs
Signs of Depakote toxicity
Disorientation, confusion, lethargy
You suspect depakote toxicity what do you do?
Check
-LFT
-Ammonia
-Depakote Level
What herbal supplement can cause hepatoxicity?
Kava Kava
When taking Kava Kava in combinations with other medications you should caution about
Risk of Hepatoxicity and Sedation
TCAs carry a risk of
Hepatotoxicity
Signs of Stevens-Johnson Syndrome
-fever, mouth pain, swelling, burning eyes, blisters, skin pain
two psychotropics known to cause steven johnson syndrome
lamictal and tegretol
What nationality is most suseptible of getting steven johnson?
Asians
When treating asians with tegretal screen for?
HLAB-1502 Allele
What two medications cause agranulocytosis?
Clozaril & Tegretal
3|Page
, Agranulocytosis when to discontinue medication
Less than 1000
When monitoring for agranulocytosis in patients look for s/s of what?
Infection
-Fever, sore throat, fatigue, chills
Before starting any mood stabilizer in a female of childbearing age be sure to check?
HCG
Which two medications may decrease the risk of suicide?
clozaril and lithium
Medications that increase lithium level
NSAID-ibuprofen, INDOCIN
THIAZIDES-hydrochlorithiazide ACE INHIBITORS-lisinopril
Ace inhibitors are treatment of choice for?
Heart Failure
Certain medications are known to increase lithium level, but HOW?
by reducing renal clearance
When educating a patient about lithium teach them about
Hyponatremia
Dehydration-hot days, exercise
Normal Lithium Level
0.6-1.2
Lithium Toxicity
1.5 or above
Discontinue and re-order lithium level
Lithium level of 1.4
Monitor for toxicity
Labs before starting lithium
4|Page
