PM HNP BOARD CERTIFICATION EXAM 2026-2027
QUESTIONS AND ANSWERS WITH RATIONALS COMPLETE
EXAM QUESTIONS AND VERIFIED ANSWERS | 2026–2027
LATEST UPDATE | GUARANTEED PASS | DETAILED
RATIONALES | FULL STUDY GUIDE | EXAM PREP | PRACTICE
TEST | CERTIFICATION PREPARATION
1. A 34-year-old patient presents with persistent low mood, anhedonia, and fatigue for 3 weeks.
Which diagnosis is most consistent with these symptoms?
A. Bipolar I Disorder
B. Major Depressive Disorder
C. Cyclothymic Disorder
D. Generalized Anxiety Disorder
Correct Answer: B. Major Depressive Disorder
Rationale: Major Depressive Disorder requires at least 2 weeks of persistent depressive symptoms
including anhedonia and low mood. Bipolar I requires manic episodes, cyclothymia involves chronic
fluctuating hypomanic/depressive symptoms, and GAD is primarily anxiety-based.
2. Which medication is considered first-line for acute psychosis in schizophrenia?
A. Sertraline
B. Haloperidol
C. Lithium
D. Bupropion
Correct Answer: B. Haloperidol
Rationale: Haloperidol is a typical antipsychotic effective for acute psychosis. Sertraline is an SSRI,
lithium is a mood stabilizer, and bupropion is an antidepressant.
3. A patient taking lithium reports tremors, confusion, and diarrhea. What is the priority action?
A. Increase hydration
B. Hold lithium and obtain serum level
C. Give next scheduled dose with food
D. Reduce sodium intake
Correct Answer: B. Hold lithium and obtain serum level
Rationale: These symptoms suggest lithium toxicity. Immediate discontinuation and serum level
assessment are required. Continuing dosing risks severe toxicity.
4. Which symptom is most indicative of mania?
A. Fatigue and insomnia
B. Grandiosity and decreased need for sleep
C. Excessive worry
D. Social withdrawal
Correct Answer: B. Grandiosity and decreased need for sleep
Rationale: Mania includes elevated mood, grandiosity, and decreased need for sleep. Fatigue and
worry are not defining features.
,5. Which therapy is most effective as first-line for PTSD?
A. Exposure-based cognitive behavioral therapy
B. Benzodiazepines
C. Long-term antipsychotics
D. Electroconvulsive therapy
Correct Answer: A. Exposure-based cognitive behavioral therapy
Rationale: Trauma-focused CBT is first-line for PTSD. Benzodiazepines are not recommended due to
dependency risk.
6. A patient begins SSRI therapy. What is the most common early side effect?
A. Weight gain
B. Increased anxiety
C. Kidney failure
D. Severe hypotension
Correct Answer: B. Increased anxiety
Rationale: SSRIs may initially increase anxiety before therapeutic effects occur. Serious organ effects
are not typical early reactions.
7. Which finding suggests serotonin syndrome?
A. Bradycardia and sedation
B. Hyperreflexia and clonus
C. Weight gain and lethargy
D. Dry skin and constipation
Correct Answer: B. Hyperreflexia and clonus
Rationale: Serotonin syndrome presents with neuromuscular hyperactivity including clonus and
hyperreflexia.
8. Which medication is contraindicated in a patient taking MAOIs?
A. Acetaminophen
B. Sertraline
C. Amoxicillin
D. Metformin
Correct Answer: B. Sertraline
Rationale: SSRIs with MAOIs increase risk of serotonin syndrome.
9. A patient with schizophrenia reports hearing voices commanding self-harm. What is the priority
intervention?
A. Encourage journaling
B. Assess for suicide risk
C. Offer group therapy
D. Delay medication change
Correct Answer: B. Assess for suicide risk
Rationale: Command hallucinations require immediate safety and suicide risk assessment.
10. Which symptom is characteristic of OCD?
A. Delusions of persecution
B. Intrusive thoughts with compulsions
C. Elevated mood
D. Memory loss
, Correct Answer: B. Intrusive thoughts with compulsions
Rationale: OCD involves obsessions and compulsions aimed at reducing anxiety.
11. A patient is prescribed valproate. What lab must be monitored?
A. Hemoglobin A1C
B. Liver function tests
C. Troponin
D. D-dimer
Correct Answer: B. Liver function tests
Rationale: Valproate carries risk of hepatotoxicity, requiring liver monitoring.
12. Which condition is most associated with panic attacks?
A. Panic Disorder
B. Schizophrenia
C. Dementia
D. Delirium
Correct Answer: A. Panic Disorder
Rationale: Panic disorder is defined by recurrent unexpected panic attacks.
13. A patient on antipsychotics develops rigidity, fever, and autonomic instability. Diagnosis?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Anxiety attack
D. Hypoglycemia
Correct Answer: B. Neuroleptic malignant syndrome
Rationale: NMS is a life-threatening reaction to antipsychotics with rigidity and hyperthermia.
14. First-line treatment for ADHD in adults is typically:
A. Benzodiazepines
B. Stimulants
C. Antipsychotics
D. MAOIs
Correct Answer: B. Stimulants
Rationale: Stimulants such as methylphenidate are first-line for ADHD.
15. Which symptom is most consistent with generalized anxiety disorder?
A. Episodic hallucinations
B. Persistent excessive worry
C. Manic episodes
D. Motor tics only
Correct Answer: B. Persistent excessive worry
Rationale: GAD involves chronic, excessive worry across multiple domains.
16. A patient abruptly stops benzodiazepines. What is the primary risk?
A. Liver failure
B. Withdrawal seizures
C. Hypertension crisis
D. Weight gain
Correct Answer: B. Withdrawal seizures
Rationale: Benzodiazepine withdrawal can cause seizures and requires tapering.
QUESTIONS AND ANSWERS WITH RATIONALS COMPLETE
EXAM QUESTIONS AND VERIFIED ANSWERS | 2026–2027
LATEST UPDATE | GUARANTEED PASS | DETAILED
RATIONALES | FULL STUDY GUIDE | EXAM PREP | PRACTICE
TEST | CERTIFICATION PREPARATION
1. A 34-year-old patient presents with persistent low mood, anhedonia, and fatigue for 3 weeks.
Which diagnosis is most consistent with these symptoms?
A. Bipolar I Disorder
B. Major Depressive Disorder
C. Cyclothymic Disorder
D. Generalized Anxiety Disorder
Correct Answer: B. Major Depressive Disorder
Rationale: Major Depressive Disorder requires at least 2 weeks of persistent depressive symptoms
including anhedonia and low mood. Bipolar I requires manic episodes, cyclothymia involves chronic
fluctuating hypomanic/depressive symptoms, and GAD is primarily anxiety-based.
2. Which medication is considered first-line for acute psychosis in schizophrenia?
A. Sertraline
B. Haloperidol
C. Lithium
D. Bupropion
Correct Answer: B. Haloperidol
Rationale: Haloperidol is a typical antipsychotic effective for acute psychosis. Sertraline is an SSRI,
lithium is a mood stabilizer, and bupropion is an antidepressant.
3. A patient taking lithium reports tremors, confusion, and diarrhea. What is the priority action?
A. Increase hydration
B. Hold lithium and obtain serum level
C. Give next scheduled dose with food
D. Reduce sodium intake
Correct Answer: B. Hold lithium and obtain serum level
Rationale: These symptoms suggest lithium toxicity. Immediate discontinuation and serum level
assessment are required. Continuing dosing risks severe toxicity.
4. Which symptom is most indicative of mania?
A. Fatigue and insomnia
B. Grandiosity and decreased need for sleep
C. Excessive worry
D. Social withdrawal
Correct Answer: B. Grandiosity and decreased need for sleep
Rationale: Mania includes elevated mood, grandiosity, and decreased need for sleep. Fatigue and
worry are not defining features.
,5. Which therapy is most effective as first-line for PTSD?
A. Exposure-based cognitive behavioral therapy
B. Benzodiazepines
C. Long-term antipsychotics
D. Electroconvulsive therapy
Correct Answer: A. Exposure-based cognitive behavioral therapy
Rationale: Trauma-focused CBT is first-line for PTSD. Benzodiazepines are not recommended due to
dependency risk.
6. A patient begins SSRI therapy. What is the most common early side effect?
A. Weight gain
B. Increased anxiety
C. Kidney failure
D. Severe hypotension
Correct Answer: B. Increased anxiety
Rationale: SSRIs may initially increase anxiety before therapeutic effects occur. Serious organ effects
are not typical early reactions.
7. Which finding suggests serotonin syndrome?
A. Bradycardia and sedation
B. Hyperreflexia and clonus
C. Weight gain and lethargy
D. Dry skin and constipation
Correct Answer: B. Hyperreflexia and clonus
Rationale: Serotonin syndrome presents with neuromuscular hyperactivity including clonus and
hyperreflexia.
8. Which medication is contraindicated in a patient taking MAOIs?
A. Acetaminophen
B. Sertraline
C. Amoxicillin
D. Metformin
Correct Answer: B. Sertraline
Rationale: SSRIs with MAOIs increase risk of serotonin syndrome.
9. A patient with schizophrenia reports hearing voices commanding self-harm. What is the priority
intervention?
A. Encourage journaling
B. Assess for suicide risk
C. Offer group therapy
D. Delay medication change
Correct Answer: B. Assess for suicide risk
Rationale: Command hallucinations require immediate safety and suicide risk assessment.
10. Which symptom is characteristic of OCD?
A. Delusions of persecution
B. Intrusive thoughts with compulsions
C. Elevated mood
D. Memory loss
, Correct Answer: B. Intrusive thoughts with compulsions
Rationale: OCD involves obsessions and compulsions aimed at reducing anxiety.
11. A patient is prescribed valproate. What lab must be monitored?
A. Hemoglobin A1C
B. Liver function tests
C. Troponin
D. D-dimer
Correct Answer: B. Liver function tests
Rationale: Valproate carries risk of hepatotoxicity, requiring liver monitoring.
12. Which condition is most associated with panic attacks?
A. Panic Disorder
B. Schizophrenia
C. Dementia
D. Delirium
Correct Answer: A. Panic Disorder
Rationale: Panic disorder is defined by recurrent unexpected panic attacks.
13. A patient on antipsychotics develops rigidity, fever, and autonomic instability. Diagnosis?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Anxiety attack
D. Hypoglycemia
Correct Answer: B. Neuroleptic malignant syndrome
Rationale: NMS is a life-threatening reaction to antipsychotics with rigidity and hyperthermia.
14. First-line treatment for ADHD in adults is typically:
A. Benzodiazepines
B. Stimulants
C. Antipsychotics
D. MAOIs
Correct Answer: B. Stimulants
Rationale: Stimulants such as methylphenidate are first-line for ADHD.
15. Which symptom is most consistent with generalized anxiety disorder?
A. Episodic hallucinations
B. Persistent excessive worry
C. Manic episodes
D. Motor tics only
Correct Answer: B. Persistent excessive worry
Rationale: GAD involves chronic, excessive worry across multiple domains.
16. A patient abruptly stops benzodiazepines. What is the primary risk?
A. Liver failure
B. Withdrawal seizures
C. Hypertension crisis
D. Weight gain
Correct Answer: B. Withdrawal seizures
Rationale: Benzodiazepine withdrawal can cause seizures and requires tapering.
