PMHNP-BC / Psychiatric-Mental Health Nurse
Practitioner EXAM QUESTIONS ANSWERS ARE
BOLDED WITH RATIONALES 2025
1. A 25-year-old patient presents with auditory hallucinations and delusional
thoughts. He has poor hygiene and flat affect. What is the most likely diagnosis?
A. Major depressive disorder with psychotic features
B. Schizophrenia
C. Schizoaffective disorder
D. Delusional disorder
Rationale: Schizophrenia includes positive symptoms (hallucinations, delusions)
and negative symptoms (flat affect, avolition). Schizoaffective disorder would
require mood symptoms to be prominent.
2. Which of the following medications requires monitoring of absolute
neutrophil count (ANC)?
A. Olanzapine
B. Clozapine
C. Risperidone
D. Aripiprazole
,Rationale: Clozapine carries a risk of agranulocytosis and requires regular ANC
monitoring.
3. A PMHNP is using motivational interviewing with a patient in the
precontemplation stage. What is the primary goal?
A. Encourage the patient to take action
B. Raise awareness of the need for change
C. Establish a treatment plan
D. Identify coping strategies
Rationale: In the precontemplation stage, the patient is not yet considering
change. The goal is to increase insight and awareness.
4. Which medication is most appropriate for treating generalized anxiety
disorder (GAD) with a low risk of dependence?
A. Alprazolam
B. Buspirone
C. Diazepam
D. Clonazepam
Rationale: Buspirone is non-benzodiazepine with no risk of dependence,
appropriate for long-term use in GAD.
5. A PMHNP is prescribing sertraline for depression. What is the black box
warning for this medication?
, A. Hypertension
B. Serotonin syndrome
C. Increased risk of suicidality in young adults and children
D. Liver toxicity
Rationale: All SSRIs carry a black box warning about the risk of suicidal ideation in
younger populations.
6. Which of the following is a common side effect of valproic acid?
A. Agranulocytosis
B. Hepatotoxicity
C. Renal failure
D. Stevens-Johnson Syndrome
Rationale: Valproic acid can cause liver toxicity, especially in young children and
patients with mitochondrial disorders.
7. A 45-year-old with bipolar I disorder is started on lithium. What baseline test
is essential before initiating therapy?
A. Complete blood count
B. Liver function tests
C. EKG
D. Renal function tests
Rationale: Lithium is excreted by the kidneys and can impair renal function.
Baseline BUN and creatinine are essential.
Practitioner EXAM QUESTIONS ANSWERS ARE
BOLDED WITH RATIONALES 2025
1. A 25-year-old patient presents with auditory hallucinations and delusional
thoughts. He has poor hygiene and flat affect. What is the most likely diagnosis?
A. Major depressive disorder with psychotic features
B. Schizophrenia
C. Schizoaffective disorder
D. Delusional disorder
Rationale: Schizophrenia includes positive symptoms (hallucinations, delusions)
and negative symptoms (flat affect, avolition). Schizoaffective disorder would
require mood symptoms to be prominent.
2. Which of the following medications requires monitoring of absolute
neutrophil count (ANC)?
A. Olanzapine
B. Clozapine
C. Risperidone
D. Aripiprazole
,Rationale: Clozapine carries a risk of agranulocytosis and requires regular ANC
monitoring.
3. A PMHNP is using motivational interviewing with a patient in the
precontemplation stage. What is the primary goal?
A. Encourage the patient to take action
B. Raise awareness of the need for change
C. Establish a treatment plan
D. Identify coping strategies
Rationale: In the precontemplation stage, the patient is not yet considering
change. The goal is to increase insight and awareness.
4. Which medication is most appropriate for treating generalized anxiety
disorder (GAD) with a low risk of dependence?
A. Alprazolam
B. Buspirone
C. Diazepam
D. Clonazepam
Rationale: Buspirone is non-benzodiazepine with no risk of dependence,
appropriate for long-term use in GAD.
5. A PMHNP is prescribing sertraline for depression. What is the black box
warning for this medication?
, A. Hypertension
B. Serotonin syndrome
C. Increased risk of suicidality in young adults and children
D. Liver toxicity
Rationale: All SSRIs carry a black box warning about the risk of suicidal ideation in
younger populations.
6. Which of the following is a common side effect of valproic acid?
A. Agranulocytosis
B. Hepatotoxicity
C. Renal failure
D. Stevens-Johnson Syndrome
Rationale: Valproic acid can cause liver toxicity, especially in young children and
patients with mitochondrial disorders.
7. A 45-year-old with bipolar I disorder is started on lithium. What baseline test
is essential before initiating therapy?
A. Complete blood count
B. Liver function tests
C. EKG
D. Renal function tests
Rationale: Lithium is excreted by the kidneys and can impair renal function.
Baseline BUN and creatinine are essential.
