1
AANP PMHNP Exam 2025-2026: Complete 10+
Practice Questions & Detailed Answers for Guaranteed
Success
1.
A 32-year-old client presents with persistent sadness, anhedonia, insomnia, and
fatigue for the past 6 weeks. Which is the most likely diagnosis?
A. Persistent depressive disorder
B. Major depressive disorder
C. Cyclothymic disorder
D. Bipolar II disorder
Correct Answer: B. Major depressive disorder
Rationale: Major depressive disorder is diagnosed when a client experiences at
least two weeks of depressed mood or anhedonia along with other symptoms such
as changes in sleep, energy, appetite, and concentration. This client meets the
duration and symptom criteria. Persistent depressive disorder lasts for at least 2
years, cyclothymic disorder involves mood fluctuations without full episodes, and
bipolar II requires hypomanic episodes.
2.
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A PMHNP is initiating sertraline for a 28-year-old with generalized anxiety
disorder. Which teaching is most important?
A. “You may notice immediate improvement in symptoms.”
B. “Do not take this medication with grapefruit juice.”
C. “It may take several weeks to feel full benefits.”
D. “You must avoid dairy products while taking this.”
Correct Answer: C. “It may take several weeks to feel full benefits.”
Rationale: SSRIs like sertraline require 4–6 weeks to achieve full therapeutic
effect, though some improvement may occur sooner. Grapefruit juice interaction is
more relevant for certain other medications (e.g., some benzodiazepines). There are
no dairy restrictions. Expecting immediate relief could cause nonadherence.
3.
Which symptom is most characteristic of a manic episode?
A. Hypersomnia
B. Psychomotor retardation
C. Grandiosity
D. Social withdrawal
Correct Answer: C. Grandiosity
Rationale: Grandiosity, or inflated self-esteem, is a hallmark feature of mania
along with decreased need for sleep, increased goal-directed activity, pressured
speech, and risk-taking behaviors. Hypersomnia and psychomotor retardation are
depressive symptoms; social withdrawal is more common in depression or
schizophrenia.
, 3
4.
A client with schizophrenia has poor adherence to oral antipsychotics. Which
intervention is most appropriate?
A. Increase the oral dose
B. Switch to a long-acting injectable formulation
C. Discontinue antipsychotic therapy
D. Prescribe benzodiazepines instead
Correct Answer: B. Switch to a long-acting injectable formulation
Rationale: Long-acting injectable antipsychotics (e.g., haloperidol decanoate,
risperidone microspheres) improve adherence for clients with chronic
schizophrenia and poor compliance. Increasing dose won’t improve adherence, and
discontinuing treatment risks relapse. Benzodiazepines are not indicated for
schizophrenia.
5.
When initiating lithium, which baseline test is most important?
A. Liver function tests
B. Thyroid function tests
C. Hemoglobin A1C
D. Serum vitamin B12
Correct Answer: B. Thyroid function tests
Rationale: Lithium can impair thyroid function, so baseline and periodic
monitoring of TSH is necessary. Kidney function tests are also essential. Liver
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function is not primarily affected by lithium. Hemoglobin A1C is more relevant for
antipsychotics with metabolic effects.
6.
Which finding requires urgent intervention in a client on clozapine?
A. Constipation
B. Drooling
C. Fever and sore throat
D. Weight gain
Correct Answer: C. Fever and sore throat
Rationale: Fever and sore throat can indicate agranulocytosis, a life-threatening
adverse effect of clozapine. Immediate CBC is warranted. Constipation, drooling,
and weight gain are common side effects but not emergent.
7.
Which psychotherapy is best supported for obsessive-compulsive disorder?
A. Supportive therapy
B. Cognitive behavioral therapy with exposure and response prevention
C. Psychoanalysis
D. Eye movement desensitization and reprocessing (EMDR)
Correct Answer: B. Cognitive behavioral therapy with exposure and response
prevention
AANP PMHNP Exam 2025-2026: Complete 10+
Practice Questions & Detailed Answers for Guaranteed
Success
1.
A 32-year-old client presents with persistent sadness, anhedonia, insomnia, and
fatigue for the past 6 weeks. Which is the most likely diagnosis?
A. Persistent depressive disorder
B. Major depressive disorder
C. Cyclothymic disorder
D. Bipolar II disorder
Correct Answer: B. Major depressive disorder
Rationale: Major depressive disorder is diagnosed when a client experiences at
least two weeks of depressed mood or anhedonia along with other symptoms such
as changes in sleep, energy, appetite, and concentration. This client meets the
duration and symptom criteria. Persistent depressive disorder lasts for at least 2
years, cyclothymic disorder involves mood fluctuations without full episodes, and
bipolar II requires hypomanic episodes.
2.
, 2
A PMHNP is initiating sertraline for a 28-year-old with generalized anxiety
disorder. Which teaching is most important?
A. “You may notice immediate improvement in symptoms.”
B. “Do not take this medication with grapefruit juice.”
C. “It may take several weeks to feel full benefits.”
D. “You must avoid dairy products while taking this.”
Correct Answer: C. “It may take several weeks to feel full benefits.”
Rationale: SSRIs like sertraline require 4–6 weeks to achieve full therapeutic
effect, though some improvement may occur sooner. Grapefruit juice interaction is
more relevant for certain other medications (e.g., some benzodiazepines). There are
no dairy restrictions. Expecting immediate relief could cause nonadherence.
3.
Which symptom is most characteristic of a manic episode?
A. Hypersomnia
B. Psychomotor retardation
C. Grandiosity
D. Social withdrawal
Correct Answer: C. Grandiosity
Rationale: Grandiosity, or inflated self-esteem, is a hallmark feature of mania
along with decreased need for sleep, increased goal-directed activity, pressured
speech, and risk-taking behaviors. Hypersomnia and psychomotor retardation are
depressive symptoms; social withdrawal is more common in depression or
schizophrenia.
, 3
4.
A client with schizophrenia has poor adherence to oral antipsychotics. Which
intervention is most appropriate?
A. Increase the oral dose
B. Switch to a long-acting injectable formulation
C. Discontinue antipsychotic therapy
D. Prescribe benzodiazepines instead
Correct Answer: B. Switch to a long-acting injectable formulation
Rationale: Long-acting injectable antipsychotics (e.g., haloperidol decanoate,
risperidone microspheres) improve adherence for clients with chronic
schizophrenia and poor compliance. Increasing dose won’t improve adherence, and
discontinuing treatment risks relapse. Benzodiazepines are not indicated for
schizophrenia.
5.
When initiating lithium, which baseline test is most important?
A. Liver function tests
B. Thyroid function tests
C. Hemoglobin A1C
D. Serum vitamin B12
Correct Answer: B. Thyroid function tests
Rationale: Lithium can impair thyroid function, so baseline and periodic
monitoring of TSH is necessary. Kidney function tests are also essential. Liver
, 4
function is not primarily affected by lithium. Hemoglobin A1C is more relevant for
antipsychotics with metabolic effects.
6.
Which finding requires urgent intervention in a client on clozapine?
A. Constipation
B. Drooling
C. Fever and sore throat
D. Weight gain
Correct Answer: C. Fever and sore throat
Rationale: Fever and sore throat can indicate agranulocytosis, a life-threatening
adverse effect of clozapine. Immediate CBC is warranted. Constipation, drooling,
and weight gain are common side effects but not emergent.
7.
Which psychotherapy is best supported for obsessive-compulsive disorder?
A. Supportive therapy
B. Cognitive behavioral therapy with exposure and response prevention
C. Psychoanalysis
D. Eye movement desensitization and reprocessing (EMDR)
Correct Answer: B. Cognitive behavioral therapy with exposure and response
prevention
