ANCC PMHNP
EXAM REVIEW
reflect the content outline and structure
of the ANCC PMHNP exam
This exam review is designed for nursing
graduates and prac cing nurses pursuing
board cer fica on as a Psychiatric-Mental
Health Nurse Prac oner (PMHNP-BC). With
updated 2025 exam material, it helps
candidates strengthen knowledge, apply clinical
judgment, and build exam confidence.
,What are the five primary symptoms of hyperthyroidism?
Heat Intolerance
Agitation, Anxiety, Irritability
Tachycardia
Mood Swings
Weight Loss
What are the four primary symptoms of hypothyroidism?
Cold Intolerance
Lethargy
Weight Gain
Decreased Libido
Hypothyroidism mimics symptoms of what psychiatric disorder?
Depression
Hyperthyroidism mimics symptoms of what psychiatric disorder?
Mania
Valproic acid produces what teratogenic effect?
Spina bifida (neural tube defect)
What is the primary organ where valproic acid is toxic?
Liver
,What are four signs of hepatotoxicity?
Abdominal pain in the URQ
Reddish-brown urine
Yellowing of the skin and sclera
Fatigue
What drugs should be avoided with Kava Kava?
Alprazolam, CNS depressants
What are examples of CNS depressants?
phenobarbital, zolpidem
What is the normal range for TSH? (mu/L)
0.5-5
In hyperthyroidism, TSH is [increased/decreased] and T4/T3 is
[increased/decreased].
decreased, increased
In hypothyroidism, TSH is [increased/decreased] and T4/T3 is
[increased/decreased].
increased, decreased
What is the therapeutic range for valproic acid? (mcg/mL)
50-125
, What is a toxic level of valproic acid? (Greater than, mcg/mL)
150
What are four signs of valproic acid toxicity?
Disorientation
Lethargy
Respiratory Depression
Nausea/Vomiting
A patient on Depakote complains of abdominal pain in the URQ and
reddish-brown urine. What do you suspect?
Hepatotoxicity
A patient on Depakote complains of abdominal pain in the URQ and
reddish-brown urine. What do you do?
Hold medication
Draw LFTs (priority)
DVP level
With suspected toxicity with valproic acid, what steps/labs should be
drawn?
Stop drug
Check drug level
Obtain LFTs
Obtain ammonia level
EXAM REVIEW
reflect the content outline and structure
of the ANCC PMHNP exam
This exam review is designed for nursing
graduates and prac cing nurses pursuing
board cer fica on as a Psychiatric-Mental
Health Nurse Prac oner (PMHNP-BC). With
updated 2025 exam material, it helps
candidates strengthen knowledge, apply clinical
judgment, and build exam confidence.
,What are the five primary symptoms of hyperthyroidism?
Heat Intolerance
Agitation, Anxiety, Irritability
Tachycardia
Mood Swings
Weight Loss
What are the four primary symptoms of hypothyroidism?
Cold Intolerance
Lethargy
Weight Gain
Decreased Libido
Hypothyroidism mimics symptoms of what psychiatric disorder?
Depression
Hyperthyroidism mimics symptoms of what psychiatric disorder?
Mania
Valproic acid produces what teratogenic effect?
Spina bifida (neural tube defect)
What is the primary organ where valproic acid is toxic?
Liver
,What are four signs of hepatotoxicity?
Abdominal pain in the URQ
Reddish-brown urine
Yellowing of the skin and sclera
Fatigue
What drugs should be avoided with Kava Kava?
Alprazolam, CNS depressants
What are examples of CNS depressants?
phenobarbital, zolpidem
What is the normal range for TSH? (mu/L)
0.5-5
In hyperthyroidism, TSH is [increased/decreased] and T4/T3 is
[increased/decreased].
decreased, increased
In hypothyroidism, TSH is [increased/decreased] and T4/T3 is
[increased/decreased].
increased, decreased
What is the therapeutic range for valproic acid? (mcg/mL)
50-125
, What is a toxic level of valproic acid? (Greater than, mcg/mL)
150
What are four signs of valproic acid toxicity?
Disorientation
Lethargy
Respiratory Depression
Nausea/Vomiting
A patient on Depakote complains of abdominal pain in the URQ and
reddish-brown urine. What do you suspect?
Hepatotoxicity
A patient on Depakote complains of abdominal pain in the URQ and
reddish-brown urine. What do you do?
Hold medication
Draw LFTs (priority)
DVP level
With suspected toxicity with valproic acid, what steps/labs should be
drawn?
Stop drug
Check drug level
Obtain LFTs
Obtain ammonia level
