PMHNP ACTUAL EXAM
PMHNP ACTUAL EXAM COMPLETE QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES GRADED A+
GUARANTEED PASS- ACE YOUR EXAM
A 42-year-old woman has initiated sertraline therapy (100 mg daily) for
depression. At a follow-up visit, she reports some improvement in depression
symptoms but has noticed a diminished sex drive that is putting a strain on her
relationship with her partner. The PMHNP recommends:
Advising that sexual adverse effects are transient and will resolve over time.
Decrease the dose to 50 mg daily.
Switch to paroxetine.
Switch to bupropion. - Correct Answer-Switch to bupropion.
Sexual adverse effects are a class effect of the SSRIs and so switching to another
SSRI agent will not likely resolve the issue (C). Lowering the dose will also not
likely resolve the issue and will result in a diminished effect on depression
symptoms (B). Sexual adverse effects are not transient and so a switch in
therapy is needed (A).
When considering the use of a cholinesterase inhibitor for a 73-year-old with
early-stage Alzheimer's dementia, the PMHNP counsels the patient's caretaker
about all of the following potential adverse effects except:
Sedation.
Diarrhea.
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, PMHNP ACTUAL EXAM
Hand tremors.
Lacrimation. - Correct Answer-Hand tremors.
Parasympathetic activation results in slowing of heart rate and activation of the
gastrointestinal tract, which can result in diarrhea (B). Other common adverse
effects include salivation, lacrimation (D), and sedation (A).
Mary is a 64-year-old woman who is accompanied by her son who insists that she
gets help for chronic alcohol abuse. Mary states, "I don't have a problem. I can
stop whenever I want." According to Prochaska's stages of preparation for change,
she is most likely in which stage?
Precontemplation
Contemplation
Preparation
Action - Correct Answer-Precontemplation
Prochaska identified 5 stages of change and it is important for healthcare
providers to encourage change when needed and provide support to transition
the patient through the stages. Precontemplation describes the patient who is
not interested in change or does not even realize a change is needed (A).
During patient history-taking, Mary states that she drinks about half a bottle of
alcohol during the day followed by a few beers at night. Which of the following
laboratory results would most likely be found?
2|Page
, PMHNP ACTUAL EXAM
Elevated LDL-C
Elevated MCV
Proteinuria
Diminished TSH - Correct Answer-Elevated MCV
Chronic alcohol abuse is not associated with elevated LDL-C or the presence of
proteinuria (A, C). Diminished TSH levels is an indication of a thyroid disorder
and not derived from alcohol abuse (D).
Mary returns 3 weeks later after participating in several therapy sessions. She
admits that she would like to cut down on her alcohol use but is fearful of
withdrawal effects. The PMHNP offers to prescribe which of the following to help
manage alcohol withdrawal symptoms?
Naltrexone
Clonidine
Disulfiram
Naloxone - Correct Answer-Clonidine
Disulfiram is used to assist in maintaining abstinence from alcohol use by
causing noxious physical effects, such as nausea, vomiting, sweating and
headache, when alcohol is consumed (C). Naloxone is used to rapidly reverse the
effects of opioids during an overdose but would not be used for alcohol
withdrawal symptoms (D). Naltrexone is used to block the euphoric feeling
when alcohol or opioids are consumed but would not be helpful for alcohol
withdrawal symptoms (A).
3|Page
, PMHNP ACTUAL EXAM
At the request of his partner, a 51-year-old man is being evaluated for obsessive-
compulsive disorder. He admits that he finds it difficult to leave his apartment
without checking that the lights and water are turned off. It can take him up to 30
minutes to exit the apartment and this is putting a strain on his relationship. In
addition to recommending psychotherapy, the PMHNP suggests initiating
pharmacologic therapy with:
Duloxetine.
Bupropion.
Lurasidone.
Selegiline. - Correct Answer-Duloxetine.
SSRIs and SNRIs such as duloxetine are the first-line treatments for obsessive-
compulsive disorder, with a response rate ranging from 50-70% (A). High doses
are often needed to achieve the desired effect. Second-line treatment can
include clomipramine, while treatment can be augmented with the use of
valproate, lithium, or carbamazepine.
A 28-year-old man will initiate pharmacotherapy for generalized anxiety disorder.
His records show that he has chronic hepatitis B. Which of the following agents
should be avoided?
Sertraline
Duloxetine
Venlafaxine
4|Page
PMHNP ACTUAL EXAM COMPLETE QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES GRADED A+
GUARANTEED PASS- ACE YOUR EXAM
A 42-year-old woman has initiated sertraline therapy (100 mg daily) for
depression. At a follow-up visit, she reports some improvement in depression
symptoms but has noticed a diminished sex drive that is putting a strain on her
relationship with her partner. The PMHNP recommends:
Advising that sexual adverse effects are transient and will resolve over time.
Decrease the dose to 50 mg daily.
Switch to paroxetine.
Switch to bupropion. - Correct Answer-Switch to bupropion.
Sexual adverse effects are a class effect of the SSRIs and so switching to another
SSRI agent will not likely resolve the issue (C). Lowering the dose will also not
likely resolve the issue and will result in a diminished effect on depression
symptoms (B). Sexual adverse effects are not transient and so a switch in
therapy is needed (A).
When considering the use of a cholinesterase inhibitor for a 73-year-old with
early-stage Alzheimer's dementia, the PMHNP counsels the patient's caretaker
about all of the following potential adverse effects except:
Sedation.
Diarrhea.
1|Page
, PMHNP ACTUAL EXAM
Hand tremors.
Lacrimation. - Correct Answer-Hand tremors.
Parasympathetic activation results in slowing of heart rate and activation of the
gastrointestinal tract, which can result in diarrhea (B). Other common adverse
effects include salivation, lacrimation (D), and sedation (A).
Mary is a 64-year-old woman who is accompanied by her son who insists that she
gets help for chronic alcohol abuse. Mary states, "I don't have a problem. I can
stop whenever I want." According to Prochaska's stages of preparation for change,
she is most likely in which stage?
Precontemplation
Contemplation
Preparation
Action - Correct Answer-Precontemplation
Prochaska identified 5 stages of change and it is important for healthcare
providers to encourage change when needed and provide support to transition
the patient through the stages. Precontemplation describes the patient who is
not interested in change or does not even realize a change is needed (A).
During patient history-taking, Mary states that she drinks about half a bottle of
alcohol during the day followed by a few beers at night. Which of the following
laboratory results would most likely be found?
2|Page
, PMHNP ACTUAL EXAM
Elevated LDL-C
Elevated MCV
Proteinuria
Diminished TSH - Correct Answer-Elevated MCV
Chronic alcohol abuse is not associated with elevated LDL-C or the presence of
proteinuria (A, C). Diminished TSH levels is an indication of a thyroid disorder
and not derived from alcohol abuse (D).
Mary returns 3 weeks later after participating in several therapy sessions. She
admits that she would like to cut down on her alcohol use but is fearful of
withdrawal effects. The PMHNP offers to prescribe which of the following to help
manage alcohol withdrawal symptoms?
Naltrexone
Clonidine
Disulfiram
Naloxone - Correct Answer-Clonidine
Disulfiram is used to assist in maintaining abstinence from alcohol use by
causing noxious physical effects, such as nausea, vomiting, sweating and
headache, when alcohol is consumed (C). Naloxone is used to rapidly reverse the
effects of opioids during an overdose but would not be used for alcohol
withdrawal symptoms (D). Naltrexone is used to block the euphoric feeling
when alcohol or opioids are consumed but would not be helpful for alcohol
withdrawal symptoms (A).
3|Page
, PMHNP ACTUAL EXAM
At the request of his partner, a 51-year-old man is being evaluated for obsessive-
compulsive disorder. He admits that he finds it difficult to leave his apartment
without checking that the lights and water are turned off. It can take him up to 30
minutes to exit the apartment and this is putting a strain on his relationship. In
addition to recommending psychotherapy, the PMHNP suggests initiating
pharmacologic therapy with:
Duloxetine.
Bupropion.
Lurasidone.
Selegiline. - Correct Answer-Duloxetine.
SSRIs and SNRIs such as duloxetine are the first-line treatments for obsessive-
compulsive disorder, with a response rate ranging from 50-70% (A). High doses
are often needed to achieve the desired effect. Second-line treatment can
include clomipramine, while treatment can be augmented with the use of
valproate, lithium, or carbamazepine.
A 28-year-old man will initiate pharmacotherapy for generalized anxiety disorder.
His records show that he has chronic hepatitis B. Which of the following agents
should be avoided?
Sertraline
Duloxetine
Venlafaxine
4|Page
