PMHNP-BC 2026 BOARD REVIEW +
CASE STUDIES LATEST 2026 UPDATE FAST REVIWED
FROM ACTUAL TEST 150 QUESTIONS AND 100% VERIFIED
ANSWERS| A+ GRADE Q&A | INSTANT DOWNLOAD PDF
1. A 25-year-old patient presents with persistent sadness, fatigue, and loss of interest for the
past 6 weeks. Which is the most likely diagnosis?
A) Dysthymia
B) Major Depressive Disorder
C) Bipolar II Disorder
D) Adjustment Disorder
Explanation: Symptoms lasting more than 2 weeks with functional impairment suggest Major
Depressive Disorder rather than dysthymia or adjustment disorder.
2. A patient with schizophrenia reports hearing voices telling him to harm others. Which is
the priority nursing action?
A) Encourage journaling
B) Ensure patient safety
C) Teach relaxation techniques
D) Provide psychoeducation
Explanation: Immediate safety assessment is the priority for patients with command
hallucinations.
3. A 30-year-old woman presents with panic attacks characterized by palpitations, sweating,
and fear of dying. Which medication is first-line?
A) Benzodiazepines
B) Tricyclic antidepressants
C) SSRIs
D) Beta-blockers
Explanation: SSRIs are first-line for panic disorder due to efficacy and long-term safety.
4. A patient on lithium therapy reports nausea, vomiting, and tremors. What is the first
nursing action?
A) Increase fluid intake
B) Check lithium serum levels
C) Encourage exercise
D) Reassure patient
Explanation: These are signs of lithium toxicity; checking serum levels is critical.
, 5. Which neurotransmitter is most closely associated with schizophrenia?
A) Serotonin
B) Dopamine
C) GABA
D) Acetylcholine
Explanation: Dopamine hyperactivity in the mesolimbic pathway contributes to positive
symptoms of schizophrenia.
6. A 22-year-old presents with recurrent intrusive thoughts of contamination and
compulsive handwashing. Best treatment?
A) Antipsychotics
B) Mood stabilizers
C) SSRIs and CBT
D) Benzodiazepines
Explanation: OCD responds well to SSRIs and cognitive-behavioral therapy.
7. A patient with bipolar I disorder is in a manic episode. Which is the priority intervention?
A) Schedule therapy
B) Administer mood stabilizer
C) Teach nutrition
D) Encourage journaling
Explanation: Pharmacologic stabilization is urgent to prevent harm and manage mania.
8. A patient with PTSD experiences nightmares, hypervigilance, and avoidance. Which
therapy is evidence-based?
A) Psychodynamic therapy
B) Trauma-focused CBT
C) Interpersonal therapy
D) Biofeedback
Explanation: Trauma-focused cognitive-behavioral therapy is the most effective treatment for
PTSD.
9. Which side effect is most concerning with clozapine therapy?
A) Weight gain
B) Agranulocytosis
C) Sedation
D) Orthostatic hypotension
Explanation: Agranulocytosis is potentially life-threatening and requires regular CBC
monitoring.
, 10. A 40-year-old patient reports depressed mood most of the day for 3 years with low self-
esteem. Likely diagnosis?
A) Persistent Depressive Disorder (Dysthymia)
B) Major Depressive Disorder
C) Cyclothymia
D) Adjustment Disorder
Explanation: Chronic low-grade depression ≥2 years fits persistent depressive disorder.
11. Which lab should be monitored routinely in a patient taking valproate?
A) Electrolytes
B) Liver function tests and platelets
C) Thyroid function
D) Renal function
Explanation: Valproate can cause hepatotoxicity and thrombocytopenia.
12. A patient with borderline personality disorder demonstrates self-harm behaviors. Priority
intervention?
A) Provide long-term therapy
B) Ensure immediate safety
C) Discuss past trauma
D) Encourage journaling
Explanation: Safety is the top priority for self-harming behaviors.
13. Which symptom is positive in schizophrenia?
A) Flat affect
B) Hallucinations
C) Social withdrawal
D) Lack of motivation
Explanation: Positive symptoms include hallucinations and delusions; negative symptoms
include flat affect and withdrawal.
14. A patient with major depression is started on an SSRI. What should the nurse educate
about?
A) Immediate symptom relief
B) 2–4 weeks for effect
C) Risk of addiction
D) Avoid therapy
Explanation: SSRIs typically require 2–4 weeks for therapeutic effects.
15. Which condition is a contraindication for MAOI therapy?
A) Depression
CASE STUDIES LATEST 2026 UPDATE FAST REVIWED
FROM ACTUAL TEST 150 QUESTIONS AND 100% VERIFIED
ANSWERS| A+ GRADE Q&A | INSTANT DOWNLOAD PDF
1. A 25-year-old patient presents with persistent sadness, fatigue, and loss of interest for the
past 6 weeks. Which is the most likely diagnosis?
A) Dysthymia
B) Major Depressive Disorder
C) Bipolar II Disorder
D) Adjustment Disorder
Explanation: Symptoms lasting more than 2 weeks with functional impairment suggest Major
Depressive Disorder rather than dysthymia or adjustment disorder.
2. A patient with schizophrenia reports hearing voices telling him to harm others. Which is
the priority nursing action?
A) Encourage journaling
B) Ensure patient safety
C) Teach relaxation techniques
D) Provide psychoeducation
Explanation: Immediate safety assessment is the priority for patients with command
hallucinations.
3. A 30-year-old woman presents with panic attacks characterized by palpitations, sweating,
and fear of dying. Which medication is first-line?
A) Benzodiazepines
B) Tricyclic antidepressants
C) SSRIs
D) Beta-blockers
Explanation: SSRIs are first-line for panic disorder due to efficacy and long-term safety.
4. A patient on lithium therapy reports nausea, vomiting, and tremors. What is the first
nursing action?
A) Increase fluid intake
B) Check lithium serum levels
C) Encourage exercise
D) Reassure patient
Explanation: These are signs of lithium toxicity; checking serum levels is critical.
, 5. Which neurotransmitter is most closely associated with schizophrenia?
A) Serotonin
B) Dopamine
C) GABA
D) Acetylcholine
Explanation: Dopamine hyperactivity in the mesolimbic pathway contributes to positive
symptoms of schizophrenia.
6. A 22-year-old presents with recurrent intrusive thoughts of contamination and
compulsive handwashing. Best treatment?
A) Antipsychotics
B) Mood stabilizers
C) SSRIs and CBT
D) Benzodiazepines
Explanation: OCD responds well to SSRIs and cognitive-behavioral therapy.
7. A patient with bipolar I disorder is in a manic episode. Which is the priority intervention?
A) Schedule therapy
B) Administer mood stabilizer
C) Teach nutrition
D) Encourage journaling
Explanation: Pharmacologic stabilization is urgent to prevent harm and manage mania.
8. A patient with PTSD experiences nightmares, hypervigilance, and avoidance. Which
therapy is evidence-based?
A) Psychodynamic therapy
B) Trauma-focused CBT
C) Interpersonal therapy
D) Biofeedback
Explanation: Trauma-focused cognitive-behavioral therapy is the most effective treatment for
PTSD.
9. Which side effect is most concerning with clozapine therapy?
A) Weight gain
B) Agranulocytosis
C) Sedation
D) Orthostatic hypotension
Explanation: Agranulocytosis is potentially life-threatening and requires regular CBC
monitoring.
, 10. A 40-year-old patient reports depressed mood most of the day for 3 years with low self-
esteem. Likely diagnosis?
A) Persistent Depressive Disorder (Dysthymia)
B) Major Depressive Disorder
C) Cyclothymia
D) Adjustment Disorder
Explanation: Chronic low-grade depression ≥2 years fits persistent depressive disorder.
11. Which lab should be monitored routinely in a patient taking valproate?
A) Electrolytes
B) Liver function tests and platelets
C) Thyroid function
D) Renal function
Explanation: Valproate can cause hepatotoxicity and thrombocytopenia.
12. A patient with borderline personality disorder demonstrates self-harm behaviors. Priority
intervention?
A) Provide long-term therapy
B) Ensure immediate safety
C) Discuss past trauma
D) Encourage journaling
Explanation: Safety is the top priority for self-harming behaviors.
13. Which symptom is positive in schizophrenia?
A) Flat affect
B) Hallucinations
C) Social withdrawal
D) Lack of motivation
Explanation: Positive symptoms include hallucinations and delusions; negative symptoms
include flat affect and withdrawal.
14. A patient with major depression is started on an SSRI. What should the nurse educate
about?
A) Immediate symptom relief
B) 2–4 weeks for effect
C) Risk of addiction
D) Avoid therapy
Explanation: SSRIs typically require 2–4 weeks for therapeutic effects.
15. Which condition is a contraindication for MAOI therapy?
A) Depression
