Georgette Review PMHNP 2026–2027 | Complete
Psychiatric Mental Health Nurse Practitioner Exam Prep |
Verified Questions & Correct Answers | Comprehensive
ANCC PMHNP Certification Study Guide for Guaranteed
Success
THIS EXAM INCLUDES:
✔ Comprehensive PMHNP Practice Questions with Verified Correct Answers
✔ Latest 2026–2027 Psychiatric Mental Health Nurse Practitioner Exam Content
✔ ANCC PMHNP Certification Preparation Materials
✔ DSM-5 Psychiatric Disorders, Diagnosis & Treatment Review
✔ Psychopharmacology Medications, Side Effects & Nursing Interventions
✔ Therapy Modalities, Counseling Techniques & Therapeutic Communication
✔ Psychiatric Assessment, Mental Status Examination & Differential Diagnosis
,Pharmacology & Mood Stabilizers
1. A patient's lithium level is 1.8 mEq/L. What signs and symptoms would the
PMHNP expect to find?
A. Hyperactivity, insomnia, and weight gain
B. Severe nausea, diarrhea, confusion, and coarse hand tremors
C. Increased appetite, sedation, and bradycardia
D. Hair loss, hepatotoxicity, and rash
Answer: B - Lithium toxicity occurs at levels >1.5 and presents with severe nausea,
diarrhea, vomiting, confusion, drowsiness, muscle weakness, coarse hand tremors, and
unsteady gait.
2. A 28-year-old female with bipolar disorder is planning to become pregnant. She
has been stable on lithium for 3 years. What should the PMHNP discuss with her
regarding fetal risk?
A. Lithium is safe throughout pregnancy
B. Lithium causes spina bifida, especially in the first trimester
C. Lithium causes Ebstein anomaly, a congenital heart defect, especially in the first
trimester
D. Lithium causes cleft palate and floppy baby syndrome
Answer: C - Lithium is associated with Ebstein anomaly (congenital heart defect),
particularly when taken during the first trimester.
3. Before initiating lithium therapy, which baseline laboratory studies are
essential?
,A. CBC, CMP, vitamin D, and iron panel
B. TSH, creatinine, BUN, HCG (for females 12-51), EKG (for patients 50+), and urinalysis
C. Liver function tests only
D. TSH and free T4 only
Answer: B - Baseline labs include TSH, creatinine (0.6-1.2), BUN (10-20), HCG for
childbearing females, EKG for patients 50 and older, and urinalysis to check for protein.
4. A patient on lithium presents with severe nausea, vomiting, diarrhea, confusion,
and coarse hand tremors. What is the most appropriate intervention?
A. Increase the lithium dose
B. Add benztropine for tremors
C. Check lithium level; hold medication and evaluate for toxicity
D. Prescribe antiemetics and antidiarrheals
Answer: C - These symptoms are consistent with lithium toxicity. The PMHNP should
check the lithium level and hold the medication.
5. A patient with bipolar I disorder is prescribed valproate (Depakote). What is the
therapeutic range?
A. 0.6-1.2
B. 50-125
C. 5-15
D. 100-150
Answer: B - The normal therapeutic level for Depakote (valproate) is 50-125.
, 6. Which of the following is a teratogenic effect associated with valproate
(Depakote)?
A. Ebstein anomaly
B. Cleft palate
C. Spina bifida (neural tube defect)
D. Floppy baby syndrome
Answer: C - Valproate (Depakote) is associated with neural tube defects/spina bifida.
7. A patient on valproate reports hair loss and right upper quadrant pain. What
should the PMHNP order?
A. Serum lithium level
B. Liver function tests (AST, ALT)
C. Thyroid function tests
D. Serum glucose and lipid panel
Answer: B - Alopecia and hepatotoxicity (RUQ pain) are adverse effects of Depakote.
The PMHNP should order LFTs (AST 5-40, ALT 5-35).
8. A patient on valproate presents with disorientation, lethargy, and respiratory
depression. What is the priority intervention?
A. Increase the valproate dose
B. Administer naloxone
C. Discontinue valproate, check level, and order LFTs and ammonia
D. Add lithium to the regimen
Psychiatric Mental Health Nurse Practitioner Exam Prep |
Verified Questions & Correct Answers | Comprehensive
ANCC PMHNP Certification Study Guide for Guaranteed
Success
THIS EXAM INCLUDES:
✔ Comprehensive PMHNP Practice Questions with Verified Correct Answers
✔ Latest 2026–2027 Psychiatric Mental Health Nurse Practitioner Exam Content
✔ ANCC PMHNP Certification Preparation Materials
✔ DSM-5 Psychiatric Disorders, Diagnosis & Treatment Review
✔ Psychopharmacology Medications, Side Effects & Nursing Interventions
✔ Therapy Modalities, Counseling Techniques & Therapeutic Communication
✔ Psychiatric Assessment, Mental Status Examination & Differential Diagnosis
,Pharmacology & Mood Stabilizers
1. A patient's lithium level is 1.8 mEq/L. What signs and symptoms would the
PMHNP expect to find?
A. Hyperactivity, insomnia, and weight gain
B. Severe nausea, diarrhea, confusion, and coarse hand tremors
C. Increased appetite, sedation, and bradycardia
D. Hair loss, hepatotoxicity, and rash
Answer: B - Lithium toxicity occurs at levels >1.5 and presents with severe nausea,
diarrhea, vomiting, confusion, drowsiness, muscle weakness, coarse hand tremors, and
unsteady gait.
2. A 28-year-old female with bipolar disorder is planning to become pregnant. She
has been stable on lithium for 3 years. What should the PMHNP discuss with her
regarding fetal risk?
A. Lithium is safe throughout pregnancy
B. Lithium causes spina bifida, especially in the first trimester
C. Lithium causes Ebstein anomaly, a congenital heart defect, especially in the first
trimester
D. Lithium causes cleft palate and floppy baby syndrome
Answer: C - Lithium is associated with Ebstein anomaly (congenital heart defect),
particularly when taken during the first trimester.
3. Before initiating lithium therapy, which baseline laboratory studies are
essential?
,A. CBC, CMP, vitamin D, and iron panel
B. TSH, creatinine, BUN, HCG (for females 12-51), EKG (for patients 50+), and urinalysis
C. Liver function tests only
D. TSH and free T4 only
Answer: B - Baseline labs include TSH, creatinine (0.6-1.2), BUN (10-20), HCG for
childbearing females, EKG for patients 50 and older, and urinalysis to check for protein.
4. A patient on lithium presents with severe nausea, vomiting, diarrhea, confusion,
and coarse hand tremors. What is the most appropriate intervention?
A. Increase the lithium dose
B. Add benztropine for tremors
C. Check lithium level; hold medication and evaluate for toxicity
D. Prescribe antiemetics and antidiarrheals
Answer: C - These symptoms are consistent with lithium toxicity. The PMHNP should
check the lithium level and hold the medication.
5. A patient with bipolar I disorder is prescribed valproate (Depakote). What is the
therapeutic range?
A. 0.6-1.2
B. 50-125
C. 5-15
D. 100-150
Answer: B - The normal therapeutic level for Depakote (valproate) is 50-125.
, 6. Which of the following is a teratogenic effect associated with valproate
(Depakote)?
A. Ebstein anomaly
B. Cleft palate
C. Spina bifida (neural tube defect)
D. Floppy baby syndrome
Answer: C - Valproate (Depakote) is associated with neural tube defects/spina bifida.
7. A patient on valproate reports hair loss and right upper quadrant pain. What
should the PMHNP order?
A. Serum lithium level
B. Liver function tests (AST, ALT)
C. Thyroid function tests
D. Serum glucose and lipid panel
Answer: B - Alopecia and hepatotoxicity (RUQ pain) are adverse effects of Depakote.
The PMHNP should order LFTs (AST 5-40, ALT 5-35).
8. A patient on valproate presents with disorientation, lethargy, and respiratory
depression. What is the priority intervention?
A. Increase the valproate dose
B. Administer naloxone
C. Discontinue valproate, check level, and order LFTs and ammonia
D. Add lithium to the regimen
