PMHNP-C sample questions

Question 1

Prior to initiating lithium carbonate maintenance therapy for an adult female presenting with acute mania in bipolar I disorder, which baseline laboratory tests must the PMHNP order to assess organ function and safety?

Accepted Answer

Serum creatinine, blood urea nitrogen, estimated glomerular filtration rate, thyroid-stimulating hormone, and human chorionic gonadotropin

Answer

Serum troponin, creatine kinase-MB, and 24-hour urinary copper clearance

Answer

Serum amylase, lipase, total bilirubin, and international normalized ratio (INR)

Answer

Glycosylated hemoglobin (HbA1c), fasting lipid panel, and serum prolactin level

Question 2

A 48-year-old patient with severe alcohol use disorder tells the PMHNP during an assessment, "I realize my drinking is damaging my liver and ruining my marriage. I have been researching local recovery groups and seriously want to stop drinking within the next thirty days, but I haven't actually quit yet." According to the Transtheoretical Model of Change, which stage of readiness is the patient exhibiting?

Accepted Answer

Contemplation

Answer

Precontemplation

Answer

Action

Answer

Maintenance

Question 3

True or False: In conducting a comprehensive psychiatric evaluation and assessing readiness for care, identifying a patient's limited health literacy, lack of reliable transportation, and food insecurity represents an evaluation of social determinants of health and structural barriers to care.

Accepted Answer

True

Answer

False

Question 4

A 52-year-old female presents with persistent fatigue, a 16-pound weight gain, constipation, psychomotor slowing, and low mood over the past four months. Laboratory tests reveal an elevated thyroid-stimulating hormone (TSH) level of 14.8 mIU/L (reference range: 0.4–4.0 mIU/L) and low free thyroxine (FT4). How should the PMHNP interpret these diagnostic results to inform clinical decision-making?

Accepted Answer

The presentation is consistent with a depressive disorder due to another medical condition (hypothyroidism), requiring primary medical endocrinologic management

Answer

The lab results indicate hyperthyroidism masquerading as generalized anxiety disorder

Answer

The patient meets criteria for primary Major Depressive Disorder with atypical features and requires immediate venlafaxine initiation

Answer

The elevated TSH is a transient, benign psychogenic manifestation of major depressive disorder that warrants no intervention

Question 5

When interpreting the Mood Disorder Questionnaire (MDQ) to screen an adult patient presenting with treatment-resistant depression for an underlying bipolar spectrum disorder, which criteria must be satisfied to establish a positive screen?

Accepted Answer

Affirming at least 7 of the 13 symptom items, confirming several occurred during the same timeframe, and reporting moderate to serious impairment

Answer

Scoring positive on at least 9 symptom items while explicitly denying any psychosocial problems from those behaviors

Answer

Endorsement of any 4 lifetime hypomanic symptoms regardless of co-occurrence or functional impairment

Answer

Reporting active suicidal ideation with depressive symptoms lasting longer than two consecutive months

Question 6

A PMHNP evaluates a 24-year-old female who presents with affective instability, recurrent intense anger, fear of abandonment, chronic feelings of emptiness, and identity disturbance. Which clinical feature most reliably differentiates this patient's condition (Borderline Personality Disorder) from Bipolar II Disorder?

Accepted Answer

Rapid, reactive mood shifts triggered by interpersonal stressors lasting hours, compared to distinct sustained hypomanic episodes lasting at least four consecutive days

Answer

The complete absence of major depressive episodes in the clinical course of borderline personality disorder

Answer

The presence of passive suicidal ideation, which occurs exclusively in personality disorders

Answer

An abrupt therapeutic response to mood stabilizer monotherapy, which confirms a personality disorder

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Free PMHNP-C sample questions

Prior to initiating lithium carbonate maintenance therapy for an adult female presenting with acute mania in bipolar I disorder, which baseline laboratory tests must the PMHNP order to assess organ function and safety?

True or False: In conducting a comprehensive psychiatric evaluation and assessing readiness for care, identifying a patient's limited health literacy, lack of reliable transportation, and food insecurity represents an evaluation of social determinants of health and structural barriers to care.

When interpreting the Mood Disorder Questionnaire (MDQ) to screen an adult patient presenting with treatment-resistant depression for an underlying bipolar spectrum disorder, which criteria must be satisfied to establish a positive screen?

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