PMHNP Certification Q & A

The PMHNP is managing a patient of Chinese ancestry with a diagnosis of bipolar disorder. The patient is currently experiencing some symptoms consistent with an early manic episode.  When considering prescribing carbamazepine, the NP considers that this patient is at particular risk for which of the following adverse effects?  A. Drug-induced hepatitis  B. Pancreatitis  C. Hypothyroidism  D. Toxic...

The PMHNP is called to the emergency department to evaluate a patient with an acute onset mental status change. The patient has a long history of schizophrenia and has been managed on a variety of antipsychotic therapies that have had some success, but the patient has not ever really achieved goal remission.  Most recently he was started on a first generation antipsychotic along with benztropine (...

The PMHNP is evaluating a 73-year-old patient who has just been discharged from the hospital after being treated for a urinary tract infection with associated delirium. She has a baseline major neurocognitive disorder and the spouse has been told in the past that the patient cannot take antipsychotics. However, while she was hospitalized she was given an antipsychotic for delirium and it seemed to...

A 3-year-old child is being seen because the daycare facility staff have suggested to the parents that the child is having difficulty interacting with other children. Additionally, the staff have observed that when the child seems to become anxious or upset, he always becomes fixated on stacking building blocks one on top of the other to the extent that he will not acknowledge anyone or anything e...

The PMHNP is performing a new patient assessment on a 41-year-old patient referred from primary care for depressive disorder refractory to SSRIs. During the mental status examination, the patient is unable to successfully perform a serial 7’s backward count. The NP documents an abnormal finding in the area of:  A. Speech  B. Thought process  C. Judgment  D. Cognition --- YouTube: https://www.youtu...

Patients with a deficit in one of six neurocognitive domains to the extent that it represents a deterioration of function from their baseline and makes it impossible for them to live independently are diagnosed with major neurocognitive disorder.  Which of the following is not one of the six neurocognitive domains?  A. Learning and memory  B. Language  C. Perceptual motor  D. Cognition and emotion...

The PMHNP is evaluating a new patient who has been referred by his employer for evaluation.  His supervisor is concerned about his mental health and his safety. The NP evaluates the patient and does not find criteria consistent with major depressive disorder, but identifies which of the following as particularly concerning for risk of suicide?  A. Anhedonia  B. Hopelessness C. Depressed mood  D. W...

The PMHNP is called to consult on a patient in the emergency department who has been admitted following a traumatic motor vehicle/pedestrian accident. He was walking across the street when a speeding driver crashed into him at high speed. The patient remarkably does not have serious injuries, the staff noted that he seemed a bit “odd” and decided to call for a mental health consult.  The patient l...

Which of the following laboratory abnormalities is not consistent with a female patient who drinks more than 3 alcoholic drinks daily?  A. Elevated high density lipoprotein B. Elevated macrocytosis  C. Elevated transaminases D. Elevated triglycerides --- YouTube: https://www.youtube.com/watch?v=XL6auWRfup8&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=113

The PMHNP is counseling a patient who wants to enter treatment for a substance use disorder. The patient has been using methamphetamine for over one year and freely acknowledges how much he likes the way it makes him feel. However, he is realizing that it is destroying his marriage, his professional reputation, and his health. He genuinely wants to stop using it, and is willing to do whatever he h...

When managing a patient in the stabilization phase of schizophrenia primary goals and process include which of the following?  A. Self-management skills  B. Supported employment  C. Assertive community treatment  D. Minimizing stress and supporting recovery --- YouTube: https://www.youtube.com/watch?v=3CM5_CTX69U&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=111

A 50 -year-old female patient has been followed by the PMHNP for over 6 years for a diagnosis of major depressive disorder, recurrent. The patient has achieved a successful remission on sertraline, 75 mg daily.  Today presents complaining of an acute onset depressed mood, tearful days, and difficulty concentrating for the last month. It has become a problem at work, and her boss has suggested that...

A 48-year-old patient who reports a diagnosis of obsessive-compulsive disorder has transferred to your care after moving from out of state. You are unable to obtain medical records and must rely on the patient for information. During the initial appointment the patient says reports a very stressful home life. She has a school-aged daughter with severe chronic illness who requires 24-7 total care,...

A patient with bipolar I disorder is currently being managed with lithium, 60 mg q.h.s. along with quetiapine 300 mg daily. The patient presents today for follow-up and reports that her mood has been very stable. Her work as a pastry chef has been really stressful around the holiday season, but she has handled it well and has no concerns about any mood deviations, either manic or depressive. She i...

A 27-year-old patient presents for evaluation at the suggestion of his intimate partner who thinks he might have depression. During the initial evaluation the patient admits that he is often “down,” has a really hard time feeling happy even when really good things happen. He denies any particular precipitating factor and in retrospect thinks he has been like this for “years.” He denies any difficu...

The PMHNP is seeing a patient who has been struggling with a collection of anxiety and depressive symptoms. She is resistant to pharmacotherapy and prefers to begin with a psychotherapy approach. As it turns out, the primary source of her symptoms is that she is married to a spouse in the military and has had to move thousands of miles from home, friends and family.  An attempt to implement soluti...

The PMHNP is interviewing a new patient, a 32-year-old single female who is presenting for evaluation of underlying anxiety. While collecting a social history the PMNP asks the patient if she has a boyfriend. The patient is uncomfortable with the question as she is lesbian and is now afraid that the PMHNP will not treat her fairly and with dignity.  The PMHNP is most likely demonstrating which of...

A 64-year-old patient presents with new onset anxiety. She denies any history of anxiety disorder or any psychiatric disorder previously in her life, but for the last 9 months she has been having episodes that she describes as “attacks.” Out of the blue she will develop a sense of racing heart, hyperventilation, numbness and tingling in her arms, and feeling lightheaded. She worries about this a l...

The dopamine hypothesis of schizophrenia postulates an abnormality in which of the following dopamine pathway as the etiology of symptoms?  Select all that apply.  A. The mesolimbic pathway B. The mesocortical pathway C. The nigrostriatal pathway  D. The tuberoinfundibular pathway  --- YouTube: https://www.youtube.com/watch?v=oQ42kYfwJU4&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=103

The PMHNP is seeing a patient who presents with a chief complaint of feeling depressed. Further exploration reveals that while the patient does have several symptoms of a depressive episode, he does not quite meet criteria for any of the commonly encountered depressive disorders. The primary issue seems to center around the fact that the client feels as if his life has no meaning. He says he gets...

The PMHNP is evaluating a 69-year-old patient who has self-referred for evaluation. The patient retired from his professional role as a CEO from a major fortune 500 company 8 months ago and admits that he feels himself sinking into an uncharacteristic depression. For most of his life he has been a high-achiever, and he retired 8 months ago with the intention of enjoying the wealth he worked so har...

Which of the following medical conditions should be considered when a patient presents complaining of new onset  episodes of anxiety-like symptoms including hypervigilance, tremulousness, tachycardia, and palpitations?  A. Hypothyroidism B. Insulinoma C. Anemia  D. Hepatitis  --- YouTube: https://www.youtube.com/watch?v=PgcoKYwUNMo&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=100

A PMHNP partners with a local women’s health practice to develop a program to screen pregnant women for depression in an effort to identify patients at high risk for post-partum depression and institute treatment as appropriate. This is an example of which level of prevention?  A. Primary prevention  B. Secondary prevention C. Tertiary prevention  D. Collaborative prevention --- YouTube: https://w...

The PMHNP is evaluating a patient who has presented for care repeatedly reporting that she is bipolar and has manic episodes. She has been medicated in the past with a number of mood stabilizers without any meaningful improvement. Today a more detailed history reports that what she is calling manic episodes are actually periods of dramatic responses to stressors. When she argues with her significa...

A 67-year-old female is being evaluated for complaints of depression. She has always struggled with times where she was down but never liked taking medication and has tried to treat herself with nutraceuticals. Her symptoms have gotten much worse lately because her husband died and she is struggling with that. She has been seeing a therapist for the last few months but is not feeling any real impr...