PMHNP Certification Q & A

A 14-year-old female is diagnosed with obsessive-compulsive disorder and has been in exposure and response prevention (ERP) therapy for the last three months. While there has been some improvement of symptoms, the patient, patient’s Mom, and therapist would all like to discuss augmenting therapy with medication management. Which of the following would be a likely pharmacologic option? A. Fluoxetin...

Which of the following organisms are associated with an increased risk of neurodevelopmental disorders? A. Group B Streptococcus B. Escherichia coli C. Herpes simplex virus D. Proteus sp. --- YouTube: https://www.youtube.com/watch?v=FMg1bZE4o00&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=27

The PMHNP is evaluating Jared, a 47-year-old male who is brought to care by his wife because “he’s not the man I married 20 years ago.”  He denies any significant medical history. He takes no medication and his remaining histories are unremarkable. According to his wife, she and Jared have been married for 20 years, have two children, and have lived a “normal” life. Jared owns a local construction...

Janel is a 37-year-old woman who is being interviewed as part of a family assessment. Her 10-year-old son is having some behavioral issues in school and has been referred for evaluation. While interviewing Janel the PMHNP appreciates that she appears very emotional. She expresses extreme distress at her son’s behavior and says she will do anything to help him; they are “best friends.” She is very...

Cory is a 23-year-old male recently incarcerated in the county correction facility for a 9-month sentence following his third conviction for battery. As part of an early release program he is required to participate in therapy. During his initial interview he is very pleasant and engaged, expressing no anxiety or distress with his current circumstances. His psychiatric history is significant for n...

Trudy L. is a 29-year-old female patient who initiated care because she feels like she has no energy. She just had her annual wellness exam and her primary care provider told her that she is in excellent health. Because she complained about this excessive fatigue, her PCP performed a CBC, CMP, UA and thyroid function tests and told her that, along with her physical examination, everything looks no...

Anthony is a 41-year-old male patient who presents for evaluation. His wife made the appointment because she is worried about him, and she says he would never seek care on his own. Reportedly, Anthony has become progressively withdrawn over the last few months, and actually is in danger of losing his job because he misses so many days. He has been evaluated by his primary care provider and has no...

Patients on lithium carbonate for management of bipolar disorder should be subject to routine assessment of:  A. CBC and BMP  B. TSH and serum Na+  C. CMP and ECG  D.  LFTs and EEG  --- YouTube: https://www.youtube.com/watch?v=nZY82DoTVCw&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=21

A 22-year-old male patient is started on sertraline 50 mg p.o. daily after presenting with a major depressive episode. After tolerating it without difficulty for two weeks his dose was increased to 100 mg p.o. daily. Approximately 4 weeks later he reported an unusual set of new symptoms for the last week and a half. He says he feels “amped up” and just very generally agitated and nervous. He was s...

Jeffrey T. is a 27-year-old man who has presented for care after being required to do so by the county court. He was involved in a car accident, and while he was not at fault for the accident, routine blood alcohol screening revealed that he was driving while intoxicated. He is a bit resentful at being required to attend therapy; he is vocal that his driving was not impaired and that he can functi...

Fletcher is a 29-year-old male referred for court-ordered counseling. He has a long history of repeated offenses including DUI, domestic violence, battery, and other violent acts that fortunately have not yet caused any serious injury or death to the victims. An interview with his wife reveals that for the last few years he has lied about almost everything; he is able to get hired for jobs because...

Mrs. Bowen is a 33-year-old female who presents as a new patient requesting medication for depression. She reports a long history of mood disorders on and off going back to adolescence. She is very articulate in describing her history and reports that neither sertraline nor fluoxetine “worked for her.” With respect to considering Mrs. Bowen’s medication history, the PMHNP knows that:  A. A SNRI wi...

Chantel is a 19-year-old female who presents for care because she thinks she is bipolar. During her initial interview, she admits that she has a long history of feeling like she was the person in the family of whom there were always high expectations, and she was never able to express her feelings of inadequacy. When asked why she thinks she is bipolar, she says she gets very moody. She was at the...

Renee is a 27-year-old female who has come to group therapy while incarcerated in the city jail. She was arrested for vagrancy because she was sleeping in her car. She could not post bail and was sentenced to 14 days in jail. During group she contributes that none of this is her fault. Her mother is totally evil because she would not let Alexa stay in the family home. She has some other family but...

Mrs. Maxwell is a 75-year-old patient with neurocognitive disorder due to  Alzheimer’s disease. She lives with her son and his wife and generally does very well with her day-to-day activities. The family understand the importance of routine and Mrs. Maxwell maintains a regular schedule of activities including her meals, timed toileting, and recreational activities. Which of the following behaviors...

M.T. is a 39-year-old female being seen by the PMHNP for a major depressive disorder. She is being managed with SNRI therapy in combination with cognitive behavioral therapy, but is having difficulty achieving remission. Her husband is becoming very frustrated. He wants to be supportive, but does not understand why she is so depressed. Two years ago she had an episode of depression when her sister...

A PMHNP student is reviewing his notes from his clinical experience over the past week to prepare his first required case presentation on a patient suffering a major depressive episode. Which of the following patients best represents the DSM-V criteria for major depressive episode?  A. A 27-year-old female with a one-month history of social withdrawal, anorexia, hypersomnia, unprovoked outbursts o...

When evaluating the laboratory assessment of a patient with alcohol use disorder, the PMHNP may reasonably expect to find all of the following abnormalities due to chronic alcohol use except:  A. Macrocytosis B. Transaminitis  C. Uremia  D. Hypertriglyceridemia  --- YouTube: https://www.youtube.com/watch?v=8djjQHcSTWI&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=11

The PMHNP is considering a diagnosis of narcissistic personality disorder in a new patient. When reviewing the history and physical examination, which of the following findings would be most consistent with this diagnosis?  A. The presence of fixed delusional thought  B. Disdain for weak or sickly people  C. A history of antisocial behavior  D. Extreme “drama” in most personal relationships  --- Y...

When performing a psychiatric assessment of an elderly patient with Alzheimer’s disease, the PMHNP recognizes that:    a. The most important part of the history will come from the caregiver   b. The patient must be interviewed alone to preserve privacy of the relationship    c.  A sexual history is not necessary in patients who are not sexually active    d. Age often defines the character of trans...

Jen is a 31-year-old female who presents for care complaining of depressed mood. During the interview it becomes apparent that she has a long history of depressive symptoms, as well as a long history of being socially isolated and feeling generally inadequate. When considering a diagnosis of persistent depressive disorder, the PMHNP considers that the core concept of persistent depressive disorder...

Validated and reliable instruments are an important part of assessment for both clinical practice and research in mental health. Which of the following tools is currently considered the standard for assessing clinical outcomes in treatment studies of schizophrenia? A. SCID B. BPRS  C. PANSS  D. HAM-D --- YouTube: https://www.youtube.com/watch?v=KaCK-iVbQ1U&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35O...

Laura is a 27-year-old female who is being seen today for psychiatric evaluation. She has no significant psychiatric or medical history and denies any history of substance abuse. She is being seen today because she is persistently having olfactory hallucinations. For the last three months she has been having a progressive sense of smelling particularly foul odors – feces, rotting food, and trash,...

C.J. is a 23-year-old male being seen today by the PMHNP today for an initial evaluation. He says that he does not think anything is wrong but his family, specifically his mother, grandmother, and aunt, have all told him that he must be “mentally ill.” He cannot hold a job. He has worked as a cook at more than 5 chain restaurants in the last 6 months. He has no real friends – he says his friends o...

The PMHNP is asked to evaluate the parent of one of her existing patients. The patient reports that her father, a 78-year-old man who lives alone, has always been in good health. However, last Sunday during breakfast with him he was overtly confused and at first he did not even seem to recognize his daughter. This patient is concerned that her father has Alzheimer’s disease and is amazed because t...