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PMHNP Certification Q & A

PMHNP Certification Q & A
Author: Fitzgerald Health Education Associates
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© 2025 PMHNP Certification Q & A
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This podcast is for NP students studying to pass their PMHNP certification exam. Expert Fitzgerald faculty clinicians share their knowledge and experience to help you dissect the anatomy of a test question so you can better understand how to arrive at the correct test answer.
88 Episodes
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A 14-year-old patient has been managed for the last year with fluoxetine 40 mg daily for a diagnosis of generalized anxiety disorder. She had been doing well, but today her mother reports that ever since returning to school after the summer break she has been distant, sullen, argumentative and defiant. She has been spending time with new friends from school and is always out somewhere with them. The PMHNP recognizes that today’s appointment should include use of which of the following objecti...
PMHNP is asked to evaluate a 71-year-old male patient who is reportedly having visual hallucinations. His adult daughter accompanies him to the appointment and reports that he was diagnosed with Parkinson’s disease approximately 2 years ago. It began with the classic motor symptoms, but over the last year he has developed more and more difficulty with memory loss, difficulty with decision making, and episodes of depression and apathy. Sinemet has helped his motor symptoms, but he has not resp...
A 71-year-old patient with neurocognitive disorder due to Lewy Body disease presents for a routine follow-up. His wife reveals that he seems to be hallucinating, sometimes at night becoming very agitated as a result of visual hallucinations, and she is afraid for his safety. The patient himself does not really seem to understand that there is a problem, but his wife is very concerned and firm that he seems to have visual hallucinations more and more frequently. Which of the follow...
A.G. is a 51-year-old female patient who is being managed for a variety of mental health conditions including bipolar disorder, opioid use disorder, generalized anxiety disorder, and adjustment disorder. Her medication regimen includes a buprenorphine-based medication for OUD, an antipsychotic, an SSRI, and antihistamine. The physical examination documentation for each encounter should include a(n) : A. A PHQ-9 B. An AIMS score C. A GAD-7 D. An ORT --- YouT...
A 31-year-old Middle Eastern female presents to establish care. She recently relocated to the United States with her husband and is struggling with living in an environment so different from that in which she grew up. She shares that her husband seems more comfortable because he is working and integrating outside of the home, but she does not have that experience and feels very isolated from everything she knows. She is in her first trimester of pregnancy with their first child, and clearly s...
The PMHNP is conducting a new patient assessment with a patient who has self-referred for treatment of her panic attacks. The patient relates that she has had anxiety for years, and that she has episodes during which she gets very agitated, she can feel her heart pounding, feels as if she cannot breathe, feels very shaky, and has to sit down and wait for it to pass. These episodes can last for more than 15 minutes until she starts to calm down. Which of the following is inconsistent wit...
A 22-year-old female patient is transferred to your care after another provider in the practice retired. She has been managed for bipolar I disorder for 3 years and has had some challenging extremes of exacerbation. She is currently taking a mood stabilizer, an antipsychotic, and an antidepressant. Today she reports a worsening of her depression, admitting to true hopelessness about the future, worsening malaise to the extent that she is not attending to basic hygiene, and for the first time ...
A patient with a history of rapid-cycling bipolar disorder presents for evaluation of her current, profound depressive symptoms. The patient has been maintained for the last two years on valproic acid and quetiapine, but now a major depressive episode has occurred and the patient is reporting passive suicidal ideation. Concerned that the suicidal ideation may progress, the PMHNP consider which of the following pharmacotherapeutic options? A. Cariprazine B. Lumateperone ...
The PMHNP is seeing a patient who presents for complaint of depressive symptoms. The patient reports a history of anhedonia, hopelessness, worthlessness, sleep dysfunction, marked decrease in appetite with an unplanned 5 lb wt loss in the last month, and a marked inability to concentrate on necessary tasks. Before diagnosing the patient with major depressive disorder and beginning antidepressive therapy, the PMHNP should: A. Document a Patient Health Questionnaire-9 B. Admin...
The PMHNP has a new patient who reminds her of a former teacher who played an important role in her life and whom she regards as a mentor. The NP is concerned that she may express countertransference and is especially watchful for all of the following except: A. Resistance and strong emotion from the patient B. Dreaming about the patient C. Extending appointments beyond normal time frame D. Offering small, inexpensive gifts occasionally to the patient
The PMHNP is conducting a follow-up appointment with a patient who is being treated for generalized anxiety disorder. The patient has a long-standing difficult relationship with her mother and today it is evident that this is being exacerbated by her mother recently being diagnosed with cancer. Her mother does not appear to appreciate the sacrifices that the patient is making to help her, and the patient is very upset by this. At this appointment the patient is agitated and begins to pe...
The mother of a 3-year-old female brings her daughter in for a psychiatric evaluation. The mother is concerned because she sometimes sees her daughter talking to an “imaginary friend” and Mom is worried because she has a cousin with schizophrenia. Further the staff at her daughter’s daycare report that this little girl seems to prefer playing alone, even though there are lots of other children to play with. The child does not want to share her toys, and does not seem interested in playing wit...
The PMNP is evaluating a patient who is being treated for obsessive compulsive disorder with fluoxetine 60 mg daily. The patient has been on fluoxetine for months without any concerning adverse effects, but today the patient reports that for the past few weeks she has had a distinct sense of agitation, racing heart, nausea, and has been really clumsy. Suspecting serotonin syndrome, the NP assess for: A. New onset delusional thought B. Constipation C. Irritability D. Re...
The PMHNP is on call at the residential treatment facility and is called to urgently see a patient being treated for methamphetamine use disorder. The patient was admitted earlier this day and being and was still being assessed for appropriate psychotherapy and medication needs. Facility staff was performing routine observation rounds and found the patient unresponsive. You arrive at the bedside and find the patient to be unresponsive, with a blood pressure of 78/50 mm Hg and a respiratory ra...
A 32-year-old female patient tells the PMHNP in the course of an office visit that her toddler’s pediatrician has suggested that the 3-year-old be referred for further assessment because his MCHAT-R score was high. Your patient is upset and does not think that the result was correct. Which of the following findings in the child would support an elevated MCHAT R score? A. The child is mostly non-verbal and uses gestures to communicate B. The child’s growth is not maintaining a consistent...
Which of the following is a true statement with respect to the CAGE-AID questionnaire? A. It is a 5-item questionnaire used to screen for alcohol use disorder B. A “yes” answer to 1 item is considered highly sensitive for use disorder C. A positive CAGE questionnaire mandates intervention for use disorder D. Volume of alcohol or drug use is not a factor in a positive result --- YouTube: https://www.youtube.com/watch?v=-HCBrL4iP7o&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&a...
The PMHNP has ordered a comprehensive metabolic panel, CBC, TSH, and HgbA1c as part of a new patient screening panel to evaluate very generic complaints of fatigue, decreased motivation, and unplanned weight gain of 15 lbs in the last 6 months, insomnia and increased irritability. The patient believes he is depressed and is asking for an antidepressant, but the NP has concerns that the history provided is not complete and wants to ensure there is not an underlying organic etiology. Whic...
The PMHNP is seeing a patient who has been in Exposure-Response Therapy for obsessive-compulsive disorder for the last four months with suboptimal clinical improvement. After consulting with the therapist the PMHNP is discussing the addition of pharmacotherapy with the patient. The patient is advised that SSRIs may be helpful, and the most appropriate treatment expectations include: A. Allowing at least 12 weeks for onset of action then maintenance for at least one year. B. Realiz...
Developmental theorists often assert that dysfunction of some sort during growth and development may result in psychopathological traits in adulthood. According to Erikson’s Developmental Theory, which of the following maladaptive developmental conflicts increases the risk of obsessive-compulsive disorder in adulthood? A. Trust versus mistrust B. Autonomy versus shame and doubt C. Initiative versus guilt D. Industry versus inferiority --- YouTube: https://w...
A 15-year-old male patient reveals that he does not feel comfortable in his body. When considering a diagnosis of gender dysphoria the PMHNP recognizes that which of the following must be present to constitute this diagnosis? A. A strong desire to be of a gender other than assigned at birth B. Feelings associated with clinically significant distress C. A need to be treated as the gender not assigned by birth D. Plans for gender reassignment treatment --- YouTube:...