Claim OwnershipPMHNP Certification Q & A
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© 2026 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.
108 Episodes
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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 is sleeping approximately 7 hours nightly. Her last blood work was 7 months ago, and at the time t...
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 difficulty sleeping, although says he never really wakes up feeling “well-rested and ready to go.” His a...
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 solution-focused therapy would include which of the following techniques? A. Motivational in...
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 the following? A. An appropriate approach to collecting social history B. A mani...
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 lot, and now worries virtually all the time about why this is happening. It is causing difficulty ...
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 up, he gets dressed, goes to work, pays the bills, does all of the things he is supposed to do in...
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 hard to build. While he did take some big trips and had a lot of fun at first, now he feels oddly em...
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://www.youtube.com/watch?v=QtlF5hZ5e0U&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&...
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 significant other, her mother, and even people at work she becomes very animated. In response to stressors...
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 improvement. When considering pharmacotherapy for her, which of the following medications should be a...
The PMHNP is evaluating a family at the request of county social services. A mother, father, 8-year-old and 2-year-old are present for the evaluation. The NP notes that the 2-year-old clings excessively to the parents, despite the fact that the parents do not seem to be particularly responsive to the child’s caution. The 2-year-old does not exhibit typical curiosity about his new environment and does not express any curiosity about the PMHNP. These behaviors are consistent with: A...
A 78-year-old man presents for a follow-up visit. Two months ago he was started on sertraline for major depressive disorder and has been titrated up to 100 mg daily. Today his daughter reports that she cannot really evaluate if his mood has improved because he seems to have become confused. The patient’s daughter reports a distinct new onset confusion and forgetfulness. The PMHNP considers the most likely cause of his confusion to be: A. Urinary tract infection. B. Hyp...
Cognitive assessment in children characterizes stages of development consistent with Piaget’s developmental theory. One of the cognitive principles typically developed during the sensorimotor stage is: A. Object permanence B. Animalistic thinking C. Phenomenalistic causality D. Learning without reasoning. YouTube: https://www.youtube.com/watch?v=AIZ5H14yUqI&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=94
A 12-year-old patient is being seen today in follow-up after being started on fluoxetine 1 month ago for a diagnosis of generalized anxiety disorder. The patient and her father both report that while there does appear to be a mild improvement in anxiety, some adverse effects have developed about which they are concerned. Which of the following is not an expected adverse effect and is a cause for concern? A. Vivid nightmares B. Diaphoresis C. Restless legs ...
The PMHNP is evaluating a patient who presents complaining of panic attacks that occur for no identifiable reason. The patients has been treated for these previously with a variety of pharmacotherapies that did not provide any meaningful improvement. Upon further conversation, the NP learns that the patient experienced a near-fatal bicycle accident 4 years ago after being hit by a car. When considering a diagnosis of PTSD, the NP explores his history for all of the following diagn...
J.B. is a 41-year-old female patient who is being managed for obsessive compulsive disorder. She has been in exposure response therapy (ERT) for several months with marginal improvement, but she has never approached true remission. At one time she was on fluvoxamine with notable improvement, but after a few months it ceased to produce any notable impact and after conferring with her therapist she was converted to fluoxetine 20 mg qd. After two months she was still struggling with symptoms, so...
The PMHNP is evaluating a patient with significant anxiety and depressive symptoms. In the course of the evaluation the NP further appreciates that the patient is having hypnopompic hallucinations, and that the patient is very concerned about this because his uncle has schizophrenia. The PMHNP advises the patient that: A. There are a variety of pharmacologic options that can be helpful. B. The hallucinations are benign and not a cause for concern. C. There is no need for int...
A.J. is an 8-year-old male who is under the care of the PMHNP for ADHD. His symptoms are profound, and the recommendation is to begin psychostimulant therapy along with behavioral therapy. The parents are concerned because they have read that psychostimulant therapy can impact growth and final adult height if the child starts taking it before the growth spurt of adolescence. The most appropriate response to the parents is to say that: A. The impact on growth can be minimized...
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