PMHNP Exam Reported Questions 2026 Complete Questions and Answers Solved 100%

What is dissemination?

Getting the research information out to those who need to know it!

Publication - highest level

Presenting at National Conference

Presenting at Local Conference

Journal Club where one person reviews an article

What does a 17 on MMSE mean?

Moderate cognitive impairment

What is Tegretol in the CYP450 system?

Inducer -->will lower dose of Lamictal and BCP's

What do BCP's do to Lamictal?

Inducer - will lower dose of Lamictal

What is a Type I research error?

There IS a difference but you say there isn't a difference.

What is a Type II research error?

There is NO difference but you say there is a difference.

What is pseudo-dementia?

Cognitive impairment secondary to depression that clears when treated in the elderly. Dementia won't improve.

Is it normal for a 1 month old to have a palmar grasp?

Yes.

What is a drug 1/2 life?

The time it takes for 50% of a drug to be eliminated from the body.

What 3 atypicals can be used with teens?

Zyprexa, Abilify, Seroquel - low doses

What is a risk of using Tramadol?

Serotonin Syndrome as it is very serotonergic.

What is the allele seen in Asians that increase the risk of SJS?

HLAB-1502

When might you see toxic epidermal necrolysis?

With worsening of SJS

How many generations do you include for a genogram?

1st degree - mother, father, siblings

2nd degree - grandparents & cousins

3rd degree -

What does messenger RNA code for?

Amino Acids

What is epigenetics?

Factors that affect genes - environmental, smoking, stress, etc...

What part of the brain is involved with OCD?

Basal Ganglia

Occipito-Frontal

What happens to the brain during adolescence?

Dendritic pruning

Emotions are controlled by amygdala

By adulthood, PFC involved as well

When do males typically present with schizophrenia?

10-25 yo

When do females typically present with schizophrenia?

25-35 yo

What does Erythromycin to trileptal?

You will need to decreases the level because Trileptal(inducer) and erythromycin is a inhibitor

ACE Inhibitors are the drug of choice for what?

Heart Failure

HTN

What are some psychiatric side effects seen with some asthma drugs

Leukotriene receptor agonists - singulair, accolade, zyflo = agitation, aggression, anxiety, hallucinations, depression, insomnia, SI, tremor

What should you watch for with Tegretol?

Agranulocytosis and Hyponatremia

What are the 3 CK muscle enzyme tests?

CKBB, CKMM, CKMB

Which one of the 3 muscle enzymes are related to cardiac muscle damage?

CKMB

What is the risk of a seriously elevated CKMB?

Polymyositis

Rhabdo

What is a normal CKMB?

0.3 mcg/L

What psychoactives does Detrol interact with?

Topamax

KCL

Zonegran

What CN are you assessing when you have the patient shrug their shoulders?

CN XI - Spinal Accessory

What do you see in labs with HIV & Dementia?

CD4 <200

Viral Load is high

<20% get it with antiretroviral treatment

What is the scoring with the Beck Depression Inventory?

Self-Report - 0-63

0-13 - minimal

14-19 - mild

20-28 - moderate

29-63 - severe

What is sensitivity?

Helps rule-out disease = True Positive = Snout

What is specificity?

Helps rule-in disease = True Negative = Spin

What does a sed rate measure?

Inflammation (ESR - Erythrocyte Sedimentation Rate) = distance in mm RBC's have descended in 1 hour.

What is a normal sed rate or ESR?

0-22 males

0-29 females

What is a retic count?

Measures % of reticulocytes in blood (immature RBC's) Indicates whether enough RBC's are being produced by bone marrow.

What does a decreased retic count indicate?

Anemia - acute or chronic bleeding

What does an increased retic count indicate?

Bone marrow disorder or Vitamin Deficiency

What does an abnormal retic ount indicate in general?

Doesn't diagnose anything. First step is ID source of the issue.

What happens when you mix tegretol and macrolides?

Increase tegretol levels.

What happens if a pregnant women takes Accutane?

Birth defects.

What labs do you get with RA?

Sed rate, RF, ANA, C reactive protein, CBC, CMP, CRP - helps confirm diagnosis.

CRP and ESR are both increased in RA but NOT in osteoarthritis.

Where does the NP Code of Ethics come from?

ANA

When do you assume informed consent?

Unconscious

Incompetent

Life Threatening Situation

What are the legal ramifications of treating w/o informed consent?

Same as with informed consent

Who can declare a patient incompetent and appoint a guardian?

Only a court

Does impaired judgment mean one is incompetent?

No.

Can an advanced directive ever be revoked?

Yes, at any time.

What is the different between a Healthcare Agent, Proxy, Surrogate, and Attorney in Fact?

Nothing. They are all the same.

Does the de facto rule of proxy apply in same sex marriages?

No.

How do Asians see HC providers?

As in a position of authority.

Expect to give instructions and help make decisions

What does it mean when an Asian patient does not make eye contact with the NP?

SIgn of respect

What is the evil eye?

When a stronger or more powerful person looks at a weaker person - often infant/child resulting in a hex which presents in illness such as HA, fever, diarrhea, disturbed sleep, increased fussiness.

How do you protect from the evil eye?

Red ribbon on an infant

Amulet for adults

How do you treat for evil eye?

Access traditional healer + traditional care.

For there to be a duty to a patient, what must exist?

Relationship

What is a proximate cause?

Connection between A + B.

For there to be damages, what must exist first?

Negligence

What is an occurrence basis liability insurance?

"occurred" during the policy period, no matter when the claim is brought against the insured

What is a claims made/based liability insurance?

provides coverage for a claim that is brought within the policy period, no matter when the loss occurred.

Who sets the minimum requirements for NP's?

Board of Nursing

State

What are the various controlled substance classes?

Schedule I - nobody has these - not good for health - heroin, PCP, MDMA, researchers can get it sometimes.

Schedule II - Significant Abuse Potential - morphine, methadone, methyphenidate

Schedule III - Moderate Abuse Potential - hydrocodone, codeine

Schedule IV - Low Abuse Potential - benzo's, ambien, phentermine

Schedule V - Very low abuse potential - anti-tussives, lomotil

What classes of CS's is the NP approved to prescribe?

Schedules III-V ONLY.

Where does 50% of healthcare funds come from?

The government

Who is eligible for Medicare?

>65 or under 65 with diability, ANY age with renal disease.

What is incident to billing?

Means MD initiates treatment and NP is an extension of the care and directly under the supervision of the MD.

Allows NP to get reimbursed at 100% rather than 85%.

How are Medicaid benefits determined?

State determines qualification - Partnership between State and Fed Govt.

Must be impoverished

Must be US resident and low or very low income.

Can you have Medicare and Medicaid?

Yes, impoverished elderly but Medicaid is always payor of last resort.

Is dental care included in Medicaid?

Yes, <21 gets basic dental as part of the Medicaid plan.

What is the purpose of HIPAA?

National standards for electronic HC transactions

National ID for providers, health plans and employers.

Not SIMPLY Confidentiality.

What must be signed prior to any healthcare in the state

Notice of Privacy Practices Statement

What happens if a patient refuses to sign an ROI?

Can decline to treat

Health plan may condition enrollment on provision of consent

When is HIPAA not required?

Emergency treatment

Substantial communication barriers and consent is inferred

Involuntary committment

Is it ok to announce a patient's name in a waiting room?

Yes, no other way to give care.

Is it ok to leave a message on a patient's vm?

Yes, but should be limited.

What is the impact of steroid inhalers on children?

Slows bone growth and may decrease ultimate height.

What is the long-term impact of using steroid inhalers?

Cataracts, glaucoma, thinning of bones and skin

What is included in the treatment of fibromyalgia?

Sleeping meds

Antidepressants

Pain meds

What psychoactives are first line treatment for fibro?

Cymbalta, Effexor

Elavil, Pamelor

Lyrica, Gabapentin

Ultram, Benzo's

What is the purpose of telepsychiatry?

Increase the ability to reach rural and underserved areas.

What is the purpose of Motivational Interviewing?

Explore ambiguity

Maintain passive position

What is required for Medicare submission?

ICD 10 and narrative or CPT

What is the neurotransmitter problem in Schizophrenia?

Excess dopamine in mesolimbic pathway.

What is the neurotransmitter problem in ADHD?

Dopamine, norepinephrine and serotonergic dysfunction

What is the benefit of play therapy?

Don't have to confront emotions head on.

What neurotransmitters are involved in the bioamine hypothesis of depression?

Noradrenaline

Serotonin

Dopamine

MAOi's inhibit MAO's which break down neurotransmitters so allow increase in the amount in the synapse.

How do you test CN XII?

Stick out your tongue.

What CN are you testing when you have a patient clinch their jaw and assess temporal muscles?

CN V - Trigeminal

What are two important things to measure when using Zyprexa?

Lipid level and abdominal circumference

What is included in the mini-cognitive exam?

Clock, memory questions from MSE.

What is HIV related dementia often mistaken for, especially at the beginning?

Depression

What do you do when a patient is on tegretol and their ANC (Absolute Neutrophil count) <1000?

Stop and repeat lab.

Normal is 1500-8000 mm3

Can you take Buspar during pregnancy?

Category B - ok if really needed.

Can you take Klonopin during pregnancy?

Category C - avoid if possible; does excrete into breast-milk and infant could get withdrawal symptoms.

What is the concern when prescribing Lamictal with Depakote?

Both are CYP450 inducers of the other and therefore together will lower the level of both drugs.

Can asthma medications cause depression?

Yes.

If a patient has muscle pain and red urine with an elevated leukocyte esterase. What lab do you order?

Microalbumin?

What is often common to patients with fibro?

Sexual abuse

How is telepsychiatry evaluated?

Outcome based - measure at intervals.