Psychiatric-Mental Health Nurse Practitioner Exam Cheat Sheet 2026

The 30 highest-yield Psychiatric-Mental Health Nurse Practitioner Exam facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which psychiatric disorder is most prevalent among incarcerated individuals in the US, highlighting a major gap in mental health care access? → Substance use disorder comorbid with serious mental illness
2. Which benzodiazepine is preferred in elderly patients due to its lack of active metabolites and shorter half-life? → Lorazepam
3. A patient with schizophrenia believes that a television news anchor is sending personal messages specifically to them. This is an example of: → Ideas of reference
4. The American Nurses Association Code of Ethics requires PMHNPs to address what in relation to cultural competence? → Advocate for health equity and recognize the influence of culture on mental health
5. A PMHNP evaluating a patient in crisis should first prioritize which action? → Establish safety and assess risk of harm to self or others
6. A patient with schizophrenia on risperidone develops gynecomastia and galactorrhea. What is the most likely cause? → Tuberoinfundibular dopamine blockade causing hyperprolactinemia
7. When assessing grief in a patient who lost a spouse 14 months ago with persistent daily yearning and functional impairment, a PMHNP would consider: → Prolonged grief disorder (PGD)
8. Which DSM-5 specifier distinguishes a manic episode with flight of ideas, decreased need for sleep, and grandiosity lasting 4 days without hospitalization? → Hypomanic episode
9. Which neurotransmitter imbalance is most associated with the positive symptoms of schizophrenia? → Dopamine excess in the mesolimbic pathway
10. A patient discloses they plan to harm a specific, identifiable third party. According to the Tarasoff duty-to-protect principle, the PMHNP is obligated to: → Warn the intended victim and notify law enforcement
11. Which legal principle established the duty to warn potential third-party victims of a patient's credible threat of harm? → Tarasoff v. Regents of the University of California
12. A PMHNP prescribes naltrexone for a patient with alcohol use disorder. What must be confirmed BEFORE initiating this medication? → The patient is opioid-free for at least 7–10 days
13. Which rating scale is used specifically to assess extrapyramidal side effects (EPS) in patients taking antipsychotics? → Simpson-Angus Scale (SAS)
14. A care plan is being created by nurse Shenny for a female client who has anorexia nervosa. Which action has to be included in the plan by the nurse? → Set-up a strict eating plan for the client.
15. A nurse practitioner is evaluating a 16-year-old who self-harms by cutting. Which therapeutic approach has the strongest evidence base for this population? → Dialectical Behavior Therapy adapted for adolescents (DBT-A)
16. A PMHNP assessing insight asks a patient, 'Do you think you have a mental illness?' A patient who denies having any illness despite clear evidence demonstrates: → Poor insight
17. Which intervention, according to psychodynamic theory, would be suitable for a patient with a panic disorder? → Discuss the overuse of ego defense mechanisms and their impact on anxiety.
18. A psychiatric patient in crisis states, 'I have a plan and I have the means.' According to risk stratification, this patient is best classified as: → High risk
19. A patient with schizophrenia is prescribed clozapine. Which laboratory monitoring is MOST critical due to the risk of agranulocytosis? → Absolute neutrophil count (ANC) per REMS protocol
20. Which personality disorder cluster includes paranoid, schizoid, and schizotypal personality disorders? → Cluster A (odd/eccentric)
21. Which validated tool is commonly used by PMHNPs to assess suicide risk in emergency settings? → Columbia Suicide Severity Rating Scale (C-SSRS)
22. Which instrument is the gold standard for measuring the severity of alcohol withdrawal? → Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar)
23. A PMHNP is seeing a patient who takes bupropion and decides to add an SSRI. Which serious risk must be discussed with the patient? → Lowered seizure threshold due to bupropion
24. The following is the best method for separating delirium from other types of confusion: → Confusion Assessment Method
25. A patient on a stable dose of an SSRI reports decreased libido and inability to achieve orgasm. The PMHNP's BEST initial intervention is: → Add bupropion to address sexual side effects
26. A patient with OCD is not responding to adequate SSRI trials. According to evidence-based guidelines, what is the next pharmacological step? → Augment with a low-dose antipsychotic such as risperidone or aripiprazole
27. Dependent personality disorder was identified in a patient who is 20 years old. Which conduct is least likely to be indicative of inadequate personal coping? → Inability to make choices and decisions without advice.
28. A PMHNP screens a patient using the GAD-7 and obtains a score of 15. This score indicates: → Severe anxiety
29. A patient with obsessive-compulsive disorder has spent the past four days in the hospital. Which intervention is most important right now? → Reinforce the use of learned relaxation techniques.
30. A PMHNP is assessing a patient using motivational interviewing. Which technique best exemplifies the 'rolling with resistance' strategy? → Reflecting the patient's ambivalence without challenging it directly