Free practice quiz
PMHNP-BC Prep Course (PMHNP): free quiz
10 questions from the program. See your score right away, then unlock the explanation of every answer.
- Question 1 of 10
A 16-year-old in ongoing PMHNP treatment for anxiety arrives with a parent who asks you to write a court letter stating the other parent is psychologically unfit for custody. The adolescent denies suicidal or homicidal thoughts, has normal vital signs, and reports feeling pressured to choose sides. The parent says the court date is tomorrow and wants the letter today. What is the priority PMHNP action?
Priority follows safety and professional role boundaries. A: releases and factual records may be appropriate later, but the PMHNP must first clarify limits and assess coercion or safety. C: correct—therapeutic clinicians avoid custody or forensic determinations, document the request, continue indicated care, and refer to a qualified forensic evaluator. B: family work may help, but postponing the court-pressure issue misses the immediate boundary and safety assessment. D: collateral can inform treatment only with appropriate consent; contacting the other parent for a custody opinion risks confidentiality and role conflict. ANA standards support assessment, therapeutic boundaries, documentation, and referral when needs exceed competence.
- Question 2 of 10
A 29-year-old patient in a first telehealth visit reports severe depression, recent heavy alcohol use, and no sleep for 2 days. The patient says, “I’m going to shoot myself tonight,” and shows a handgun on the desk. The patient refuses to go to the emergency department and lives alone. What PMHNP action best matches the immediate task in this stem?
D is correct: the task is immediate safety; lethal means, stated intent, intoxication risk, and refusal require emergency evaluation. A is assessment but wrong priority; history follows stabilization. B is treatment planning but unsafe before crisis containment. C is appropriate for lower imminent risk, but safety planning alone is insufficient with current intent and firearm access. Using Maslow/safety and nursing process, first protect life, maintain contact, and escalate to emergency services per law and protocol.
- Question 3 of 10
A 32-year-old patient presents for an initial PMHNP visit with worsening anxiety, insomnia, and missed work after an emergency visit for palpitations. The patient takes sertraline from primary care, used a friend’s clonazepam twice, reports childhood abuse, and says a parent had “mood swings.” Before selecting a treatment plan, what is the priority psychiatric history action?
A: Sleep teaching may help but is premature before assessment. D: Correct; the nursing process starts with comprehensive assessment to identify safety risks, bipolar/substance/medical mimics, treatment history, adherence, trauma, culture, function, medications, and allergies. B: Collateral information can be useful, but patient consent, confidentiality, and direct assessment come first unless immediate safety prevents it. C: Rating scales support, but do not replace, a full psychiatric history and clinical formulation.
- Question 4 of 10
A 32-year-old patient is seen for worsening depression. The patient says, “I can’t keep doing this,” reports writing a goodbye note, drank heavily last night, and has a loaded handgun at home. The patient denies current intent and states, “My kids need me.” What is the PMHNP’s priority action?
B is correct. Safety is the priority: plan, firearm access, preparatory behavior, intoxication, and hopelessness indicate high acute risk despite protective factors, requiring immediate evaluation and lethal-means restriction. C is a real intervention but wrong priority; outpatient follow-up is unsafe for current high risk. D supports safety but is insufficient when means and preparation are present. A may help later, but psychotherapy does not address imminent danger first. Use the nursing process: assess acute risk, intervene for safety, and escalate level of care.
- Question 5 of 10
A 23-year-old arrives for emergency psychiatric evaluation after texting a friend, “I won’t be here tomorrow.” The patient is guarded, intoxication is denied, and they refuse permission to contact family. They admit owning a firearm but minimize risk and provide inconsistent details about prior attempts. Which PMHNP action is the safest next step?
D is correct: Safety is the priority. When imminent risk is possible and self-report is unreliable, the PMHNP may seek minimum necessary collateral under emergency/safety exceptions and document the rationale. A respects consent but is the wrong priority because waiting may miss lethal risk. C is an assessment tool, but rating scales do not replace urgent risk clarification. B is unsafe because outpatient follow-up does not address current firearm access and possible suicide risk.
- Question 6 of 10
A 13-year-old is brought for evaluation because of declining grades, irritability, and school refusal for 2 months. The parent reports the child is “lazy” and asks about medication for attention. The adolescent sleeps 5 hours nightly and quietly says, “Sometimes I wish I could disappear.” The PMHNP notes possible bullying and no prior developmental or school history is available. Which action is the priority?
A: School collateral is appropriate, but safety assessment comes first. B: Correct; using the nursing process and Maslow safety priorities, suicidal statements, bullying, abuse, sleep, and substances require immediate private assessment before planning. D: Sleep education is useful but premature when self-harm risk may be present. C: Family-based behavior strategies may help, but they do not address imminent safety or clarify pathology versus age-expected behavior.
- Question 7 of 10
A 34-year-old refugee is evaluated for insomnia, low mood, and missed medication visits. He says he sometimes hears his deceased grandmother during evening prayers telling him to “stay strong.” He denies commands, suicidal thoughts, substance use, and disorganized behavior. His adolescent son is interpreting. His partner says he stopped an antidepressant because the family believes it may “weaken the spirit.” What is the PMHNP’s priority nursing action?
D: Assessment is appropriate, but English-only testing risks invalid data and misses meaning. C: Family input can help, but using a minor as interpreter threatens accuracy, privacy, and consent. A: Correct: nursing process prioritizes accurate assessment and safety. A qualified interpreter and cultural formulation help distinguish culturally normative experiences from psychopathology while exploring adherence barriers and supports. B: Education and follow-up may be needed, but they come after understanding the patient’s explanatory model and communication needs.
- Question 8 of 10
A PMHNP is asked to evaluate a 72-year-old hospitalized patient for “new anxiety.” The patient is being treated for pneumonia and now has fluctuating attention, visual misperceptions, temperature 101.8°F, oxygen saturation 89% on room air, and recently received diphenhydramine for sleep. Which nursing-scope action is the priority in this setting?
C is correct. Using ABCs and safety, hypoxemia, fever, fluctuating attention, and anticholinergic exposure suggest delirium or medical instability; consult-liaison assessment must integrate medical and psychiatric data first. B is appropriate for outpatient continuity, but discharge monitoring is not the priority before stabilization. D may help distress, but psychotherapy follows assessment of reversible medical causes. A is important in community care planning, but resources are addressed after acute stabilization and disposition decisions.
- Question 9 of 10
A 27-year-old patient reports 6 weeks of depressed mood, anhedonia, insomnia, 10-lb weight loss, poor concentration, and missed work. They deny substance use, psychosis, and current suicidal intent. During assessment, they describe a 5-day period last year of decreased need for sleep, unusually elevated mood, pressured speech, impulsive spending, and increased goal-directed activity. Which PMHNP action has the highest priority for safe diagnostic clarification?
D: Tempting because neurovegetative depressive symptoms are present, but safety and diagnostic priority require screening for hypomania; antidepressant monotherapy may worsen bipolar illness. B: Supportive counseling is appropriate when grief is the primary syndrome, but this stem shows impairment and a past hypomanic-like episode. C: Correct. Nursing-process priority is assessment before intervention: clarify bipolar depression, assess suicide risk, and rule out medical/substance causes before selecting treatment. A: Persistent depressive disorder requires chronic depressed mood for at least 2 years in adults, not 6 weeks.
- Question 10 of 10
A 19-year-old college student is brought to clinic by a parent for 2 months of social withdrawal, declining grades, hearing a voice, and believing classmates monitor his phone. He appears disheveled and distracted. He says the voice told him last night to stab his mother, and he is unsure he can resist. Urine drug screen and medical history have not yet been obtained. What is the priority PMHNP action?
D is correct: command hallucinations to harm another person plus impaired control create imminent safety risk; Maslow/safety priorities require supervision, emergency evaluation, and higher level of care. C is necessary in first-episode psychosis because medical and substance causes must be assessed, but it is not the first action when violence risk is acute. A helps characterize psychosis duration and functional decline, but education cannot supersede immediate protection. B may become part of treatment, but outpatient initiation alone is unsafe before stabilizing risk and completing urgent assessment.
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