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Exam Review

Key Facts: AANPCB PMHNP-C Exam

150

Total Questions

AANPCB PMHNP-C exam page

3h

Exam Time

AANPCB PMHNP-C exam page

500

Passing Scaled Score

AANPCB scoring (200-800 scale)

Apr 25, 2024

Inaugural Exam Date

AANPCB PMHNP-C launch announcement

~82%

Inaugural Pass Rate

AANPCB 2024 PMHNP-C statistics (small sample)

$240/$315

Member/Nonmember Fee

AANPCB fee schedule

AANPCB's PMHNP-C exam, launched April 25, 2024, uses 150 questions (135 scored + 15 pretest), 3 hours of testing, and a scaled passing score of 500 on a 200-800 scale. Application fees are $240 for AANP members and $315 for non-members. The blueprint follows the NP process across the lifespan: assessment, diagnosis, plan, and evaluation, applied to psychiatric mental health practice. AANPCB reports an inaugural first-time pass rate of approximately 82% on the new exam.

Sample AANPCB PMHNP-C Practice Questions

Try these sample questions to review concepts for the AANPCB PMHNP-C exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 32-year-old presents with low mood, anhedonia, hypersomnia, and 12-pound weight gain over six weeks. The PMHNP completes the mental status examination. Which observation BEST documents the patient's affect?
A.States 'I feel hopeless' for the last month
B.Reports auditory hallucinations of a critical voice
C.Constricted range, congruent with reported sad mood
D.Linear, goal-directed thought process
Explanation: Affect is the observable, moment-to-moment emotional expression (the clinician's observation), described in range, intensity, congruence, and stability. Constricted, congruent with sad mood is an affect description. Mood is the patient's subjective report ('I feel hopeless').
2Which standardized instrument is most appropriate for stratifying acute suicide risk in a PMHNP outpatient assessment?
A.Columbia Suicide Severity Rating Scale (C-SSRS)
B.Beck Depression Inventory-II (BDI-II)
C.Mini-Mental State Examination (MMSE)
D.Yale-Brown Obsessive Compulsive Scale (Y-BOCS)
Explanation: The Columbia Suicide Severity Rating Scale (C-SSRS) is the gold-standard validated instrument used by clinicians and the FDA for assessing both ideation and behavior, stratifying acute suicide risk across age groups.
3A patient presents with one week of decreased need for sleep, racing thoughts, grandiosity, and impulsive spending. They have a history of one prior major depressive episode but no prior hospitalization or psychosis. Which DSM-5-TR diagnosis is MOST likely?
A.Bipolar I disorder
B.Bipolar II disorder
C.Cyclothymic disorder
D.Major depressive disorder with mixed features
Explanation: Bipolar II requires at least one hypomanic episode (4+ days, no marked impairment, no psychosis, no hospitalization) plus at least one major depressive episode. The 1-week duration meets full mania criteria, but the absence of marked impairment, psychosis, or hospitalization keeps this hypomanic.
4A patient on lithium for 4 years presents with new-onset coarse tremor, ataxia, and confusion. Lithium level is 1.8 mEq/L. What is the FIRST action?
A.Increase lithium dose to overcome tolerance
B.Hold lithium, ensure hydration, and obtain renal function and electrolytes
C.Add valproate as adjunct mood stabilizer
D.Order brain MRI to rule out structural cause
Explanation: Therapeutic lithium is 0.6-1.2 mEq/L. A level of 1.8 with coarse tremor, ataxia, and confusion is lithium toxicity. First action: hold lithium, hydrate, check renal function and electrolytes. Severe cases (>2.5, AMS, seizure) need hemodialysis.
5Which black-box warning is associated with lamotrigine?
A.Agranulocytosis requiring weekly ANC monitoring
B.Stevens-Johnson syndrome and toxic epidermal necrolysis with rapid titration
C.QT prolongation and torsades de pointes
D.Tyramine-induced hypertensive crisis
Explanation: Lamotrigine carries a black-box warning for serious skin reactions including Stevens-Johnson syndrome and toxic epidermal necrolysis, particularly with rapid titration or co-administration of valproate. Slow titration (starter packs) is mandatory.
6A 28-year-old veteran has 8 months of intrusive nightmares, hyperarousal, and avoidance of crowds following a deployment. Which evidence-based first-line psychotherapy is MOST appropriate?
A.Supportive psychotherapy
B.Prolonged exposure therapy or cognitive processing therapy
C.Psychodynamic free association
D.Group reminiscence therapy
Explanation: VA/DoD and APA PTSD guidelines recommend trauma-focused therapies as first-line: prolonged exposure (PE), cognitive processing therapy (CPT), and EMDR. These have the strongest evidence base for PTSD.
7A patient threatens to harm a specific named coworker. The PMHNP determines the threat is credible. Which legal duty is invoked?
A.Tarasoff duty to warn or protect identifiable third parties
B.HIPAA prohibits all disclosure to non-patients
C.Mandatory psychiatric advance directive activation
D.Federal duty to file with the National Instant Criminal Background Check System
Explanation: The Tarasoff doctrine (Tarasoff v. Regents of UC, 1976) established a duty to protect identifiable third parties from a credible threat, typically through warning, hospitalization, or law enforcement notification. State statutes vary in scope.
8An adolescent with ADHD requires pharmacotherapy. The family is concerned about stimulant misuse. Which non-stimulant has FDA approval for ADHD in pediatric patients?
A.Bupropion
B.Atomoxetine
C.Buspirone
D.Mirtazapine
Explanation: Atomoxetine, a selective norepinephrine reuptake inhibitor, is FDA-approved for ADHD in patients 6 years and older. Other non-stimulant options include guanfacine ER, clonidine ER, and viloxazine. Atomoxetine carries a black-box warning for suicidal ideation in pediatric patients.
9A perinatal patient with severe postpartum depression who has not responded to sertraline asks about brexanolone. What is a KEY administration consideration?
A.It is a once-weekly oral tablet
B.It is a 60-hour continuous IV infusion requiring REMS-monitored facility administration
C.It requires monthly intramuscular injections for 6 months
D.It is a single sublingual dose self-administered at home
Explanation: Brexanolone (Zulresso) is a 60-hour continuous IV infusion administered in a REMS-certified healthcare facility due to risk of excessive sedation and sudden loss of consciousness. Zuranolone (Zurzuvae) is the 14-day oral alternative for postpartum depression approved 2023.
10Which of these antipsychotics carries the HIGHEST risk for metabolic syndrome (weight gain, dyslipidemia, hyperglycemia)?
A.Aripiprazole
B.Lurasidone
C.Olanzapine
D.Ziprasidone
Explanation: Olanzapine and clozapine carry the highest metabolic risk among second-generation antipsychotics. APA guidelines recommend baseline and serial monitoring of weight, BMI, fasting glucose, A1C, and lipid panel.

About the AANPCB PMHNP-C Exam

The AANPCB PMHNP-C exam launched April 25, 2024 as the second national pathway for Psychiatric Mental Health NP certification, ending ANCC's monopoly. It uses 150 multiple-choice questions (135 scored + 15 pretest) over 3 hours with a scaled passing score of 500.

Exam sponsor: AANPCB / PSI. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

150 questions

Time Limit

3 hours

Passing Score

500 scaled (200-800 scale)

Exam / Certification Fees

$240 AANP members / $315 non-members

Exam sponsor website

Reported exam pass rate: ~82%. Inaugural 2024 first-time pass rate per AANPCB; small sample on a brand-new exam This describes exam candidates, not OpenExamPrep users or results from using our resources. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

~25%

Comprehensive Psychiatric Evaluation

Psychiatric interview, mental status exam, suicide and homicide risk assessment, violence risk, decisional capacity

~25%

Diagnosis Using DSM-5-TR

Mood, anxiety, psychotic, trauma, substance, neurocognitive, personality, and lifespan-specific disorders

~25%

Psychopharmacology

SSRIs, SNRIs, mood stabilizers, antipsychotics, stimulants, MAT, ketamine/esketamine, brexanolone/zuranolone, monitoring

~12%

Psychotherapy

CBT, DBT, IPT, ACT, motivational interviewing, EMDR, family/group therapy, modality matching

~13%

Lifespan, Ethics, Care Coordination

Pediatric, perinatal, geriatric considerations; Tarasoff, capacity, involuntary holds; PHQ-9/GAD-7 measurement-based care

Preparing for the AANPCB PMHNP-C Exam

What You Need to Know

  • Passing score: 500 scaled (200-800 scale)
  • Exam length: 150 questions
  • Time limit: 3 hours
  • Exam / certification fees: $240 AANP members / $315 non-members Official sources

Using Our Practice Resources

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

AANPCB PMHNP-C: Suggested Study Strategy

1Drill DSM-5-TR criteria as differentials, not memorization: bipolar I vs II, MDD vs persistent depressive, schizophrenia vs schizoaffective vs schizophreniform
2Anchor every prescribing decision to monitoring labs: lithium 0.6-1.2 mEq/L, valproate teratogenicity, clozapine ANC, atypical metabolic panels
3Memorize black-box warnings: SSRI suicidality in youth, lamotrigine SJS, clozapine agranulocytosis, MAOI tyramine, stimulant cardiac risk
4Practice safety triage first in vignettes: suicide and homicide risk, capacity, involuntary commitment criteria, Tarasoff duty
5Match psychotherapy modality to disorder: CBT for anxiety/depression, DBT for borderline, prolonged exposure or EMDR for PTSD, MI for substance use
6Train measurement-based care: PHQ-9 for depression, GAD-7 for anxiety, ASRS for adult ADHD, AIMS for tardive dyskinesia, MoCA for cognition

Frequently Asked Questions

When did the AANPCB PMHNP-C exam launch?

AANPCB launched the PMHNP-C exam on April 25, 2024, ending ANCC's long-standing monopoly on national psychiatric NP certification.

How many questions are on the AANPCB PMHNP-C exam?

AANPCB lists 150 multiple-choice questions: 135 scored items plus 15 unscored pretest items, administered over 3 hours.

What score do I need to pass AANPCB PMHNP-C?

AANPCB uses a scaled scoring range of 200 to 800 with a passing scaled score of 500, consistent across AANPCB exams.

How much does the AANPCB PMHNP-C exam cost?

AANPCB lists application fees of $240 for AANP members and $315 for non-members for online application to the PMHNP-C exam.

Is AANPCB PMHNP-C different from ANCC PMHNP-BC?

Yes. AANPCB's PMHNP-C is a new competing credential to ANCC's PMHNP-BC. Both are nationally recognized; employers typically accept either. Different blueprints and item formats.

What is the AANPCB PMHNP-C pass rate?

AANPCB reports an inaugural first-time pass rate of approximately 82% in 2024. Sample sizes are small for a brand-new exam, so future cohorts may shift this number.