100+ Free PMHS Practice Questions

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Which is a key component of lethal means restriction counseling for families of suicidal adolescents?

Have the adolescent store medications themselves.

Discuss restricting access to firearms (locked, unloaded, separate from ammunition or removed) and dangerous medications.

Avoid mentioning firearms.

Recommend purchasing a firearm for protection.

to track

Same family resources

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2026 Statistics

Key Facts: PMHS Exam

150

Total Questions

125 scored + 25 pretest

3 hrs

Time Limit

PNCB

25%

Largest Domain Weight

Health Promotion

4/yr

Testing Windows

Apr, Jun, Sep, Nov

$309

Exam Fee

PNCB

3 years

Certification Validity

PNCB

The PMHS (Pediatric Primary Care Mental Health Specialist) exam is administered by PNCB and consists of 150 multiple-choice questions (125 scored, 25 pretest) with a 3-hour time limit. The exam is open to PNPs, FNPs, and CNSs (plus PMHCNS-BC and PMHNP-BC per APNA joint statement) with 30 hours of pediatric DBMH CE or one graduate course. Health Promotion is the largest domain at 25%. Testing windows are April, June, September, and November. Credential valid 3 years.

Sample PMHS Practice Questions

Try these sample questions to test your PMHS exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1At what well-child visit ages does the AAP recommend universal autism-specific screening using the M-CHAT-R/F?

A.9 and 18 months

B.18 and 24 months

C.24 and 30 months

D.12 and 18 months

Explanation: The AAP recommends autism-specific screening with the M-CHAT-R/F at the 18-month and 24-month well-child visits, in addition to ongoing developmental surveillance. Two screens are used because some children pass at 18 months but show concerns by 24 months as social-communication demands increase.

2A parent of a 4-month-old asks how to foster secure attachment. Which response BEST reflects evidence-based anticipatory guidance?

A.Let the infant cry it out so they learn independence early.

B.Respond consistently and warmly to the infant's cues.

C.Hold the baby only at scheduled feeding times to prevent spoiling.

D.Limit eye contact so the infant becomes self-soothing.

Explanation: Secure attachment develops when caregivers respond sensitively and consistently to infant signals, building the child's expectation that needs will be met. This is foundational to Bowlby/Ainsworth attachment theory and supported by current AAP anticipatory guidance on infant social-emotional development.

3Which screening tool is BEST suited for universal psychosocial screening of school-age children in pediatric primary care?

A.Vanderbilt ADHD Diagnostic Rating Scale

B.Pediatric Symptom Checklist (PSC-17 or PSC-35)

C.Columbia Suicide Severity Rating Scale (C-SSRS)

D.M-CHAT-R/F

Explanation: The Pediatric Symptom Checklist (PSC) is a brief, validated universal psychosocial screen broadly used in primary care to detect emotional, behavioral, and attention problems in school-age children. The Vanderbilt is a risk-related (not universal) ADHD scale, the C-SSRS is a suicide-specific risk tool, and the M-CHAT-R/F is autism-specific for toddlers.

4The PHQ-9 Modified for Adolescents (PHQ-A) is recommended by USPSTF and AAP for universal depression screening starting at what age?

A.Age 8

B.Age 10

C.Age 12

D.Age 16

Explanation: USPSTF and the AAP/Bright Futures recommend universal depression screening for adolescents starting at age 12 and continuing annually through age 21. The PHQ-A and PHQ-9 modified for adolescents are validated and widely used tools for this purpose.

5Which best describes the role of temperament in anticipatory guidance?

A.Temperament should be modified by parents to fit family preferences.

B.Temperament is a stable individual difference that shapes goodness-of-fit between child and environment.

C.Temperament refers to a child's intelligence quotient.

D.Temperament is identical across siblings raised in the same home.

Explanation: Temperament refers to early-appearing, biologically based individual differences in reactivity and self-regulation (Thomas & Chess; Rothbart). The clinician helps families recognize their child's temperament and adapt expectations and parenting strategies to optimize 'goodness of fit' rather than trying to change the child.

6A parent reports that their 7-year-old has frequent meltdowns over transitions. Which evidence-based parenting strategy should the PMHS first recommend?

A.Spanking when the meltdown begins

B.Predictable routines with advance warnings before transitions

C.Withholding meals as a consequence

D.Lengthy lectures during the meltdown

Explanation: Predictable routines and advance warnings reduce dysregulation during transitions, which is a hallmark anticipatory-guidance recommendation supported by AAP and behavioral parent training literature. Corporal punishment, food deprivation, and lecturing during dysregulation are not effective and can worsen behavior.

7An adolescent with no known mental health concerns presents for an annual visit. Which screening battery is MOST consistent with Bright Futures recommendations?

A.PHQ-A and CRAFFT

B.M-CHAT-R/F and ASQ-SE

C.Vanderbilt and SCARED

D.C-SSRS only, with no other screening

Explanation: Bright Futures recommends annual depression screening (PHQ-A or PHQ-9 modified) and substance use screening (CRAFFT or S2BI) for adolescents at well visits. The M-CHAT-R/F and ASQ-SE are early-childhood tools, Vanderbilt and SCARED are risk-related, and C-SSRS alone does not meet annual universal screening recommendations.

8Which is the BEST example of psychoeducation about social determinants of health?

A.Telling a family that mental illness is purely genetic

B.Discussing how housing instability and food insecurity influence a child's behavioral health

C.Recommending that all families purchase organic food

D.Avoiding any discussion of finances or housing in primary care

Explanation: Social determinants of health—housing, food security, neighborhood safety, income, education—strongly influence pediatric mental and behavioral health. The AAP recommends screening for and addressing SDOH as part of primary care to support the whole child and family.

9Which AAP recommendation BEST supports healthy media use for a 3-year-old?

A.Unlimited screen time as long as content is educational

B.No screens at all until age 6

C.Limit non-educational screen use to about 1 hour per day of high-quality programming, co-viewed when possible

D.Allow background TV during all meals

Explanation: The AAP recommends that for children ages 2-5, screen time be limited to about 1 hour per day of high-quality programming, ideally co-viewed with a caregiver. Background media interferes with parent-child interaction and language development.

10A teen reports being bullied at school and online. Which initial response is MOST therapeutic?

A.Tell the teen to ignore the bullies and they will stop.

B.Validate the teen's experience, screen for safety/depression/suicidality, and collaborate on a safety plan.

C.Recommend the teen retaliate online.

D.Reassure the teen that bullying does not have lasting effects.

Explanation: Bullying and cyberbullying are linked to increased risk of depression, anxiety, and suicidality. Best practice is to validate the experience, screen for mental health symptoms and suicide risk, and involve the family and school in a safety plan.

About the PMHS Exam

Specialty certification for advanced practice nurses providing pediatric behavioral and mental health care in primary care settings. The PMHS validates expertise in mental health promotion and screening, comprehensive evaluation, DSM-5 diagnostic decision-making, evidence-based management (psychotherapy and pediatric psychopharmacology), and the professional role in integrated primary care.

Questions

150 scored questions

Time Limit

3 hours

Passing Score

Pass/Fail (scaled)

Exam Fee

$309 (PNCB)

PMHS Exam Content Outline

25%

Health Promotion: Developmental, Behavioral and Mental Health

Universal/risk screening, HEEADSSS, ACEs, trauma-informed care, anticipatory guidance

24%

Evaluation

History, family/psychosocial assessment, school collaboration, suicide risk, condition-specific evaluation

22%

Diagnostic Decision Making

DSM-5 differential diagnosis, comorbidity, medical mimics, referral triggers

23%

Management

Evidence-based psychotherapy and pediatric psychopharmacology, safety planning, school collaboration

Professional Role

Confidentiality, mandated reporting, ethics, billing, integrated care leadership

How to Pass the PMHS Exam

What You Need to Know

Passing score: Pass/Fail (scaled)
Exam length: 150 questions
Time limit: 3 hours
Exam fee: $309

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

PMHS Study Tips from Top Performers

1Master pediatric mental health screening tools by age band: ASQ for development, M-CHAT-R/F at 18 and 24 months for autism, PSC-17 for general behavioral health, PHQ-A for adolescent depression, SCARED for anxiety, CRAFFT for substance use, C-SSRS for suicide risk

2Know FDA-approved pediatric SSRIs (fluoxetine for depression and OCD; escitalopram for adolescent depression; sertraline for OCD) and the FDA black box warning for suicidality in those under 25

3Memorize DSM-5 diagnostic criteria for ADHD (≥6 symptoms in inattention or hyperactivity-impulsivity, age <12, two settings) and major depression (≥5 symptoms × 2 weeks, includes irritability in youth)

4Understand evidence-based pediatric therapies and their indications: PCIT (ages 2-7 disruptive behavior), PMT (school-age behavioral problems), CBT (anxiety, depression), TF-CBT (trauma), IPT-A (adolescent depression)

5Complete at least 100 practice questions before scheduling your exam

Frequently Asked Questions

Who is eligible for the PMHS exam?

PMHS is open to advanced practice nurses with an active APRN license — Pediatric Nurse Practitioners (PNPs), Family Nurse Practitioners (FNPs), and Clinical Nurse Specialists (CNSs). Per a joint APNA/PNCB statement, PMHCNS-BC and PMHNP-BC certified clinicians are also eligible. Candidates need 30 contact hours of pediatric developmental/behavioral/mental health CE OR one graduate course (≥2 credits) in pediatric mental health within the last 3 years.

When can I take the PMHS exam?

PNCB offers the PMHS exam in four testing windows per year: April, June, September, and November. Each window is approximately 4 weeks long. Candidates must apply and complete eligibility verification before being authorized to schedule with PSI. Plan ahead since application deadlines precede each window.

What is the most heavily weighted PMHS domain?

Health Promotion: Developmental, Behavioral and Mental Health carries the largest weight at 25%. This domain emphasizes universal and targeted mental health screening (PSC-17, M-CHAT-R/F, PHQ-A, SCARED, CRAFFT, ASQ), the HEEADSSS adolescent interview, ACEs awareness, trauma-informed care, anticipatory guidance per AAP Bright Futures, and supporting healthy attachment, parenting, and resilience.

What does PMHS qualify me to do?

The PMHS credential signals expertise in pediatric primary care mental health and supports advanced practice nurses functioning as the behavioral health resource within pediatric primary care, integrated care models, and school-based health. PMHS clinicians screen, evaluate, diagnose, and manage common pediatric mental health conditions (ADHD, anxiety, depression, behavioral problems) and coordinate referrals for higher-acuity needs.

How should I study for the PMHS exam?

Plan for 60-100 hours of study over 8-12 weeks. Anchor your study to the PNCB PMHS Detailed Content Outline. Focus on Health Promotion (25%) and Evaluation (24%) — together nearly half the exam. Master the validated screening tools by age band, DSM-5 criteria for common pediatric conditions, FDA-approved pediatric psychotropics with monitoring requirements (especially the SSRI black box for suicidality), and evidence-based therapies (CBT, PMT, PCIT, TF-CBT).