Family Psychiatric & Mental Health Nurse Practitioner Test Review

Are you a registered nurse who has an interest in diagnosing psychiatric disorders in patients? If so, you’ll need to take the Psychiatric-Mental Health Nurse Practitioner certification in order to meet your goals. Getting there will require lots of study, and you’ll need strong study tools like those provided by Mometrix, a leader in creating comprehensive study guides on topics like this one. But first, let’s take a look at what you’ll need to take the test, and what you can expect.

Degree requirements to take the test

  • Hold a current, valid RN license in the United State or a legally recognized equivalent from another country
  • Hold a Masters, postgraduate, or PhD degree from a psychiatric-mental health nurse practitioner program accredited by one of two groups --- the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN)

Educational requirements to take the test

Candidates must have taken graduate level courses in advanced physiology/pathophysiology, advanced health assessment, and advanced pharmacology; with content in health promotion and/or maintenance, and differential diagnosis and disease management. Additionally, candidates are required to have clinical training in at least two psychotherapeutic treatment methods.

Who provides the certification

The American Nurses Credentialing Center (ANCC) provides the accreditation.

Taking the test

The test is 200 total questions --- 175 are scored, 25 are not. Candidates are tested on three areas of practice, called domains, and they are:

  • Foundations of advanced practice nursing (29 percent)
  • Professional role and policy (40 percent)
  • Independent practice competencies (31 percent)

In the Foundations of advanced practice nursing portion of the test, you’ll be tested on knowledge and skills assessment in six areas --- Advanced Pathophysiology, Neurobiology, and Neuroanatomy; Advanced Pharmacology and Psychopharmacology; Advanced Health Assessment; Epidemiology/Risk Analysis; Patient-Centered Care; and Psychotherapy.

The Professional role and policy section tests knowledge and skills in seven sections --- Leadership; Quality Improvement and Safety; Practice Inquiry; Health Policy and Advocacy; Technology and Information Literacy; Health Delivery System; Ethics, Legalities; and Scope and Standards.

For the indepent practice competencies, there are three areas that test knowledge and skills --- Health Promotion and Disease Prevention, Advanced Psychiatric and Mental Health Assessment, and Disorder and Symptom Treatment/Management.

The test is graded on a pass/fail basis. Candidates have to meet a minimum score in order to pass the test, and that minimum scale score has been set at 350.

You’ll spend four hours at the testing center. The test takes 3.5 hours, with another 30 minutes set aside for check-in, instructions, and a practice session.

What does it cost to take the test?

There are different fees. ANCC offers discounts to members of the following organizations:

  • American Psychiatric Nurses Association ($282)
  • American Association of Nurse Practitioners student member ($290)
  • American Nurse Association ($295)
  • American Association of Nurse Practitioners ($340)
  • International Society of Psychiatric-Mental Health Nurses ($340)

If you don’t belong to any of those groups, it costs $395 to take the test.

How do I register to take the tests?

You need an authorization from the ANCC to take the test. Once you get it, you have 90 days to schedule an appointment to take the test at one of the hundreds of test centers across the United States.

You can register, to take the test through the ANCC online website.

What should I expect the day of the test?

Make sure to bring your government ID and your test confirmation letter. When checking in, any accessory --- eyeglasses, jewelry, electronic devices – will be inspected to search for any sort of camera device that could be used to copy portions of the exam. All eyeglasses could be checked at check-in and after breaks. Wedding rings and engagement bands are the only jewelry permitted in the testing room. All books, paper, calculators, tissues, food, drink, water, notes, cell phone, or personal electronics are prohibited from being taken into the exam room. Use of cell phones or other electronic devices is prohibited.

When will I get my test results?

You’ll get the results as soon as you’ve completed the exam. If you pass the test, certification becomes effective immediately.

What If I need to withdraw?

You can withdraw from the test as long as you do so within the 90-day eligibility period. You can withdraw by contacting your testing center, writing the ANCC or sending an email to the American Nurses Association.

Can I retake the test?

Yes. If you fail the test you can retake it after a 60-day waiting period, and you can retake it up to three times in 12 months. The retest fee is $270 each time you retake the test.

How long does the certification last?

The certification lasts five years and can be renewed.

True, there’s a lot to go through here, and it doesn’t even include all of the study needed to pass the exam. That’s where Mometrix can help, because it has developed number of tools that can help you study for the exam.

It’s comprehensive study guide had been researched by a team of professionals with years of experience helping students prepare for exams just like this one. The guide provides specifics on how to tackle the questions you’ll be asked, and if you’re stumped, you can ask one of our experts for help via a useful email address.

Mometrix’s large, easy-to-read flashcards help you learn through repetition, and the questions cover every content area of the exam. Not only that, the cards make it easy for a friend or relative to help quiz you on the questions you’ll need to know in order to pass the test and become a Psychiatric-Mental Health Nurse Practitioner.

Psychiatric - Mental Health Nurse Practitioner Exam Prep

Free Family Psychiatric & Mental Health Nurse Practitioner Test

1. The pathophysiology of major depressive disorder includes which of the following biochemical abnormalities?

a. Cortisol secretion following administration of 1 mg of dexamethasone will be suppressed after 12 hours in 75% of patients with clinical signs and symptoms sufficient to diagnose major depressive disorder.
b. Secretion of TSH following administration of TRH is suppressed in a significant proportion of patients with major depressive disorder relative to normal subjects.
c. CSF levels of 5HIAA are elevated in the majority of patients with major depressive disorder who commit suicide.
d. MHPG (3-methoxy-4-hydroxyphenylglycol), a metabolite of norepinephrine, is lower in the urine of patients with delusional depression than in patients with nondelusional depression.

2. A 25-year-old woman is brought by her family to the emergency room after complaining of having seizures again. She had been evaluated fairly recently for this same complaint, according to the family, but no medication was prescribed. The patient states that she doesn't like the neurologist and doesn't want him involved. You suspect that she is having pseudoseizures with a psychogenic etiology. What clinical observations or symptoms would help to confirm this possibility?

a. Her seizures involve bilateral tonic/clonic movements during which she remains conscious and verbal.
b. The patient holds her breath and becomes slightly cyanotic during an observed seizure in the ER.
c. She reports having the olfactory hallucination of burning rubber just before the seizures.
d. The patient and the family report that she is sometimes incontinent during the seizures.

3. You receive a notice from the pharmacy management service of your patient's insurance plan that he has been obtaining benzodiazepine medication from three other practitioners besides yourself, violating your agreement with him that you would prescribe these medications only if you were the sole provider. You decide that you will terminate treatment with this individual. You are concerned that he may become abusive, violent, or threatening if confronted with this directly. Your best course of action is which of the following?

a. Leave him a phone message telling him that you are canceling his next appointment, not refilling any more prescriptions for him, and terminating your services as his clinician.
b. At your next appointment, have a security guard or policeman present as you discuss the notice with him, give him a chance to respond to it, state that you believe that he is abusing these medications and may be dependent on them or addicted to them, suggest in-patient detoxification and substance abuse treatment, and inform him that you have decided that you can no longer treat him and will cease to be available as his clinician after 1 month, which will give him time to find another practitioner.
c. Send him a registered letter (return receipt requested), in which you inform him of your decision to terminate with him as his clinician, cancel his next appointment, and tell him that you will be available for emergencies only for the next month, during which time he can seek alternative sources of treatment.
d. Speak with him directly by phone to discuss the notice and its implications, give him a chance to respond to it, inform him of your decision to terminate with him as his clinician, suggest possibilities for in-patient detoxification and substance abuse treatment, and offer to be available by phone only for emergencies for 1 month while he seeks alternative treatment. Document the conversation fully in the medical record.

4. Your patient is a 70-year-old recently widowed woman who complains of initial insomnia as she works through her bereavement and requests something from you to help her with sleep. The best option of the following medications is:

a. Flurazepam
b. Diazepam
c. Temazepam
d. Eszopiclone

5. You are meeting in your office with a 24-year-old man and his mother. His working diagnosis is schizophrenia, but he has become very depressed and is almost mute. His therapist and his mother agree that he should be hospitalized, but the mother would like him to be at the university hospital psychiatric unit, which will not have a bed available until the next day. The local community hospital psychiatric unit has a bed available immediately. Although he mumbles "no" to questions about suicidality, you feel that he should be hospitalized immediately because he is psychotic and unpredictable. Your supervisor is unavailable for consultation. What is the safest course of action?

a. Allow the mother to take him home until tomorrow because she has agreed to take responsibility for monitoring him.
b. Explain that you have no choice but to hospitalize him immediately, given your assessment, and instruct the mother to take him to the community hospital for admission.
c. Ask the patient and his mother to sit in the waiting area while you make arrangements and then call the police and the ambulance service, fill out an involuntary commitment form, and wait for the police to arrive.
d. Outline your recommendation that the patient be admitted immediately. State that you will arrange for him to be taken to the community hospital by ambulance and that you will assist with the transfer to the university hospital psychiatric unit the next day, if possible. Explain that you would prefer to avoid an involuntary commitment action but that you are willing to do so if the family does not agree to the plan.

Answers and Explanations

1. B: The response of TSH to TRH is blunted in a significant proportion of patients with major depressive disorder. The dexamethasone suppression test is positive (that is, cortisol is not suppressed) in only about 50% of patients with major depressive disorder. CSF levels of the serotonin metabolite 5HIAA are significantly reduced in patients who commit suicide. MHPG is elevated in the urine of patients with delusional depression compared with patients without delusional depression.

2. A: Patients may remain conscious during unilateral, partial motor seizures; however, the spread of the seizures to both cerebral hemispheres (indicated by bilateral tonic/clonic movements) is always associated with loss of consciousness. The other symptoms are frequently seen during seizure disorders.

3. D: You are not required to expose yourself to undue risk of injury or even abuse from a potentially violent patient. The compassionate and correct way to terminate your services is to speak with the patient directly, by telephone if an office visit will present too great a risk, and inform them of your decision and why you are making it, offering to help arrange additional treatment for substance abuse issues. Full documentation in the medical record and in a registered letter and the offer to be available on an emergency basis for 1 month will protect you against any accusation of abandonment. Offering to help arrange in-patient detoxification will protect you against any liability should the patient refuse and then have withdrawal complications.

4. C: Both flurazepam and diazepam have long elimination half-lives and are not recommended for use in patients over the age of 65 years. Eszopiclone is likely to be more expensive than the other agents listed, which are available in generic form. Temazepam has an intermediate half-life, is FDA-approved for insomnia, and is well-tolerated and inexpensive.

5. D: Although family members might be willing to "take responsibility," they are not trained mental health professionals and you will be liable for any adverse outcome resulting from delaying the admission overnight. Even expecting the mother to follow through on taking her son to the community hospital is risky, because she could decide to drive him home instead. An involuntary commitment without discussion with the family would be needlessly challenging to the therapeutic alliance, unless your assessment is that the patient would run away if he knew that he would be taken to the community hospital immediately, instead of waiting for a bed to become available at the university hospital. Sending the patient voluntarily by ambulance is the best route, if the family agrees, with involuntary commitment as the fall-back option.


Last Updated: 05/31/2018

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