PMH-BC Practice Questions (2026) — Free Sample Questions with Answers

Answer: D

AUDIT questionnaire: AUDIT screens for hazardous drinking patterns; it does not measure current withdrawal severity.

Clinical Opiate Withdrawal Scale: COWS rates opioid, not alcohol, withdrawal.

Abnormal Involuntary Movement Scale: AIMS monitors tardive dyskinesia in clients taking antipsychotics.

CIWA-Ar scale: Correct. The Clinical Institute Withdrawal Assessment for Alcohol, revised, scores withdrawal severity to direct symptom-triggered benzodiazepine dosing.

CIWA-Ar for alcohol withdrawal, COWS for opioids, AIMS for tardive dyskinesia, AUDIT/CAGE for screening.

Answer: B

Generativity versus stagnation: Generativity concerns middle adulthood and contributing to the next generation, not late-life review.

Ego integrity versus despair: Correct. In late adulthood people review their lives; a sense of failure and that it is 'too late' reflects despair rather than integrity.

Intimacy versus isolation: Intimacy versus isolation is the young-adult task of forming close relationships.

Identity versus role confusion: Identity formation is the adolescent stage.

Erikson's last stage (65+): integrity versus despair; reminiscence and life-review therapy support integrity.

Answer: C

Client will feel less depressed and more hopeful soon: This is not specific, measurable or time-bound.

Client will understand the importance of joining groups: 'Understand' is not measurable, and no time frame is given.

Client will attend at least 3 groups daily by day 4: Correct. It is specific (groups), measurable (3), achievable, relevant to depression and time-bound (day 4).

Nurse will encourage client to attend more groups daily: This describes a nursing intervention, not a client outcome.

SMART goals are client-centered, Specific, Measurable, Achievable, Relevant and Time-bound.

Answer: C

Neuroleptic malignant syndrome: NMS follows dopamine antagonists, develops over days and features rigidity with slowed reflexes, not clonus.

Anticholinergic toxicity: Anticholinergic toxicity causes dry, hot skin and absent bowel sounds, not diaphoresis and clonus.

Serotonin syndrome: Correct. An SSRI plus a serotonergic drug (tramadol) with rapid-onset agitation, autonomic instability, hyperreflexia and clonus meets Hunter criteria.

Alcohol withdrawal syndrome: Nothing in the history suggests alcohol use, and inducible clonus after a new serotonergic drug points elsewhere.

Serotonin syndrome: rapid onset, clonus and hyperreflexia (Hunter criteria); NMS: slow onset, rigidity, bradyreflexia.

Answer: B

Give the dose with food to reduce the GI upset: Giving more lithium at a toxic level worsens toxicity; food does not address the problem.

Hold the next dose and notify the prescriber now: Correct. A level of 1.9 mEq/L with GI and neurologic symptoms indicates moderate toxicity; stop lithium, notify the prescriber, and anticipate fluids and monitoring.

Restrict sodium intake to help lower the lithium level: Low sodium causes the kidneys to retain lithium, raising the level further.

Recheck the level in one week, since it is near normal: Maintenance levels are about 0.6–1.2 mEq/L; 1.9 with symptoms is toxic and needs action now.

Lithium: therapeutic ~0.6–1.2 mEq/L; >1.5 with coarse tremor, vomiting, diarrhea or confusion = toxicity → hold and notify.

Answer: C

Remission achieved; plan to taper the medication: Remission on the PHQ-9 is a score below 5; a score of 9 still reflects mild symptoms, and tapering after 8 weeks would be premature.

No response; the treatment has failed and must change: A drop from 20 to 9 is more than a 50% reduction, which counts as response.

Response but not remission; continue and reassess the plan: Correct. A ≥50% reduction (20 → 9 is 55%) is a response; because the score is not below 5, the goal of remission is not yet met and the plan is revisited.

Symptoms worsened; the client needs a higher level of care: The score fell, indicating improvement, not worsening.

PHQ-9: response = ≥50% reduction; remission = score <5; measure-based care guides when to adjust treatment.