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PMHNP Review

This focused and high-yield review course is designed to prepare Psychiatric-Mental Health Nurse Practitioner (PMHNP) candidates to confidently pass their certification exam in one sitting. Covering critical clinical topics, the course integrates evidence-based insights into psychiatric and physiological systems relevant to advanced practice.
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Here’s a breakdown of the ANCC PMHNP exam domains based on the most recent test content outline, along with key topics to focus on within each domain to maximize your chances of passing the exam:

1. Scientific Foundation (30 questions – 20%)

Focus Areas
Tips
  • Neuroanatomy and neurobiology
  • Psychopharmacology (mechanism of action, side effects, interactions)
  • Pathophysiology of psychiatric conditions
  • Evidence-based practice and research utilization
  • Theoretical foundations (developmental theories, behaviorism, psychodynamic theory)
  • Integrative and complementary approaches (e.g., supplements, mindfulness)
  • Know how medications work at the receptor level.
  • Understand how to apply research evidence to clinical decision-making.

2. Advanced Practice Skills (38 questions – 25%)

Focus Areas
Tips
  • Health assessment (physical and psychiatric)
  • Diagnostic reasoning and differential diagnoses
  • Screening tools and rating scales (PHQ-9, GAD-7, MMSE, etc.)
  • Cultural competence in assessment
  • Risk assessment (suicide, homicide, abuse)
  • Lab interpretation (CBC, CMP, thyroid, drug levels, etc.)
  • Memorize which labs to order before/after starting medications (e.g., lithium, valproate).
  • Practice prioritizing patient safety and accurate diagnosis.

3. Diagnosis and Treatment (44 questions – 29%)

Focus Areas
Tips
  • DSM-5 diagnostic criteria
  • Formulating treatment plans
  • Psychopharmacology: selecting, adjusting, and managing meds
  • Managing side effects and adverse reactions
  • Medication interactions and contraindications
  • Substance use disorders (assessment, MAT, withdrawal protocols)
  • Pediatric, adult, and geriatric considerations
  • Comorbid medical and psychiatric conditions
  • Know first-line treatments by condition (e.g., SSRIs for MDD).
  • Understand black box warnings, contraindications, and age-specific prescribing.

4. Psychotherapy and Related Theories (27 questions – 18%)

Focus Areas
Tips
  • Major therapy modalities: CBT, DBT, psychodynamic, motivational interviewing, family therapy
  • Therapeutic communication techniques
  • Stages of change model
  • Group therapy dynamics
  • Therapeutic alliance building
  • Crisis intervention
  • Learn which therapy fits which disorder or patient population.
  • Be prepared to choose interventions that align with scope of practice.

5. Ethical, Legal, and Professional Practice (11 questions – 8%)

Focus Areas
Tips
  • Scope of practice and state/federal regulations
  • Informed consent and confidentiality (including minors)
  • HIPAA and documentation
  • Reporting requirements (abuse, duty to warn, etc.)
  • Prescriptive authority and DEA regulations
  • Professional boundaries and ethics
  • Cultural humility and health equity
  • Know the difference between autonomy, beneficence, and nonmaleficence.
  • Be clear on what’s within the PMHNP role and when to refer.

Summary Table:

Domain
% of Exam
Key Topics to Master
  • Scientific Foundation
  • Advanced Practice Skills
  • Diagnosis and Treatment
  • Psychotherapy & Theories
  • Ethical/Legal/Professional
  • 20%
  • 25%
  • 29%
  • 18%
  • 8%
  • Psychopharm, pathophysiology, EBP, theory
  • Assessment, diagnostics, labs, screening
  • DSM-5, meds, treatment planning, comorbidities
  • Modalities, therapeutic techniques, interventions
  • Scope, consent, documentation, legal mandates, ethics
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