Free PMHNP board review · 10 practice questions

PMHNP Screening Tools Practice Questions

Connect PHQ-9, GAD-7, MDQ, and other scores to clinical assessment.

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Independent educational practice, not official ANCC exam items. Not affiliated with or endorsed by ANCC. Not individual clinical advice; use current prescribing information, local protocols, and clinical judgment in practice.

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Question 1 of 10

An adult has a PHQ-9 total of 12. Which interpretation is most appropriate?

  1. A. Severe depressive symptom severity on this measure.
  2. B. An automatic indication for a specific antidepressant.
  3. C. Moderate depressive symptom severity on this measure, requiring clinical assessment.
  4. D. A confirmed diagnosis of major depressive disorder.
Show answer and explanation for question 1

Correct answer: C. Moderate depressive symptom severity on this measure, requiring clinical assessment.

The usual PHQ-9 band of 10–14 describes moderate symptom severity, not a completed diagnosis.

Why the other answers are less appropriate

  • D. A confirmed diagnosis of major depressive disorder.: Diagnosis also requires history, impairment, and alternative-cause assessment.
  • A. Severe depressive symptom severity on this measure.: The severe PHQ-9 band is 20–27.
  • B. An automatic indication for a specific antidepressant.: Medication selection cannot be determined by the total alone.

Question 2 of 10

An adult has a GAD-7 score of 16. What does the score establish?

  1. A. Severe anxiety symptom severity on the scale.
  2. B. A definitive six-month history of generalized anxiety disorder.
  3. C. A medication dose that must be prescribed.
  4. D. Evidence that a medical cause has been excluded.
Show answer and explanation for question 2

Correct answer: A. Severe anxiety symptom severity on the scale.

Scores of 15–21 fall in the usual severe GAD-7 symptom band.

Why the other answers are less appropriate

  • B. A definitive six-month history of generalized anxiety disorder.: The two-week scale does not establish the full diagnostic duration.
  • C. A medication dose that must be prescribed.: A scale total does not dictate a dose.
  • D. Evidence that a medical cause has been excluded.: Medical and substance-related causes still require assessment.

Question 3 of 10

A patient’s PHQ-9 total is 6, but they endorse the item concerning death or self-harm. What is the best response?

  1. A. Defer all safety questions because the total is mild.
  2. B. Assume imminent danger without clarifying thoughts, intent, or context.
  3. C. Remove the item from the score and interpret the remaining total.
  4. D. Directly assess what the response means and evaluate suicide risk.
Show answer and explanation for question 3

Correct answer: D. Directly assess what the response means and evaluate suicide risk.

A low total does not remove the need to clarify a positive death/self-harm response.

Why the other answers are less appropriate

  • A. Defer all safety questions because the total is mild.: The total can conceal a clinically important safety concern.
  • B. Assume imminent danger without clarifying thoughts, intent, or context.: Risk level and disposition require assessment of the actual experience.
  • C. Remove the item from the score and interpret the remaining total.: Deleting the response avoids rather than addresses the concern.

Question 4 of 10

A depressed patient screens positive on the MDQ. Which next step is best?

  1. A. Discard the result because the patient is currently depressed.
  2. B. Assess episodes, duration, associated changes, impairment, and possible alternative causes.
  3. C. Record bipolar I disorder solely from the score.
  4. D. Assume the result identifies the current episode as mania.
Show answer and explanation for question 4

Correct answer: B. Assess episodes, duration, associated changes, impairment, and possible alternative causes.

MDQ results guide a bipolar-spectrum evaluation; the diagnosis remains clinical.

Why the other answers are less appropriate

  • C. Record bipolar I disorder solely from the score.: The questionnaire does not independently establish the diagnosis.
  • D. Assume the result identifies the current episode as mania.: A lifetime screen does not identify the current episode by itself.
  • A. Discard the result because the patient is currently depressed.: A depressed presentation does not exclude past hypomania or mania.

Question 5 of 10

A patient has a negative MDQ, but their history includes a distinct period of markedly decreased need for sleep, increased energy, and impulsive spending. What should the clinician do?

  1. A. Assume the history is irrelevant to treatment planning.
  2. B. Continue a focused assessment of possible mood episodes despite the screen.
  3. C. Rule out bipolar disorder because the MDQ is negative.
  4. D. Diagnose a personality disorder instead without further assessment.
Show answer and explanation for question 5

Correct answer: B. Continue a focused assessment of possible mood episodes despite the screen.

A negative screen does not override a concerning clinical history.

Why the other answers are less appropriate

  • C. Rule out bipolar disorder because the MDQ is negative.: Screening instruments can miss cases.
  • D. Diagnose a personality disorder instead without further assessment.: The alternative diagnosis is unsupported by the stated information.
  • A. Assume the history is irrelevant to treatment planning.: Past activation can be important to the differential and plan.

Question 6 of 10

A patient’s PHQ-9 falls from 18 to 9 over several visits, but they remain unable to work. Which conclusion is best?

  1. A. Full remission and recovery are established by the score reduction alone.
  2. B. The score cannot reflect any meaningful improvement.
  3. C. Treatment must be stopped because the score is now below 10.
  4. D. Reported symptoms improved, but functional recovery and residual needs still require assessment.
Show answer and explanation for question 6

Correct answer: D. Reported symptoms improved, but functional recovery and residual needs still require assessment.

Serial measures help track change, while function and patient goals provide additional outcomes.

Why the other answers are less appropriate

  • A. Full remission and recovery are established by the score reduction alone.: Improvement on a scale does not establish full recovery.
  • B. The score cannot reflect any meaningful improvement.: A lower score can be useful evidence of improvement.
  • C. Treatment must be stopped because the score is now below 10.: Continuation decisions require an individualized clinical review.

Question 7 of 10

A clinic wants a clinician-rated measure of depressive symptom severity rather than a patient-completed inventory. Which is the best fit?

  1. A. Hamilton Depression Rating Scale (HAM-D/HDRS)
  2. B. Beck Depression Inventory-II (BDI-II)
  3. C. GAD-7
  4. D. CAGE
Show answer and explanation for question 7

Correct answer: A. Hamilton Depression Rating Scale (HAM-D/HDRS)

HAM-D is a clinician-rated depression severity measure.

Why the other answers are less appropriate

  • B. Beck Depression Inventory-II (BDI-II): BDI-II is a self-report depression inventory.
  • C. GAD-7: GAD-7 is an anxiety symptom measure.
  • D. CAGE: CAGE addresses alcohol-related problems.

Question 8 of 10

A chart says “Hamilton score 15,” without naming the scale or version. What should the reviewing clinician do before assigning a severity category?

  1. A. Convert it directly into a PHQ-9 category.
  2. B. Use the number alone to choose between therapy and medication.
  3. C. Verify the instrument, version, scoring method, and relevant interpretation.
  4. D. Assume HAM-A and HAM-D share a universal cutoff.
Show answer and explanation for question 8

Correct answer: C. Verify the instrument, version, scoring method, and relevant interpretation.

Hamilton scales and versions are not interchangeable; an unlabeled score is insufficient.

Why the other answers are less appropriate

  • D. Assume HAM-A and HAM-D share a universal cutoff.: Anxiety and depression scales measure different constructs and use their own interpretations.
  • A. Convert it directly into a PHQ-9 category.: Scores are not directly interchangeable across instruments.
  • B. Use the number alone to choose between therapy and medication.: Treatment choices require more than a severity number.

Question 9 of 10

A patient completes a symptom scale using an unvalidated translation and struggles to understand several questions. What is the best next step?

  1. A. Interpret the total with the same confidence as a validated administration.
  2. B. Assume misunderstood items indicate cognitive impairment.
  3. C. Treat the missing information as proof that symptoms are absent.
  4. D. Use an appropriate validated language version when available and clarify clinical symptoms with language support.
Show answer and explanation for question 9

Correct answer: D. Use an appropriate validated language version when available and clarify clinical symptoms with language support.

Administration and language affect the validity of the score.

Why the other answers are less appropriate

  • A. Interpret the total with the same confidence as a validated administration.: Changing the language or wording may change what the scale measures.
  • B. Assume misunderstood items indicate cognitive impairment.: Language difficulty is not equivalent to cognitive impairment.
  • C. Treat the missing information as proof that symptoms are absent.: Missing or misunderstood responses do not show symptom absence.

Question 10 of 10

Two patients have the same depression-scale total, but one has new agitation, reduced need for sleep, and recent medication changes. Which plan best uses the score?

  1. A. Investigate the differing clinical histories before deciding on treatment.
  2. B. Choose identical treatment because the totals match.
  3. C. Average their symptom profiles to identify one shared diagnosis.
  4. D. Ignore the activation symptoms because they are not reflected in the total.
Show answer and explanation for question 10

Correct answer: A. Investigate the differing clinical histories before deciding on treatment.

Equal totals can represent different symptoms, risks, and differential diagnoses.

Why the other answers are less appropriate

  • B. Choose identical treatment because the totals match.: Identical scores do not establish identical treatment needs.
  • C. Average their symptom profiles to identify one shared diagnosis.: Diagnosis is individual and cannot be inferred by averaging patients.
  • D. Ignore the activation symptoms because they are not reflected in the total.: Clinically important symptoms remain relevant beyond the measure.

Turn missed questions into focused review

Identify the clue that supports the best answer, then explain why the closest alternative is less appropriate. Return to the linked article to revisit a missed concept. This short practice set does not predict certification performance.

Frequently asked questions

Do screening scores tell me whether to prescribe medication?

They inform assessment and monitoring. Treatment also depends on the diagnosis, safety, impairment, past response, medical factors, and the patient’s preferences.

Are Hamilton scale totals interchangeable?

No. Confirm whether the measure is HAM-A, HAM-D, or a specific version and use its scoring instructions. Avoid importing a cutoff from a different instrument.