Students in psychiatric-mental health nurse practitioner (PMHNP) programs have a new option for national certification. This spring, the American Academy of Nurse Practitioners Certification Board (AANPCB) will administer its first PMHNP exams.
The introduction of the AANPCB exam for PMHNPs means that the American Nurses Credentialing Center (ANCC) will no longer be the sole certifying body for NPs specializing in psychiatric-mental health. This specialty is the fastest growing among nurse practitioners, who are answering the call for more providers with expertise in psychiatric healthcare.
The American Association of Nurse Practitioners (AANP) has reported that more than 158 million people in the United States live in areas with shortages of mental healthcare providers.
Schools of nursing have taken notice, and more than 100 of them have added PMHNP programs in the last decade. More than 13,000 new PMHNPs have earned certification since 2012, AANP reported.
The impact of NP-provided mental health services is significant. A study published in 2022 found that the number of NPs treating Medicare beneficiaries for psychiatric and mental health conditions grew 162% between 2011 and 2019, compared with a 6% decrease in the number of psychiatrists treating Medicare patients.
The new PMHNP certification examination is an entry-level competency-based examination that tests clinical knowledge of psychiatric-mental health across the life span, the AANPCB states in the candidate information.
The 150 questions on the new exam are all multiple choice and “limited to content that can be tested in an objective format,” the AANPCB states. The questions “are competency-based and focused solely on the requirements for safe clinical practice.”
A candidate's text score is based on their answers to the 135 questions that are scored. The 15 remaining questions are pretest questions that are not scored. By comparison, the ANCC exam for PMHNPs contains 175 questions, 25 of which are unscored pretest items.
The graphic below provides an overview of the two exams for PMHNPs. A future article will more thoroughly explore the differences between the two tests.
The AANPCB exam blueprint outlines the domains and tasks that are evaluated on the exam, and PMHNP candidates should use this information to focus their study and preparation.
Domains are the areas of major responsibility that constitute professional practice and encompass the tasks performed by NPs. The AANPCB exam blueprint identifies the domains for PMHNP practice as follows:
Domain I: Assess
Domain II: Diagnose
Domain III: Plan
Domain 4: Evaluate
The AANPCB exam blueprint identifies the following applied knowledge areas as important for candidate preparation:
Scientific foundations
Pharmacology
Nonpharmacologic therapies
Psychotherapies
Assessment and diagnosis
Care practices
Professional role
Questions on the PMHNP exam from AANPCB assess knowledge of clinical disorders described in the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM); the current version is DSM-5-TR.
The AANPCB blueprint organizes the disorders into three groups that reflect the general frequency with which the disorders are the focus of questions on a typical exam.
Most frequently included:
Somewhat included:
Least frequently included:
To be successful on the PMHNP exam from AANPCB or ANCC, the exam preparation experts at Advanced Practice Education Associates (APEA) recommend two key steps: Reviewing the exam blueprint and using it to guide your study, and answering high-level practice questions that provide detailed rationales. Practice until you feel comfortable answering questions accurately at a pace of about 1 minute per question.
The most effective study questions reflect the clinical and practice areas covered on the exam and provide detailed rationales to continue building knowledge. Speaking of knowledge, APEA exam experts emphasize that knowledge-level questions are best used early in an NP program — not to prepare for a certification exam.
Knowledge-level questions ask what a student knows about a topic (the facts), but they don’t require application of critical thinking. All NP certification exam questions require the candidate to critically think about the situations presented — not to state basic knowledge.
APEA has developed a high-level question bank for the PMHNP specialty that builds critical thinking.
MyQBank Psychiatric-Mental Health provides 800 multiple choice questions that reflect the blueprints for both PMHNP certification exams. This bank covers general psychiatric disorders encountered in PMHNP primary care settings, as well as other subject areas covered on the PMHNP certification exam.
All questions provide detailed rationales that build the knowledge and critical thinking abilities necessary to pass the PMHNP certification exam. The questions in MyQBank Psych-Mental Health cover patient presentations throughout the age continuum, ensuring that new PMHNPs are prepared to treat the complete range of patients.
In addition to reviewing the blueprint and answering study questions, take advantage of two free resources provided on the AANPCB website: A guide to test-taking and the PMHNP candidate handbook (the handbook also addresses the FNP and AGPCNP exams).