I Took the PMHNP Exam: Let Me Tell You about It

Becoming a Psychiatric Mental Health Nurse Practitioner (PMHNP) is an exciting and rewarding career path, but before you can hang your diploma and start working with patients, there’s one big hurdle: the PMHNP board exam. This test ensures that you have the knowledge and skills necessary to provide top-notch care to individuals dealing with a wide range of psychiatric and mental health disorders.

The landscape of the PMHNP exam has changed, and as of 2024, there are two separate exams you need to be aware of:

  • the ANCC exam (from the American Nurses Credentialing Center)
  • and the newer AANP exam (from the American Academy of Nurse Practitioners).
Both are important, but they have some key differences. If you're wondering which one to take or what the exams entail, you’ve come to the right place. Let’s dive in and explore everything you need to know about the PMHNP exams.

The Two PMHNP Exams: ANCC vs. AANP

First things first, let’s talk about the two exam options.

ANCC PMHNP Exam

The ANCC PMHNP exam is the original and still the most widely recognized certification for Psychiatric Mental Health Nurse Practitioners. Most job descriptions will explicitly mention ANCC certification, and this exam is generally seen as the industry standard. If you're preparing for the ANCC exam, you're aligning yourself with the tried-and-true path.

AANP PMHNP Exam

In 2024, the AANP launched its own PMHNP exam, which is new on the scene. As with anything new, there are still some kinks being worked out. The AANP is recognized and respected, but it hasn’t yet achieved the same level of recognition as ANCC—at least not in job descriptions. While the AANP PMHNP exam is certainly valid and legitimate, you may want to keep in mind that the ANCC certification is what many employers are still looking for.
It’s important to note that choosing the AANP exam doesn’t make you any less of a PMHNP—it’s just that the ANCC is the “OG” in this space. Think of the ANCC exam as the seasoned veteran and the AANP as the rookie with potential. In time, the AANP will likely become as well-recognized, but for now, the ANCC remains the go-to for most employers.

ANCC vs AANP PMHNP Exam Comparison Table

ANCC PMHNP Board Exam AANP PMHNP Board Exam
Organization American Nurses Credentialing Center (ANCC) American Academy of Nurse Practitioners (AANP)
Exam Content Comprehensive exam covering psychiatric-mental health nursing theory, practice, and research Broad-based exam covering all aspects of advanced practice nursing
Application Process Online application through the ANCC website Online application through the AANP website
Number of Questions 175 total (150 scored, 25 pre-test) 150 total (135 scored, 15 pre-test)
Passing Score 75% 75%
Retake Policy Wait 60 days after failed attempt 2 attempts per year
Question Breakdown The ANCC exam breaks down into different domains or content areas. These are the major topics you’ll need to be familiar with:
  • Scientific Foundation (25% of the exam) This section tests your knowledge of the underlying scientific principles that form the basis of psychiatric care. Be prepared to understand
    • neurobiology
    • Pathophysiology
    • the pharmacology of psychiatric medications.
  • Advanced Practice Skills (38% of the exam) Here, you’ll be tested on
    • diagnostic reasoning
    • assessment techniques
    • the ability to create and implement treatment plans.
This is where your knowledge of mood disorders (e.g., depression, bipolar disorder), anxiety disorders, and psychotic disorders (e.g., schizophrenia) will come in handy.
  • Diagnosis and Treatment (32% of the exam) - This is a huge section. You’ll need to know
    • how to diagnose a variety of psychiatric disorders
    • apply the DSM-5 criteria
    • and understand which treatments (both pharmacologic and nonpharmacologic) are appropriate.
This is where your in-depth knowledge of medications becomes crucial—think mood stabilizers, antipsychotics, antidepressants, and anxiolytics.
  • Ethics and Legal Considerations (5% of the exam) - A small but important part of the exam, this section ensures that you’re up to date on legal requirements, ethical decision-making, and professional responsibilities.
 The AANP PMHNP exam is newer, so it’s a little different from the ANCC in terms of content focus. The breakdown includes:
  • Clinical Management (60% of the exam) - This is the heart of the exam. You’ll need to show competency in
    • Assessing
    • Diagnosing
    • and treating psychiatric conditions.
Like the ANCC exam, you’ll be expected to know your stuff when it comes to medications, especially those used in mood disorders and psychotic disorders. Be sure to review therapeutic ranges, potential side effects, and drug interactions.
  • Professional Role and Policy (40% of the exam) - This section focuses on the role of the PMHNP in the healthcare system, including
    • ethical and legal considerations
    • collaboration with other healthcare professionals
    • and advocacy for mental health patients.
Exam Length 3.5 hours 3 hours
Renewal Period Every 5 years Every 5 years

PMHNP Exam Preparation: What You Need to Review

Regardless of whether you choose the ANCC or AANP exam, there are some core topics and content areas that you’ll need to be familiar with. Here are some of the most important things to review:

1.Psychiatric Medications

  • Antidepressants:

    SSRIs, SNRIs, tricyclics, and MAOIs. Know their mechanisms of action, side effects, and contraindications.

  • Antipsychotics:

    First-generation and second-generation antipsychotics. Focus on indications, side effects (like tardive dyskinesia), and dosing

  • Mood Stabilizers:

    Lithium and anticonvulsants. Make sure you understand their therapeutic ranges, side effects, and monitoring requirements.

  • Anxiolytics:

    Benzodiazepines and non-benzodiazepine options (like Buspirone). You should know the potential for dependency and alternatives for anxiety management.

2. Psychiatric Disorders

  • Mood Disorders:

    Understand the diagnostic criteria for major depressive disorder, bipolar disorder, and dysthymia. Be familiar with the various treatment modalities, including medications and psychotherapies like Cognitive Behavioral Therapy (CBT).

  • Anxiety Disorders:

    Review generalized anxiety disorder, panic disorder, and social anxiety disorder. Know how to differentiate between these and other conditions like PTSD or OCD.

  • Psychotic Disorders:

    Know the ins and outs of schizophrenia, schizoaffective disorder, and delusional disorder. Be prepared to discuss both acute and long-term management strategies.

  • Substance Use Disorders:

    Be familiar with the treatment of addiction, including medications like buprenorphine for opioid use disorder.

3. Therapeutic Approaches

  • While pharmacology is essential, you’ll also need to review common psychotherapy modalities.
  • CBT is a big one, but be prepared to touch on other therapies like Dialectical Behavior Therapy (DBT) for patients with borderline personality disorder

4. Neurobiology and Pathophysiology

  • Having a strong understanding of the neurobiological basis of psychiatric disorders will be crucial for both exams.
  • Review the role of neurotransmitters (like serotonin, dopamine, and norepinephrine) and how they relate to various conditions like depression, schizophrenia, and anxiety

Am I eligible to take the PMHNP exam?

Before you set out to take the PMHNP board exam, make sure you meet ANCC or AANP eligibility criteria. Not only are these requirements for the certifying organizations, but they’re also great steps to gaining experience that will support your success on the PMHNP certification exam. Below is a brief overview of eligibility requirements, but you can also visit the ANCC and AANP websites for more detailed information.

ANCC Eligibility Requirements

Applicants for the ANCC PMHNP exam must hold a current, active RN license. They must have a PMHNP master’s, post-graduate certificate, or DNP from an accredited institution. This must include a minimum of 500 faculty-supervised clinical hours, and three separate, graduate-level, APRN Core courses in designated topics. Finally, you must hav e completed clinical training in at least two psychotherapeutic treatment modalities.

AANP Eligibility Requirements

Applicants for the AANP PMHNP exam must have completed a nationally accredited graduate, postgraduate, or doctoral PMHP educational program, including a minimum of 500 clinical practice hours. They must complete the APRN Core, including advanced physical assessment, advanced pharmacology, and advanced pathophysiology. A current professional nursing license is requ ired to process your application.

How hard is the PMHNP exam?

So how many people pass the PMHNP exam? Since AANP just began accepting applications for the new PMHNP exam in January 2024, we don’t yet have access to the score statistics and pass rates. However, here’s a look at two different years of ANCC PMHNP exam stats, provided by ANCC.

Year Total Tested Total Passed Pass Rate
2016 1,550 1,364 88%
2022 7,476 6,789 91%

As you can see, the majority of well-prepared candidates achieve a passing score–and you can too!

External Resources for PMHNP Exam Prep

For more information on these exams, you can visit the official sites of both the American Nurses Credentialing Center (ANCC) and the American Academy of Nurse Practitioners (AANP). These sites offer detailed breakdowns of the exams, study guides, and other essential resources.

Conclusion

In summary, passing the PMHNP exam—whether through ANCC or AANP—is your gateway to becoming a Psychiatric Mental Health Nurse Practitioner. The exams are rigorous, but

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