OpenExamsFREE PRACTICE — ANY EXAM

Free CNA Psychiatric and Mental Health Nursing Certification Exam Practice Questions

100 free questions · Answer explanations · No signup required

View examination details, outline and sources

Loading selected examination banks…

Sample Practice Questions

Try these 10 sample questions from the CNA Psychiatric and Mental Health Nursing Certification Exam practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

  1. 1A client says that losing a job has made them feel worthless. The nurse replies, "It sounds as though losing that role has deeply affected how you see yourself. Have I understood you?" Which therapeutic quality is the nurse demonstrating?

    1. A.Interpretation
    2. B.Confrontation
    3. C.EmpathyCorrect answer: C
    4. D.Reframing

    Explanation: RNAO states, "Empathy involves the nurse being able to attend to the subjective experience of the client and validate that his/her understanding is an accurate reflection of the client’s experience." The nurse reflects the client’s experience and checks its accuracy, rather than offering an interpretation, highlighting a discrepancy or suggesting a different meaning.

    Reference: RNAO Establishing Therapeutic Relationships — p. 21, Requisite capacities, Empathy

  2. 2While taking a safety history, the nurse needs to identify prior suicidal behaviour. Which history most directly establishes this risk factor?

    1. A.An episode of panic that led to an emergency department visit.
    2. B.A medication overdose taken with the intention of ending life.Correct answer: B
    3. C.An episode of checking locks repeatedly to reduce intense anxiety.
    4. D.A period of markedly reduced sleep during an elevated mood.

    Explanation: The source states, "Previous suicide attempt(s)" The stated intention to die distinguishes the overdose as a previous suicide attempt. The other histories may affect care but do not establish prior suicidal behaviour.

    Reference: Open RN Nursing Mental Health and Community Concepts 2e — 1.6 Establishing Safety, Recognizing Risk Factors for Suicide

  3. 3A client with persistent auditory hallucinations has returned to valued volunteer work and describes a satisfying life with supports. Which concept recognizes this progress despite ongoing symptoms?

    1. A.Clinical remission
    2. B.Personal recoveryCorrect answer: B
    3. C.Acute stabilization
    4. D.Diagnostic conversion

    Explanation: The source states, "The concept of “recovery” in mental health refers to living a satisfying, hopeful, and contributing life, even when a person may be experiencing ongoing symptoms" Recovery can include meaningful participation while symptoms persist. Remission concerns symptoms, stabilization concerns acute state, and diagnostic conversion concerns a change in diagnosis.

    Reference: CNA Psychiatric and Mental Health Nursing Blueprint — pp. 2–3, Assumptions: Mental Health

  4. 4A client reports difficult-to-control worry about finances, work and family on most days for eight months, with restlessness, muscle tension and poor sleep. Substance and medical causes have been excluded. Which pattern is most consistent with these findings?

    1. A.Social anxiety disorder
    2. B.Panic disorder
    3. C.Generalized anxiety disorderCorrect answer: C
    4. D.Specific phobia

    Explanation: The source states, "excessive anxiety and worry, occurring on more days than not for at least six months, about a number of events or activities" Persistent worry across several areas with associated symptoms fits generalized anxiety. Panic is episodic, social anxiety centres on social evaluation, and a specific phobia centres on a particular object or situation.

    Reference: Open RN Nursing Mental Health and Community Concepts 2e — 9.3 Anxiety-Related Disorders, Generalized Anxiety Disorder

  5. 5A nurse's community assessment finds worse mental health outcomes in residents who cannot obtain affordable housing or accessible services. What concept describes these avoidable differences linked to social conditions?

    1. A.Genetic susceptibility
    2. B.Health inequitiesCorrect answer: B
    3. C.Diagnostic comorbidity
    4. D.Illness behaviour

    Explanation: The source states, "SDOH can contribute to health inequities, defined as avoidable differences in health status seen within and between communities." The difference arises from modifiable social conditions. Genetic susceptibility, coexisting diagnoses and responses to illness describe different constructs.

    Reference: Open RN Nursing Mental Health and Community Concepts 2e — 16.2 Community Health Concepts, Social determinants of health

  6. 6During a mental status examination, a client's speech repeatedly links words by sound, such as "train, rain, plain," without a meaningful connection to the question. Which term best documents this thought-process finding?

    1. A.Clang associationsCorrect answer: A
    2. B.Loose associations
    3. C.Thought blocking
    4. D.Echolalia

    Explanation: The source states, "Clang associations refers to stringing words together that rhyme without logical association and do not convey rational meaning." The organizing link is rhyme. Loose associations lack a logical link, thought blocking interrupts thought, and echolalia repeats another person's speech.

    Reference: Open RN Nursing Mental Health and Community Concepts 2e — 4.3 Assessment, Thoughts and Perceptions

  7. 7A client with a phobia is working through a very gradual hierarchy of feared situations while practising relaxation. Which intervention is being reinforced?

    1. A.Interpersonal psychotherapy
    2. B.Aversion therapy
    3. C.Systematic desensitizationCorrect answer: C
    4. D.Psychodynamic interpretation

    Explanation: The source states, "Systematic desensitization is a graduated exposure therapy conducted at a very slow pace used in combination with relaxation techniques and imagery." Gradual exposure paired with relaxation identifies systematic desensitization. The other therapies use different mechanisms.

    Reference: Open RN Nursing Mental Health and Community Concepts 2e — 9.4 Treatments for Anxiety, Psychotherapy

  8. 8A client is prescribed sertraline for a depressive disorder. To which antidepressant class does this medicine belong?

    1. A.Monoamine oxidase inhibitors
    2. B.Tricyclic antidepressants
    3. C.Serotonin-norepinephrine reuptake inhibitors
    4. D.Selective serotonin reuptake inhibitorsCorrect answer: D

    Explanation: The source states, "Examples of common SSRIs include fluoxetine, citalopram, sertraline, paroxetine, and escitalopram." Sertraline is an SSRI. The other options are different antidepressant classes.

    Reference: Open RN Nursing Mental Health and Community Concepts 2e — 6.3 Antidepressants, Selective Serotonin Reuptake Inhibitors

  9. 9Before meeting a client, a nurse assumes the client will be violent solely because the chart lists schizophrenia. No individual violence assessment has been completed. Which process should the nurse recognize and challenge?

    1. A.Countertransference
    2. B.Transference
    3. C.Diagnostic overshadowing
    4. D.StereotypingCorrect answer: D

    Explanation: The source states, "clients with mental health disorders have been portrayed in the media as dangerous, unpredictable, violent, or bizarre, and these portrayals can cause fearful attitudes." Assigning dangerousness from a diagnostic group rather than individual evidence is stereotyping. Countertransference and transference concern displaced relational feelings; diagnostic overshadowing concerns attributing other symptoms to an existing diagnosis.

    Reference: Open RN Nursing Mental Health and Community Concepts 2e — 1.4 Stigma, attitudes among health professionals

  10. 10An Indigenous client describes a healing practice unfamiliar to the nurse. The nurse acknowledges the limits of their own knowledge and asks to learn what the practice means to this client. Which professional concept most specifically describes this stance?

    1. A.Cultural humilityCorrect answer: A
    2. B.Cultural assimilation
    3. C.Cultural generalization
    4. D.Cultural imposition

    Explanation: CNA describes humility as "humbly acknowledging being a learner when attempting to understand another person’s experience". The nurse approaches this client as a learner. Assimilation, generalization and imposition replace the client’s individual perspective with other cultural expectations or assumptions.

    Reference: CNA Cultural Competence and Cultural Safety Competencies — Therapeutic relationship building, 2.1

Exam Review

About CNA Psychiatric and Mental Health Nursing Certification Exam

CNA Psychiatric and Mental Health Nursing Certification Exam · CA

Key exam facts

Provider
Canadian Nurses Association (CNA) owns the specialty certification program and develops the blueprint with specialty nurses and Meazure Learning. Meazure Learning provides testing services; remote examinations use ProctorU, with an in-person Meazure Learning test-centre option.
Format
Computer-based multiple-choice knowledge examination, remotely proctored at home or at selected Canadian test centres. The specialty blueprint specifies 60–70% independent questions and 30–40% case-based questions (approximately four questions per case). This practice bank uses four-option questions and does not reproduce all official delivery features.
Exam questions
Total questions: 160–165.
Time limit
Four hours (240 minutes) to complete the examination; this is the answering time described by CNA, not a combined check-in or tutorial duration.
Passing score
Criterion-referenced standard set by the specialty exam committee using a modified Angoff method, with testing-consultant statistical review. CNA explicitly states that the pass mark is not published. Results are reported as pass or unsuccessful; no fixed percentage or scaled passing score is asserted.
Exam fee
CNA's Canadian fee schedule displays dollar ($) amounts: initial application $588 for CNA members or $780 for non-members; an additional appointment fee is $85 for remote online proctoring or $110 in person. Eligible unsuccessful candidates pay a reduced rewrite application fee of $378 (member) or $500 (non-member), valid for the next two calendar years. Application amounts include a $130 non-refundable administrative fee; applicable taxes are additional. The published table does not spell out an ISO currency code; amounts are retained in its original $ notation.

Topics covered

The authority publishes percentage ranges for each content area. The practice percentages below use the midpoint of each range, normalized to 100%; they are not exact percentages published by the authority. Practice question counts may differ slightly because of rounding.

  • Therapeutic Relationships — Official range: 11–15% (Practice allocation: 13%)

    • Integrates principles, concepts and dimensions underlying the therapeutic relationship
    • Demonstrates humility in interactions with all clients
    • Recognizes culture-specific meanings of symptoms, causes, illness acceptance and treatment seeking
    • Employs therapeutic use of self
    • Establishes, maintains and terminates a therapeutic relationship
    • Uses a range of communication skills and approaches
    • Has self-awareness, including reflective practice
    • Identifies own and person's values and beliefs and impact on relationship
    • Recognizes and responds to transference and counter-transference
    • Recognizes influence of team, agencies, family, supports and community on relationship
    • Distinguishes phases of therapeutic relationship
    • Plans care for initial phase
    • Partners with the person
    • Discusses confidentiality and consent
    • Advocates, promotes and values lived experience
    • Collaboratively develops goals
    • Plans care for working phase
    • Identifies and incorporates strengths, resilience and resources
    • Promotes healthy coping and problem-solving
    • Revises therapeutic goals
    • Plans care for termination phase
    • Initiates transitions
    • Evaluates ongoing or continuing care for future

  • Safety — Official range: 14–18% (Practice allocation: 16%)

    • Knows predisposing safety risk factors
    • Assesses physiological and mental status changes indicating safety risks
    • Intervenes respecting culture, equity, orientation, gender, justice, intersectionality and dignity
    • Identifies impact of violence, trauma and abuse
    • Applies strategies minimizing risk to person, nurse, team and circle of care
    • Selects nursing interventions for safety-related presentations
    • Suicidal thoughts, plans or behaviour
    • Homicidal thoughts, plans or behaviour
    • Self-injurious behaviour
    • Aggressive behaviour
    • Disorganized thoughts and behaviour
    • Abuse and neglect
    • Manages complex and rapidly changing physiological or mental health states
    • Collaborates with health-care team on actual or potential unsafe situations
    • Plans and implements safety assessment, crisis prevention and de-escalation
    • Uses trauma-informed care, including harm reduction
    • Engages, monitors and observes
    • Modifies environment
    • Uses interventions from least to most restrictive
    • Facilitates support systems
    • Documents care plan and intervention
    • Evaluates effectiveness and modifies plan as necessary

  • Promoting Mental Health and Recovery — Official range: 7–11% (Practice allocation: 9%)

    • Knows mental health promotion and recovery principles
    • Strengthens individual resilience
    • Fosters supportive environments
    • Incorporates social determinants in care and anticipated outcomes
    • Understands primary, secondary and tertiary prevention
    • Uses evidence-informed interventions for ethical, culturally competent, safe and effective care
    • Recognizes mental health risk and protective factors
    • Applies recovery principles: strengths, autonomy, choice, self-management, collaboration and civic engagement
    • Applies trauma-informed care principles
    • Encourages active engagement in recovery
    • Promotes formal and informal supports and continuity

  • Therapeutic Approaches and Processes — Knowledge of Psychiatric Disorders and Mental Health Issues — Official range: 6–10% (Practice allocation: 8%)

    • Recognizes and understands people experiencing anxiety
    • Recognizes and understands alterations in mood
    • Recognizes and understands alterations in cognition
    • Recognizes and understands psychosis
    • Recognizes and understands personality disorders
    • Recognizes and understands trauma and stressor-related disorders
    • Recognizes and understands substance-related and addictive disorders
    • Recognizes and understands eating disorders
    • Recognizes and understands neurodevelopmental disorders
    • Recognizes and understands disruptive, impulse control and conduct disorders
    • Recognizes and understands obsessive and compulsive related disorders
    • Recognizes and understands other psychiatric disorders

  • Therapeutic Approaches and Processes — Contextual Factors within the Continuum of Care — Official range: 6–10% (Practice allocation: 8%)

    • Addresses social determinants
    • Addresses person's trauma history
    • Addresses responses to previous interventions and care
    • Addresses combined conditions: concurrent disorders, dual diagnoses and medical comorbidities
    • Addresses life events: crisis and loss
    • Addresses culture and diversity
    • Addresses stigma and access to care
    • Addresses technology

  • Therapeutic Approaches and Processes — Assessment — Official range: 10–14% (Practice allocation: 12%)

    • Uses comprehensive mental status examination
    • Assesses safety and risk
    • Assesses strengths, resilience and support
    • Assesses readiness for change
    • Assesses stress exposure and responses
    • Assesses physiological manifestations
    • Assesses social interactions and interpersonal relationships
    • Assesses functional status

  • Therapeutic Approaches and Processes — Interventions — Official range: 10–14% (Practice allocation: 12%)

    • Individualized interventions for psychiatric presentations
    • Individualized interventions for anxiety
    • Individualized interventions for alterations in mood
    • Individualized interventions for alterations in cognition
    • Individualized interventions for psychosis
    • Individualized interventions for personality disorders
    • Individualized interventions for trauma and stressor related disorder
    • Individualized interventions for substance related and addiction disorder
    • Individualized interventions for eating disorders
    • Individualized interventions for neurodevelopmental disorders
    • Individualized interventions for disruptive, impulsive control and conduct disorders
    • Individualized interventions for obsessive compulsive disorders
    • Individualized interventions for other psychiatric disorders
    • Provides care for persons receiving ECT
    • Differentiates delirium, dementia and depression
    • Evaluates intervention progress, outcomes and goals
    • Considers complementary, alternative and traditional healing practices

  • Psychopharmacology — Official range: 14–18% (Practice allocation: 16%)

    • Knows classifications of psychotropic medications
    • Administers medication accurately and safely
    • Assesses and monitors side effects
    • Cognitive changes
    • Neurological changes
    • Physiological changes
    • Sexual dysfunction
    • Paradoxical responses
    • Anticholinergic effects
    • Assesses and monitors toxicity
    • Lithium toxicity
    • Serotonin syndrome
    • Assesses and monitors possible life-threatening adverse effects
    • Agranulocytosis
    • Neuroleptic malignant syndrome
    • Metabolic syndrome
    • Intentional overdose
    • Knows factors influencing medication adherence
    • Attitudes, beliefs and choices including alternative treatments
    • Knowledge, understanding and treatment preferences
    • Therapeutic response
    • Age and culture
    • Costs
    • Intramuscular versus oral and depot medication
    • Initiates medication and precautions teaching
    • Evaluates medication needs and responses

  • Professional Roles — Official range: 4–8% (Practice allocation: 6%)

    • Respectful engagement and reflection on biases, stigma and judgment
    • Applies applicable provincial, territorial and national legislation, institutional rules and guidelines
    • Advocates for rights
    • Engages in self-care
    • Ongoing professional development
    • Health teaching based on needs and capacities
    • Develops partnerships with persons
    • Develops interprofessional and intersectoral partnerships
    • Assists navigation across systems

How to prepare

Work through the topics, read the explanation after each answer, and revisit the areas where you miss questions. Use the official outline and reference materials below to guide your study.

These independent practice questions are not actual exam items and do not guarantee a passing result.

Frequently asked questions

What is the exam format?

Computer-based multiple-choice knowledge examination, remotely proctored at home or at selected Canadian test centres. The specialty blueprint specifies 60–70% independent questions and 30–40% case-based questions (approximately four questions per case). This practice bank uses four-option questions and does not reproduce all official delivery features.

How many questions are on the exam?

Total questions: 160–165.

How long is the exam?

Four hours (240 minutes) to complete the examination; this is the answering time described by CNA, not a combined check-in or tutorial duration.

What is the passing score?

Criterion-referenced standard set by the specialty exam committee using a modified Angoff method, with testing-consultant statistical review. CNA explicitly states that the pass mark is not published. Results are reported as pass or unsuccessful; no fixed percentage or scaled passing score is asserted.

How much does the exam cost?

CNA's Canadian fee schedule displays dollar ($) amounts: initial application $588 for CNA members or $780 for non-members; an additional appointment fee is $85 for remote online proctoring or $110 in person. Eligible unsuccessful candidates pay a reduced rewrite application fee of $378 (member) or $500 (non-member), valid for the next two calendar years. Application amounts include a $130 non-refundable administrative fee; applicable taxes are additional. The published table does not spell out an ISO currency code; amounts are retained in its original $ notation.

Official sources and references

Confirm current exam arrangements with the exam provider.