PMHS Exam Resources

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New Eligibility Timeframe
PNCB has expanded the timeframe in which required practice hours and CE/graduate coursework can be counted toward exam eligibility from 3 years to 5 years. See the eligibility page for details.

PMHS Exam Resources

The exam is 2.5 hours and asks 150 multiple-choice questions based on categories in the content outline, an essential study reference. PNCB offers the resources below to help you create a personal study plan and prepare, plus a short video of suggestions from PMHSs.

These study resources are not inclusive of all resources that may be used in the preparation of the certification exam.

Use this step-by-step checklist to help you plan and prepare for your exam.

The content outline/test blueprint is an essential tool as you study. It describes all subject areas covered by the exam and questions per category.

PNCB certification exams are comprehensive tests, so be sure to study all areas of the content outline.

This exam tests your ability to apply knowledge and use critical thinking skills to determine one best answer among answer choices.

All questions that rely on DSM information reference DSM-5.

This content outline resulted from routine Job Task Analyses (JTA). To read highlights from the latest 2016-17 study, see our executive summary of highlights from the 2016-17 PMHS JTA study and PNCB's 2016-17 PMHS Exam PowerPoint.

The below list is an overview of possible resources as you prepare for the Pediatric Primary Care Mental Health Specialist Certification Exam. Our PMHS exam item writers and committee members have found the most current edition of the following references useful for their review. Additions or deletions to this list are a result of exam committee member input. The PNCB does not provide or endorse specific review courses or materials for certification preparation.

Respected Clinical Practice Guidelines/Statements/Reports

Preparatory resources include this list of respected clinical practice resources.


Textbooks and Related Resources

Developmental/Behavioral/Mental Health Textbooks:

American Academy of Pediatrics Committee on Psychosocial Aspects of Child and Family Health and Task Force on Mental Health. Policy statement - the future of pediatrics: mental health competencies for pediatric providers. Pediatr. 2009; 124:410-421. Reaffirmed 2013;132 (6): e1715.

American Psychiatric Association. DSM-5: Diagnostic and Statistical Manual of Mental Disorders.

Carey WB, Crocker AC, Elias RE, Feldman HM, Coleman WL. Developmental-Behavioral Pediatrics.

Dulcan MK. Dulcan's Textbook of Child and Adolescent Psychiatry.

Duncan P, Hagan JF, Shaw JS. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents.

Ginsburg KR, Kinsman SB. Guiding Adolescents to Use Healthy Strategies to Manage Stress.

Marks KP, Poon JK, Macias MM, Glascoe FP. Identifying and Addressing Developmental-Behavioral Problems: A Practical Guide for Medical and Non-Medical Professionals, Trainees, Researchers and Advocates.

Melnyk BM, Jensen P, eds. A Practical Guide to Child and Adolescent Mental Health Screening, Early Intervention, and Health Promotion.

Parker SJ, Zuckerman BS, Augustyn MC, eds. Developmental and Behavioral Pediatrics: A Handbook for Primary Care.

Trivedi HK, Kershner JD. Practical Child and Adolescent Psychiatry for Pediatrics and Primary Care.

Voigt RG, Macias MM, Meyers SM. Developmental and Behavioral Pediatrics.

Pediatric Psychopharmacology:

Elbe D, Bezchlibnyk-Butler KZ, Virani AS, Procyshyn RM. Clinical Handbook of Psychotropic Drugs for Children and Adolescents.

Klykylo W, Bowers R, Jackson J, Weston C. Green's Child and Adolescent Clinical Psychopharmacology.

Riddle, M. Pediatric Psychopharmacology for Primary Care.

Stahl SM. The Prescriber's Guide: Stahl's Essential Psychopharmacology.

Other References:

Addressing Mental Health Concerns in Primary Care: A Clinicians Toolkit (CD ROM).

ADHD: Caring for Children with ADHD: A Resource Toolkit for Clinicians (Spanish/English).

Autism: Caring for Children with Autism Spectrum Disorders: A Resource Toolkit for Clinicians.

Burns CE, Dunn AM, Brady MA, Starr NB, Blosser CG. Pediatric Primary Care.


Coding and Billing References:

American Psychiatric Association. DSM-5: Diagnostic and Statistical Manual of Mental Disorders.


For Providers and Families:

Greene RW. The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, Chronically Inflexible Children.

Hallowell EM, Ratey JJ. Driven to Distraction (Revised): Recognizing and Coping with Attention Deficit Disorder.

Kemper KJ. Mental Health Naturally: The Family Guide to Holistic Care for a Healthy Mind and Body.

Reiff MI. ADHD: What Every Parent Needs to Know.



Children's Mental Health in Primary Care (American Academy of Pediatrics)

The REsource for Advancing Children's Health (REACH): Resources for families and professionals

National Initiative for Children's Healthcare Quality

Centers for Disease Control (CDC)

First Signs

Autism Speaks

Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD)

Child Mind Institute


Professional Associations and Programs

American Academy of Child and Adolescent Psychiatry

American Psychiatric Nurses Association

International Society of Psychiatric Nurses (ISPN)

Society for Developmental and Behavioral Pediatrics

Society of Pediatric Nurses


Discount Information

American Academy of Pediatrics Discount. Save 15% on 35 bestselling print books or eBooks and other digital resources from the AAP. Includes Red Book 2018 and Red Book Online, Textbook of Neonatal Resuscitation, 7th Edition, PCEP, Nelson's 2017, Pediatric Clinical Practice Guidelines and Policies, Bright Futures, and more. Order online at and apply promotion code PNCB2018 at checkout. Or call toll-free at 888/227-1770 and mention the PNCB promotion code. Discount available through December 31, 2018.

The PMHS Practice Test offers in-depth rationale for right answers to enhance critical thinking. Score reports can help you focus studies.

The cost is $35. You receive unlimited attempts of 50 questions for 150 days.

PNCB's Test-taking Strategies resource is a free PowerPoint developed to help you learn exam preparation tips, strategies for answering multiple-choice exam questions, and techniques to manage test anxiety. Not a study or a review course.

Sample Questions

Note that these are only sample question types you may encounter and do not reflect the scope or degree of difficulty of the exam. The answer key is located at the bottom of the page.

Select the ONE answer that is BEST in each case.

1. A genogram is an important assessment tool because it provides a method of

A. disclosing mental health history and response to treatment.

B. depicting major factors that comprise a family's current social life and relationships.

C. assessing events and relationships related to patterns of mental health and illness systematically.

D. determining patterns of social networks that contribute to mental health and illness within families.

2. A child with generalized anxiety disorder (GAD) and ADHD is experiencing significant difficulties completing assignments in school. Caregivers are seeking information regarding medications. Response to their concerns is based on the knowledge that

A. stimulant medication will increase anxiety.

B. children may require treatment with both stimulants and SSRIs.

C. stimulant medication is less efficacious in children with ADHD and GAD.

D. treatment with SSRIs will address behaviors related to both ADHD and GAD.

3. Which of the following SSRI medications has the longest half-life?

A. citalopram (Celexa)

B. escitalopram (Lexapro)

C. fluoxetine (Prozac)

D. sertraline (Zoloft)

4. The caregiver of a school-age child with a diagnosed development delay expresses concerns about the child’s increasing behavioral problems and constant arguing. The caregiver states, “This kid is just bad and won’t listen.” Which of the following is the MOST effective first step?

A. recommend obtaining a learning evaluation and IEP from school

B. review use of consistent time out for problematic behaviors

C. discuss ignoring disruptive behaviors 

D. recommend parent training 

5. An 8 year old has had chronic irritability and mood swings for approximately 1.5 years, occurring almost daily across multiple settings. Several times a week the child has episodes of verbal and occasional physical aggression. There is no history of appetite loss or sleep disturbance. These symptoms are MOST consistent with which of the following diagnoses?

A. bipolar disorder

B. disruptive mood dysregulation disorder

C. intermittent explosive disorder

D. major depressive disorder

Answers and References:


1. Answer: C

  • Dulcan MK. Dulcan's Textbook of Child and Adolescent Psychiatry. 2nd ed. Arlington, VA: American Psychiatric Association; 2015.

2. Answer: B

  • Klykylo W, Bowers R, Jackson J, Weston C. (2019). Green's Child and Adolescent Clinical Psychopharmacology, 6th ed. New York, NY: Lippincott Williams & Wilkins; 2019. 
  • Riddle M. Pediatric Psychopharmacology: For Primary Care, 2nd ed. Itasca, IL: American Academy of Pediatrics; 2018. 

3. Answer: C

  • Taketomo CK, Hodding JH, Kraus DM, eds. (2018). Pediatric & Neonatal Dosage Handbook, 25th ed. Hudson, Ohio: Lexicomp Inc.

4. Answer: D

  • Dulcan MK. Dulcan's Textbook of Child and Adolescent Psychiatry. 2nd ed. Arlington, VA: American Psychiatric Association; 2015.

5. Answer: B

  • American Psychiatric Association. DSM-5: Diagnostic and Statistical Manual of Mental Disorders. Arlington, VA: American Psychiatric Association; 2013.

See this video for more about preparing for the PMHS exam from those who have earned the credential.

Faces of Certification

PNCB-certified nursing professionals work in a variety of roles and settings throughout the US and beyond. Share your photo today!

Joaquin Adame, CPNP-PC Children's Health Specialty Center Dallas, TX
Heraldine Flores, CPN Baker College Chicago, IL
Joanne Wintersgill, PMHS Cumming Pediatric Group Cumming, GA
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