LATESTBARKLEY PMHNP Exam Questions and Answers |Fall
2025/2026 Update | 100% Correct Latest
Question 1
Jeremy, a suicidal inpatient, is under close observation. He is able to be observed at all times by hospital staff during
waking hours and when he sleeps, and is checked on every 15-30 minutes. Which of these reasons would least indicate the
need for this level of supervision?
1. Jeremy has expressed suicidal thoughts.
2. Jeremy experiences withdrawal from alcohol and cocaine.
3. Jeremy is ambivalent about his intent to commit suicide.
4. Jeremy was unable to commit to a "No Harm" contract.
Correct Answer
Although ambivalence regarding suicidal intent should be taken into account when considering level of observation in a
patient, it indicates a moderate risk, not a severe risk. Close observation should be employed with patients who profess
suicidal thoughts, are unable to commit to a "No Harm" contract, or experience withdrawal.
Page 1 of 67
,Question 2
Adam, a 23-year-old male, is undergoing an STD test at your clinic. When you ask him why he is here, he says, "I'm here
because I've had this increased craving for sex. I've been picking up strangers in bars, not caring about using protection ... I
don't know what it is. For the last week, I've just felt really driven. Keep throwing myself into my work, don't feel much need
for sleep, feel like my thoughts are running a marathon in my head." The patient lives a "clean life," clarifying that he does
not abuse any substance, "not even coffee or cigarettes." He also does not have a history of mental disorders. Given the
most likely diagnosis, which of these medications would you least likely recommend for Adam?
Lorazepam
Haloperidol
Carbamazepine
Bupropion
Correct Answer
The patient's recent involvement in risky pleasurable activity (e.g., unprotected sex), increase in goal-driven activity at
work, decreased need for sleep, and subjective experience of racing thoughts all suggest a manic episode; as such,
bupropion, an antidepressant, would not be considered because the patient has not displayed the diagnostic criteria for
a major depressive episode. Pharmacologic options for the treatment of manic episodes include anticonvulsants
(carbamazepine), antipsychotics (haloperidol), and benzodiazepines (lorazepam).
Page 2 of 67
,Question 3
When completing the CAGE questionnaire with a suspected alcohol abuser, which of the following questions would you
most likely ask?
1. "Do you ever feel like you can't stop drinking after you start?"
2. "Do you drink at work?"
3. "Have you ever felt bad about your drinking?"
4. "Have you ever gotten sick from drinking?"
Correct Answer
Asking if a person has ever felt bad about his or her drinking addresses the "guilt" component of the CAGE questionnaire.
The CAGE questionnaire consists of C (Cut down: Have you ever felt you should cut down on your drinking?), A
(Annoyed: Have people annoyed you by criticizing your drinking?), G (Guilty: Have you ever felt bad or guilty about your
drinking?), and E (Eye Opener: Have you ever had a drink first thing in the morning to steady your nerves or to get rid of
a hangover?). Questions regarding drinking at work, getting sick, and being unable to stop drinking do not fall within the
guidelines of the CAGE questionnaire.
Page 3 of 67
, Question 4
You are counseling a patient who has recently lost her child in a car accident. Which of these statements during the session
would best reflect the skill of immediacy?
1. "When you say you feel 'empty,' I need to know how that affects your life."
2. "I feel that your honesty about your emotional state indicates we're moving forward."
3. "If you're still grieving, why did you go to that party?"
4. "Mourning takes many forms. Here, you can grieve as you feel best; no one will judge."
Correct Answer
In counseling, immediacy is demonstrated by clearly and swiftly laying out the relationship between patient and
counselor; as such, a counselor stating that he or she feels the patient's honesty represents forward movement reflects
this skill. Concreteness is centered on having a patient express his or her feelings in clear and concrete terms, such as
explaining how feelings of "emptiness" manifest or affect everyday life. By letting the patient know that the counselor
understands his or her feelings and is not there to pass judgment, the counselor demonstrates empathy. Confrontation
requires the counselor to point out discrepancies between the patient's stated emotions, body language, and actions,
such as asking a grieving mother why she went to a party soon after her loss.
Page 4 of 67
2025/2026 Update | 100% Correct Latest
Question 1
Jeremy, a suicidal inpatient, is under close observation. He is able to be observed at all times by hospital staff during
waking hours and when he sleeps, and is checked on every 15-30 minutes. Which of these reasons would least indicate the
need for this level of supervision?
1. Jeremy has expressed suicidal thoughts.
2. Jeremy experiences withdrawal from alcohol and cocaine.
3. Jeremy is ambivalent about his intent to commit suicide.
4. Jeremy was unable to commit to a "No Harm" contract.
Correct Answer
Although ambivalence regarding suicidal intent should be taken into account when considering level of observation in a
patient, it indicates a moderate risk, not a severe risk. Close observation should be employed with patients who profess
suicidal thoughts, are unable to commit to a "No Harm" contract, or experience withdrawal.
Page 1 of 67
,Question 2
Adam, a 23-year-old male, is undergoing an STD test at your clinic. When you ask him why he is here, he says, "I'm here
because I've had this increased craving for sex. I've been picking up strangers in bars, not caring about using protection ... I
don't know what it is. For the last week, I've just felt really driven. Keep throwing myself into my work, don't feel much need
for sleep, feel like my thoughts are running a marathon in my head." The patient lives a "clean life," clarifying that he does
not abuse any substance, "not even coffee or cigarettes." He also does not have a history of mental disorders. Given the
most likely diagnosis, which of these medications would you least likely recommend for Adam?
Lorazepam
Haloperidol
Carbamazepine
Bupropion
Correct Answer
The patient's recent involvement in risky pleasurable activity (e.g., unprotected sex), increase in goal-driven activity at
work, decreased need for sleep, and subjective experience of racing thoughts all suggest a manic episode; as such,
bupropion, an antidepressant, would not be considered because the patient has not displayed the diagnostic criteria for
a major depressive episode. Pharmacologic options for the treatment of manic episodes include anticonvulsants
(carbamazepine), antipsychotics (haloperidol), and benzodiazepines (lorazepam).
Page 2 of 67
,Question 3
When completing the CAGE questionnaire with a suspected alcohol abuser, which of the following questions would you
most likely ask?
1. "Do you ever feel like you can't stop drinking after you start?"
2. "Do you drink at work?"
3. "Have you ever felt bad about your drinking?"
4. "Have you ever gotten sick from drinking?"
Correct Answer
Asking if a person has ever felt bad about his or her drinking addresses the "guilt" component of the CAGE questionnaire.
The CAGE questionnaire consists of C (Cut down: Have you ever felt you should cut down on your drinking?), A
(Annoyed: Have people annoyed you by criticizing your drinking?), G (Guilty: Have you ever felt bad or guilty about your
drinking?), and E (Eye Opener: Have you ever had a drink first thing in the morning to steady your nerves or to get rid of
a hangover?). Questions regarding drinking at work, getting sick, and being unable to stop drinking do not fall within the
guidelines of the CAGE questionnaire.
Page 3 of 67
, Question 4
You are counseling a patient who has recently lost her child in a car accident. Which of these statements during the session
would best reflect the skill of immediacy?
1. "When you say you feel 'empty,' I need to know how that affects your life."
2. "I feel that your honesty about your emotional state indicates we're moving forward."
3. "If you're still grieving, why did you go to that party?"
4. "Mourning takes many forms. Here, you can grieve as you feel best; no one will judge."
Correct Answer
In counseling, immediacy is demonstrated by clearly and swiftly laying out the relationship between patient and
counselor; as such, a counselor stating that he or she feels the patient's honesty represents forward movement reflects
this skill. Concreteness is centered on having a patient express his or her feelings in clear and concrete terms, such as
explaining how feelings of "emptiness" manifest or affect everyday life. By letting the patient know that the counselor
understands his or her feelings and is not there to pass judgment, the counselor demonstrates empathy. Confrontation
requires the counselor to point out discrepancies between the patient's stated emotions, body language, and actions,
such as asking a grieving mother why she went to a party soon after her loss.
Page 4 of 67
