BARKLEY PMHNP Pract... ONE
EXAMINATION QUESTIONS WITH CORRECT
VERIFIED AND WELL ANALYZED
ANSWERS GRADED A+(2025-2026 Latest
Update)!!!
Although the patient may be rationalizing her behavior as a righteous
act, patients with kleptomania do not commit theft to express anger or
vengeance. Kleptomania is characterized as failing to resist the
impulse to steal, and the stolen objects are typically not needed. The
act of stealing, which usually is performed alone, gives the person
gratification.
Harriet is a well-established business woman who provides for her
family. She was recently arrested for stealing over $10,000 worth of
merchandise from the mall. When Harriet is asked to describe her
behavior, she says: "It just comes on me quickly, and when it's done,
I feel really good." She also describes how she grew up poor and sees
the theft as a way to "even the score" against those with "empty
wealth." Which of the following does not meet the diagnostic criteria
for kleptomania?
Harriet views her shoplifting as a righteous act.
Harriet's stealing is described as pleasurable.
Harriet is well-off and can support her family's needs.
Harriet's stealing is described as impulsive.
Borderline personality disorder is not considered a differential
diagnosis for conduct disorder, as indicated by the patient's truancy,
defiance of authority figures, fights with family members, poor
academic performance, sexual promiscuity, running away from home,
and "tough guy" demeanor. Oppositional defiant disorder, bipolar
disorders, and adjustment disorders are all considered potential
,differential diagnoses for conduct disorder, as are depressive
disorders, attention-deficit/hyperactivity disorder, and intermittent
explosive disorder.
Tony, a 16-year-old male, has been sent to your clinic for counseling.
He has a long record of skipping school, talking back to his teachers,
and getting poor grades. His parents say he has often gotten in fights
with them, has frequently been caught sneaking girls into his room,
and has run away from home on two occasions. During the session,
you notice Tony acts tough and aloof, not deigning to speak much. If
you suspect conduct disorder, which of the following conditions
would you be least likely to include in your differential diagnosis?
1. Borderline personality disorder
2. Oppositional defiant disorder
3. Adjustment disorder with disturbance of conduct
4. Bipolar disorder
Depressive symptoms are associated with decreased, not increased,
levels of somatostatin in cerebrospinal fluid. Patients with depression
may exhibit a decreased thyroid-stimulating hormone response to
thyrotropin-releasing hormone, as well as hypersecretion of cortisol.
Depressive symptoms are also associated with irregularities in
growth hormone release, such as reduced nocturnal secretion and
diurnal hypersecretion.
Which of these lab findings would be least expected in a patient with
depression?
1. Decreased nocturnal growth hormone secretion
2. Decreased thyroid-stimulating hormone response
3. Increased somatostatin in cerebrospinal fluid
4. Increased secretion of cortisol
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.
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.
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).
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
Lorazepam would not be the first choice to treat delirium in a
dehydrated patient because benzodiazepines may cause respiratory
depression, especially in debilitated patients. Antipsychotics such as
haloperidol, quetiapine, and risperidone are considered the mainstay
in managing agitation in delirium patients; haloperidol is considered
the standard of care, but newer agents such as quetiapine and
risperidone may be preferred due to reduced chance of side effects.
You have determined that a patient's delirium stems from
dehydration. As you begin treatment, you realize the patient will
, require pharmacologic management for his agitation. Which of these
agents would be least appropriate in this situation?
Risperidone
Haloperidol
Quetiapine
Lorazepam
Most inpatients who develop a suicide plan and follow it have agreed
to a "No Harm" contract. The most common method of suicide among
inpatients is hanging, not self-inflicted wounds. When "unsolvable"
problems at work, school, or home motivate the ideation, inpatients
are most likely to attempt suicide either within the first 5 days at the
hospital or shortly after discharge, not after a month. The rate of
suicide among bipolar patients is relatively low, about 10%-15%, and
risk would be higher in patients with schizophrenia or an untreated
anxiety disorder.
Which of the following is true about suicide among inpatients?
Most patients who develop a suicide plan and follow it have agreed to
a "No Harm" contract.
Self-inflicted wounds are the most common means of suicide.
Inpatients with bipolar disorder are most likely to commit suicide.
Patients who attempt suicide due to "unsolvable" problems usually
do so after a month in care.
Auditory hallucinations, loss of memory, and lack of personal hygiene
are all markers of the acute phase of schizophrenia. Other signs and
symptoms of this stage include illogical thinking, inappropriate social
behavior, catatonic excitement, and poor concentration. The
premorbid phase is indicated by depression, sleep disturbance, and
bedwetting. The prodromal phase is characterized by suspiciousness,
inappropriate expression of feeling, and feelings of unreality. Lastly,
the stable phase is symptomatically similar to the prodromal phase.
Cam, a 23-year-old female, is brought to the hospital by her boyfriend.
He states that she has been hearing voices, cannot remember
anything, and refuses to take a shower or change her clothes. He
adds, "She used to be a very clean person and had a really good
memory." Which phase of schizophrenia is Cam most likely
experiencing?
Premorbid phase
Prodromal phase
EXAMINATION QUESTIONS WITH CORRECT
VERIFIED AND WELL ANALYZED
ANSWERS GRADED A+(2025-2026 Latest
Update)!!!
Although the patient may be rationalizing her behavior as a righteous
act, patients with kleptomania do not commit theft to express anger or
vengeance. Kleptomania is characterized as failing to resist the
impulse to steal, and the stolen objects are typically not needed. The
act of stealing, which usually is performed alone, gives the person
gratification.
Harriet is a well-established business woman who provides for her
family. She was recently arrested for stealing over $10,000 worth of
merchandise from the mall. When Harriet is asked to describe her
behavior, she says: "It just comes on me quickly, and when it's done,
I feel really good." She also describes how she grew up poor and sees
the theft as a way to "even the score" against those with "empty
wealth." Which of the following does not meet the diagnostic criteria
for kleptomania?
Harriet views her shoplifting as a righteous act.
Harriet's stealing is described as pleasurable.
Harriet is well-off and can support her family's needs.
Harriet's stealing is described as impulsive.
Borderline personality disorder is not considered a differential
diagnosis for conduct disorder, as indicated by the patient's truancy,
defiance of authority figures, fights with family members, poor
academic performance, sexual promiscuity, running away from home,
and "tough guy" demeanor. Oppositional defiant disorder, bipolar
disorders, and adjustment disorders are all considered potential
,differential diagnoses for conduct disorder, as are depressive
disorders, attention-deficit/hyperactivity disorder, and intermittent
explosive disorder.
Tony, a 16-year-old male, has been sent to your clinic for counseling.
He has a long record of skipping school, talking back to his teachers,
and getting poor grades. His parents say he has often gotten in fights
with them, has frequently been caught sneaking girls into his room,
and has run away from home on two occasions. During the session,
you notice Tony acts tough and aloof, not deigning to speak much. If
you suspect conduct disorder, which of the following conditions
would you be least likely to include in your differential diagnosis?
1. Borderline personality disorder
2. Oppositional defiant disorder
3. Adjustment disorder with disturbance of conduct
4. Bipolar disorder
Depressive symptoms are associated with decreased, not increased,
levels of somatostatin in cerebrospinal fluid. Patients with depression
may exhibit a decreased thyroid-stimulating hormone response to
thyrotropin-releasing hormone, as well as hypersecretion of cortisol.
Depressive symptoms are also associated with irregularities in
growth hormone release, such as reduced nocturnal secretion and
diurnal hypersecretion.
Which of these lab findings would be least expected in a patient with
depression?
1. Decreased nocturnal growth hormone secretion
2. Decreased thyroid-stimulating hormone response
3. Increased somatostatin in cerebrospinal fluid
4. Increased secretion of cortisol
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.
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.
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).
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
Lorazepam would not be the first choice to treat delirium in a
dehydrated patient because benzodiazepines may cause respiratory
depression, especially in debilitated patients. Antipsychotics such as
haloperidol, quetiapine, and risperidone are considered the mainstay
in managing agitation in delirium patients; haloperidol is considered
the standard of care, but newer agents such as quetiapine and
risperidone may be preferred due to reduced chance of side effects.
You have determined that a patient's delirium stems from
dehydration. As you begin treatment, you realize the patient will
, require pharmacologic management for his agitation. Which of these
agents would be least appropriate in this situation?
Risperidone
Haloperidol
Quetiapine
Lorazepam
Most inpatients who develop a suicide plan and follow it have agreed
to a "No Harm" contract. The most common method of suicide among
inpatients is hanging, not self-inflicted wounds. When "unsolvable"
problems at work, school, or home motivate the ideation, inpatients
are most likely to attempt suicide either within the first 5 days at the
hospital or shortly after discharge, not after a month. The rate of
suicide among bipolar patients is relatively low, about 10%-15%, and
risk would be higher in patients with schizophrenia or an untreated
anxiety disorder.
Which of the following is true about suicide among inpatients?
Most patients who develop a suicide plan and follow it have agreed to
a "No Harm" contract.
Self-inflicted wounds are the most common means of suicide.
Inpatients with bipolar disorder are most likely to commit suicide.
Patients who attempt suicide due to "unsolvable" problems usually
do so after a month in care.
Auditory hallucinations, loss of memory, and lack of personal hygiene
are all markers of the acute phase of schizophrenia. Other signs and
symptoms of this stage include illogical thinking, inappropriate social
behavior, catatonic excitement, and poor concentration. The
premorbid phase is indicated by depression, sleep disturbance, and
bedwetting. The prodromal phase is characterized by suspiciousness,
inappropriate expression of feeling, and feelings of unreality. Lastly,
the stable phase is symptomatically similar to the prodromal phase.
Cam, a 23-year-old female, is brought to the hospital by her boyfriend.
He states that she has been hearing voices, cannot remember
anything, and refuses to take a shower or change her clothes. He
adds, "She used to be a very clean person and had a really good
memory." Which phase of schizophrenia is Cam most likely
experiencing?
Premorbid phase
Prodromal phase
