BARKLEY DRT PMHNP PRACTICUM 1 370 ACTUAL
QUESTIONA AND CORRECT ANSWERS WITH RATIONALE
LATEST UPDATE ALREADY GRADED A+
This comprehensive 400-question exam bank thoroughly covers the
BARKLEY DRT PMHNP Practicum 1 exam, focusing on the foundational
knowledge required for psychiatric mental health nurse practitioner students.
It systematically tests clinical skills including psychiatric evaluations, Mental
Status Examinations (MSE), DSM-5 diagnostic criteria, differential diagnosis,
and psychopharmacology. Key topics include mood disorders (major
depression, bipolar disorder), anxiety disorders (GAD, panic disorder, OCD),
psychotic disorders (schizophrenia), personality disorders (borderline,
antisocial), and trauma-related disorders (PTSD). The questions address
substance use disorders, suicide risk assessment, crisis intervention,
medication side effects (EPS, metabolic syndrome, serotonin syndrome), and
ethical/legal principles. Additionally, the bank covers child/adolescent
psychiatry, geriatric considerations, therapeutic communication, and
evidence-based psychotherapies (CBT, CPT).
1) A patient describes a sudden urge to steal items she does not need, followed by a
release of tension and pleasure. She feels remorse afterward but cannot resist the
impulse. What is the most likely diagnosis?
A) Antisocial personality disorder
B) Kleptomania
C) Intermittent explosive disorder
D) Conduct disorder
Answer: B
Rationale: Kleptomania is characterized by recurrent failure to resist impulses to
steal objects that are not needed for personal use or monetary value. The act is
accompanied by a sense of tension before the theft and pleasure or relief during the
theft. The stealing is not committed to express anger or vengeance, and the stolen
items are typically not needed .
,2) A 16-year-old male is referred for truancy, defiance of authority, and multiple
physical fights. He has run away from home twice. Which diagnosis should be
prioritized?
A) Oppositional defiant disorder
B) Conduct disorder
C) Adjustment disorder
D) Bipolar disorder
Answer: B
Rationale: Conduct disorder involves a repetitive and persistent pattern of behavior
that violates the rights of others or major age-appropriate societal norms. Key
symptoms include aggression to people and animals, destruction of property,
deceitfulness or theft, and serious violations of rules (e.g., truancy, running away) .
3) Which of the following disorders is LEAST likely to be considered a differential
diagnosis for conduct disorder?
A) Oppositional defiant disorder
B) Bipolar disorder
C) Borderline personality disorder
D) Adjustment disorder
Answer: C
Rationale: While oppositional defiant disorder, bipolar disorder, depressive
disorders, ADHD, and adjustment disorders are considered in the differential
diagnosis of conduct disorder, borderline personality disorder is not typically a
primary differential for conduct disorder in adolescents .
4) A patient experiencing a manic episode presents with increased goal-directed
activity, decreased need for sleep, and rapid speech. Which medication would be
LEAST appropriate?
A) Lorazepam
B) Haloperidol
C) Carbamazepine
D) Bupropion
Answer: D
Rationale: Antidepressants such as bupropion can precipitate or worsen manic
episodes in patients with bipolar disorder. Mood stabilizers (carbamazepine),
antipsychotics (haloperidol), and benzodiazepines (lorazepam) are appropriate for
managing acute mania .
5) A patient with major depression is expected to have which of the following
laboratory findings?
,A) Increased somatostatin in cerebrospinal fluid
B) Increased nocturnal growth hormone secretion
C) Increased thyroid-stimulating hormone response to thyrotropin-releasing
hormone
D) Hypersecretion of cortisol
Answer: D
Rationale: Depressive symptoms are associated with hypersecretion of cortisol and
a decreased thyroid-stimulating hormone response. Somatostatin levels are
typically decreased, and nocturnal growth hormone secretion is reduced in
depression .
6) A suicidal inpatient is placed under close observation with checks every 15-30
minutes. Which of the following would LEAST indicate the need for this level of
observation?
A) Patient has expressed suicidal thoughts
B) Patient is experiencing alcohol withdrawal
C) Patient is ambivalent about suicide intent
D) Patient was unable to sign a "No Harm" contract
Answer: C
Rationale: Ambivalence about suicidal intent indicates a moderate risk, not
necessarily the need for close observation. Close observation is indicated for
patients with active suicidal ideation, inability to commit to a safety plan, or
experiencing withdrawal that may impair judgment .
7) A well-established businesswoman is arrested for stealing over $10,000 worth
of merchandise. She describes the act as impulsive and pleasurable, stating she
grew up poor and sees the theft as a way to "even the score." Which of the
following does NOT meet the criteria for kleptomania?
A) The stealing is described as impulsive
B) The stealing is described as pleasurable
C) The patient is well-off and can support her family's needs
D) The patient views her shoplifting as a righteous act
Answer: D
Rationale: In kleptomania, individuals fail to resist the impulse to steal items that
are not needed. The act is impulsive and pleasurable, and the stolen items are
typically not needed. Viewing the theft as a "righteous act" to express anger or
vengeance is not characteristic of kleptomania .
8) What is the primary purpose of the "full psychiatric evaluation" in PMHNP
Practicum I?
, A) To establish a therapeutic alliance
B) To identify medical and psychiatric comorbidities
C) To formulate a DSM-5 diagnosis and treatment plan
D) To assess for risk of harm to self or others
Answer: C
Rationale: The comprehensive psychiatric evaluation serves as the foundation for
identifying a patient's chief complaint, history of present illness, psychiatric
history, and medical history. It culminates in a DSM-5 differential diagnosis, a
prioritized problem list, and an evidence-based treatment plan .
9) Which clinical skill is a core competency for PMHNP students in Practicum I?
A) Prescribing psychotropic medications independently
B) Conducting individual psychotherapy
C) Performing a Mental Status Examination (MSE)
D) Supervising other mental health clinicians
Answer: C
Rationale: Core competencies for the first PMHNP practicum include recognizing
signs and symptoms of psychiatric illness, differentiating between
pathophysiological and psychopathological conditions, and performing and
interpreting a comprehensive psychiatric evaluation, which includes the Mental
Status Examination .
10) For the PMHNP Practicum I setting, which preceptor is NOT appropriate?
A) A board-certified Psychiatric Mental Health Nurse Practitioner (PMHNP)
B) A psychiatrist
C) A licensed clinical social worker (LCSW) conducting psychiatric assessments
D) A Family Nurse Practitioner (FNP)
Answer: D
Rationale: While PMHNPs, psychiatrists, LCSWs, and licensed mental health
counselors are appropriate preceptors for psychiatric assessment, an FNP (Family
Nurse Practitioner) is not board-certified in psychiatry and is not an appropriate
preceptor for this role .
11) A patient presents with symptoms that meet the criteria for a manic episode.
What is the initial step in developing a treatment plan?
A) Start a selective serotonin reuptake inhibitor (SSRI)
B) Assess for safety and need for hospitalization
C) Prescribe a long-acting benzodiazepine
D) Order a complete blood count (CBC)
Answer: B
QUESTIONA AND CORRECT ANSWERS WITH RATIONALE
LATEST UPDATE ALREADY GRADED A+
This comprehensive 400-question exam bank thoroughly covers the
BARKLEY DRT PMHNP Practicum 1 exam, focusing on the foundational
knowledge required for psychiatric mental health nurse practitioner students.
It systematically tests clinical skills including psychiatric evaluations, Mental
Status Examinations (MSE), DSM-5 diagnostic criteria, differential diagnosis,
and psychopharmacology. Key topics include mood disorders (major
depression, bipolar disorder), anxiety disorders (GAD, panic disorder, OCD),
psychotic disorders (schizophrenia), personality disorders (borderline,
antisocial), and trauma-related disorders (PTSD). The questions address
substance use disorders, suicide risk assessment, crisis intervention,
medication side effects (EPS, metabolic syndrome, serotonin syndrome), and
ethical/legal principles. Additionally, the bank covers child/adolescent
psychiatry, geriatric considerations, therapeutic communication, and
evidence-based psychotherapies (CBT, CPT).
1) A patient describes a sudden urge to steal items she does not need, followed by a
release of tension and pleasure. She feels remorse afterward but cannot resist the
impulse. What is the most likely diagnosis?
A) Antisocial personality disorder
B) Kleptomania
C) Intermittent explosive disorder
D) Conduct disorder
Answer: B
Rationale: Kleptomania is characterized by recurrent failure to resist impulses to
steal objects that are not needed for personal use or monetary value. The act is
accompanied by a sense of tension before the theft and pleasure or relief during the
theft. The stealing is not committed to express anger or vengeance, and the stolen
items are typically not needed .
,2) A 16-year-old male is referred for truancy, defiance of authority, and multiple
physical fights. He has run away from home twice. Which diagnosis should be
prioritized?
A) Oppositional defiant disorder
B) Conduct disorder
C) Adjustment disorder
D) Bipolar disorder
Answer: B
Rationale: Conduct disorder involves a repetitive and persistent pattern of behavior
that violates the rights of others or major age-appropriate societal norms. Key
symptoms include aggression to people and animals, destruction of property,
deceitfulness or theft, and serious violations of rules (e.g., truancy, running away) .
3) Which of the following disorders is LEAST likely to be considered a differential
diagnosis for conduct disorder?
A) Oppositional defiant disorder
B) Bipolar disorder
C) Borderline personality disorder
D) Adjustment disorder
Answer: C
Rationale: While oppositional defiant disorder, bipolar disorder, depressive
disorders, ADHD, and adjustment disorders are considered in the differential
diagnosis of conduct disorder, borderline personality disorder is not typically a
primary differential for conduct disorder in adolescents .
4) A patient experiencing a manic episode presents with increased goal-directed
activity, decreased need for sleep, and rapid speech. Which medication would be
LEAST appropriate?
A) Lorazepam
B) Haloperidol
C) Carbamazepine
D) Bupropion
Answer: D
Rationale: Antidepressants such as bupropion can precipitate or worsen manic
episodes in patients with bipolar disorder. Mood stabilizers (carbamazepine),
antipsychotics (haloperidol), and benzodiazepines (lorazepam) are appropriate for
managing acute mania .
5) A patient with major depression is expected to have which of the following
laboratory findings?
,A) Increased somatostatin in cerebrospinal fluid
B) Increased nocturnal growth hormone secretion
C) Increased thyroid-stimulating hormone response to thyrotropin-releasing
hormone
D) Hypersecretion of cortisol
Answer: D
Rationale: Depressive symptoms are associated with hypersecretion of cortisol and
a decreased thyroid-stimulating hormone response. Somatostatin levels are
typically decreased, and nocturnal growth hormone secretion is reduced in
depression .
6) A suicidal inpatient is placed under close observation with checks every 15-30
minutes. Which of the following would LEAST indicate the need for this level of
observation?
A) Patient has expressed suicidal thoughts
B) Patient is experiencing alcohol withdrawal
C) Patient is ambivalent about suicide intent
D) Patient was unable to sign a "No Harm" contract
Answer: C
Rationale: Ambivalence about suicidal intent indicates a moderate risk, not
necessarily the need for close observation. Close observation is indicated for
patients with active suicidal ideation, inability to commit to a safety plan, or
experiencing withdrawal that may impair judgment .
7) A well-established businesswoman is arrested for stealing over $10,000 worth
of merchandise. She describes the act as impulsive and pleasurable, stating she
grew up poor and sees the theft as a way to "even the score." Which of the
following does NOT meet the criteria for kleptomania?
A) The stealing is described as impulsive
B) The stealing is described as pleasurable
C) The patient is well-off and can support her family's needs
D) The patient views her shoplifting as a righteous act
Answer: D
Rationale: In kleptomania, individuals fail to resist the impulse to steal items that
are not needed. The act is impulsive and pleasurable, and the stolen items are
typically not needed. Viewing the theft as a "righteous act" to express anger or
vengeance is not characteristic of kleptomania .
8) What is the primary purpose of the "full psychiatric evaluation" in PMHNP
Practicum I?
, A) To establish a therapeutic alliance
B) To identify medical and psychiatric comorbidities
C) To formulate a DSM-5 diagnosis and treatment plan
D) To assess for risk of harm to self or others
Answer: C
Rationale: The comprehensive psychiatric evaluation serves as the foundation for
identifying a patient's chief complaint, history of present illness, psychiatric
history, and medical history. It culminates in a DSM-5 differential diagnosis, a
prioritized problem list, and an evidence-based treatment plan .
9) Which clinical skill is a core competency for PMHNP students in Practicum I?
A) Prescribing psychotropic medications independently
B) Conducting individual psychotherapy
C) Performing a Mental Status Examination (MSE)
D) Supervising other mental health clinicians
Answer: C
Rationale: Core competencies for the first PMHNP practicum include recognizing
signs and symptoms of psychiatric illness, differentiating between
pathophysiological and psychopathological conditions, and performing and
interpreting a comprehensive psychiatric evaluation, which includes the Mental
Status Examination .
10) For the PMHNP Practicum I setting, which preceptor is NOT appropriate?
A) A board-certified Psychiatric Mental Health Nurse Practitioner (PMHNP)
B) A psychiatrist
C) A licensed clinical social worker (LCSW) conducting psychiatric assessments
D) A Family Nurse Practitioner (FNP)
Answer: D
Rationale: While PMHNPs, psychiatrists, LCSWs, and licensed mental health
counselors are appropriate preceptors for psychiatric assessment, an FNP (Family
Nurse Practitioner) is not board-certified in psychiatry and is not an appropriate
preceptor for this role .
11) A patient presents with symptoms that meet the criteria for a manic episode.
What is the initial step in developing a treatment plan?
A) Start a selective serotonin reuptake inhibitor (SSRI)
B) Assess for safety and need for hospitalization
C) Prescribe a long-acting benzodiazepine
D) Order a complete blood count (CBC)
Answer: B
