Barkley PMHNP CHaPter Quiz 17:
FeediNg aNd eatiNg disorders –
advaNCed PraCtiCe exaMiNatioN
(voluMe 2) a well detailed oNe
writteN aNd graded
a+ uPgraded
Target Audience: Psychiatric-Mental Health Nurse Practitioner (PMHNP) candidates and
professionals preparing for certification examinations
Difficulty Level: Advanced/Hard
Total Questions: 150 multiple-choice questions
Instructions: Select the single best answer for each question. Each question includes the correct
answer and a detailed rationale.
Section 1: Diagnostic Criteria and Core Features (Questions 1–20)
1. A 16-year-old female presents with a BMI of 16.8 kg/m², intense fear of gaining weight, and
amenorrhea for 6 months. She restricts her caloric intake to approximately 600 calories daily
and exercises excessively. Which DSM-5 specifier best applies to this presentation?
• A) Anorexia nervosa, restricting type, moderate severity
• B) Anorexia nervosa, binge-eating/purging type, moderate severity
• C) Anorexia nervosa, restricting type, severe severity
, • D) Anorexia nervosa, binge-eating/purging type, severe severity
Correct Answer: A
Rationale: This patient meets criteria for anorexia nervosa restricting type with moderate
severity (BMI 16–16.99 kg/m²). The restricting type is characterized by the absence of recurrent
binge-eating or purging behaviors over the preceding 3 months. Severity is based on BMI:
moderate (16–16.99 kg/m²), severe (15–15.99 kg/m²), and extreme (<15 kg/m²).
2. A 22-year-old female reports recurrent episodes of eating large amounts of food within 2
hours, accompanied by a sense of loss of control. She engages in self-induced vomiting 2–3
times weekly for the past 4 months. Her BMI is 24.5 kg/m². Which diagnosis best fits this
clinical picture?
• A) Binge-eating disorder
• B) Bulimia nervosa
• C) Anorexia nervosa binge-eating/purging type
• D) Other specified feeding or eating disorder
Correct Answer: B
Rationale: This patient meets DSM-5 criteria for bulimia nervosa: recurrent binge eating (at
least once weekly for 3 months), recurrent inappropriate compensatory behaviors (self-induced
vomiting), and self-evaluation unduly influenced by weight and shape. The normal BMI excludes
anorexia nervosa binge-eating/purging type.
3. Which of the following is the minimum duration requirement for binge-eating episodes in
bulimia nervosa according to DSM-5?
• A) 2 months
• B) 3 months
• C) 6 months
• D) 12 months
Correct Answer: B
Rationale: DSM-5 requires binge-eating episodes to occur at least once weekly for a minimum
of 3 months for the diagnosis of bulimia nervosa. This represents a change from DSM-IV, which
required twice weekly for 3 months.
,4. A 34-year-old male presents with recurrent episodes of binge eating without compensatory
behaviors, occurring 2–3 times weekly for the past 6 months. He reports marked distress
about these episodes. His BMI is 32.5 kg/m². Which diagnosis is most appropriate?
• A) Bulimia nervosa
• B) Binge-eating disorder
• C) Other specified feeding or eating disorder
• D) Obesity
Correct Answer: B
Rationale: This patient meets criteria for binge-eating disorder: recurrent binge eating (at least
once weekly for 3 months), marked distress regarding binge eating, and absence of
compensatory behaviors. The elevated BMI is consistent with the obesity commonly seen in this
disorder.
5. A 7-year-old male presents with persistent eating of paint chips for the past 2 months. His
parents report this behavior is developmentally inappropriate and not culturally supported.
Which diagnosis is most appropriate?
• A) Pica
• B) Avoidant/restrictive food intake disorder
• C) Rumination disorder
• D) Other specified feeding or eating disorder
Correct Answer: A
Rationale: Pica is diagnosed when there is persistent eating of nonnutritive, nonfood
substances for at least 1 month, the behavior is developmentally inappropriate, and it is not
part of a culturally supported practice. The duration requirement of 1 month is met.
6. A 4-year-old female has a history of repeatedly regurgitating food after meals over the past
2 months. She rechews and reswallows the regurgitated food. She has no gastrointestinal
symptoms and her weight is at the 25th percentile. Which diagnosis best fits this
presentation?
• A) Gastroesophageal reflux disease
• B) Rumination disorder
• C) Pica
, • D) Avoidant/restrictive food intake disorder
Correct Answer: B
Rationale: Rumination disorder is characterized by repeated regurgitation of food over a period
of at least 1 month. The regurgitated food may be rechewed, reswallowed, or spit out. The
absence of gastrointestinal symptoms distinguishes this from GERD.
7. Which of the following distinguishes ARFID from anorexia nervosa?
• A) Presence of significant weight loss
• B) Absence of body image disturbance
• C) Fear of choking or vomiting
• D) Both B and C
Correct Answer: D
Rationale: ARFID is distinguished from anorexia nervosa by the absence of body image
disturbance, fear of weight gain, and overvaluation of weight and shape. Fear of choking or
vomiting may be present in ARFID but is not a feature of anorexia nervosa.
8. A 15-year-old female with a BMI of 16.5 kg/m² reports significant weight loss over the past
4 months. She denies fear of weight gain or body image disturbance. She has limited food
intake due to sensory sensitivities. Which diagnosis is most appropriate?
• A) Anorexia nervosa, restricting type
• B) Avoidant/restrictive food intake disorder
• C) Other specified feeding or eating disorder
• D) Unspecified feeding or eating disorder
Correct Answer: B
Rationale: This patient meets criteria for ARFID: significant weight loss, restriction of food
intake, no body image disturbance or fear of weight gain, and the restriction is related to
sensory sensitivities. The absence of body image disturbance is the key feature distinguishing
ARFID from anorexia nervosa.
9. According to DSM-5, which of the following is NOT required for the diagnosis of anorexia
nervosa?
• A) Significantly low body weight
• B) Intense fear of gaining weight
FeediNg aNd eatiNg disorders –
advaNCed PraCtiCe exaMiNatioN
(voluMe 2) a well detailed oNe
writteN aNd graded
a+ uPgraded
Target Audience: Psychiatric-Mental Health Nurse Practitioner (PMHNP) candidates and
professionals preparing for certification examinations
Difficulty Level: Advanced/Hard
Total Questions: 150 multiple-choice questions
Instructions: Select the single best answer for each question. Each question includes the correct
answer and a detailed rationale.
Section 1: Diagnostic Criteria and Core Features (Questions 1–20)
1. A 16-year-old female presents with a BMI of 16.8 kg/m², intense fear of gaining weight, and
amenorrhea for 6 months. She restricts her caloric intake to approximately 600 calories daily
and exercises excessively. Which DSM-5 specifier best applies to this presentation?
• A) Anorexia nervosa, restricting type, moderate severity
• B) Anorexia nervosa, binge-eating/purging type, moderate severity
• C) Anorexia nervosa, restricting type, severe severity
, • D) Anorexia nervosa, binge-eating/purging type, severe severity
Correct Answer: A
Rationale: This patient meets criteria for anorexia nervosa restricting type with moderate
severity (BMI 16–16.99 kg/m²). The restricting type is characterized by the absence of recurrent
binge-eating or purging behaviors over the preceding 3 months. Severity is based on BMI:
moderate (16–16.99 kg/m²), severe (15–15.99 kg/m²), and extreme (<15 kg/m²).
2. A 22-year-old female reports recurrent episodes of eating large amounts of food within 2
hours, accompanied by a sense of loss of control. She engages in self-induced vomiting 2–3
times weekly for the past 4 months. Her BMI is 24.5 kg/m². Which diagnosis best fits this
clinical picture?
• A) Binge-eating disorder
• B) Bulimia nervosa
• C) Anorexia nervosa binge-eating/purging type
• D) Other specified feeding or eating disorder
Correct Answer: B
Rationale: This patient meets DSM-5 criteria for bulimia nervosa: recurrent binge eating (at
least once weekly for 3 months), recurrent inappropriate compensatory behaviors (self-induced
vomiting), and self-evaluation unduly influenced by weight and shape. The normal BMI excludes
anorexia nervosa binge-eating/purging type.
3. Which of the following is the minimum duration requirement for binge-eating episodes in
bulimia nervosa according to DSM-5?
• A) 2 months
• B) 3 months
• C) 6 months
• D) 12 months
Correct Answer: B
Rationale: DSM-5 requires binge-eating episodes to occur at least once weekly for a minimum
of 3 months for the diagnosis of bulimia nervosa. This represents a change from DSM-IV, which
required twice weekly for 3 months.
,4. A 34-year-old male presents with recurrent episodes of binge eating without compensatory
behaviors, occurring 2–3 times weekly for the past 6 months. He reports marked distress
about these episodes. His BMI is 32.5 kg/m². Which diagnosis is most appropriate?
• A) Bulimia nervosa
• B) Binge-eating disorder
• C) Other specified feeding or eating disorder
• D) Obesity
Correct Answer: B
Rationale: This patient meets criteria for binge-eating disorder: recurrent binge eating (at least
once weekly for 3 months), marked distress regarding binge eating, and absence of
compensatory behaviors. The elevated BMI is consistent with the obesity commonly seen in this
disorder.
5. A 7-year-old male presents with persistent eating of paint chips for the past 2 months. His
parents report this behavior is developmentally inappropriate and not culturally supported.
Which diagnosis is most appropriate?
• A) Pica
• B) Avoidant/restrictive food intake disorder
• C) Rumination disorder
• D) Other specified feeding or eating disorder
Correct Answer: A
Rationale: Pica is diagnosed when there is persistent eating of nonnutritive, nonfood
substances for at least 1 month, the behavior is developmentally inappropriate, and it is not
part of a culturally supported practice. The duration requirement of 1 month is met.
6. A 4-year-old female has a history of repeatedly regurgitating food after meals over the past
2 months. She rechews and reswallows the regurgitated food. She has no gastrointestinal
symptoms and her weight is at the 25th percentile. Which diagnosis best fits this
presentation?
• A) Gastroesophageal reflux disease
• B) Rumination disorder
• C) Pica
, • D) Avoidant/restrictive food intake disorder
Correct Answer: B
Rationale: Rumination disorder is characterized by repeated regurgitation of food over a period
of at least 1 month. The regurgitated food may be rechewed, reswallowed, or spit out. The
absence of gastrointestinal symptoms distinguishes this from GERD.
7. Which of the following distinguishes ARFID from anorexia nervosa?
• A) Presence of significant weight loss
• B) Absence of body image disturbance
• C) Fear of choking or vomiting
• D) Both B and C
Correct Answer: D
Rationale: ARFID is distinguished from anorexia nervosa by the absence of body image
disturbance, fear of weight gain, and overvaluation of weight and shape. Fear of choking or
vomiting may be present in ARFID but is not a feature of anorexia nervosa.
8. A 15-year-old female with a BMI of 16.5 kg/m² reports significant weight loss over the past
4 months. She denies fear of weight gain or body image disturbance. She has limited food
intake due to sensory sensitivities. Which diagnosis is most appropriate?
• A) Anorexia nervosa, restricting type
• B) Avoidant/restrictive food intake disorder
• C) Other specified feeding or eating disorder
• D) Unspecified feeding or eating disorder
Correct Answer: B
Rationale: This patient meets criteria for ARFID: significant weight loss, restriction of food
intake, no body image disturbance or fear of weight gain, and the restriction is related to
sensory sensitivities. The absence of body image disturbance is the key feature distinguishing
ARFID from anorexia nervosa.
9. According to DSM-5, which of the following is NOT required for the diagnosis of anorexia
nervosa?
• A) Significantly low body weight
• B) Intense fear of gaining weight
