Barkley Psychiatric Disorders Practice ACTUAL
EXAM ALL QUESTIONS AND ANSWERS ALREADY
GRADED A+. 100% VERIFIED SOLUTIONS |
UPDATED PER LATEST GUIDELINES | GRADED A+
Questions 1–25: Mood Disorders
1. A patient has depressed mood, anhedonia, fatigue, insomnia, poor concentration, and
feelings of worthlessness for 3 weeks. Which diagnosis is most likely?
A. Generalized anxiety disorder
B. Major depressive disorder
C. Bipolar I disorder
D. Adjustment disorder
Answer: B. Major depressive disorder
Rationale: Major depressive disorder requires at least 2 weeks of persistent depressed mood or
anhedonia plus associated symptoms causing clinically significant impairment.
2. Which symptom is most specific to major depressive disorder?
A. Anhedonia
B. Fatigue
C. Insomnia
D. Poor concentration
Answer: A. Anhedonia
Rationale: Anhedonia—loss of interest or pleasure—is a core depressive symptom and is
particularly important when assessing for major depressive episodes.
3. A patient with depression reports, "My family would be better off without me." What
should the PMHNP do first?
,A. Schedule follow-up in 1 month
B. Assess suicide risk directly
C. Reassure the patient
D. Change the antidepressant immediately
Answer: B. Assess suicide risk directly
Rationale: Feelings of worthlessness and perceived burdensomeness can indicate suicide risk.
Direct assessment should include suicidal thoughts, intent, plan, means, previous attempts, and
protective factors.
4. Which finding indicates the greatest immediate suicide risk?
A. Passive thoughts of death without intent
B. History of depression
C. Specific suicide plan with access to lethal means
D. Family history of depression
Answer: C. Specific suicide plan with access to lethal means
Rationale: A specific plan, intent, and access to lethal means substantially increase acute suicide
risk.
5. A patient has recurrent depression accompanied by periods of elevated mood, decreased
need for sleep, grandiosity, and risky behavior lasting 8 days. What diagnosis is most likely?
A. Bipolar I disorder
B. Bipolar II disorder
C. Persistent depressive disorder
D. Cyclothymic disorder
Answer: A. Bipolar I disorder
Rationale: Bipolar I requires at least one manic episode. The episode may occur with or without
a history of major depression.
6. Which feature distinguishes mania from hypomania?
A. Irritability
B. Increased energy
,C. Marked functional impairment or hospitalization
D. Decreased need for sleep
Answer: C. Marked functional impairment or hospitalization
Rationale: Mania is more severe than hypomania and causes marked impairment, requires
hospitalization, or may include psychotic features.
7. A patient has elevated mood, increased energy, decreased need for sleep, and increased
productivity for 5 days without marked impairment. Which condition should be considered?
A. Hypomanic episode
B. Manic episode
C. Schizophrenia
D. Delirium
Answer: A. Hypomanic episode
Rationale: Hypomania involves a distinct period of elevated, expansive, or irritable mood and
increased activity lasting at least 4 consecutive days without the marked impairment
characteristic of mania.
8. Which symptom is particularly suggestive of mania?
A. Increased goal-directed activity
B. Fatigue
C. Psychomotor slowing
D. Hypersomnia
Answer: A. Increased goal-directed activity
Rationale: Mania commonly includes increased energy, decreased need for sleep, pressured
speech, racing thoughts, grandiosity, distractibility, and increased goal-directed or risky activity.
9. A patient with bipolar disorder develops pressured speech, grandiosity, and impulsive
spending. Which medication class is commonly used for acute mania?
A. Mood stabilizers
B. Stimulants
, C. Cholinesterase inhibitors
D. Benzodiazepines alone
Answer: A. Mood stabilizers
Rationale: Mood stabilizers such as lithium and certain anticonvulsants are important
treatments for bipolar disorder. Antipsychotics are also frequently used in acute mania.
10. Which medication requires monitoring of serum levels and renal and thyroid function?
A. Lithium
B. Sertraline
C. Fluoxetine
D. Buspirone
Answer: A. Lithium
Rationale: Lithium has a narrow therapeutic index and requires monitoring of serum
concentration, kidney function, thyroid function, electrolytes, and clinical status.
11. Which symptom may indicate lithium toxicity?
A. Severe coarse tremor and ataxia
B. Mild thirst only
C. Increased appetite only
D. Nasal congestion
Answer: A. Severe coarse tremor and ataxia
Rationale: Toxicity can cause worsening tremor, gastrointestinal symptoms, confusion, ataxia,
dysarthria, and potentially seizures or severe neurologic impairment.
12. Which factor can increase lithium levels?
A. Dehydration
B. Increased fluid intake
C. Increased dietary sodium
D. Consistent hydration
Answer: A. Dehydration
EXAM ALL QUESTIONS AND ANSWERS ALREADY
GRADED A+. 100% VERIFIED SOLUTIONS |
UPDATED PER LATEST GUIDELINES | GRADED A+
Questions 1–25: Mood Disorders
1. A patient has depressed mood, anhedonia, fatigue, insomnia, poor concentration, and
feelings of worthlessness for 3 weeks. Which diagnosis is most likely?
A. Generalized anxiety disorder
B. Major depressive disorder
C. Bipolar I disorder
D. Adjustment disorder
Answer: B. Major depressive disorder
Rationale: Major depressive disorder requires at least 2 weeks of persistent depressed mood or
anhedonia plus associated symptoms causing clinically significant impairment.
2. Which symptom is most specific to major depressive disorder?
A. Anhedonia
B. Fatigue
C. Insomnia
D. Poor concentration
Answer: A. Anhedonia
Rationale: Anhedonia—loss of interest or pleasure—is a core depressive symptom and is
particularly important when assessing for major depressive episodes.
3. A patient with depression reports, "My family would be better off without me." What
should the PMHNP do first?
,A. Schedule follow-up in 1 month
B. Assess suicide risk directly
C. Reassure the patient
D. Change the antidepressant immediately
Answer: B. Assess suicide risk directly
Rationale: Feelings of worthlessness and perceived burdensomeness can indicate suicide risk.
Direct assessment should include suicidal thoughts, intent, plan, means, previous attempts, and
protective factors.
4. Which finding indicates the greatest immediate suicide risk?
A. Passive thoughts of death without intent
B. History of depression
C. Specific suicide plan with access to lethal means
D. Family history of depression
Answer: C. Specific suicide plan with access to lethal means
Rationale: A specific plan, intent, and access to lethal means substantially increase acute suicide
risk.
5. A patient has recurrent depression accompanied by periods of elevated mood, decreased
need for sleep, grandiosity, and risky behavior lasting 8 days. What diagnosis is most likely?
A. Bipolar I disorder
B. Bipolar II disorder
C. Persistent depressive disorder
D. Cyclothymic disorder
Answer: A. Bipolar I disorder
Rationale: Bipolar I requires at least one manic episode. The episode may occur with or without
a history of major depression.
6. Which feature distinguishes mania from hypomania?
A. Irritability
B. Increased energy
,C. Marked functional impairment or hospitalization
D. Decreased need for sleep
Answer: C. Marked functional impairment or hospitalization
Rationale: Mania is more severe than hypomania and causes marked impairment, requires
hospitalization, or may include psychotic features.
7. A patient has elevated mood, increased energy, decreased need for sleep, and increased
productivity for 5 days without marked impairment. Which condition should be considered?
A. Hypomanic episode
B. Manic episode
C. Schizophrenia
D. Delirium
Answer: A. Hypomanic episode
Rationale: Hypomania involves a distinct period of elevated, expansive, or irritable mood and
increased activity lasting at least 4 consecutive days without the marked impairment
characteristic of mania.
8. Which symptom is particularly suggestive of mania?
A. Increased goal-directed activity
B. Fatigue
C. Psychomotor slowing
D. Hypersomnia
Answer: A. Increased goal-directed activity
Rationale: Mania commonly includes increased energy, decreased need for sleep, pressured
speech, racing thoughts, grandiosity, distractibility, and increased goal-directed or risky activity.
9. A patient with bipolar disorder develops pressured speech, grandiosity, and impulsive
spending. Which medication class is commonly used for acute mania?
A. Mood stabilizers
B. Stimulants
, C. Cholinesterase inhibitors
D. Benzodiazepines alone
Answer: A. Mood stabilizers
Rationale: Mood stabilizers such as lithium and certain anticonvulsants are important
treatments for bipolar disorder. Antipsychotics are also frequently used in acute mania.
10. Which medication requires monitoring of serum levels and renal and thyroid function?
A. Lithium
B. Sertraline
C. Fluoxetine
D. Buspirone
Answer: A. Lithium
Rationale: Lithium has a narrow therapeutic index and requires monitoring of serum
concentration, kidney function, thyroid function, electrolytes, and clinical status.
11. Which symptom may indicate lithium toxicity?
A. Severe coarse tremor and ataxia
B. Mild thirst only
C. Increased appetite only
D. Nasal congestion
Answer: A. Severe coarse tremor and ataxia
Rationale: Toxicity can cause worsening tremor, gastrointestinal symptoms, confusion, ataxia,
dysarthria, and potentially seizures or severe neurologic impairment.
12. Which factor can increase lithium levels?
A. Dehydration
B. Increased fluid intake
C. Increased dietary sodium
D. Consistent hydration
Answer: A. Dehydration
