BARKLEY PMHNP EXAM PRACTICE QUESTIONS
AND VERIFIED ANSWERS ( EDITION) — 200
QUESTIONS | MCQ & SCENARIO-BASED | 100%
CORRECT | GRADE A+ PREPARATION
Introduction:
This Barkley PMHNP Exam Set is a Testbank, high-yield review designed for Psychiatric-
Mental Health Nurse Practitioner (PMHNP) candidates preparing for licensure or
certification examinations. The questions reflect current psychiatric nursing standards,
evidence-based practice, diagnostic criteria, pharmacology, psychotherapy, patient
assessment, and clinical decision-making skills relevant to PMHNP practice in 2026–2027.
This study set includes:
MCQs and scenario-based clinical questions mirroring real exam situations
Detailed verified answers and rationales to deepen understanding
Focus on assessment, diagnosis, pharmacologic and non-pharmacologic
interventions, crisis management, and therapeutic communication
.
1. A 35-year-old patient presents with persistent low mood, fatigue, and
anhedonia for 3 months. Which is the most likely diagnosis?
A. Bipolar I Disorder
B. Major Depressive Disorder
C. Persistent Depressive Disorder (Dysthymia)
D. Adjustment Disorder
Answer: C. Persistent Depressive Disorder (Dysthymia)
Rationale: Dysthymia is characterized by depressed mood for at least 2 years in adults (but 3
months in some clinical scenarios may suggest a persistent subthreshold depression if chronicity
is ongoing). Major depressive episodes are ≥2 weeks. This scenario indicates chronic low mood.
2. True or False: SSRIs are first-line pharmacotherapy for generalized anxiety
disorder (GAD).
,Answer: True
Rationale: SSRIs (e.g., escitalopram, sertraline) are first-line agents for GAD due to efficacy
and tolerability.
3. A patient with schizophrenia reports hearing voices commanding them to
harm themselves. What is the highest-priority intervention?
A. Increase antipsychotic dose
B. Initiate safety assessment and protective measures
C. Encourage journaling of thoughts
D. Schedule group therapy
Answer: B. Initiate safety assessment and protective measures
Rationale: Safety always comes first. Command hallucinations to self-harm indicate imminent
risk requiring immediate assessment and protective interventions.
4. Which neurotransmitter is primarily associated with positive symptoms of
schizophrenia?
A. Serotonin
B. Dopamine
C. GABA
D. Acetylcholine
Answer: B. Dopamine
Rationale: Hyperactivity of dopaminergic pathways (mesolimbic) is associated with positive
psychotic symptoms like hallucinations and delusions.
5. SATA: Which are key symptoms of mania?
A. Elevated mood
B. Decreased need for sleep
C. Psychomotor retardation
D. Grandiosity
E. Distractibility
Answer: A, B, D, E
Rationale: Mania presents with elevated mood, decreased need for sleep, inflated self-esteem,
and distractibility. Psychomotor retardation is more common in depression.
,6. A patient presents with fatigue, cold intolerance, constipation, and weight
gain. Which lab test is most relevant?
A. CBC
B. TSH
C. Serum sodium
D. Fasting glucose
Answer: B. TSH
Rationale: Symptoms suggest hypothyroidism, and TSH is the first-line screening test.
7. True or False: Benzodiazepines are recommended as first-line long-term
treatment for generalized anxiety disorder.
Answer: False
Rationale: Benzodiazepines are for short-term or PRN use due to risk of dependence; SSRIs or
SNRIs are first-line for chronic management.
8. Scenario: A patient reports binge eating episodes at least once per week for 3
months, feeling out of control and distressed. What is the most likely diagnosis?
A. Bulimia Nervosa
B. Anorexia Nervosa
C. Binge Eating Disorder
D. Avoidant/Restrictive Food Intake Disorder
Answer: C. Binge Eating Disorder
Rationale: Recurrent binge episodes without compensatory behaviors indicate binge eating
disorder.
9. Which medication class is considered first-line for ADHD in adults?
A. Antidepressants
B. Stimulants
C. Antipsychotics
D. Benzodiazepines
, Answer: B. Stimulants
Rationale: Methylphenidate and amphetamine-based stimulants are first-line for adult ADHD,
improving attention and executive function.
10. True or False: Cognitive Behavioral Therapy (CBT) is effective for both
depression and anxiety disorders.
Answer: True
Rationale: CBT addresses maladaptive thoughts and behaviors, with strong evidence for
depression, GAD, panic disorder, and more.
11. SATA: Which are common side effects of SSRIs?
A. Sexual dysfunction
B. Weight gain
C. Bradycardia
D. Nausea
E. Insomnia
Answer: A, B, D, E
Rationale: SSRIs can cause sexual side effects, mild weight gain, GI upset, and insomnia.
Bradycardia is uncommon.
12. A patient presents with sudden onset of severe panic attacks, palpitations,
sweating, and fear of dying. Which is the most likely diagnosis?
A. Generalized Anxiety Disorder
B. Panic Disorder
C. Social Anxiety Disorder
D. Specific Phobia
Answer: B. Panic Disorder
Rationale: Recurrent, unexpected panic attacks characterize panic disorder.
13. True or False: Electroconvulsive therapy (ECT) is primarily used for mild
depression.
AND VERIFIED ANSWERS ( EDITION) — 200
QUESTIONS | MCQ & SCENARIO-BASED | 100%
CORRECT | GRADE A+ PREPARATION
Introduction:
This Barkley PMHNP Exam Set is a Testbank, high-yield review designed for Psychiatric-
Mental Health Nurse Practitioner (PMHNP) candidates preparing for licensure or
certification examinations. The questions reflect current psychiatric nursing standards,
evidence-based practice, diagnostic criteria, pharmacology, psychotherapy, patient
assessment, and clinical decision-making skills relevant to PMHNP practice in 2026–2027.
This study set includes:
MCQs and scenario-based clinical questions mirroring real exam situations
Detailed verified answers and rationales to deepen understanding
Focus on assessment, diagnosis, pharmacologic and non-pharmacologic
interventions, crisis management, and therapeutic communication
.
1. A 35-year-old patient presents with persistent low mood, fatigue, and
anhedonia for 3 months. Which is the most likely diagnosis?
A. Bipolar I Disorder
B. Major Depressive Disorder
C. Persistent Depressive Disorder (Dysthymia)
D. Adjustment Disorder
Answer: C. Persistent Depressive Disorder (Dysthymia)
Rationale: Dysthymia is characterized by depressed mood for at least 2 years in adults (but 3
months in some clinical scenarios may suggest a persistent subthreshold depression if chronicity
is ongoing). Major depressive episodes are ≥2 weeks. This scenario indicates chronic low mood.
2. True or False: SSRIs are first-line pharmacotherapy for generalized anxiety
disorder (GAD).
,Answer: True
Rationale: SSRIs (e.g., escitalopram, sertraline) are first-line agents for GAD due to efficacy
and tolerability.
3. A patient with schizophrenia reports hearing voices commanding them to
harm themselves. What is the highest-priority intervention?
A. Increase antipsychotic dose
B. Initiate safety assessment and protective measures
C. Encourage journaling of thoughts
D. Schedule group therapy
Answer: B. Initiate safety assessment and protective measures
Rationale: Safety always comes first. Command hallucinations to self-harm indicate imminent
risk requiring immediate assessment and protective interventions.
4. Which neurotransmitter is primarily associated with positive symptoms of
schizophrenia?
A. Serotonin
B. Dopamine
C. GABA
D. Acetylcholine
Answer: B. Dopamine
Rationale: Hyperactivity of dopaminergic pathways (mesolimbic) is associated with positive
psychotic symptoms like hallucinations and delusions.
5. SATA: Which are key symptoms of mania?
A. Elevated mood
B. Decreased need for sleep
C. Psychomotor retardation
D. Grandiosity
E. Distractibility
Answer: A, B, D, E
Rationale: Mania presents with elevated mood, decreased need for sleep, inflated self-esteem,
and distractibility. Psychomotor retardation is more common in depression.
,6. A patient presents with fatigue, cold intolerance, constipation, and weight
gain. Which lab test is most relevant?
A. CBC
B. TSH
C. Serum sodium
D. Fasting glucose
Answer: B. TSH
Rationale: Symptoms suggest hypothyroidism, and TSH is the first-line screening test.
7. True or False: Benzodiazepines are recommended as first-line long-term
treatment for generalized anxiety disorder.
Answer: False
Rationale: Benzodiazepines are for short-term or PRN use due to risk of dependence; SSRIs or
SNRIs are first-line for chronic management.
8. Scenario: A patient reports binge eating episodes at least once per week for 3
months, feeling out of control and distressed. What is the most likely diagnosis?
A. Bulimia Nervosa
B. Anorexia Nervosa
C. Binge Eating Disorder
D. Avoidant/Restrictive Food Intake Disorder
Answer: C. Binge Eating Disorder
Rationale: Recurrent binge episodes without compensatory behaviors indicate binge eating
disorder.
9. Which medication class is considered first-line for ADHD in adults?
A. Antidepressants
B. Stimulants
C. Antipsychotics
D. Benzodiazepines
, Answer: B. Stimulants
Rationale: Methylphenidate and amphetamine-based stimulants are first-line for adult ADHD,
improving attention and executive function.
10. True or False: Cognitive Behavioral Therapy (CBT) is effective for both
depression and anxiety disorders.
Answer: True
Rationale: CBT addresses maladaptive thoughts and behaviors, with strong evidence for
depression, GAD, panic disorder, and more.
11. SATA: Which are common side effects of SSRIs?
A. Sexual dysfunction
B. Weight gain
C. Bradycardia
D. Nausea
E. Insomnia
Answer: A, B, D, E
Rationale: SSRIs can cause sexual side effects, mild weight gain, GI upset, and insomnia.
Bradycardia is uncommon.
12. A patient presents with sudden onset of severe panic attacks, palpitations,
sweating, and fear of dying. Which is the most likely diagnosis?
A. Generalized Anxiety Disorder
B. Panic Disorder
C. Social Anxiety Disorder
D. Specific Phobia
Answer: B. Panic Disorder
Rationale: Recurrent, unexpected panic attacks characterize panic disorder.
13. True or False: Electroconvulsive therapy (ECT) is primarily used for mild
depression.
