BARKLEY PMHNP CERT REVIEW LATEST 2025
REVISED EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED COMPLETE SOLUTION)
ALREADY PASSED SCORE A+
Therapeutic relationship/ working diagnosis/need for further evaluation and testing/initial plan of care. -
ANSWER- To begin the process of assessment you would establish:
referral information/ patient questionnaires/ health assessments - ANSWER- Prior to the interview
review:
introducing yourself ( consider cultural norms)/ ensure that you won't be interrupted/ consider clinician
safety, with exit strategies if patient should escalate. - ANSWER- You would set the stage and make the
client comfortable by:
Document the problem in the patient's words/
are symptoms: affective/ cognitive/ physical
seek permission to consult with family member - ANSWER- Chief complaint:
duration of problem (s)
What other things were going on in their life when they started to have problems. - ANSWER- History of
presenting problems:
1. exacerbating factors
2. triggers
3. connecting events
4. causality - ANSWER- Precipitating factors:
,1. changes in role or social function
2. history of abuse and victimization - ANSWER- Social History:
1. identify who played roles in person's life.
2. Who are presently involved.
3. Social support - ANSWER- Social and developmental history:
biological: eval autosomal dominant genetic inheritance which is rare: present in more than one
generation
~autosomal recessive- expressed in one generation
process: examine family patterns of communication and relating. - ANSWER- Family genogram:
1. friendships/ relationships with service providers
2. religious groups and/or clergy
3. history re: intimate relationships
4. status of interpersonal relationships
5. are important people in client's life- loving vs angry
6. involvement of family or other's in client's care
7. client's living situation
8. occupational status
9. educational/training status
10. financial situation
11. difficulties of activities of daily living - ANSWER- Social history continued:
1. family members with mental illness
2. unusual symptoms and behaviors
3. substance abuse/use - ANSWER- Family history:
,evaluate strengths, hobbies, and area of pride/expertise/ competence- coping stratagies - ANSWER-
Personal Evaluation
1. named religion or beliefs
2. source of strength and hope
3. source of comfort? - ANSWER- Spirituality:
1. previous psychiatric care
2. experiences with hospitalization
3. past treatment
4. medications
5. names of previous therapist (written consent needed to consult with previous therapist and get
records) - ANSWER- Past psychiatric history:
1. some chronic medical illnesses have a high prevalence of psychiatric disorders
2. stressors that may have added strain to resources
3. history of:
a. autoimmune illness e.g. lupus
b. fibromyalgia
c. parkinson's disease
d. thyroid problems
e. cardiac disease
f. diabetes
4. any medications with a history of causing psychiatric problems e. g. acutane
5. new onset of physical illness that alters social life or image e.g. burns/ amputations - ANSWER-
medical history:
1. normal coping
2. how patient handles stress
3. use of substances to deal with difficulties
, 4. frequency/amount of drinking/ intake of substances
5. document first use, including circumstances
6. consequences of use- social, economic, interpersonal
7. inquire about each drug separately
8. ask about use in social history -keep in context
9. CAGE questionnaire - ANSWER- Substance use and abuse:
1. have you ever tried to CUT down on your drinking?
2. have you ever been ANNOYED about criticism of your drinking?
3. Have you ever felt GUILTY about your drinking?
4. Have you ever had a morning EYE opener? - ANSWER- CAGE questionnaire
1. Does the patient have any SOCIAL SUPPORT?
2. Is the plan LETHAL?
3. Does the patient have ACCESS to the means to end his/her life?
4. Can the patient describe the PLAN and PREVIOUS attempts?
5. Family history of suicide? - ANSWER- Suicidal risk (SLAP)
I. ideation
S. Substance Abuse: usually increased
P. Purpose for living seems lost
A. Anxiety with agitation and inability to sleep, or sleeping too much.
T. Trapped feeling, no way out.
H. Hopelessness
W. Withdrawing from friends and loved ones
A. Anger and rage, revengeful
R. Reckless behaviors, almost without thought.
M. Mood changes, usually dramatic shifts. - ANSWER- Suicidal Risk (IS PATH WARM?) endorced by the
American Association of Suicidology
REVISED EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED COMPLETE SOLUTION)
ALREADY PASSED SCORE A+
Therapeutic relationship/ working diagnosis/need for further evaluation and testing/initial plan of care. -
ANSWER- To begin the process of assessment you would establish:
referral information/ patient questionnaires/ health assessments - ANSWER- Prior to the interview
review:
introducing yourself ( consider cultural norms)/ ensure that you won't be interrupted/ consider clinician
safety, with exit strategies if patient should escalate. - ANSWER- You would set the stage and make the
client comfortable by:
Document the problem in the patient's words/
are symptoms: affective/ cognitive/ physical
seek permission to consult with family member - ANSWER- Chief complaint:
duration of problem (s)
What other things were going on in their life when they started to have problems. - ANSWER- History of
presenting problems:
1. exacerbating factors
2. triggers
3. connecting events
4. causality - ANSWER- Precipitating factors:
,1. changes in role or social function
2. history of abuse and victimization - ANSWER- Social History:
1. identify who played roles in person's life.
2. Who are presently involved.
3. Social support - ANSWER- Social and developmental history:
biological: eval autosomal dominant genetic inheritance which is rare: present in more than one
generation
~autosomal recessive- expressed in one generation
process: examine family patterns of communication and relating. - ANSWER- Family genogram:
1. friendships/ relationships with service providers
2. religious groups and/or clergy
3. history re: intimate relationships
4. status of interpersonal relationships
5. are important people in client's life- loving vs angry
6. involvement of family or other's in client's care
7. client's living situation
8. occupational status
9. educational/training status
10. financial situation
11. difficulties of activities of daily living - ANSWER- Social history continued:
1. family members with mental illness
2. unusual symptoms and behaviors
3. substance abuse/use - ANSWER- Family history:
,evaluate strengths, hobbies, and area of pride/expertise/ competence- coping stratagies - ANSWER-
Personal Evaluation
1. named religion or beliefs
2. source of strength and hope
3. source of comfort? - ANSWER- Spirituality:
1. previous psychiatric care
2. experiences with hospitalization
3. past treatment
4. medications
5. names of previous therapist (written consent needed to consult with previous therapist and get
records) - ANSWER- Past psychiatric history:
1. some chronic medical illnesses have a high prevalence of psychiatric disorders
2. stressors that may have added strain to resources
3. history of:
a. autoimmune illness e.g. lupus
b. fibromyalgia
c. parkinson's disease
d. thyroid problems
e. cardiac disease
f. diabetes
4. any medications with a history of causing psychiatric problems e. g. acutane
5. new onset of physical illness that alters social life or image e.g. burns/ amputations - ANSWER-
medical history:
1. normal coping
2. how patient handles stress
3. use of substances to deal with difficulties
, 4. frequency/amount of drinking/ intake of substances
5. document first use, including circumstances
6. consequences of use- social, economic, interpersonal
7. inquire about each drug separately
8. ask about use in social history -keep in context
9. CAGE questionnaire - ANSWER- Substance use and abuse:
1. have you ever tried to CUT down on your drinking?
2. have you ever been ANNOYED about criticism of your drinking?
3. Have you ever felt GUILTY about your drinking?
4. Have you ever had a morning EYE opener? - ANSWER- CAGE questionnaire
1. Does the patient have any SOCIAL SUPPORT?
2. Is the plan LETHAL?
3. Does the patient have ACCESS to the means to end his/her life?
4. Can the patient describe the PLAN and PREVIOUS attempts?
5. Family history of suicide? - ANSWER- Suicidal risk (SLAP)
I. ideation
S. Substance Abuse: usually increased
P. Purpose for living seems lost
A. Anxiety with agitation and inability to sleep, or sleeping too much.
T. Trapped feeling, no way out.
H. Hopelessness
W. Withdrawing from friends and loved ones
A. Anger and rage, revengeful
R. Reckless behaviors, almost without thought.
M. Mood changes, usually dramatic shifts. - ANSWER- Suicidal Risk (IS PATH WARM?) endorced by the
American Association of Suicidology
