Ultimate Barkley DRT PMHNP Practicum 1 Actual
Exam 2026/2027 – A+ Graded Full-Length Practice
Exam with Verified Answers, Detailed Clinical
Rationales, DSM-5-TR-Aligned 200 Questions, and
Instant Download – The Ultimate Study Resource
to Pass on Your First Attempt
Question 1
A 45-year-old patient presents with anhedonia, fatigue,
and sleep disturbances for the last two months. As a
PMHNP, which initial diagnostic step is most
appropriate?
A) Order a brain MRI
B) Conduct a comprehensive psychiatric interview
C) Begin antidepressant therapy immediately
D) Recommend mindfulness training
Correct Answer: B
Rationale: A comprehensive psychiatric interview allows
for a thorough assessment of history, symptoms, and
differential diagnoses before initiating treatment.
Imaging (A) is reserved for suspected neurological
,causes, and interventions (C, D) should follow a
confirmed assessment .
Question 2
Which neurotransmitter imbalance is most closely
associated with the positive symptoms of schizophrenia?
A) Decreased serotonin
B) Increased dopamine
C) Decreased glutamate
D) Increased GABA
Correct Answer: B
Rationale: Hyperactivity of dopamine in the mesolimbic
pathway is linked to hallucinations and delusions—core
positive symptoms of schizophrenia .
Question 3
Which symptom best differentiates PTSD from Acute
Stress Disorder?
A) Flashbacks
B) Dissociation
C) Duration of symptoms
D) Nightmares
Correct Answer: C
,Rationale: PTSD symptoms persist beyond one month;
Acute Stress Disorder is characterized by symptoms
lasting less than one month .
Question 4
Which personality disorder is most characterized by
instability in relationships, identity disturbance, and
impulsivity?
A) Narcissistic
B) Borderline
C) Antisocial
D) Dependent
Correct Answer: B
Rationale: Borderline Personality Disorder involves
emotional volatility, splitting, identity disturbance,
impulsivity, and fear of abandonment .
Question 5
What is the primary feature distinguishing delirium from
dementia?
A) Chronic course
B) Gradual memory decline
C) Acute onset and fluctuating consciousness
D) Associated depressive symptoms
, Correct Answer: C
Rationale: Delirium presents acutely and fluctuates,
while dementia develops insidiously over months to
years .
Question 6
Which of the following is NOT among the necessary
symptoms for a diagnosis of dementia?
A) Agnosia
B) Aphasia
C) Anosognosia
D) Apraxia
Correct Answer: C
Rationale: Anosognosia (lack of awareness of deficit) is
not among the necessary symptoms for dementia
diagnosis. The DSM-5 criteria for major neurocognitive
disorder require deficits in at least one cognitive
domain .
Question 7
In a patient presenting with new-onset confusion, which
medical condition must be ruled out before psychiatric
diagnosis?
Exam 2026/2027 – A+ Graded Full-Length Practice
Exam with Verified Answers, Detailed Clinical
Rationales, DSM-5-TR-Aligned 200 Questions, and
Instant Download – The Ultimate Study Resource
to Pass on Your First Attempt
Question 1
A 45-year-old patient presents with anhedonia, fatigue,
and sleep disturbances for the last two months. As a
PMHNP, which initial diagnostic step is most
appropriate?
A) Order a brain MRI
B) Conduct a comprehensive psychiatric interview
C) Begin antidepressant therapy immediately
D) Recommend mindfulness training
Correct Answer: B
Rationale: A comprehensive psychiatric interview allows
for a thorough assessment of history, symptoms, and
differential diagnoses before initiating treatment.
Imaging (A) is reserved for suspected neurological
,causes, and interventions (C, D) should follow a
confirmed assessment .
Question 2
Which neurotransmitter imbalance is most closely
associated with the positive symptoms of schizophrenia?
A) Decreased serotonin
B) Increased dopamine
C) Decreased glutamate
D) Increased GABA
Correct Answer: B
Rationale: Hyperactivity of dopamine in the mesolimbic
pathway is linked to hallucinations and delusions—core
positive symptoms of schizophrenia .
Question 3
Which symptom best differentiates PTSD from Acute
Stress Disorder?
A) Flashbacks
B) Dissociation
C) Duration of symptoms
D) Nightmares
Correct Answer: C
,Rationale: PTSD symptoms persist beyond one month;
Acute Stress Disorder is characterized by symptoms
lasting less than one month .
Question 4
Which personality disorder is most characterized by
instability in relationships, identity disturbance, and
impulsivity?
A) Narcissistic
B) Borderline
C) Antisocial
D) Dependent
Correct Answer: B
Rationale: Borderline Personality Disorder involves
emotional volatility, splitting, identity disturbance,
impulsivity, and fear of abandonment .
Question 5
What is the primary feature distinguishing delirium from
dementia?
A) Chronic course
B) Gradual memory decline
C) Acute onset and fluctuating consciousness
D) Associated depressive symptoms
, Correct Answer: C
Rationale: Delirium presents acutely and fluctuates,
while dementia develops insidiously over months to
years .
Question 6
Which of the following is NOT among the necessary
symptoms for a diagnosis of dementia?
A) Agnosia
B) Aphasia
C) Anosognosia
D) Apraxia
Correct Answer: C
Rationale: Anosognosia (lack of awareness of deficit) is
not among the necessary symptoms for dementia
diagnosis. The DSM-5 criteria for major neurocognitive
disorder require deficits in at least one cognitive
domain .
Question 7
In a patient presenting with new-onset confusion, which
medical condition must be ruled out before psychiatric
diagnosis?
