Barkley ENP-C Diagnostic Readiness
Test (DRT) #2 | 100 Predictor
Questions and Answers
Question 1
During a suicide intervention with a 28-year-old male patient, to which agreement
should you ask for his consent, verbally or in writing?
A) "No Harm" contract
B) "No Suicide" contract
C) "Prevention" contract
D) "Affirming Life" contract
,,,answer,,,,: A) "No Harm" contract
Rationale: Healthcare professionals are obligated to ask suicidal patients to agree
to a "no harm" contract, verbally or in writing, detailing specifically that the patient
will refrain from harming themselves. While the effectiveness of no-harm contracts
is debated, they remain a standard component of suicide risk assessment and
intervention.
,Question 2
Courtney, 35, is a rape victim. You note that she has an expressed style of coping in
her acute rape trauma syndrome. Which of the following would most lead you to
this conclusion?
A) Patient's masked face
B) Patient's distractibility
C) Patient smiling
D) Patient having difficulty making decisions
,,,answer,,,,: C) Patient smiling
Rationale: An "expressed" style of coping in acute rape trauma syndrome is
characterized by visible emotional expression, which may include smiling, laughing,
or appearing overly cheerful. This is a coping mechanism to mask underlying
distress. A masked or controlled style would present with a flat affect,
distractibility, or difficulty making decisions.
Question 3
Which of the following patients would NOT require hospitalization?
A) A 29-year-old self-admitted bulimic male with bradycardia
B) A 27-year-old female with repeated use of laxatives and diuretics at least two
times a week for 3 months
C) A 20-year-old male suffering from persistent hypothermia
D) An 18-year-old young woman who is 5'4" and weighs 92 pounds
,,,answer,,,,: B) A 27-year-old female with repeated use of laxatives and
diuretics at least two times a week for 3 months
,Rationale: Hospitalization is indicated for eating disorder patients with
hemodynamic instability (bradycardia), electrolyte imbalances, hypothermia, or
significant malnutrition. A BMI <18.5 with weight <85% ideal body weight also
warrants hospitalization. The patient in option B, while using laxatives and diuretics,
does not meet the criteria for immediate hospitalization based on the information
provided, though outpatient monitoring would be necessary.
Question 4
Terry, 35, visits your office with the assumption that he is experiencing depression.
Terry explains that he has a history of substance abuse and a family history of mood
disorders. He claims that he has recently been incredibly fatigued, possessing no
energy to even perform day-to-day activities. Even with the sudden onset of fatigue,
Terry explains that he is still experiencing insomnia. He also complains about
recurring confusion and loss of weight, and confesses that he has been
experiencing more recurrent suicidal thoughts. Of the following, which is the best
medication to prescribe Terry for his situation?
A) Sympathomimetics
B) Bupropion
C) Olanzapine
D) Risperidone
,,,answer,,,,: B) Bupropion
Rationale: Bupropion is the better choice for this patient due to his history of
substance abuse, as it has a lower risk of abuse potential compared to
sympathomimetics. Bupropion also has a favorable side effect profile for patients
with fatigue and can help with weight management. Sympathomimetics have
, potential for abuse. Olanzapine and risperidone are atypical antipsychotics more
appropriate for bipolar disorder or schizophrenia.
Question 5
A patient presents with acute agitation and hallucinations. He has a history of
schizophrenia and has not taken his antipsychotic medication for several weeks.
What is the most appropriate medication for acute agitation?
A) Haloperidol
B) Lorazepam
C) Olanzapine
D) Diphenhydramine
,,,answer,,,,: A) Haloperidol
Rationale: Haloperidol (a typical antipsychotic) is commonly used for acute
agitation in schizophrenia, often in combination with lorazepam (B52 protocol).
Olanzapine is an alternative but may cause more sedation. Lorazepam alone may
not adequately treat psychotic symptoms. Diphenhydramine is for extrapyramidal
symptoms.
Trauma & Orthopedic Emergencies (Questions 6-15)
Question 6
A 28-year-old male presents with a puncture wound to his left hand after being
bitten by a stray cat 4 hours ago. What is the preferred first-line antibiotic choice?
Test (DRT) #2 | 100 Predictor
Questions and Answers
Question 1
During a suicide intervention with a 28-year-old male patient, to which agreement
should you ask for his consent, verbally or in writing?
A) "No Harm" contract
B) "No Suicide" contract
C) "Prevention" contract
D) "Affirming Life" contract
,,,answer,,,,: A) "No Harm" contract
Rationale: Healthcare professionals are obligated to ask suicidal patients to agree
to a "no harm" contract, verbally or in writing, detailing specifically that the patient
will refrain from harming themselves. While the effectiveness of no-harm contracts
is debated, they remain a standard component of suicide risk assessment and
intervention.
,Question 2
Courtney, 35, is a rape victim. You note that she has an expressed style of coping in
her acute rape trauma syndrome. Which of the following would most lead you to
this conclusion?
A) Patient's masked face
B) Patient's distractibility
C) Patient smiling
D) Patient having difficulty making decisions
,,,answer,,,,: C) Patient smiling
Rationale: An "expressed" style of coping in acute rape trauma syndrome is
characterized by visible emotional expression, which may include smiling, laughing,
or appearing overly cheerful. This is a coping mechanism to mask underlying
distress. A masked or controlled style would present with a flat affect,
distractibility, or difficulty making decisions.
Question 3
Which of the following patients would NOT require hospitalization?
A) A 29-year-old self-admitted bulimic male with bradycardia
B) A 27-year-old female with repeated use of laxatives and diuretics at least two
times a week for 3 months
C) A 20-year-old male suffering from persistent hypothermia
D) An 18-year-old young woman who is 5'4" and weighs 92 pounds
,,,answer,,,,: B) A 27-year-old female with repeated use of laxatives and
diuretics at least two times a week for 3 months
,Rationale: Hospitalization is indicated for eating disorder patients with
hemodynamic instability (bradycardia), electrolyte imbalances, hypothermia, or
significant malnutrition. A BMI <18.5 with weight <85% ideal body weight also
warrants hospitalization. The patient in option B, while using laxatives and diuretics,
does not meet the criteria for immediate hospitalization based on the information
provided, though outpatient monitoring would be necessary.
Question 4
Terry, 35, visits your office with the assumption that he is experiencing depression.
Terry explains that he has a history of substance abuse and a family history of mood
disorders. He claims that he has recently been incredibly fatigued, possessing no
energy to even perform day-to-day activities. Even with the sudden onset of fatigue,
Terry explains that he is still experiencing insomnia. He also complains about
recurring confusion and loss of weight, and confesses that he has been
experiencing more recurrent suicidal thoughts. Of the following, which is the best
medication to prescribe Terry for his situation?
A) Sympathomimetics
B) Bupropion
C) Olanzapine
D) Risperidone
,,,answer,,,,: B) Bupropion
Rationale: Bupropion is the better choice for this patient due to his history of
substance abuse, as it has a lower risk of abuse potential compared to
sympathomimetics. Bupropion also has a favorable side effect profile for patients
with fatigue and can help with weight management. Sympathomimetics have
, potential for abuse. Olanzapine and risperidone are atypical antipsychotics more
appropriate for bipolar disorder or schizophrenia.
Question 5
A patient presents with acute agitation and hallucinations. He has a history of
schizophrenia and has not taken his antipsychotic medication for several weeks.
What is the most appropriate medication for acute agitation?
A) Haloperidol
B) Lorazepam
C) Olanzapine
D) Diphenhydramine
,,,answer,,,,: A) Haloperidol
Rationale: Haloperidol (a typical antipsychotic) is commonly used for acute
agitation in schizophrenia, often in combination with lorazepam (B52 protocol).
Olanzapine is an alternative but may cause more sedation. Lorazepam alone may
not adequately treat psychotic symptoms. Diphenhydramine is for extrapyramidal
symptoms.
Trauma & Orthopedic Emergencies (Questions 6-15)
Question 6
A 28-year-old male presents with a puncture wound to his left hand after being
bitten by a stray cat 4 hours ago. What is the preferred first-line antibiotic choice?
