PA PSYCHIATRY EXAM 5 2026
COMPREHENSIVE QUESTION SET WITH
RATIONALES AND PATIENT MANAGEMENT
REVIEW
◉ A 23-year-old man with a history of opiate use presents to the
emergency department with tachycardia, hypertension and
mydriasis. Which medication do you give.
Answer: Clonidine (opioid withdrawal treatment)
◉ A 22-year-old war veteran returns from Afghanistan. Shortly after
returning home, he is found wandering in a city far from his home
and does not recall his name or how he got there. What is the most
likely diagnosis.
Answer: Dissociative Fugue (loss of identity and travel to new
location)
◉ An 82-year-old woman presents for evaluation of pain on her
sacrum. The patient is alert and oriented to person, place, and time.
Physical examination is notable for a stage II pressure ulcer. Multiple
bruises are noted on her legs as well. She acknowledges that she
remains in bed most of the day and sometimes her son who is her
caretaker forgets to give her meals or change her diaper. She also
states that the son causes her pain by pinching her arms and legs
,when she does not move quickly enough. You are concerned about
elder neglect and abuse. She does not wish to report her son or
speak with social work. Which is your most appropriate action?.
Answer: Notify adult protective services ( in most states, emergency
med providers are mandatory reports of adult abuse)
◉ Which two fractures are highly suspicious for non-accidental
trauma in a pediatric patient?.
Answer: posterior rib fractures
fractures of different ages
◉ A 28-year-old man presents to the clinic for his annual physical.
The patient has a history of schizophrenia, which has been well
managed with the medication olanzapine. What screening test
should you do?.
Answer: Lipid panel
blood glucose measurements
◉ An 18-year-old woman with a history of frequent visits to the ED
presents with multiple superficial lacerations to her left wrist. She is
agitated and states she is suicidal. She is yelling at the nurses and
demands to be seen only by the psychiatrist. Which of the following
is the most appropriate next step in management?.
Answer: Engage in discussion, validate distress, discuss symptoms
,◉ Which of the following is correct with regards to autism?
Caused by thimerosal-containing vaccines
Developmental screening tests have good sensitivity for autism
Early intervention with a multidisciplinary approach improves
outcomes
Onset typically occurs after the age of 5.
Answer: Early intervention with a multidisciplinary approach
improves outcomes
◉ A 19-year-old woman is brought in by her husband for evaluation.
He states that over the last week, she has exhibited a number of
concerning symptoms including tremors and seizures. On entering
the room, the patient is noted to be resting comfortably. When asked
about the tremor, the patient begins to exhibit coarse diffuse
tremors. During the evaluation the patient has generalized shaking
but is able to respond to questions. Further discussion with the
patient's husband reveals that they are currently going through a
separation and there has been a lot of stress at home. Which of the
disorder accounts for the patient's symptoms?.
Answer: Factitious disorder
, ◉ Which of the following is associated with an organic cause of
psychosis?
Auditory hallucinations
Disorientation
Normal vital signs
Slow onset of symptoms.
Answer: Disorientation
◉ A 35-year-old man with a history of alcohol abuse presents to
your office with complaints of a 3-day history of abdominal pain and
vomiting after a night of binge drinking. He has not eaten in days.
Laboratory values show an elevated anion gap, ketonemia and
normal glucose levels. In addition to thiamine, what other treatment
should be provided for this patient?.
Answer: Normal saline and glucose
◉ Which of the following is consistent with a diagnosis of bulimia?
Congestive heart failure
COMPREHENSIVE QUESTION SET WITH
RATIONALES AND PATIENT MANAGEMENT
REVIEW
◉ A 23-year-old man with a history of opiate use presents to the
emergency department with tachycardia, hypertension and
mydriasis. Which medication do you give.
Answer: Clonidine (opioid withdrawal treatment)
◉ A 22-year-old war veteran returns from Afghanistan. Shortly after
returning home, he is found wandering in a city far from his home
and does not recall his name or how he got there. What is the most
likely diagnosis.
Answer: Dissociative Fugue (loss of identity and travel to new
location)
◉ An 82-year-old woman presents for evaluation of pain on her
sacrum. The patient is alert and oriented to person, place, and time.
Physical examination is notable for a stage II pressure ulcer. Multiple
bruises are noted on her legs as well. She acknowledges that she
remains in bed most of the day and sometimes her son who is her
caretaker forgets to give her meals or change her diaper. She also
states that the son causes her pain by pinching her arms and legs
,when she does not move quickly enough. You are concerned about
elder neglect and abuse. She does not wish to report her son or
speak with social work. Which is your most appropriate action?.
Answer: Notify adult protective services ( in most states, emergency
med providers are mandatory reports of adult abuse)
◉ Which two fractures are highly suspicious for non-accidental
trauma in a pediatric patient?.
Answer: posterior rib fractures
fractures of different ages
◉ A 28-year-old man presents to the clinic for his annual physical.
The patient has a history of schizophrenia, which has been well
managed with the medication olanzapine. What screening test
should you do?.
Answer: Lipid panel
blood glucose measurements
◉ An 18-year-old woman with a history of frequent visits to the ED
presents with multiple superficial lacerations to her left wrist. She is
agitated and states she is suicidal. She is yelling at the nurses and
demands to be seen only by the psychiatrist. Which of the following
is the most appropriate next step in management?.
Answer: Engage in discussion, validate distress, discuss symptoms
,◉ Which of the following is correct with regards to autism?
Caused by thimerosal-containing vaccines
Developmental screening tests have good sensitivity for autism
Early intervention with a multidisciplinary approach improves
outcomes
Onset typically occurs after the age of 5.
Answer: Early intervention with a multidisciplinary approach
improves outcomes
◉ A 19-year-old woman is brought in by her husband for evaluation.
He states that over the last week, she has exhibited a number of
concerning symptoms including tremors and seizures. On entering
the room, the patient is noted to be resting comfortably. When asked
about the tremor, the patient begins to exhibit coarse diffuse
tremors. During the evaluation the patient has generalized shaking
but is able to respond to questions. Further discussion with the
patient's husband reveals that they are currently going through a
separation and there has been a lot of stress at home. Which of the
disorder accounts for the patient's symptoms?.
Answer: Factitious disorder
, ◉ Which of the following is associated with an organic cause of
psychosis?
Auditory hallucinations
Disorientation
Normal vital signs
Slow onset of symptoms.
Answer: Disorientation
◉ A 35-year-old man with a history of alcohol abuse presents to
your office with complaints of a 3-day history of abdominal pain and
vomiting after a night of binge drinking. He has not eaten in days.
Laboratory values show an elevated anion gap, ketonemia and
normal glucose levels. In addition to thiamine, what other treatment
should be provided for this patient?.
Answer: Normal saline and glucose
◉ Which of the following is consistent with a diagnosis of bulimia?
Congestive heart failure
