, Barkley PMHNP DSM-5 Exam Questions and
Answers with Rationale 2026/2027
Question 1
A 34-year-old female presents to the outpatient psychiatric clinic
reporting persistent, excessive anxiety and worry about a wide
range of everyday events, such as job performance, financial
security, and family health. These symptoms have been present
more days than not for the past 8 months and are accompanied
by muscle tension, restlessness, and sleep disturbances. What is
the minimum duration of symptoms required to establish this
diagnosis according to the DSM-5?
A. At least 1 month
B. At least 3 months
C. At least 6 months
D. At least 12 months
Correct Answer: C. At least 6 months
Rationale: According to the DSM-5, the core diagnostic criteria
for Generalized Anxiety Disorder (GAD) require excessive
anxiety and worry occurring more days than not for at least 6
months, concerning a number of events or activities.
Question 2
A 28-year-old male is brought to the emergency department
after experiencing a sudden, discrete episode of intense fear and
discomfort that peaked within minutes. During this episode, he
,developed palpitations, chest pain, dizziness, trembling, and a
profound fear that he was dying. He reports experiencing several
similar unexpected attacks over the past month, accompanied by
persistent worry about having additional attacks. What is the
DSM-5 diagnosis?
A. Panic Disorder
B. Agoraphobia
C. Specific Phobia
D. Acute Stress Disorder
Correct Answer: A. Panic Disorder
Rationale: Panic disorder is characterized by recurrent
unexpected panic attacks followed by at least 1 month of
persistent concern about additional attacks, worry about
their consequences, or significant maladaptive behavioral
changes related to the attacks.
Question 3
A 42-year-old male presents with a 9-month history of intrusive,
unwanted thoughts about being contaminated by germs, which
cause marked anxiety. To neutralize these thoughts, he feels
compelled to wash his hands repeatedly for hours each day, to
the point of skin breakdown and severe interference with his
occupational functioning. According to the DSM-5, these
repetitive behaviors are classified as:
A. Obsessions
B. Compulsions
C. Tics
D. Impulsivity
, Correct Answer: B. Compulsions
Rationale: In obsessive-compulsive disorder, obsessions are
defined as recurrent, persistent thoughts, urges, or images
experienced as intrusive and unwanted, whereas
compulsions are repetitive behaviors or mental acts that an
individual feels driven to perform in response to an
obsession.
Question 4
A 23-year-old female is evaluated after surviving a severe motor
vehicle collision 3 weeks ago. She reports recurrent,
involuntary, and intrusive distressing memories of the accident,
severe psychological distress when exposed to reminders,
persistent inability to experience positive emotions,
hypervigilance, and sleep disturbances. What is the most
accurate DSM-5 diagnosis?
A. Acute Stress Disorder
B. Posttraumatic Stress Disorder (PTSD)
C. Adjustment Disorder with Anxiety
D. Generalized Anxiety Disorder
Correct Answer: B. Posttraumatic Stress Disorder (PTSD)
Rationale: While Acute Stress Disorder shares similar
symptom criteria, it is diagnosed when symptom duration is
between 3 days and 1 month following trauma exposure.
Because symptoms have persisted and the clinical picture
spans intrusion, negative mood, avoidance, and arousal
beyond 1 month (or can be applied past 1 month), PTSD is
the appropriate DSM-5 diagnosis.
Answers with Rationale 2026/2027
Question 1
A 34-year-old female presents to the outpatient psychiatric clinic
reporting persistent, excessive anxiety and worry about a wide
range of everyday events, such as job performance, financial
security, and family health. These symptoms have been present
more days than not for the past 8 months and are accompanied
by muscle tension, restlessness, and sleep disturbances. What is
the minimum duration of symptoms required to establish this
diagnosis according to the DSM-5?
A. At least 1 month
B. At least 3 months
C. At least 6 months
D. At least 12 months
Correct Answer: C. At least 6 months
Rationale: According to the DSM-5, the core diagnostic criteria
for Generalized Anxiety Disorder (GAD) require excessive
anxiety and worry occurring more days than not for at least 6
months, concerning a number of events or activities.
Question 2
A 28-year-old male is brought to the emergency department
after experiencing a sudden, discrete episode of intense fear and
discomfort that peaked within minutes. During this episode, he
,developed palpitations, chest pain, dizziness, trembling, and a
profound fear that he was dying. He reports experiencing several
similar unexpected attacks over the past month, accompanied by
persistent worry about having additional attacks. What is the
DSM-5 diagnosis?
A. Panic Disorder
B. Agoraphobia
C. Specific Phobia
D. Acute Stress Disorder
Correct Answer: A. Panic Disorder
Rationale: Panic disorder is characterized by recurrent
unexpected panic attacks followed by at least 1 month of
persistent concern about additional attacks, worry about
their consequences, or significant maladaptive behavioral
changes related to the attacks.
Question 3
A 42-year-old male presents with a 9-month history of intrusive,
unwanted thoughts about being contaminated by germs, which
cause marked anxiety. To neutralize these thoughts, he feels
compelled to wash his hands repeatedly for hours each day, to
the point of skin breakdown and severe interference with his
occupational functioning. According to the DSM-5, these
repetitive behaviors are classified as:
A. Obsessions
B. Compulsions
C. Tics
D. Impulsivity
, Correct Answer: B. Compulsions
Rationale: In obsessive-compulsive disorder, obsessions are
defined as recurrent, persistent thoughts, urges, or images
experienced as intrusive and unwanted, whereas
compulsions are repetitive behaviors or mental acts that an
individual feels driven to perform in response to an
obsession.
Question 4
A 23-year-old female is evaluated after surviving a severe motor
vehicle collision 3 weeks ago. She reports recurrent,
involuntary, and intrusive distressing memories of the accident,
severe psychological distress when exposed to reminders,
persistent inability to experience positive emotions,
hypervigilance, and sleep disturbances. What is the most
accurate DSM-5 diagnosis?
A. Acute Stress Disorder
B. Posttraumatic Stress Disorder (PTSD)
C. Adjustment Disorder with Anxiety
D. Generalized Anxiety Disorder
Correct Answer: B. Posttraumatic Stress Disorder (PTSD)
Rationale: While Acute Stress Disorder shares similar
symptom criteria, it is diagnosed when symptom duration is
between 3 days and 1 month following trauma exposure.
Because symptoms have persisted and the clinical picture
spans intrusion, negative mood, avoidance, and arousal
beyond 1 month (or can be applied past 1 month), PTSD is
the appropriate DSM-5 diagnosis.
