FLORIDA BOARD OF MEDICINE
PSYCHIATRY CERTIFICATION EXAM WITH
ACTUAL QUESTIONS AND VERIFIED
ANSWERS, PLUS EXPLAINED
RATIONALES/EXPERT VERIFIED FOR
GUARANTEED 100% PASS 2026/LATEST
UPDATE/INSTANT DOWNLOAD PDF
1.
A 32-year-old woman presents with a 3-month history of depressed
mood, anhedonia, early-morning awakening, diminished appetite,
psychomotor retardation, impaired concentration, feelings of
worthlessness, and recurrent thoughts that she would be better off dead.
She denies hallucinations, delusions, manic symptoms, or substance use.
She has no specific suicide plan or intent. Her symptoms have caused
substantial occupational impairment. Which diagnosis best captures her
current presentation?
A. Persistent depressive disorder
B. Bipolar I disorder, current depressive episode
C. Major depressive disorder, single episode, severe without psychotic
features
D. Adjustment disorder with depressed mood
E. Cyclothymic disorder
Answer: C. Major depressive disorder, single episode, severe
without psychotic features
Rationale: The patient has a sustained cluster of depressive
symptoms involving mood, anhedonia, sleep, appetite, psychomotor
activity, cognition, self-worth, and suicidal ideation, with significant
functional impairment and no evidence of mania or psychosis. The
1
,severity is consistent with a severe major depressive episode, while
the absence of delusions or hallucinations argues against psychotic
features. Persistent depressive disorder requires a chronic depressed
mood pattern lasting at least 2 years, whereas adjustment disorder
requires an identifiable stressor and symptoms that do not meet
criteria for a major depressive episode.*
2.
A 24-year-old man reports periods of dramatically decreased need for
sleep, during which he sleeps only 2–3 hours nightly but feels
completely rested. During these periods he becomes excessively
talkative, develops grandiose plans, spends large amounts of money, and
engages in risky sexual behavior. One episode resulted in hospitalization
after he became severely disorganized and required emergency
intervention. Which diagnosis is most appropriate?
A. Bipolar II disorder
B. Cyclothymic disorder
C. Bipolar I disorder
D. Borderline personality disorder
E. Schizoaffective disorder
Answer: C. Bipolar I disorder
Rationale: Bipolar I disorder is defined by the occurrence of at least
one manic episode. The presence of severe functional impairment
and hospitalization strongly supports mania rather than hypomania.
Psychotic symptoms, hospitalization, or marked impairment can
occur during mania and automatically distinguish it from
hypomania. Bipolar II disorder requires hypomania plus a major
depressive episode and specifically excludes a history of mania.*
2
,3.
A 29-year-old woman has recurrent episodes of binge eating followed
by self-induced vomiting. She reports intense concern about body shape
and weight but currently has a BMI of 21 kg/m². Laboratory testing
shows mild hypokalemia. Which diagnosis is most likely?
A. Anorexia nervosa, restricting type
B. Bulimia nervosa
C. Binge-eating disorder
D. Avoidant/restrictive food intake disorder
E. Pica
Answer: B. Bulimia nervosa
Rationale: Bulimia nervosa is characterized by recurrent binge-
eating episodes accompanied by a sense of lack of control followed
by inappropriate compensatory behaviors such as vomiting, fasting,
or excessive exercise, with excessive influence of body weight or
shape on self-evaluation. A normal BMI does not exclude bulimia
nervosa. Hypokalemia is an important medical complication of
recurrent vomiting. Binge-eating disorder lacks regular
compensatory behavior.*
4.
A 41-year-old man develops recurrent episodes of sudden intense fear
accompanied by palpitations, sweating, trembling, chest tightness,
dizziness, and fear of dying. Cardiac evaluation is normal. He
subsequently becomes preoccupied with having another attack and
begins avoiding shopping centers because he fears being unable to
escape. What is the most likely diagnosis?
A. Generalized anxiety disorder
B. Panic disorder
3
, C. Social anxiety disorder
D. Specific phobia
E. Illness anxiety disorder
Answer: B. Panic disorder
Rationale: Panic disorder involves recurrent unexpected panic
attacks followed by persistent concern about additional attacks or
maladaptive behavioral changes such as avoidance. The
physiological symptoms described are characteristic of panic
attacks. Avoidance may develop secondarily but does not itself
establish agoraphobia. Generalized anxiety disorder involves
excessive anxiety across multiple domains rather than discrete
unexpected attacks.*
5.
A 38-year-old teacher experiences intense fear whenever required to
speak before groups. She knows the fear is excessive but nevertheless
develops tremulousness, sweating, flushing, and difficulty speaking. She
has begun declining professional presentations because of these
symptoms. Which treatment has the strongest evidence for long-term
management of this condition?
A. Long-term benzodiazepine monotherapy
B. Exposure-based cognitive behavioral therapy
C. Chronic antipsychotic therapy
D. Electroconvulsive therapy
E. Stimulant therapy
Answer: B. Exposure-based cognitive behavioral therapy
Rationale: Exposure-based CBT is a first-line evidence-based
treatment for social anxiety disorder because it directly targets
avoidance and fear conditioning. SSRIs and SNRIs are also
4
PSYCHIATRY CERTIFICATION EXAM WITH
ACTUAL QUESTIONS AND VERIFIED
ANSWERS, PLUS EXPLAINED
RATIONALES/EXPERT VERIFIED FOR
GUARANTEED 100% PASS 2026/LATEST
UPDATE/INSTANT DOWNLOAD PDF
1.
A 32-year-old woman presents with a 3-month history of depressed
mood, anhedonia, early-morning awakening, diminished appetite,
psychomotor retardation, impaired concentration, feelings of
worthlessness, and recurrent thoughts that she would be better off dead.
She denies hallucinations, delusions, manic symptoms, or substance use.
She has no specific suicide plan or intent. Her symptoms have caused
substantial occupational impairment. Which diagnosis best captures her
current presentation?
A. Persistent depressive disorder
B. Bipolar I disorder, current depressive episode
C. Major depressive disorder, single episode, severe without psychotic
features
D. Adjustment disorder with depressed mood
E. Cyclothymic disorder
Answer: C. Major depressive disorder, single episode, severe
without psychotic features
Rationale: The patient has a sustained cluster of depressive
symptoms involving mood, anhedonia, sleep, appetite, psychomotor
activity, cognition, self-worth, and suicidal ideation, with significant
functional impairment and no evidence of mania or psychosis. The
1
,severity is consistent with a severe major depressive episode, while
the absence of delusions or hallucinations argues against psychotic
features. Persistent depressive disorder requires a chronic depressed
mood pattern lasting at least 2 years, whereas adjustment disorder
requires an identifiable stressor and symptoms that do not meet
criteria for a major depressive episode.*
2.
A 24-year-old man reports periods of dramatically decreased need for
sleep, during which he sleeps only 2–3 hours nightly but feels
completely rested. During these periods he becomes excessively
talkative, develops grandiose plans, spends large amounts of money, and
engages in risky sexual behavior. One episode resulted in hospitalization
after he became severely disorganized and required emergency
intervention. Which diagnosis is most appropriate?
A. Bipolar II disorder
B. Cyclothymic disorder
C. Bipolar I disorder
D. Borderline personality disorder
E. Schizoaffective disorder
Answer: C. Bipolar I disorder
Rationale: Bipolar I disorder is defined by the occurrence of at least
one manic episode. The presence of severe functional impairment
and hospitalization strongly supports mania rather than hypomania.
Psychotic symptoms, hospitalization, or marked impairment can
occur during mania and automatically distinguish it from
hypomania. Bipolar II disorder requires hypomania plus a major
depressive episode and specifically excludes a history of mania.*
2
,3.
A 29-year-old woman has recurrent episodes of binge eating followed
by self-induced vomiting. She reports intense concern about body shape
and weight but currently has a BMI of 21 kg/m². Laboratory testing
shows mild hypokalemia. Which diagnosis is most likely?
A. Anorexia nervosa, restricting type
B. Bulimia nervosa
C. Binge-eating disorder
D. Avoidant/restrictive food intake disorder
E. Pica
Answer: B. Bulimia nervosa
Rationale: Bulimia nervosa is characterized by recurrent binge-
eating episodes accompanied by a sense of lack of control followed
by inappropriate compensatory behaviors such as vomiting, fasting,
or excessive exercise, with excessive influence of body weight or
shape on self-evaluation. A normal BMI does not exclude bulimia
nervosa. Hypokalemia is an important medical complication of
recurrent vomiting. Binge-eating disorder lacks regular
compensatory behavior.*
4.
A 41-year-old man develops recurrent episodes of sudden intense fear
accompanied by palpitations, sweating, trembling, chest tightness,
dizziness, and fear of dying. Cardiac evaluation is normal. He
subsequently becomes preoccupied with having another attack and
begins avoiding shopping centers because he fears being unable to
escape. What is the most likely diagnosis?
A. Generalized anxiety disorder
B. Panic disorder
3
, C. Social anxiety disorder
D. Specific phobia
E. Illness anxiety disorder
Answer: B. Panic disorder
Rationale: Panic disorder involves recurrent unexpected panic
attacks followed by persistent concern about additional attacks or
maladaptive behavioral changes such as avoidance. The
physiological symptoms described are characteristic of panic
attacks. Avoidance may develop secondarily but does not itself
establish agoraphobia. Generalized anxiety disorder involves
excessive anxiety across multiple domains rather than discrete
unexpected attacks.*
5.
A 38-year-old teacher experiences intense fear whenever required to
speak before groups. She knows the fear is excessive but nevertheless
develops tremulousness, sweating, flushing, and difficulty speaking. She
has begun declining professional presentations because of these
symptoms. Which treatment has the strongest evidence for long-term
management of this condition?
A. Long-term benzodiazepine monotherapy
B. Exposure-based cognitive behavioral therapy
C. Chronic antipsychotic therapy
D. Electroconvulsive therapy
E. Stimulant therapy
Answer: B. Exposure-based cognitive behavioral therapy
Rationale: Exposure-based CBT is a first-line evidence-based
treatment for social anxiety disorder because it directly targets
avoidance and fear conditioning. SSRIs and SNRIs are also
4
