Barkley PMHNP Predictor/Readiness Practice FLORIDA
STATE FIRE INSTRUCTOR 3 ACTUAL EXAM ALL
QUESTIONS AND ANSWERS ALREADY GRADED A+. 100%
VERIFIED SOLUTIONS | UPDATED PER LATEST
GUIDELINES | GRADED A+
SECTION 1 — PSYCHIATRIC ASSESSMENT & DIAGNOSIS
1. A patient reports hearing voices that others cannot hear. Which term best describes this
symptom?
A. Delusion
B. Hallucination
C. Obsession
D. Illusion
Answer: B. Hallucination
Rationale: A hallucination is a perception occurring without an external stimulus. Auditory
hallucinations are common in schizophrenia-spectrum disorders but can also occur with mood
disorders, substances, neurologic conditions, and other illnesses.
2. A patient firmly believes that the FBI has implanted a tracking device in their brain despite
no evidence supporting this belief. What is this?
A. Obsession
B. Delusion
C. Phobia
D. Confabulation
Answer: B. Delusion
Rationale: A delusion is a fixed, false belief that persists despite contradictory evidence. This
example represents a persecutory or bizarre delusional belief.
,3. Which finding represents a positive symptom of schizophrenia?
A. Flat affect
B. Avolition
C. Auditory hallucinations
D. Social withdrawal
Answer: C. Auditory hallucinations
Rationale: Positive symptoms include hallucinations, delusions, disorganized speech, and
grossly disorganized behavior. Negative symptoms include diminished emotional expression,
avolition, and social withdrawal.
4. Which finding is a negative symptom of schizophrenia?
A. Delusion
B. Hallucination
C. Avolition
D. Disorganized speech
Answer: C. Avolition
Rationale: Avolition is reduced motivation and goal-directed activity and is a negative symptom.
5. A patient describes recurrent intrusive thoughts about contamination and repeatedly
washes their hands for hours each day. What diagnosis is most likely?
A. OCD
B. PTSD
C. Bipolar disorder
D. Schizophrenia
Answer: A. OCD
Rationale: OCD involves obsessions, compulsions, or both. The intrusive contamination
thoughts are obsessions, while repetitive handwashing is a compulsion.
6. What is the best initial approach when evaluating a patient with a new psychiatric
presentation?
,A. Immediately prescribe medication
B. Obtain a comprehensive psychiatric and medical history
C. Assume the diagnosis based on appearance
D. Avoid asking about substance use
Answer: B
Rationale: Psychiatric assessment requires history of present illness, psychiatric history, medical
history, medications, substance use, family history, psychosocial factors, mental status
examination, and safety assessment.
7. Which component is essential in every psychiatric evaluation?
A. Suicide-risk assessment
B. Genetic testing
C. Brain MRI
D. EEG
Answer: A
Rationale: Suicide risk should be assessed when clinically indicated, particularly in patients with
depression, psychosis, substance use, significant psychosocial stressors, or suicidal thoughts.
8. A patient is oriented to person and place but cannot state the date and is unable to
maintain attention. Which condition should be considered?
A. Delirium
B. OCD
C. Panic disorder
D. Specific phobia
Answer: A
Rationale: Acute changes in attention, awareness, and cognition strongly suggest delirium,
which requires evaluation for an underlying medical or substance-related cause.
9. Which feature most strongly differentiates delirium from dementia?
A. Memory impairment
B. Older age
, C. Acute onset and fluctuating course
D. Difficulty with complex tasks
Answer: C
Rationale: Delirium typically has an acute onset and fluctuating course with prominent
inattention. Dementia is generally chronic and progressive.
10. Which mental-status finding describes a patient's emotional expression?
A. Thought process
B. Affect
C. Thought content
D. Insight
Answer: B. Affect
Rationale: Affect refers to the observable expression of emotion. Mood refers to the patient's
subjective emotional state.
SECTION 2 — DEPRESSION & SUICIDE
11. Which symptom is required for a diagnosis of major depressive disorder?
A. Insomnia
B. Depressed mood or anhedonia
C. Weight gain
D. Fatigue
Answer: B
Rationale: At least one of the core symptoms must be depressed mood or markedly diminished
interest/pleasure. Additional symptoms are required to meet full diagnostic criteria.
12. Which symptom is most characteristic of anhedonia?
A. Excessive energy
B. Loss of interest or pleasure
C. Racing thoughts
D. Increased appetite only
STATE FIRE INSTRUCTOR 3 ACTUAL EXAM ALL
QUESTIONS AND ANSWERS ALREADY GRADED A+. 100%
VERIFIED SOLUTIONS | UPDATED PER LATEST
GUIDELINES | GRADED A+
SECTION 1 — PSYCHIATRIC ASSESSMENT & DIAGNOSIS
1. A patient reports hearing voices that others cannot hear. Which term best describes this
symptom?
A. Delusion
B. Hallucination
C. Obsession
D. Illusion
Answer: B. Hallucination
Rationale: A hallucination is a perception occurring without an external stimulus. Auditory
hallucinations are common in schizophrenia-spectrum disorders but can also occur with mood
disorders, substances, neurologic conditions, and other illnesses.
2. A patient firmly believes that the FBI has implanted a tracking device in their brain despite
no evidence supporting this belief. What is this?
A. Obsession
B. Delusion
C. Phobia
D. Confabulation
Answer: B. Delusion
Rationale: A delusion is a fixed, false belief that persists despite contradictory evidence. This
example represents a persecutory or bizarre delusional belief.
,3. Which finding represents a positive symptom of schizophrenia?
A. Flat affect
B. Avolition
C. Auditory hallucinations
D. Social withdrawal
Answer: C. Auditory hallucinations
Rationale: Positive symptoms include hallucinations, delusions, disorganized speech, and
grossly disorganized behavior. Negative symptoms include diminished emotional expression,
avolition, and social withdrawal.
4. Which finding is a negative symptom of schizophrenia?
A. Delusion
B. Hallucination
C. Avolition
D. Disorganized speech
Answer: C. Avolition
Rationale: Avolition is reduced motivation and goal-directed activity and is a negative symptom.
5. A patient describes recurrent intrusive thoughts about contamination and repeatedly
washes their hands for hours each day. What diagnosis is most likely?
A. OCD
B. PTSD
C. Bipolar disorder
D. Schizophrenia
Answer: A. OCD
Rationale: OCD involves obsessions, compulsions, or both. The intrusive contamination
thoughts are obsessions, while repetitive handwashing is a compulsion.
6. What is the best initial approach when evaluating a patient with a new psychiatric
presentation?
,A. Immediately prescribe medication
B. Obtain a comprehensive psychiatric and medical history
C. Assume the diagnosis based on appearance
D. Avoid asking about substance use
Answer: B
Rationale: Psychiatric assessment requires history of present illness, psychiatric history, medical
history, medications, substance use, family history, psychosocial factors, mental status
examination, and safety assessment.
7. Which component is essential in every psychiatric evaluation?
A. Suicide-risk assessment
B. Genetic testing
C. Brain MRI
D. EEG
Answer: A
Rationale: Suicide risk should be assessed when clinically indicated, particularly in patients with
depression, psychosis, substance use, significant psychosocial stressors, or suicidal thoughts.
8. A patient is oriented to person and place but cannot state the date and is unable to
maintain attention. Which condition should be considered?
A. Delirium
B. OCD
C. Panic disorder
D. Specific phobia
Answer: A
Rationale: Acute changes in attention, awareness, and cognition strongly suggest delirium,
which requires evaluation for an underlying medical or substance-related cause.
9. Which feature most strongly differentiates delirium from dementia?
A. Memory impairment
B. Older age
, C. Acute onset and fluctuating course
D. Difficulty with complex tasks
Answer: C
Rationale: Delirium typically has an acute onset and fluctuating course with prominent
inattention. Dementia is generally chronic and progressive.
10. Which mental-status finding describes a patient's emotional expression?
A. Thought process
B. Affect
C. Thought content
D. Insight
Answer: B. Affect
Rationale: Affect refers to the observable expression of emotion. Mood refers to the patient's
subjective emotional state.
SECTION 2 — DEPRESSION & SUICIDE
11. Which symptom is required for a diagnosis of major depressive disorder?
A. Insomnia
B. Depressed mood or anhedonia
C. Weight gain
D. Fatigue
Answer: B
Rationale: At least one of the core symptoms must be depressed mood or markedly diminished
interest/pleasure. Additional symptoms are required to meet full diagnostic criteria.
12. Which symptom is most characteristic of anhedonia?
A. Excessive energy
B. Loss of interest or pleasure
C. Racing thoughts
D. Increased appetite only
