Barkley PMHNP Practice FLORIDA STATE FIRE
INSTRUCTOR 3 ACTUAL EXAM ALL QUESTIONS AND
ANSWERS ALREADY GRADED A+. 100% VERIFIED
SOLUTIONS | UPDATED PER LATEST GUIDELINES |
GRADED A+
Crisis Intervention & Assessment (Questions 1-10)
Question 1
During a suicide intervention with your 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
Correct Answer: A
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. This is a standard safety intervention in crisis situations .
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
Correct Answer: C
,Rationale: Smiling is an expressed style of coping as it masks the underlying distress. In acute
rape trauma syndrome, expressed style refers to outwardly displaying emotions that may not
reflect the true internal state. The expressed style is characterized by showing emotions that are
contrary to the internal experience .
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
Correct Answer: B
Rationale: The 27-year-old female with laxative/diuretic use twice weekly does not meet typical
inpatient criteria unless other severe symptoms are present. The other options show significant
medical instability (bradycardia, hypothermia, severe underweight) requiring hospitalization.
Medical instability is a key criterion for inpatient admission in eating disorders .
Question 4
During a crisis assessment, by showing empathy, confrontation, and immediacy, you are
exhibiting which of the following?
A. Identifying the hazard and precipitating event
B. Counseling keystones relevant to assessment of a crisis
C. Identifying coping mechanisms
D. Situational support
Correct Answer: B
Rationale: Three of the counseling keystones relevant to assessment of a crisis are empathy,
confrontation, and immediacy. These core therapeutic techniques are essential for effective
crisis intervention and assessment .
,Question 5
A patient with which of the following findings should be referred to primary care for
cardiovascular problems?
A. A patient with a blood pressure of 130/85 mmHg
B. A patient with a blood pressure of 145/92 mmHg
C. A patient with a heart rate of 85 bpm
D. A patient with a heart rate of 70 bpm
Correct Answer: B
Rationale: A blood pressure of 145/92 mmHg is elevated and requires evaluation for
hypertension. While 130/85 is borderline, 145/92 meets criteria for stage 1 hypertension and
warrants further assessment. Psychiatric medications can impact cardiovascular parameters,
making this an important consideration .
Question 6
A 28-year-old female with a history of PTSD presents with flashbacks, hypervigilance, and
nightmares. She reports using alcohol to help her sleep. What is the most appropriate first-line
pharmacologic intervention for her nightmares?
A. Quetiapine 25 mg at bedtime
B. Prazosin 1 mg at bedtime
C. Trazodone 50 mg at bedtime
D. Hydroxyzine 25 mg at bedtime
Correct Answer: B
Rationale: Prazosin is an alpha-1 antagonist with robust evidence for reducing trauma-related
nightmares in PTSD. While trazodone and quetiapine are used for sleep, prazosin is the
guideline-supported first-line agent specifically for PTSD-associated nightmares. Alcohol use
should be addressed concurrently .
Question 7
A patient on long-term haloperidol presents with parkinsonism, including bradykinesia and
rigidity. Which intervention is most appropriate?
A. Add benztropine
B. Increase haloperidol dose
, C. Switch to aripiprazole
D. Add propranolol
Correct Answer: A
Rationale: Benztropine is an anticholinergic that treats antipsychotic-induced EPS by restoring
dopamine-acetylcholine balance. Increasing the dose would worsen EPS. Aripiprazole is a partial
agonist and can also cause EPS; switching is not first-line for acute EPS management.
Propranolol treats tremor but not rigidity or bradykinesia .
Question 8
A PMHNP is reviewing a patient's chart and notes the phrase "blunted affect." Which clinical
presentation best correlates with this documentation?
A. A complete lack of emotional expression
B. A wide range of emotional expression with rapid shifts
C. A significant reduction in the intensity of emotional expression
D. Emotional expression that is incongruent with the situation
Correct Answer: C
Rationale: Blunted affect refers to a marked reduction in the intensity of emotional expression.
Flat affect is the complete absence of emotional expression. Labile affect refers to rapid shifts,
and inappropriate affect is incongruent with the content of discussion. Accurate documentation
of affect is crucial for psychiatric assessment .
Question 9
Which of the following best describes the concept of "medical necessity" as required for
insurance reimbursement in psychiatric practice?
A. The treatment is convenient for the patient's schedule
B. The treatment is intended to prevent, diagnose, or treat a condition that leads to significant
impairment in functioning
C. The treatment is requested by the patient's family
D. The treatment is the most expensive option available to ensure quality
Correct Answer: B
Rationale: Medical necessity requires that services are essential to prevent, diagnose, or treat a
condition that causes significant functional impairment. This is a core requirement for insurance
INSTRUCTOR 3 ACTUAL EXAM ALL QUESTIONS AND
ANSWERS ALREADY GRADED A+. 100% VERIFIED
SOLUTIONS | UPDATED PER LATEST GUIDELINES |
GRADED A+
Crisis Intervention & Assessment (Questions 1-10)
Question 1
During a suicide intervention with your 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
Correct Answer: A
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. This is a standard safety intervention in crisis situations .
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
Correct Answer: C
,Rationale: Smiling is an expressed style of coping as it masks the underlying distress. In acute
rape trauma syndrome, expressed style refers to outwardly displaying emotions that may not
reflect the true internal state. The expressed style is characterized by showing emotions that are
contrary to the internal experience .
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
Correct Answer: B
Rationale: The 27-year-old female with laxative/diuretic use twice weekly does not meet typical
inpatient criteria unless other severe symptoms are present. The other options show significant
medical instability (bradycardia, hypothermia, severe underweight) requiring hospitalization.
Medical instability is a key criterion for inpatient admission in eating disorders .
Question 4
During a crisis assessment, by showing empathy, confrontation, and immediacy, you are
exhibiting which of the following?
A. Identifying the hazard and precipitating event
B. Counseling keystones relevant to assessment of a crisis
C. Identifying coping mechanisms
D. Situational support
Correct Answer: B
Rationale: Three of the counseling keystones relevant to assessment of a crisis are empathy,
confrontation, and immediacy. These core therapeutic techniques are essential for effective
crisis intervention and assessment .
,Question 5
A patient with which of the following findings should be referred to primary care for
cardiovascular problems?
A. A patient with a blood pressure of 130/85 mmHg
B. A patient with a blood pressure of 145/92 mmHg
C. A patient with a heart rate of 85 bpm
D. A patient with a heart rate of 70 bpm
Correct Answer: B
Rationale: A blood pressure of 145/92 mmHg is elevated and requires evaluation for
hypertension. While 130/85 is borderline, 145/92 meets criteria for stage 1 hypertension and
warrants further assessment. Psychiatric medications can impact cardiovascular parameters,
making this an important consideration .
Question 6
A 28-year-old female with a history of PTSD presents with flashbacks, hypervigilance, and
nightmares. She reports using alcohol to help her sleep. What is the most appropriate first-line
pharmacologic intervention for her nightmares?
A. Quetiapine 25 mg at bedtime
B. Prazosin 1 mg at bedtime
C. Trazodone 50 mg at bedtime
D. Hydroxyzine 25 mg at bedtime
Correct Answer: B
Rationale: Prazosin is an alpha-1 antagonist with robust evidence for reducing trauma-related
nightmares in PTSD. While trazodone and quetiapine are used for sleep, prazosin is the
guideline-supported first-line agent specifically for PTSD-associated nightmares. Alcohol use
should be addressed concurrently .
Question 7
A patient on long-term haloperidol presents with parkinsonism, including bradykinesia and
rigidity. Which intervention is most appropriate?
A. Add benztropine
B. Increase haloperidol dose
, C. Switch to aripiprazole
D. Add propranolol
Correct Answer: A
Rationale: Benztropine is an anticholinergic that treats antipsychotic-induced EPS by restoring
dopamine-acetylcholine balance. Increasing the dose would worsen EPS. Aripiprazole is a partial
agonist and can also cause EPS; switching is not first-line for acute EPS management.
Propranolol treats tremor but not rigidity or bradykinesia .
Question 8
A PMHNP is reviewing a patient's chart and notes the phrase "blunted affect." Which clinical
presentation best correlates with this documentation?
A. A complete lack of emotional expression
B. A wide range of emotional expression with rapid shifts
C. A significant reduction in the intensity of emotional expression
D. Emotional expression that is incongruent with the situation
Correct Answer: C
Rationale: Blunted affect refers to a marked reduction in the intensity of emotional expression.
Flat affect is the complete absence of emotional expression. Labile affect refers to rapid shifts,
and inappropriate affect is incongruent with the content of discussion. Accurate documentation
of affect is crucial for psychiatric assessment .
Question 9
Which of the following best describes the concept of "medical necessity" as required for
insurance reimbursement in psychiatric practice?
A. The treatment is convenient for the patient's schedule
B. The treatment is intended to prevent, diagnose, or treat a condition that leads to significant
impairment in functioning
C. The treatment is requested by the patient's family
D. The treatment is the most expensive option available to ensure quality
Correct Answer: B
Rationale: Medical necessity requires that services are essential to prevent, diagnose, or treat a
condition that causes significant functional impairment. This is a core requirement for insurance
