Barkley DRT PMHNP Practicum 1 Pre-Test
2026 | Comprehensive Practice Exam |
Verified Questions & Answers for
Psychiatric Mental Health NP Preparation
SECTION I — Foundations of Psychiatric Assessment & Interviewing
1. A PMHNP is conducting an initial interview with a 34-year-old who speaks
English as a second language. Which action best supports accurate diagnostic
data?
A. Use a family member to interpret to save time
B. Use a trained medical interpreter and speak directly to the patient
C. Speak slowly and loudly in English
D. Defer the interview until the patient learns English
Correct Answer: B
Rationale: Trained medical interpreters reduce diagnostic error and
preserve confidentiality. Using family members risks mistranslation, role conflicts,
and censored content. Speaking loudly does not improve comprehension, and
deferring care is inappropriate and potentially harmful.
2. Which component of the mental status exam specifically assesses a patient's
ability to understand and act on information?
A. Insight
B. Judgment
C. Orientation
D. Attention
Correct Answer: B
Rationale: Judgment reflects the capacity to make sound decisions and act
appropriately on information. Insight is awareness of one's own condition.
,Orientation assesses time, place, person. Attention is tested by serial sevens or
digit span.
3. A patient reports hearing voices that others do not hear. This is best
documented as:
A. Illusion
B. Hallucination
C. Delusion
D. Depersonalization
Correct Answer: B
Rationale: A hallucination is a sensory perception without external
stimulus. An illusion is a misperception of a real stimulus. A delusion is a fixed
false belief. Depersonalization is detachment from oneself.
4. Which of the following are elements of a comprehensive psychiatric
evaluation? (Select all that apply)
A. Chief complaint and history of present illness
B. Past psychiatric and medical history
C. Substance use history
D. Family psychiatric history
E. The patient's genetic sequencing
Correct Answers: A, B, C, D
Rationale: A standard psychiatric evaluation includes CC/HPI, past
psychiatric and medical history, substance use, family history,
social/developmental history, MSE, and risk assessment. Routine genetic
sequencing is not part of a standard evaluation.
5. A patient with schizophrenia has a flat affect, poverty of speech, and social
withdrawal. These are best classified as:
,A. Positive symptoms
B. Negative symptoms
C. Cognitive symptoms
D. Affective symptoms
Correct Answer: B
Rationale: Negative symptoms involve deficits—blunted affect, alogia,
avolition, anhedonia, asociality. Positive symptoms are additions (hallucinations,
delusions). Cognitive symptoms include impaired attention and executive
function.
6. The CAGE questionnaire is used to screen for:
A. Depression
B. Anxiety
C. Alcohol use disorder
D. PTSD
Correct Answer: C
Rationale: CAGE = Cut down, Annoyed, Guilty, Eye-opener—a brief alcohol
screening tool. PHQ-9 screens depression, GAD-7 screens anxiety, PCL-5 screens
PTSD.
7. A PMHNP assesses a patient who minimizes symptoms and blames others for
his problems. Which defense mechanism is most likely?
A. Projection
B. Denial
C. Rationalization
D. Sublimation
Correct Answer: A
, Rationale: Projection involves attributing one's own unacceptable feelings
to others. Denial is refusing to accept reality. Rationalization is creating logical
excuses. Sublimation is channeling impulses into acceptable outlets.
8. Which question best assesses suicidal ideation during a risk assessment?
A. "You're not thinking of hurting yourself, are you?"
B. "Do you have thoughts of ending your life?"
C. "Has anyone in your family committed suicide?"
D. "Are you feeling sad today?"
Rationale: Direct, non-leading, open phrasing elicits accurate information.
"You're not thinking…" is leading and discourages disclosure. Family history and
mood are relevant but do not directly assess current ideation.
Correct Answer: B
9. A patient's speech is rapid, pressured, and difficult to interrupt. This is most
consistent with:
A. Alogia
B. Pressured speech
C. Clanging
D. Neologism
Correct Answer: B
Rationale: Pressured speech is rapid, urgent speech that is difficult to
interrupt, often seen in mania. Alogia is poverty of speech. Clanging is rhyming
based on sound. Neologism is a made-up word.
10. Which of the following are components of the Mini-Mental State Examination
(MMSE)? (Select all that apply)
A. Orientation
B. Registration
2026 | Comprehensive Practice Exam |
Verified Questions & Answers for
Psychiatric Mental Health NP Preparation
SECTION I — Foundations of Psychiatric Assessment & Interviewing
1. A PMHNP is conducting an initial interview with a 34-year-old who speaks
English as a second language. Which action best supports accurate diagnostic
data?
A. Use a family member to interpret to save time
B. Use a trained medical interpreter and speak directly to the patient
C. Speak slowly and loudly in English
D. Defer the interview until the patient learns English
Correct Answer: B
Rationale: Trained medical interpreters reduce diagnostic error and
preserve confidentiality. Using family members risks mistranslation, role conflicts,
and censored content. Speaking loudly does not improve comprehension, and
deferring care is inappropriate and potentially harmful.
2. Which component of the mental status exam specifically assesses a patient's
ability to understand and act on information?
A. Insight
B. Judgment
C. Orientation
D. Attention
Correct Answer: B
Rationale: Judgment reflects the capacity to make sound decisions and act
appropriately on information. Insight is awareness of one's own condition.
,Orientation assesses time, place, person. Attention is tested by serial sevens or
digit span.
3. A patient reports hearing voices that others do not hear. This is best
documented as:
A. Illusion
B. Hallucination
C. Delusion
D. Depersonalization
Correct Answer: B
Rationale: A hallucination is a sensory perception without external
stimulus. An illusion is a misperception of a real stimulus. A delusion is a fixed
false belief. Depersonalization is detachment from oneself.
4. Which of the following are elements of a comprehensive psychiatric
evaluation? (Select all that apply)
A. Chief complaint and history of present illness
B. Past psychiatric and medical history
C. Substance use history
D. Family psychiatric history
E. The patient's genetic sequencing
Correct Answers: A, B, C, D
Rationale: A standard psychiatric evaluation includes CC/HPI, past
psychiatric and medical history, substance use, family history,
social/developmental history, MSE, and risk assessment. Routine genetic
sequencing is not part of a standard evaluation.
5. A patient with schizophrenia has a flat affect, poverty of speech, and social
withdrawal. These are best classified as:
,A. Positive symptoms
B. Negative symptoms
C. Cognitive symptoms
D. Affective symptoms
Correct Answer: B
Rationale: Negative symptoms involve deficits—blunted affect, alogia,
avolition, anhedonia, asociality. Positive symptoms are additions (hallucinations,
delusions). Cognitive symptoms include impaired attention and executive
function.
6. The CAGE questionnaire is used to screen for:
A. Depression
B. Anxiety
C. Alcohol use disorder
D. PTSD
Correct Answer: C
Rationale: CAGE = Cut down, Annoyed, Guilty, Eye-opener—a brief alcohol
screening tool. PHQ-9 screens depression, GAD-7 screens anxiety, PCL-5 screens
PTSD.
7. A PMHNP assesses a patient who minimizes symptoms and blames others for
his problems. Which defense mechanism is most likely?
A. Projection
B. Denial
C. Rationalization
D. Sublimation
Correct Answer: A
, Rationale: Projection involves attributing one's own unacceptable feelings
to others. Denial is refusing to accept reality. Rationalization is creating logical
excuses. Sublimation is channeling impulses into acceptable outlets.
8. Which question best assesses suicidal ideation during a risk assessment?
A. "You're not thinking of hurting yourself, are you?"
B. "Do you have thoughts of ending your life?"
C. "Has anyone in your family committed suicide?"
D. "Are you feeling sad today?"
Rationale: Direct, non-leading, open phrasing elicits accurate information.
"You're not thinking…" is leading and discourages disclosure. Family history and
mood are relevant but do not directly assess current ideation.
Correct Answer: B
9. A patient's speech is rapid, pressured, and difficult to interrupt. This is most
consistent with:
A. Alogia
B. Pressured speech
C. Clanging
D. Neologism
Correct Answer: B
Rationale: Pressured speech is rapid, urgent speech that is difficult to
interrupt, often seen in mania. Alogia is poverty of speech. Clanging is rhyming
based on sound. Neologism is a made-up word.
10. Which of the following are components of the Mini-Mental State Examination
(MMSE)? (Select all that apply)
A. Orientation
B. Registration
