BARKLEY DRT PMHNP EXAM DIAGNOSTIC
READINESS TEST PSYCHIATRIC MENTAL HEALTH
NURSE PRACTITIONER QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD
PDF.
Core Domains
Psychiatric Assessment and Differential Diagnosis
Neurobiology and Psychopharmacology
Depressive Disorders and Treatment
Bipolar and Related Disorders
Anxiety Disorders and Trauma-Related Disorders
Schizophrenia Spectrum and Psychotic Disorders
Substance Use Disorders and Addiction Medicine
Eating Disorders
Child and Adolescent Psychiatry
Geriatric Psychiatry and Neurocognitive Disorders
Psychotherapy Modalities and Therapeutic Communication
Legal and Ethical Issues in Psychiatric Practice
Crisis Intervention and Suicide Prevention
SPMI and Rehabilitation Models
Introduction
The Barkley DRT PMHNP Examination is designed to assess the clinical knowledge,
diagnostic reasoning, and psychopharmacologic decision-making required of
psychiatric-mental health nurse practitioner students. The examination evaluates
foundational principles of psychiatric assessment, differential diagnosis,
neurobiology, and evidence-based treatment across the lifespan. Candidates are
,assessed on their ability to apply DSM-5-TR criteria, select appropriate
pharmacologic and non-pharmacologic interventions, recognize adverse effects
and drug interactions, and adhere to ethical and legal standards. The exam utilizes
multiple-choice and scenario-based questions to emphasize real-world clinical
application, critical thinking, and safe prescribing practices.
SECTION ONE: QUESTIONS 1-100
1. During a suicide intervention with a 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
A. "No Harm" contract
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 establishes a therapeutic
agreement focused on safety.
2. Courtney, 35, is a rape victim. You note that she has an expressed style of
coping in her acute rape trauma syndrome. Which finding 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
C. Patient smiling
RATIONALE: Smiling is an expressed style of coping as it masks the internal
emotional turmoil. In the expressed style of coping, patients may display their
emotions openly, including smiling, talking, and crying.
, 3. Which patient 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
B. A 27-year-old female with repeated use of laxatives and diuretics at least two
times a week for 3 months
RATIONALE: Hospitalization criteria for eating disorders include bradycardia (<
40 BPM), hypothermia (< 96°F), electrolyte imbalances, and significant weight loss
(< 85% of ideal body weight). The patient in option B may not meet hospitalization
criteria based on the information provided.
4. What does diagnostic reasoning allow the PMHNP to do?
A. Prescribe medication without assessment
B. Focus on what needs to be asked and examined, cluster abnormal findings,
develop differential diagnoses, and analyze/interprete findings
C. Make a diagnosis based on a single symptom
D. Bypass the physical examination
B. Focus on what needs to be asked and examined, cluster abnormal findings,
develop differential diagnoses, and analyze/interprete findings
RATIONALE: Diagnostic reasoning enables the provider to focus assessment,
cluster findings, develop differentials, and interpret results systematically. This is
foundational to clinical decision-making.
5. When taking a History of Present Illness (HPI), the mnemonic OLD CART
stands for:
A. Onset, Location, Duration, Character, Aggravating factors, Relieving factors,
Treatment
B. Only, Location, Diagnosis, Character, Assessment, Referral, Time
, C. Onset, Level, Duration, Cause, Aggression, Relief, Timing
D. Observation, Location, Duration, Condition, Aggravation, Resolution, Therapy
A. Onset, Location, Duration, Character, Aggravating factors, Relieving factors,
Treatment
RATIONALE: OLD CART is a comprehensive mnemonic for HPI data collection:
Onset, Location, Duration, Character, Aggravating/Associating factors, Relieving
factors, and Treatment.
6. Inductive reasoning in clinical practice is defined as:
A. Moving from general principles to specific conclusions
B. Moving from specific findings or complaints to more general patterns or
diagnoses
C. Relying solely on evidence-based guidelines
D. Using intuition without data
B. Moving from specific findings or complaints to more general patterns or
diagnoses
RATIONALE: Inductive reasoning involves building general conclusions from
specific observations. In clinical practice, this means starting with patient-specific
findings and moving toward broader diagnostic patterns.
7. A PMHNP is assessing a patient who presents with anhedonia, insomnia, and
feelings of worthlessness. The PMHNP suspects major depressive disorder.
Which neurotransmitter system is most implicated in the pathophysiology of
depression?
A. Dopaminergic system
B. Serotonergic system
C. GABAergic system
D. Glutamatergic system
B. Serotonergic system
READINESS TEST PSYCHIATRIC MENTAL HEALTH
NURSE PRACTITIONER QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD
PDF.
Core Domains
Psychiatric Assessment and Differential Diagnosis
Neurobiology and Psychopharmacology
Depressive Disorders and Treatment
Bipolar and Related Disorders
Anxiety Disorders and Trauma-Related Disorders
Schizophrenia Spectrum and Psychotic Disorders
Substance Use Disorders and Addiction Medicine
Eating Disorders
Child and Adolescent Psychiatry
Geriatric Psychiatry and Neurocognitive Disorders
Psychotherapy Modalities and Therapeutic Communication
Legal and Ethical Issues in Psychiatric Practice
Crisis Intervention and Suicide Prevention
SPMI and Rehabilitation Models
Introduction
The Barkley DRT PMHNP Examination is designed to assess the clinical knowledge,
diagnostic reasoning, and psychopharmacologic decision-making required of
psychiatric-mental health nurse practitioner students. The examination evaluates
foundational principles of psychiatric assessment, differential diagnosis,
neurobiology, and evidence-based treatment across the lifespan. Candidates are
,assessed on their ability to apply DSM-5-TR criteria, select appropriate
pharmacologic and non-pharmacologic interventions, recognize adverse effects
and drug interactions, and adhere to ethical and legal standards. The exam utilizes
multiple-choice and scenario-based questions to emphasize real-world clinical
application, critical thinking, and safe prescribing practices.
SECTION ONE: QUESTIONS 1-100
1. During a suicide intervention with a 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
A. "No Harm" contract
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 establishes a therapeutic
agreement focused on safety.
2. Courtney, 35, is a rape victim. You note that she has an expressed style of
coping in her acute rape trauma syndrome. Which finding 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
C. Patient smiling
RATIONALE: Smiling is an expressed style of coping as it masks the internal
emotional turmoil. In the expressed style of coping, patients may display their
emotions openly, including smiling, talking, and crying.
, 3. Which patient 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
B. A 27-year-old female with repeated use of laxatives and diuretics at least two
times a week for 3 months
RATIONALE: Hospitalization criteria for eating disorders include bradycardia (<
40 BPM), hypothermia (< 96°F), electrolyte imbalances, and significant weight loss
(< 85% of ideal body weight). The patient in option B may not meet hospitalization
criteria based on the information provided.
4. What does diagnostic reasoning allow the PMHNP to do?
A. Prescribe medication without assessment
B. Focus on what needs to be asked and examined, cluster abnormal findings,
develop differential diagnoses, and analyze/interprete findings
C. Make a diagnosis based on a single symptom
D. Bypass the physical examination
B. Focus on what needs to be asked and examined, cluster abnormal findings,
develop differential diagnoses, and analyze/interprete findings
RATIONALE: Diagnostic reasoning enables the provider to focus assessment,
cluster findings, develop differentials, and interpret results systematically. This is
foundational to clinical decision-making.
5. When taking a History of Present Illness (HPI), the mnemonic OLD CART
stands for:
A. Onset, Location, Duration, Character, Aggravating factors, Relieving factors,
Treatment
B. Only, Location, Diagnosis, Character, Assessment, Referral, Time
, C. Onset, Level, Duration, Cause, Aggression, Relief, Timing
D. Observation, Location, Duration, Condition, Aggravation, Resolution, Therapy
A. Onset, Location, Duration, Character, Aggravating factors, Relieving factors,
Treatment
RATIONALE: OLD CART is a comprehensive mnemonic for HPI data collection:
Onset, Location, Duration, Character, Aggravating/Associating factors, Relieving
factors, and Treatment.
6. Inductive reasoning in clinical practice is defined as:
A. Moving from general principles to specific conclusions
B. Moving from specific findings or complaints to more general patterns or
diagnoses
C. Relying solely on evidence-based guidelines
D. Using intuition without data
B. Moving from specific findings or complaints to more general patterns or
diagnoses
RATIONALE: Inductive reasoning involves building general conclusions from
specific observations. In clinical practice, this means starting with patient-specific
findings and moving toward broader diagnostic patterns.
7. A PMHNP is assessing a patient who presents with anhedonia, insomnia, and
feelings of worthlessness. The PMHNP suspects major depressive disorder.
Which neurotransmitter system is most implicated in the pathophysiology of
depression?
A. Dopaminergic system
B. Serotonergic system
C. GABAergic system
D. Glutamatergic system
B. Serotonergic system
