BARKLEY DRT PMHNP PRACTICUM 1 PRE-TEST | 200
ORIGINAL PRACTICE QUESTIONS | 2026–2027 STUDY
GUIDE
SECTION ONE — QUESTIONS 1–100
1. At an initial psychiatric intake, which approach best reflects safe practice regarding
suicide risk?
A) Directly assess suicidal intent, plan, access to means, and protective factors.
B) Reassure the person without asking about suicide.
C) Postpone the assessment until the next visit.
D) Assume denial of depression excludes suicide risk.
Correct Answer: A) Directly assess suicidal intent, plan, access to means, and protective
factors.
Rationale: The best approach to suicide risk is to directly assess suicidal intent, plan, access to
means, and protective factors. This choice emphasizes a clinically relevant assessment or
intervention rather than an unsupported shortcut. Alternatives such as reassure the person
without asking about suicide are less appropriate because they omit essential assessment,
safety, or evidence-based care. In practice, individualize the decision to the patient’s history,
current risk, preferences, and applicable clinical guidance.
2. At an initial psychiatric intake, which approach best reflects safe practice regarding
acute mania?
A) Treat the episode as uncomplicated insomnia.
B) Assess sleep, safety, psychosis, substance use, and functional impairment.
C) Diagnose adhd solely from pressured speech.
D) Start an antidepressant alone without assessing bipolar history.
Correct Answer: B) Assess sleep, safety, psychosis, substance use, and functional
impairment.
Rationale: The best approach to acute mania is to assess sleep, safety, psychosis, substance
use, and functional impairment. This choice emphasizes a clinically relevant assessment or
intervention rather than an unsupported shortcut. Alternatives such as diagnose ADHD solely
from pressured speech are less appropriate because they omit essential assessment, safety, or
evidence-based care. In practice, individualize the decision to the patient’s history, current risk,
preferences, and applicable clinical guidance.
,3. At an initial psychiatric intake, which approach best reflects safe practice regarding
major depression?
A) Omit suicide assessment if the patient smiles.
B) Prescribe treatment without screening for manic episodes.
C) Evaluate duration, impairment, suicidality, medical contributors, and past mania.
D) Base diagnosis on a single day of sadness.
Correct Answer: C) Evaluate duration, impairment, suicidality, medical contributors, and
past mania.
Rationale: The best approach to major depression is to evaluate duration, impairment,
suicidality, medical contributors, and past mania. This choice emphasizes a clinically relevant
assessment or intervention rather than an unsupported shortcut. Alternatives such as base
diagnosis on a single day of sadness are less appropriate because they omit essential
assessment, safety, or evidence-based care. In practice, individualize the decision to the
patient’s history, current risk, preferences, and applicable clinical guidance.
4. At an initial psychiatric intake, which approach best reflects safe practice regarding
generalized anxiety?
A) Equate any transient stress with the disorder.
B) Assume panic attacks are mandatory.
C) Exclude medical and substance contributors without review.
D) Assess excessive difficult-to-control worry and associated symptoms over time.
Correct Answer: D) Assess excessive difficult-to-control worry and associated symptoms
over time.
Rationale: The best approach to generalized anxiety is to assess excessive difficult-to-control
worry and associated symptoms over time. This choice emphasizes a clinically relevant
assessment or intervention rather than an unsupported shortcut. Alternatives such as equate
any transient stress with the disorder are less appropriate because they omit essential
assessment, safety, or evidence-based care. In practice, individualize the decision to the
patient’s history, current risk, preferences, and applicable clinical guidance.
5. At an initial psychiatric intake, which approach best reflects safe practice regarding
panic symptoms?
A) Consider urgent medical mimics before attributing new chest symptoms to panic.
B) Diagnose panic disorder after any isolated palpitations.
C) Dismiss chest pain without clinical evaluation.
D) Assume every panic attack indicates psychosis.
,Correct Answer: A) Consider urgent medical mimics before attributing new chest
symptoms to panic.
Rationale: The best approach to panic symptoms is to consider urgent medical mimics before
attributing new chest symptoms to panic. This choice emphasizes a clinically relevant
assessment or intervention rather than an unsupported shortcut. Alternatives such as diagnose
panic disorder after any isolated palpitations are less appropriate because they omit essential
assessment, safety, or evidence-based care. In practice, individualize the decision to the
patient’s history, current risk, preferences, and applicable clinical guidance.
6. At an initial psychiatric intake, which approach best reflects safe practice regarding
PTSD?
A) Ignore dissociation and safety.
B) Assess trauma exposure, intrusion, avoidance, negative mood/cognition, and arousal.
C) Require the person to recount trauma in detail immediately.
D) Assume all trauma exposure causes ptsd.
Correct Answer: B) Assess trauma exposure, intrusion, avoidance, negative
mood/cognition, and arousal.
Rationale: The best approach to PTSD is to assess trauma exposure, intrusion, avoidance,
negative mood/cognition, and arousal. This choice emphasizes a clinically relevant assessment
or intervention rather than an unsupported shortcut. Alternatives such as require the person to
recount trauma in detail immediately are less appropriate because they omit essential
assessment, safety, or evidence-based care. In practice, individualize the decision to the
patient’s history, current risk, preferences, and applicable clinical guidance.
7. At an initial psychiatric intake, which approach best reflects safe practice regarding
OCD?
A) Assume compulsions are always pleasurable.
B) Treat intrusive thoughts as evidence of intent.
C) Assess intrusive obsessions and repetitive compulsions with associated distress.
D) Classify every preferred routine as a compulsion.
Correct Answer: C) Assess intrusive obsessions and repetitive compulsions with
associated distress.
Rationale: The best approach to OCD is to assess intrusive obsessions and repetitive
compulsions with associated distress. This choice emphasizes a clinically relevant assessment
or intervention rather than an unsupported shortcut. Alternatives such as classify every
preferred routine as a compulsion are less appropriate because they omit essential
assessment, safety, or evidence-based care. In practice, individualize the decision to the
patient’s history, current risk, preferences, and applicable clinical guidance.
, 8. At an initial psychiatric intake, which approach best reflects safe practice regarding
psychosis?
A) Presume schizophrenia after one unusual belief.
B) Confront delusions aggressively to force agreement.
C) Ignore delirium in abrupt new symptoms.
D) Evaluate safety, onset, substance and medical causes, and psychotic symptoms.
Correct Answer: D) Evaluate safety, onset, substance and medical causes, and psychotic
symptoms.
Rationale: The best approach to psychosis is to evaluate safety, onset, substance and medical
causes, and psychotic symptoms. This choice emphasizes a clinically relevant assessment or
intervention rather than an unsupported shortcut. Alternatives such as presume schizophrenia
after one unusual belief are less appropriate because they omit essential assessment, safety, or
evidence-based care. In practice, individualize the decision to the patient’s history, current risk,
preferences, and applicable clinical guidance.
9. At an initial psychiatric intake, which approach best reflects safe practice regarding
delirium?
A) Prioritize evaluation of acute fluctuating attention and underlying medical causes.
B) Diagnose dementia based only on sudden confusion.
C) Start psychotherapy instead of medical evaluation.
D) Assume hallucinations always mean primary psychosis.
Correct Answer: A) Prioritize evaluation of acute fluctuating attention and underlying
medical causes.
Rationale: The best approach to delirium is to prioritize evaluation of acute fluctuating attention
and underlying medical causes. This choice emphasizes a clinically relevant assessment or
intervention rather than an unsupported shortcut. Alternatives such as diagnose dementia
based only on sudden confusion are less appropriate because they omit essential assessment,
safety, or evidence-based care. In practice, individualize the decision to the patient’s history,
current risk, preferences, and applicable clinical guidance.
10. At an initial psychiatric intake, which approach best reflects safe practice regarding
dementia?
A) Ignore medication and sensory effects.
B) Evaluate progressive cognitive and functional change and reversible contributors.
C) Equate normal aging with major neurocognitive disorder.
D) Diagnose based on a single forgotten appointment.
ORIGINAL PRACTICE QUESTIONS | 2026–2027 STUDY
GUIDE
SECTION ONE — QUESTIONS 1–100
1. At an initial psychiatric intake, which approach best reflects safe practice regarding
suicide risk?
A) Directly assess suicidal intent, plan, access to means, and protective factors.
B) Reassure the person without asking about suicide.
C) Postpone the assessment until the next visit.
D) Assume denial of depression excludes suicide risk.
Correct Answer: A) Directly assess suicidal intent, plan, access to means, and protective
factors.
Rationale: The best approach to suicide risk is to directly assess suicidal intent, plan, access to
means, and protective factors. This choice emphasizes a clinically relevant assessment or
intervention rather than an unsupported shortcut. Alternatives such as reassure the person
without asking about suicide are less appropriate because they omit essential assessment,
safety, or evidence-based care. In practice, individualize the decision to the patient’s history,
current risk, preferences, and applicable clinical guidance.
2. At an initial psychiatric intake, which approach best reflects safe practice regarding
acute mania?
A) Treat the episode as uncomplicated insomnia.
B) Assess sleep, safety, psychosis, substance use, and functional impairment.
C) Diagnose adhd solely from pressured speech.
D) Start an antidepressant alone without assessing bipolar history.
Correct Answer: B) Assess sleep, safety, psychosis, substance use, and functional
impairment.
Rationale: The best approach to acute mania is to assess sleep, safety, psychosis, substance
use, and functional impairment. This choice emphasizes a clinically relevant assessment or
intervention rather than an unsupported shortcut. Alternatives such as diagnose ADHD solely
from pressured speech are less appropriate because they omit essential assessment, safety, or
evidence-based care. In practice, individualize the decision to the patient’s history, current risk,
preferences, and applicable clinical guidance.
,3. At an initial psychiatric intake, which approach best reflects safe practice regarding
major depression?
A) Omit suicide assessment if the patient smiles.
B) Prescribe treatment without screening for manic episodes.
C) Evaluate duration, impairment, suicidality, medical contributors, and past mania.
D) Base diagnosis on a single day of sadness.
Correct Answer: C) Evaluate duration, impairment, suicidality, medical contributors, and
past mania.
Rationale: The best approach to major depression is to evaluate duration, impairment,
suicidality, medical contributors, and past mania. This choice emphasizes a clinically relevant
assessment or intervention rather than an unsupported shortcut. Alternatives such as base
diagnosis on a single day of sadness are less appropriate because they omit essential
assessment, safety, or evidence-based care. In practice, individualize the decision to the
patient’s history, current risk, preferences, and applicable clinical guidance.
4. At an initial psychiatric intake, which approach best reflects safe practice regarding
generalized anxiety?
A) Equate any transient stress with the disorder.
B) Assume panic attacks are mandatory.
C) Exclude medical and substance contributors without review.
D) Assess excessive difficult-to-control worry and associated symptoms over time.
Correct Answer: D) Assess excessive difficult-to-control worry and associated symptoms
over time.
Rationale: The best approach to generalized anxiety is to assess excessive difficult-to-control
worry and associated symptoms over time. This choice emphasizes a clinically relevant
assessment or intervention rather than an unsupported shortcut. Alternatives such as equate
any transient stress with the disorder are less appropriate because they omit essential
assessment, safety, or evidence-based care. In practice, individualize the decision to the
patient’s history, current risk, preferences, and applicable clinical guidance.
5. At an initial psychiatric intake, which approach best reflects safe practice regarding
panic symptoms?
A) Consider urgent medical mimics before attributing new chest symptoms to panic.
B) Diagnose panic disorder after any isolated palpitations.
C) Dismiss chest pain without clinical evaluation.
D) Assume every panic attack indicates psychosis.
,Correct Answer: A) Consider urgent medical mimics before attributing new chest
symptoms to panic.
Rationale: The best approach to panic symptoms is to consider urgent medical mimics before
attributing new chest symptoms to panic. This choice emphasizes a clinically relevant
assessment or intervention rather than an unsupported shortcut. Alternatives such as diagnose
panic disorder after any isolated palpitations are less appropriate because they omit essential
assessment, safety, or evidence-based care. In practice, individualize the decision to the
patient’s history, current risk, preferences, and applicable clinical guidance.
6. At an initial psychiatric intake, which approach best reflects safe practice regarding
PTSD?
A) Ignore dissociation and safety.
B) Assess trauma exposure, intrusion, avoidance, negative mood/cognition, and arousal.
C) Require the person to recount trauma in detail immediately.
D) Assume all trauma exposure causes ptsd.
Correct Answer: B) Assess trauma exposure, intrusion, avoidance, negative
mood/cognition, and arousal.
Rationale: The best approach to PTSD is to assess trauma exposure, intrusion, avoidance,
negative mood/cognition, and arousal. This choice emphasizes a clinically relevant assessment
or intervention rather than an unsupported shortcut. Alternatives such as require the person to
recount trauma in detail immediately are less appropriate because they omit essential
assessment, safety, or evidence-based care. In practice, individualize the decision to the
patient’s history, current risk, preferences, and applicable clinical guidance.
7. At an initial psychiatric intake, which approach best reflects safe practice regarding
OCD?
A) Assume compulsions are always pleasurable.
B) Treat intrusive thoughts as evidence of intent.
C) Assess intrusive obsessions and repetitive compulsions with associated distress.
D) Classify every preferred routine as a compulsion.
Correct Answer: C) Assess intrusive obsessions and repetitive compulsions with
associated distress.
Rationale: The best approach to OCD is to assess intrusive obsessions and repetitive
compulsions with associated distress. This choice emphasizes a clinically relevant assessment
or intervention rather than an unsupported shortcut. Alternatives such as classify every
preferred routine as a compulsion are less appropriate because they omit essential
assessment, safety, or evidence-based care. In practice, individualize the decision to the
patient’s history, current risk, preferences, and applicable clinical guidance.
, 8. At an initial psychiatric intake, which approach best reflects safe practice regarding
psychosis?
A) Presume schizophrenia after one unusual belief.
B) Confront delusions aggressively to force agreement.
C) Ignore delirium in abrupt new symptoms.
D) Evaluate safety, onset, substance and medical causes, and psychotic symptoms.
Correct Answer: D) Evaluate safety, onset, substance and medical causes, and psychotic
symptoms.
Rationale: The best approach to psychosis is to evaluate safety, onset, substance and medical
causes, and psychotic symptoms. This choice emphasizes a clinically relevant assessment or
intervention rather than an unsupported shortcut. Alternatives such as presume schizophrenia
after one unusual belief are less appropriate because they omit essential assessment, safety, or
evidence-based care. In practice, individualize the decision to the patient’s history, current risk,
preferences, and applicable clinical guidance.
9. At an initial psychiatric intake, which approach best reflects safe practice regarding
delirium?
A) Prioritize evaluation of acute fluctuating attention and underlying medical causes.
B) Diagnose dementia based only on sudden confusion.
C) Start psychotherapy instead of medical evaluation.
D) Assume hallucinations always mean primary psychosis.
Correct Answer: A) Prioritize evaluation of acute fluctuating attention and underlying
medical causes.
Rationale: The best approach to delirium is to prioritize evaluation of acute fluctuating attention
and underlying medical causes. This choice emphasizes a clinically relevant assessment or
intervention rather than an unsupported shortcut. Alternatives such as diagnose dementia
based only on sudden confusion are less appropriate because they omit essential assessment,
safety, or evidence-based care. In practice, individualize the decision to the patient’s history,
current risk, preferences, and applicable clinical guidance.
10. At an initial psychiatric intake, which approach best reflects safe practice regarding
dementia?
A) Ignore medication and sensory effects.
B) Evaluate progressive cognitive and functional change and reversible contributors.
C) Equate normal aging with major neurocognitive disorder.
D) Diagnose based on a single forgotten appointment.
