PMHNP-BC™ (DSM-5-TR focus, Pharmacology Focus, And
Integrated Clinical Vignettes). PMHNP Exam Blueprint. (American
Psychiatric Association)Questions (A–D), Correct Answer, Rationale.
,DSM-5-TR Mastery (15 questions)
1. DSM-5-TR added or clarified several diagnoses. Which of the following diagnoses
was newly included/explicitly added in DSM-5-TR (post-DSM-5)?
A) Schizophrenia spectrum disorder
B) Prolonged grief disorder
C) Cyclothymic disorder
D) Paranoid personality disorder
Answer: B.
Rationale: DSM-5-TR explicitly added prolonged grief disorder as a codable
diagnosis. (American Psychiatric Association)
2. According to DSM-5-TR, which timeframe is most consistent with the diagnosis of
Major Depressive Disorder (MDD)?
A) ≥2 days of depressed mood
B) ≥2 weeks of symptoms including at least five SIGECAPS symptoms
C) ≥6 months of persistent low mood only
D) ≥1 year of dysthymic symptoms only
Answer: B.
Rationale: MDD diagnostic threshold remains ≥2 weeks with ≥5 symptoms (one
must be depressed mood or anhedonia).
3. DSM-5-TR revised language to be more culturally sensitive concerning gender.
Which practice aligns with DSM-5-TR recommendations?
A) Use “natal male/female” exclusively
B) Use “experienced gender” and “assigned male/female at birth” terminology where
relevant
C) Avoid documenting gender at all costs
D) Replace gender identity with sexual orientation
Answer: B.
Rationale: DSM-5-TR updated language to be inclusive (e.g., “individual assigned
male/female at birth” and “experienced gender”). (American Psychiatric Association)
4. Which specifier or coding option did DSM-5-TR emphasize to allow better
documentation of suicidal behaviour or nonsuicidal self-injury when no other mental
disorder is present?
A) Always code under personality disorders
B) Coding options to document suicidal behavior/nonsuicidal self-injury as separate
V/Z codes
C) Exclude documentation unless another diagnosis exists
D) Use the substance-induced disorder category only
Answer: B.
Rationale: DSM-5-TR provides coding updates enabling documentation of suicidal
behavior/nonsuicidal self-injury even without another mental disorder. (American
Psychiatric Association)
5. For Autism Spectrum Disorder (ASD), DSM-5-TR changes mainly clarified:
A) Onset age to after 10 years only
B) Criterion A language and examples of social communication differences across
, ages
C) That ASD is a personality disorder
D) ASD requires intellectual disability for diagnosis
Answer: B.
Rationale: DSM-5-TR refined criterion language and examples, improving clarity
on social communication across developmental levels. (PMC)
6. A 70-year-old with progressive memory decline and focal neurological signs: which
DSM-5-TR category best fits if there is clear evidence of Alzheimer’s disease
pathology?
A) Mild neurocognitive disorder due to Alzheimer’s disease
B) Major neurocognitive disorder due to Alzheimer’s disease
C) Amnestic disorder not otherwise specified
D) Adjustment disorder with cognitive changes
Answer: B.
Rationale: DSM-5-TR differentiates mild vs major neurocognitive disorder; major
indicates significant impairment in independence and daily functioning.
7. DSM-5-TR introduced which diagnosis for prolonged bereavement causing marked
impairment?
A) Bereavement exclusion for MDD
B) Prolonged grief disorder
C) Uncomplicated bereavement
D) Acute stress disorder
Answer: B.
Rationale: Prolonged grief disorder is included to identify persistent, impairing
grief beyond expected cultural norms. (American Psychiatric Association)
8. Which of the following is true about the DSM-5-TR approach to race and cultural
context?
A) It removes all cultural considerations to standardize diagnosis
B) It includes guidance noting symptoms and presentation may differ by racial/ethnic
group and emphasizes cultural formulation
C) It requires genetic testing before psychiatric diagnosis
D) It only lists Western culture norms as standard
Answer: B.
Rationale: DSM-5-TR explicitly addresses cultural and racial biases and
encourages cultural formulation in assessment. (American Psychiatric Association)
9. Which specifier for depressive disorders was emphasized across DSM-5/DSM-5-TR
to denote mixed depressive and hypomanic features?
A) With melancholic features
B) With anxious distress
C) With mixed features
D) With psychotic features only
Answer: C.
Rationale: “With mixed features” remains an important specifier for depressive
episodes with subthreshold hypomanic symptoms.
10. Stimulant-induced disorders in DSM-5-TR: which new or clarified entity was noted?
A) Stimulant-induced mild neurocognitive disorder
B) Stimulant-induced major depressive disorder
C) Stimulant-induced mild neurocognitive disorder and clarification of stimulant-
, related presentations
D) No updates
Answer: C.
Rationale: DSM-5-TR added/clarified stimulant-induced mild neurocognitive
disorder and other substance-related specifiers. (Psychiatry Online)
11. Which of the following describes the DSM-5-TR treatment of “unspecified”
categories?
A) They are removed entirely
B) Unspecified diagnoses are retained to allow clinicians to document presentations
that don’t fully meet criteria when more information is needed
C) They mandate hospitalization
D) They are only used for children
Answer: B.
Rationale: Unspecified categories are used when presentations don’t meet full
criteria or when information is insufficient.
12. DSM-5-TR clarifies diagnostic thresholds for PTSD in children versus adults. Which
is true?
A) Criteria are identical for all ages with no modifications
B) There are developmental-sensitive specifiers and PTSD criteria for children
younger than 6 years have tailored symptom descriptions
C) PTSD cannot be diagnosed in children under 12
D) PTSD diagnosis for children requires symptom duration of ≥1 year
Answer: B.
Rationale: PTSD criteria include developmentally sensitive descriptions, with
modified wording for younger children.
13. DSM-5-TR’s changes to language around suicidal behavior emphasize:
A) Vague descriptors only
B) Precise documentation and coding for suicidal and nonsuicidal self-injury events
even if no other disorder is present
C) Removing mention of suicidal ideation altogether
D) Only using suicide risk for personality disorders
Answer: B.
Rationale: DSM-5-TR supports improved documentation, coding, and clarity
around suicidal behavior. (American Psychiatric Association)
14. Which of these is NOT a focus of DSM-5-TR updates?
A) Text revisions for clarity and cultural sensitivity
B) Adding novel biologic markers as diagnostic requirements
C) Updating ICD-10-CM coding crosswalks
D) Adding new diagnoses like prolonged grief disorder
Answer: B.
Rationale: DSM-5-TR refines text, criteria, and coding; it does not require
biological markers for diagnosis.
15. For diagnostic formulation, DSM-5-TR encourages use of:
A) Only symptom counts without context
B) Cultural Formulation Interview and contextual information to improve diagnostic
accuracy
C) Unstructured impressions only
D) Lab tests exclusively
Integrated Clinical Vignettes). PMHNP Exam Blueprint. (American
Psychiatric Association)Questions (A–D), Correct Answer, Rationale.
,DSM-5-TR Mastery (15 questions)
1. DSM-5-TR added or clarified several diagnoses. Which of the following diagnoses
was newly included/explicitly added in DSM-5-TR (post-DSM-5)?
A) Schizophrenia spectrum disorder
B) Prolonged grief disorder
C) Cyclothymic disorder
D) Paranoid personality disorder
Answer: B.
Rationale: DSM-5-TR explicitly added prolonged grief disorder as a codable
diagnosis. (American Psychiatric Association)
2. According to DSM-5-TR, which timeframe is most consistent with the diagnosis of
Major Depressive Disorder (MDD)?
A) ≥2 days of depressed mood
B) ≥2 weeks of symptoms including at least five SIGECAPS symptoms
C) ≥6 months of persistent low mood only
D) ≥1 year of dysthymic symptoms only
Answer: B.
Rationale: MDD diagnostic threshold remains ≥2 weeks with ≥5 symptoms (one
must be depressed mood or anhedonia).
3. DSM-5-TR revised language to be more culturally sensitive concerning gender.
Which practice aligns with DSM-5-TR recommendations?
A) Use “natal male/female” exclusively
B) Use “experienced gender” and “assigned male/female at birth” terminology where
relevant
C) Avoid documenting gender at all costs
D) Replace gender identity with sexual orientation
Answer: B.
Rationale: DSM-5-TR updated language to be inclusive (e.g., “individual assigned
male/female at birth” and “experienced gender”). (American Psychiatric Association)
4. Which specifier or coding option did DSM-5-TR emphasize to allow better
documentation of suicidal behaviour or nonsuicidal self-injury when no other mental
disorder is present?
A) Always code under personality disorders
B) Coding options to document suicidal behavior/nonsuicidal self-injury as separate
V/Z codes
C) Exclude documentation unless another diagnosis exists
D) Use the substance-induced disorder category only
Answer: B.
Rationale: DSM-5-TR provides coding updates enabling documentation of suicidal
behavior/nonsuicidal self-injury even without another mental disorder. (American
Psychiatric Association)
5. For Autism Spectrum Disorder (ASD), DSM-5-TR changes mainly clarified:
A) Onset age to after 10 years only
B) Criterion A language and examples of social communication differences across
, ages
C) That ASD is a personality disorder
D) ASD requires intellectual disability for diagnosis
Answer: B.
Rationale: DSM-5-TR refined criterion language and examples, improving clarity
on social communication across developmental levels. (PMC)
6. A 70-year-old with progressive memory decline and focal neurological signs: which
DSM-5-TR category best fits if there is clear evidence of Alzheimer’s disease
pathology?
A) Mild neurocognitive disorder due to Alzheimer’s disease
B) Major neurocognitive disorder due to Alzheimer’s disease
C) Amnestic disorder not otherwise specified
D) Adjustment disorder with cognitive changes
Answer: B.
Rationale: DSM-5-TR differentiates mild vs major neurocognitive disorder; major
indicates significant impairment in independence and daily functioning.
7. DSM-5-TR introduced which diagnosis for prolonged bereavement causing marked
impairment?
A) Bereavement exclusion for MDD
B) Prolonged grief disorder
C) Uncomplicated bereavement
D) Acute stress disorder
Answer: B.
Rationale: Prolonged grief disorder is included to identify persistent, impairing
grief beyond expected cultural norms. (American Psychiatric Association)
8. Which of the following is true about the DSM-5-TR approach to race and cultural
context?
A) It removes all cultural considerations to standardize diagnosis
B) It includes guidance noting symptoms and presentation may differ by racial/ethnic
group and emphasizes cultural formulation
C) It requires genetic testing before psychiatric diagnosis
D) It only lists Western culture norms as standard
Answer: B.
Rationale: DSM-5-TR explicitly addresses cultural and racial biases and
encourages cultural formulation in assessment. (American Psychiatric Association)
9. Which specifier for depressive disorders was emphasized across DSM-5/DSM-5-TR
to denote mixed depressive and hypomanic features?
A) With melancholic features
B) With anxious distress
C) With mixed features
D) With psychotic features only
Answer: C.
Rationale: “With mixed features” remains an important specifier for depressive
episodes with subthreshold hypomanic symptoms.
10. Stimulant-induced disorders in DSM-5-TR: which new or clarified entity was noted?
A) Stimulant-induced mild neurocognitive disorder
B) Stimulant-induced major depressive disorder
C) Stimulant-induced mild neurocognitive disorder and clarification of stimulant-
, related presentations
D) No updates
Answer: C.
Rationale: DSM-5-TR added/clarified stimulant-induced mild neurocognitive
disorder and other substance-related specifiers. (Psychiatry Online)
11. Which of the following describes the DSM-5-TR treatment of “unspecified”
categories?
A) They are removed entirely
B) Unspecified diagnoses are retained to allow clinicians to document presentations
that don’t fully meet criteria when more information is needed
C) They mandate hospitalization
D) They are only used for children
Answer: B.
Rationale: Unspecified categories are used when presentations don’t meet full
criteria or when information is insufficient.
12. DSM-5-TR clarifies diagnostic thresholds for PTSD in children versus adults. Which
is true?
A) Criteria are identical for all ages with no modifications
B) There are developmental-sensitive specifiers and PTSD criteria for children
younger than 6 years have tailored symptom descriptions
C) PTSD cannot be diagnosed in children under 12
D) PTSD diagnosis for children requires symptom duration of ≥1 year
Answer: B.
Rationale: PTSD criteria include developmentally sensitive descriptions, with
modified wording for younger children.
13. DSM-5-TR’s changes to language around suicidal behavior emphasize:
A) Vague descriptors only
B) Precise documentation and coding for suicidal and nonsuicidal self-injury events
even if no other disorder is present
C) Removing mention of suicidal ideation altogether
D) Only using suicide risk for personality disorders
Answer: B.
Rationale: DSM-5-TR supports improved documentation, coding, and clarity
around suicidal behavior. (American Psychiatric Association)
14. Which of these is NOT a focus of DSM-5-TR updates?
A) Text revisions for clarity and cultural sensitivity
B) Adding novel biologic markers as diagnostic requirements
C) Updating ICD-10-CM coding crosswalks
D) Adding new diagnoses like prolonged grief disorder
Answer: B.
Rationale: DSM-5-TR refines text, criteria, and coding; it does not require
biological markers for diagnosis.
15. For diagnostic formulation, DSM-5-TR encourages use of:
A) Only symptom counts without context
B) Cultural Formulation Interview and contextual information to improve diagnostic
accuracy
C) Unstructured impressions only
D) Lab tests exclusively
