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BARKLEY DRT PMHNP PRACTICUM 1
ACTUAL EXAM 2025/2026 Complete 90
Questions & 100%Correct VERIFid
Answer:s with Detailed
Rationales
EXAM OVERVIEW
The Barkley Documentation Review Tool (DRT) for the Psychiatric-Mental Health
Nurse Practitioner (PMHNP) Practicum 1 Exam assesses competency in psychiatric
assessment, differential diagnosis, psychopharmacology, therapeutic
communication, crisis intervention, and professional standards. This guide
contains 90 verified questions and answers updated for the 2025/2026 testing
cycle . All answers are graded A+ and include detailed rationales.
SECTION 1: CRISIS INTERVENTION & ASSESSMENT
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
,2
Correct 100%Correct VERIFid Answer:: 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 .
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 100%Correct VERIFid 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 true internal state.
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
,3
• D) An 18-year-old young woman who is 5'4" and weighs 92 pounds
Correct 100%Correct VERIFid 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.
SECTION 2: DEPRESSION & PHARMACOLOGICAL TREATMENT
Question 4
Terry, 35, visits your office with the assumption that he is experiencing
depression. Terry explains that he has a history of substance abuse and a family
history of mood disorders. He claims that he has recently been incredibly
fatigued, possessing no energy to even perform day to day activities. Even with
the sudden onset of fatigue, Terry explains that he is still experiencing insomnia.
He also complains about recurring confusion and loss of weight, and confesses
that he has been experiencing more recurrent suicidal thoughts. Which
medication is best to prescribe Terry for his situation?
• A) Sympathomimetics
• B) Bupropion
• C) Olanzapine
• D) Risperidone
Correct 100%Correct VERIFid Answer:: B
Rationale: Bupropion is a better choice due to history of substance abuse; it has
lower abuse potential compared to sympathomimetics and is effective for
depression with fatigue . Olanzapine and risperidone are antipsychotics used for
bipolar or psychotic disorders, not first-line for unipolar depression.
, 4
Question 5
You are attending to a 30-year-old male after he was shot at and almost killed. 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 100%Correct VERIFid Answer:: B
Rationale: Three of the counseling keystones relevant to assessment of a crisis
are empathy, confrontation, and immediacy .
Question 6
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
• B) Systole
• C) Diastole
• D) Low density lipoprotein level (LDL) of 69 mg/dl
Correct 100%Correct VERIFid Answer:: A
Rationale: A blood pressure of 130/85 is considered prehypertension and should
be referred to primary care for cardiovascular evaluation. LDL of 69 mg/dl is
desirable; LDL over 100 mg/dl warrants referral .
BARKLEY DRT PMHNP PRACTICUM 1
ACTUAL EXAM 2025/2026 Complete 90
Questions & 100%Correct VERIFid
Answer:s with Detailed
Rationales
EXAM OVERVIEW
The Barkley Documentation Review Tool (DRT) for the Psychiatric-Mental Health
Nurse Practitioner (PMHNP) Practicum 1 Exam assesses competency in psychiatric
assessment, differential diagnosis, psychopharmacology, therapeutic
communication, crisis intervention, and professional standards. This guide
contains 90 verified questions and answers updated for the 2025/2026 testing
cycle . All answers are graded A+ and include detailed rationales.
SECTION 1: CRISIS INTERVENTION & ASSESSMENT
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
,2
Correct 100%Correct VERIFid Answer:: 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 .
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 100%Correct VERIFid 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 true internal state.
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
,3
• D) An 18-year-old young woman who is 5'4" and weighs 92 pounds
Correct 100%Correct VERIFid 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.
SECTION 2: DEPRESSION & PHARMACOLOGICAL TREATMENT
Question 4
Terry, 35, visits your office with the assumption that he is experiencing
depression. Terry explains that he has a history of substance abuse and a family
history of mood disorders. He claims that he has recently been incredibly
fatigued, possessing no energy to even perform day to day activities. Even with
the sudden onset of fatigue, Terry explains that he is still experiencing insomnia.
He also complains about recurring confusion and loss of weight, and confesses
that he has been experiencing more recurrent suicidal thoughts. Which
medication is best to prescribe Terry for his situation?
• A) Sympathomimetics
• B) Bupropion
• C) Olanzapine
• D) Risperidone
Correct 100%Correct VERIFid Answer:: B
Rationale: Bupropion is a better choice due to history of substance abuse; it has
lower abuse potential compared to sympathomimetics and is effective for
depression with fatigue . Olanzapine and risperidone are antipsychotics used for
bipolar or psychotic disorders, not first-line for unipolar depression.
, 4
Question 5
You are attending to a 30-year-old male after he was shot at and almost killed. 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 100%Correct VERIFid Answer:: B
Rationale: Three of the counseling keystones relevant to assessment of a crisis
are empathy, confrontation, and immediacy .
Question 6
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
• B) Systole
• C) Diastole
• D) Low density lipoprotein level (LDL) of 69 mg/dl
Correct 100%Correct VERIFid Answer:: A
Rationale: A blood pressure of 130/85 is considered prehypertension and should
be referred to primary care for cardiovascular evaluation. LDL of 69 mg/dl is
desirable; LDL over 100 mg/dl warrants referral .
