LATEST BARKLEY DRT PMHNP PRACTICUM 1 ACTUAL
QUESTIONS WITH VERIFIED ANSWERS 2026/2027 VERSION
Core Domains
Crisis Intervention and Suicide Assessment
Depression and Pharmacological Treatment
Severe Persistent Mental Illness (SPMI)
Substance Abuse and Withdrawal Management
Psychiatric Assessment and Differential Diagnosis
Eating Disorders and Medical Stability
Therapeutic Modalities and Counseling
Ethical, Legal, and Professional Standards
Introduction
This assessment evaluates the candidate's mastery of essential concepts
required for the Barkley Diagnostic Readiness Test (DRT) for
Psychiatric-Mental Health Nurse Practitioner Practicum 1. It measures
knowledge of crisis intervention, suicide risk assessment,
psychopharmacology, differential diagnosis, therapeutic
communication, and professional standards. The exam employs
multiple-choice and scenario-based questions designed to simulate real-
world clinical decision-making. Emphasis is placed on applying
evidence-based psychiatric principles to manage complex patient
presentations. Success requires not only recall of clinical facts but also
critical thinking skills necessary for safe and effective psychiatric
practice.
Section One: Questions 1–100
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
A
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 .
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
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. The controlled style is characterized by a calm, composed
exterior with hidden emotions .
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
, 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. Terry, 35, visits your office with the assumption that he is
experiencing depression. He has a history of substance abuse and a
family history of mood disorders. He reports fatigue, insomnia,
confusion, weight loss, and recurrent suicidal thoughts. Which is the
best medication to prescribe?
A. Sympathomimetics
B. Bupropion
C. Olanzapine
D. Risperidone
B
RATIONALE: Bupropion is a better choice for patients with a
history of substance abuse because it has a lower potential for abuse and
is not associated with sedation or weight gain. Sympathomimetics have
potential for abuse .
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
B
, RATIONALE: Empathy, confrontation, and immediacy are three
counseling keystones relevant to assessment of a crisis. These
techniques help establish therapeutic rapport and facilitate crisis
intervention .
6. A patient expresses ambivalence regarding suicidal intent. How
should this be interpreted?
A. It indicates severe risk requiring immediate hospitalization
B. It indicates moderate risk, not severe risk
C. It indicates no risk at all
D. It indicates the patient is not being truthful
B
RATIONALE: Although ambivalence regarding suicidal intent
should be taken into account when considering level of observation in a
patient, it indicates a moderate risk, not a severe risk .
7. Which of the following is the most important question to ask a
patient who is at risk for suicide?
A. "You're not thinking of suicide, are you?"
B. "Do you have a plan to harm yourself?"
C. "Why would you want to hurt yourself?"
D. "Everything will get better soon."
B
RATIONALE: Asking directly about a plan to harm oneself is
critical for assessing imminent risk. The presence of a specific plan
elevates the risk level significantly and guides intervention decisions.
8. A 45-year-old patient presents with anhedonia, fatigue, and sleep
disturbances for the last two months. As a PMHNP, which initial
diagnostic step is most appropriate?
QUESTIONS WITH VERIFIED ANSWERS 2026/2027 VERSION
Core Domains
Crisis Intervention and Suicide Assessment
Depression and Pharmacological Treatment
Severe Persistent Mental Illness (SPMI)
Substance Abuse and Withdrawal Management
Psychiatric Assessment and Differential Diagnosis
Eating Disorders and Medical Stability
Therapeutic Modalities and Counseling
Ethical, Legal, and Professional Standards
Introduction
This assessment evaluates the candidate's mastery of essential concepts
required for the Barkley Diagnostic Readiness Test (DRT) for
Psychiatric-Mental Health Nurse Practitioner Practicum 1. It measures
knowledge of crisis intervention, suicide risk assessment,
psychopharmacology, differential diagnosis, therapeutic
communication, and professional standards. The exam employs
multiple-choice and scenario-based questions designed to simulate real-
world clinical decision-making. Emphasis is placed on applying
evidence-based psychiatric principles to manage complex patient
presentations. Success requires not only recall of clinical facts but also
critical thinking skills necessary for safe and effective psychiatric
practice.
Section One: Questions 1–100
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
A
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 .
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
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. The controlled style is characterized by a calm, composed
exterior with hidden emotions .
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
, 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. Terry, 35, visits your office with the assumption that he is
experiencing depression. He has a history of substance abuse and a
family history of mood disorders. He reports fatigue, insomnia,
confusion, weight loss, and recurrent suicidal thoughts. Which is the
best medication to prescribe?
A. Sympathomimetics
B. Bupropion
C. Olanzapine
D. Risperidone
B
RATIONALE: Bupropion is a better choice for patients with a
history of substance abuse because it has a lower potential for abuse and
is not associated with sedation or weight gain. Sympathomimetics have
potential for abuse .
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
B
, RATIONALE: Empathy, confrontation, and immediacy are three
counseling keystones relevant to assessment of a crisis. These
techniques help establish therapeutic rapport and facilitate crisis
intervention .
6. A patient expresses ambivalence regarding suicidal intent. How
should this be interpreted?
A. It indicates severe risk requiring immediate hospitalization
B. It indicates moderate risk, not severe risk
C. It indicates no risk at all
D. It indicates the patient is not being truthful
B
RATIONALE: Although ambivalence regarding suicidal intent
should be taken into account when considering level of observation in a
patient, it indicates a moderate risk, not a severe risk .
7. Which of the following is the most important question to ask a
patient who is at risk for suicide?
A. "You're not thinking of suicide, are you?"
B. "Do you have a plan to harm yourself?"
C. "Why would you want to hurt yourself?"
D. "Everything will get better soon."
B
RATIONALE: Asking directly about a plan to harm oneself is
critical for assessing imminent risk. The presence of a specific plan
elevates the risk level significantly and guides intervention decisions.
8. A 45-year-old patient presents with anhedonia, fatigue, and sleep
disturbances for the last two months. As a PMHNP, which initial
diagnostic step is most appropriate?
