Barkley DRT PMHNP 2026/2027 – Complete 250+
Practice Questions and Answers
Question 1
Which finding most strongly supports a diagnosis of major depressive
disorder?
A) At least 2 weeks of depressed mood or anhedonia with associated
symptoms and impairment
B) A single day of sadness after a stressful event
C) Recurrent panic attacks without mood symptoms
D) Lifelong distractibility beginning in childhood
Answer: A) At least 2 weeks of depressed mood or anhedonia with
associated symptoms and impairment
Explanation: Major depressive disorder requires a qualifying
depressive episode lasting at least 2 weeks with clinically significant
symptoms and impairment.
Question 2
Which feature is most characteristic of a manic episode?
A) Elevated or irritable mood with increased energy and decreased need
for sleep
B) Fatigue with hypersomnia and low motivation
,C) Recurrent obsessions with compulsions
D) Fear of social evaluation only
Answer: A) Elevated or irritable mood with increased energy and
decreased need for sleep
Explanation: Mania is characterized by a distinct period of elevated,
expansive, or irritable mood with increased energy and associated
symptoms such as decreased need for sleep.
Question 3
A patient with bipolar disorder presents with a depressive episode. Which
principle is most important when selecting treatment?
A) Screen for a history of mania before using antidepressant
monotherapy
B) Antidepressant monotherapy is always first-line
C) Stimulants should routinely replace mood stabilizers
D) Mood stabilizers are contraindicated
Answer: A) Screen for a history of mania before using
antidepressant monotherapy
Explanation: Bipolar depression requires attention to mood-
switching risk; antidepressant monotherapy may worsen cycling or
precipitate mania in some patients.
,Question 4
Which symptom is a positive symptom of schizophrenia?
A) Auditory hallucinations
B) Avolition
C) Flat affect
D) Social withdrawal
Answer: A) Auditory hallucinations
Explanation: Positive symptoms add abnormal experiences or
behaviors, including hallucinations, delusions, and disorganized
thought or behavior.
Question 5
A patient taking an antipsychotic develops fever, severe muscle rigidity,
autonomic instability, and altered mental status. What is the priority
concern?
A) Neuroleptic malignant syndrome
B) Serotonin syndrome
C) Acute dystonia only
D) Tardive dyskinesia
Answer: A) Neuroleptic malignant syndrome
Explanation: Neuroleptic malignant syndrome is a medical
emergency associated with dopamine blockade and characterized by
rigidity, hyperthermia, autonomic instability, and mental-status
changes.
, Question 6
Which medication is considered first-line for generalized anxiety
disorder?
A) Sertraline
B) Alprazolam
C) Quetiapine
D) Lithium
Answer: A) Sertraline
Explanation: SSRIs such as sertraline are first-line for generalized
anxiety disorder due to their efficacy and favorable safety profile.
Benzodiazepines like alprazolam are used short-term.
Question 7
A patient reports recurrent, unexpected panic attacks with fear of losing
control. Which diagnosis is most likely?
A) Panic disorder
B) Social anxiety disorder
C) Generalized anxiety disorder
D) Obsessive-compulsive disorder
Answer: A) Panic disorder
Explanation: Panic disorder is characterized by recurrent,
Practice Questions and Answers
Question 1
Which finding most strongly supports a diagnosis of major depressive
disorder?
A) At least 2 weeks of depressed mood or anhedonia with associated
symptoms and impairment
B) A single day of sadness after a stressful event
C) Recurrent panic attacks without mood symptoms
D) Lifelong distractibility beginning in childhood
Answer: A) At least 2 weeks of depressed mood or anhedonia with
associated symptoms and impairment
Explanation: Major depressive disorder requires a qualifying
depressive episode lasting at least 2 weeks with clinically significant
symptoms and impairment.
Question 2
Which feature is most characteristic of a manic episode?
A) Elevated or irritable mood with increased energy and decreased need
for sleep
B) Fatigue with hypersomnia and low motivation
,C) Recurrent obsessions with compulsions
D) Fear of social evaluation only
Answer: A) Elevated or irritable mood with increased energy and
decreased need for sleep
Explanation: Mania is characterized by a distinct period of elevated,
expansive, or irritable mood with increased energy and associated
symptoms such as decreased need for sleep.
Question 3
A patient with bipolar disorder presents with a depressive episode. Which
principle is most important when selecting treatment?
A) Screen for a history of mania before using antidepressant
monotherapy
B) Antidepressant monotherapy is always first-line
C) Stimulants should routinely replace mood stabilizers
D) Mood stabilizers are contraindicated
Answer: A) Screen for a history of mania before using
antidepressant monotherapy
Explanation: Bipolar depression requires attention to mood-
switching risk; antidepressant monotherapy may worsen cycling or
precipitate mania in some patients.
,Question 4
Which symptom is a positive symptom of schizophrenia?
A) Auditory hallucinations
B) Avolition
C) Flat affect
D) Social withdrawal
Answer: A) Auditory hallucinations
Explanation: Positive symptoms add abnormal experiences or
behaviors, including hallucinations, delusions, and disorganized
thought or behavior.
Question 5
A patient taking an antipsychotic develops fever, severe muscle rigidity,
autonomic instability, and altered mental status. What is the priority
concern?
A) Neuroleptic malignant syndrome
B) Serotonin syndrome
C) Acute dystonia only
D) Tardive dyskinesia
Answer: A) Neuroleptic malignant syndrome
Explanation: Neuroleptic malignant syndrome is a medical
emergency associated with dopamine blockade and characterized by
rigidity, hyperthermia, autonomic instability, and mental-status
changes.
, Question 6
Which medication is considered first-line for generalized anxiety
disorder?
A) Sertraline
B) Alprazolam
C) Quetiapine
D) Lithium
Answer: A) Sertraline
Explanation: SSRIs such as sertraline are first-line for generalized
anxiety disorder due to their efficacy and favorable safety profile.
Benzodiazepines like alprazolam are used short-term.
Question 7
A patient reports recurrent, unexpected panic attacks with fear of losing
control. Which diagnosis is most likely?
A) Panic disorder
B) Social anxiety disorder
C) Generalized anxiety disorder
D) Obsessive-compulsive disorder
Answer: A) Panic disorder
Explanation: Panic disorder is characterized by recurrent,
