Barkley Diagnostic Readiness Test (DRT)
Psychiatric-Mental Health Nurse Practitioner
Practice Exam
1) Neurotransmitter Systems in Depression
Q: A patient with major depressive disorder reports diminished
interest in activities, fatigue, and poor concentration. Which
neurotransmitter systems are most implicated in these symptoms?
A. GABA and glutamate
B. Dopamine and serotonin
C. Acetylcholine and histamine
D. Endorphins and norepinephrine
Correct Answer: B
Explanation: Serotonin and dopamine pathways are central to
mood, energy, and motivation regulation in depression.
2) Panic Disorder Neuroanatomy
Q: A 30-year-old with panic disorder experiences intense fear,
palpitations, and shortness of breath. Which brain structure is most
involved in “fight or flight”?
A. Amygdala
B. Hippocampus
C. Thalamus
D. Prefrontal cortex
,Correct Answer: A
Explanation: The amygdala triggers sympathetic responses in panic
reactions.
3) SSRI Adverse Effects in Elderly
Q: Which antidepressant is most likely to cause hyponatremia in
elderly patients?
A. Bupropion
B. Sertraline
C. Desvenlafaxine
D. Nortriptyline
Correct Answer: B
Explanation: SSRIs like sertraline are associated with increased ADH
and SIADH, especially in older adults.
4) Bipolar I vs. Bipolar II Distinction
Q: Which finding best distinguishes bipolar I from bipolar II
disorder?
A. Presence of hypomanic episodes
B. Psychosis during mood disturbance
C. Duration of depressive episodes
D. Mood lability triggered by stress
Correct Answer: B
Explanation: Bipolar I can include psychotic features or full mania.
Bipolar II does not.
5) Antipsychotics and Metabolic Risk
,Q: Which antipsychotic has the highest risk of metabolic syndrome?
A. Ziprasidone
B. Aripiprazole
C. Clozapine
D. Lurasidone
Correct Answer: C
Explanation: Clozapine (and olanzapine) are highest risk for weight
gain and metabolic changes. (
6) Pre-Lithium Labs
Q: Before starting lithium, which labs must be checked?
A. AST/ALT
B. TSH and creatinine
C. CBC and INR
D. Lipid panel
Correct Answer: B
Explanation: Lithium requires baseline thyroid and renal function
tests. (
7) Clozapine Agranulocytosis
Q: A patient on clozapine presents with fatigue and sore throat. Next
step?
A. Continue medication and monitor fever
B. Check absolute neutrophil count (ANC)
C. Add antibiotic prophylactically
D. Switch to risperidone immediately
, Correct Answer: B
Explanation: Suspected agranulocytosis requires immediate ANC
check.)
8) Longest Half-Life Benzodiazepine
Q: Which benzodiazepine has the longest half-life?
A. Lorazepam
B. Alprazolam
C. Clonazepam
D. Midazolam
Correct Answer: C
Explanation: Clonazepam’s half-life is longer than others listed.
9) ADHD + Tourette’s Management
Q: A teen with ADHD and Tourette’s needs med management. Best
choice?
A. Methylphenidate
B. Atomoxetine
C. Dextroamphetamine
D. Bupropion
Correct Answer: B
Explanation: Atomoxetine treats ADHD without worsening tics.
10) SSRI Monitoring in Adolescents
Q: When prescribing SSRIs in teens, what do you monitor?
A. Orthostatic hypotension
Psychiatric-Mental Health Nurse Practitioner
Practice Exam
1) Neurotransmitter Systems in Depression
Q: A patient with major depressive disorder reports diminished
interest in activities, fatigue, and poor concentration. Which
neurotransmitter systems are most implicated in these symptoms?
A. GABA and glutamate
B. Dopamine and serotonin
C. Acetylcholine and histamine
D. Endorphins and norepinephrine
Correct Answer: B
Explanation: Serotonin and dopamine pathways are central to
mood, energy, and motivation regulation in depression.
2) Panic Disorder Neuroanatomy
Q: A 30-year-old with panic disorder experiences intense fear,
palpitations, and shortness of breath. Which brain structure is most
involved in “fight or flight”?
A. Amygdala
B. Hippocampus
C. Thalamus
D. Prefrontal cortex
,Correct Answer: A
Explanation: The amygdala triggers sympathetic responses in panic
reactions.
3) SSRI Adverse Effects in Elderly
Q: Which antidepressant is most likely to cause hyponatremia in
elderly patients?
A. Bupropion
B. Sertraline
C. Desvenlafaxine
D. Nortriptyline
Correct Answer: B
Explanation: SSRIs like sertraline are associated with increased ADH
and SIADH, especially in older adults.
4) Bipolar I vs. Bipolar II Distinction
Q: Which finding best distinguishes bipolar I from bipolar II
disorder?
A. Presence of hypomanic episodes
B. Psychosis during mood disturbance
C. Duration of depressive episodes
D. Mood lability triggered by stress
Correct Answer: B
Explanation: Bipolar I can include psychotic features or full mania.
Bipolar II does not.
5) Antipsychotics and Metabolic Risk
,Q: Which antipsychotic has the highest risk of metabolic syndrome?
A. Ziprasidone
B. Aripiprazole
C. Clozapine
D. Lurasidone
Correct Answer: C
Explanation: Clozapine (and olanzapine) are highest risk for weight
gain and metabolic changes. (
6) Pre-Lithium Labs
Q: Before starting lithium, which labs must be checked?
A. AST/ALT
B. TSH and creatinine
C. CBC and INR
D. Lipid panel
Correct Answer: B
Explanation: Lithium requires baseline thyroid and renal function
tests. (
7) Clozapine Agranulocytosis
Q: A patient on clozapine presents with fatigue and sore throat. Next
step?
A. Continue medication and monitor fever
B. Check absolute neutrophil count (ANC)
C. Add antibiotic prophylactically
D. Switch to risperidone immediately
, Correct Answer: B
Explanation: Suspected agranulocytosis requires immediate ANC
check.)
8) Longest Half-Life Benzodiazepine
Q: Which benzodiazepine has the longest half-life?
A. Lorazepam
B. Alprazolam
C. Clonazepam
D. Midazolam
Correct Answer: C
Explanation: Clonazepam’s half-life is longer than others listed.
9) ADHD + Tourette’s Management
Q: A teen with ADHD and Tourette’s needs med management. Best
choice?
A. Methylphenidate
B. Atomoxetine
C. Dextroamphetamine
D. Bupropion
Correct Answer: B
Explanation: Atomoxetine treats ADHD without worsening tics.
10) SSRI Monitoring in Adolescents
Q: When prescribing SSRIs in teens, what do you monitor?
A. Orthostatic hypotension
