BARKLEY PMHNP 2026 DETAILED
EXAM STUDY QUESTIONS WITH
ALREADY GRADED A+ ANSWERS
1. To begin the process of assessment you would establish: - ANSWER
Therapeutic relationship/ working diagnosis/need for further evaluation and
testing/initial plan of care.
2. Prior to the interview review: - ANSWER referral information/ patient
questionnaires/ health assessments
3. You would set the stage and make the client comfortable by: - ANSWER
introducing yourself ( consider cultural norms)/ ensure that you won't be
interrupted/ consider clinician safety, with exit strategies if patient should
escalate.
4. Bipolar disorder DSM IV TR criteria: - ANSWER a. a distinct period of
abnormality and persistently elevated , expansive or irritable mood, lasting
at least a week, or such a mood of any duration if hospitalization is
necessary.
b. persistence of three or more of the following symptoms ( four if mood is only
irritable) during the period of mood disturbance and have been present to a
significant degree: ( see DIGFAST)
5. Bipolar symptoms mnemonic: - ANSWER D. distractibility
I. Indiscretion ( excessive involvement in pleasurable activities that
have a high potential for painful outcome)
G. Grandiosity or inflated self-esteem
, F. Flight of ideas or racing thoughts
A. Activities increase ( increase in goal directed activity or
psychomotor agitation)
S. Sleep deficit
T. Talkativeness ( pressured speech)
6. Bipolar facts: - ANSWER 1. most bipolar patients will not present when
manic or hypomanic.
2. may present with depression that may not respond to treatment.
7. Anxiety/possible questions: - ANSWER 1. would you describe yourself as a
worrier?
2. Have you ever had a panic or anxiety attack?
3. Are you uncomfortable in social situations?
4. Have you any special fears, such as fear of insects?
5. what does the client do to try to relieve the anxiety
6. does the client self medicate with drugs/ alcohol
8. Chief complaint: - ANSWER Document the problem in the patient's words/
are symptoms: affective/ cognitive/ physical
seek permission to consult with family member
9. History of presenting problems: - ANSWER duration of problem (s)
What other things were going on in their life when they started to have
problems.
,10.Precipitating factors: - ANSWER 1. exacerbating factors
2. triggers
3. connecting events
4. causality
11.Social History: - ANSWER 1. changes in role or social function
2. history of abuse and victimization
12.Social and developmental history: - ANSWER 1. identify who played roles
in person's life.
2. Who are presently involved.
3. Social support
13.Family genogram: - ANSWER biological: eval autosomal dominant genetic
inheritance which is rare: present in more than one generation
~autosomal recessive- expressed in one generation
process: examine family patterns of communication and relating.
14.Social history continued: - ANSWER 1. friendships/ relationships with
service providers
2. religious groups and/or clergy
3. history re: intimate relationships
4. status of interpersonal relationships
5. are important people in client's life- loving vs angry
6. involvement of family or other's in client's care
7. client's living situation
, 8. occupational status
9. educational/training status
10. financial situation
11. difficulties of activities of daily living
15.Family history: - ANSWER 1. family members with mental illness
2. unusual symptoms and behaviors
3. substance abuse/use
16.Personal Evaluation - ANSWER evaluate strengths, hobbies, and area of
pride/expertise/ competence- coping stratagies
17.Spirituality: - ANSWER 1. named religion or beliefs
2. source of strength and hope
3. source of comfort?
18.Past psychiatric history: - ANSWER 1. previous psychiatric care
2. experiences with hospitalization
3. past treatment
4. medications
5. names of previous therapist (written consent needed to consult with previous
therapist and get records)
19.Symptoms of obsessive compulsive disorder: - ANSWER 1. constantly
washing hands
2. constantly checking things
EXAM STUDY QUESTIONS WITH
ALREADY GRADED A+ ANSWERS
1. To begin the process of assessment you would establish: - ANSWER
Therapeutic relationship/ working diagnosis/need for further evaluation and
testing/initial plan of care.
2. Prior to the interview review: - ANSWER referral information/ patient
questionnaires/ health assessments
3. You would set the stage and make the client comfortable by: - ANSWER
introducing yourself ( consider cultural norms)/ ensure that you won't be
interrupted/ consider clinician safety, with exit strategies if patient should
escalate.
4. Bipolar disorder DSM IV TR criteria: - ANSWER a. a distinct period of
abnormality and persistently elevated , expansive or irritable mood, lasting
at least a week, or such a mood of any duration if hospitalization is
necessary.
b. persistence of three or more of the following symptoms ( four if mood is only
irritable) during the period of mood disturbance and have been present to a
significant degree: ( see DIGFAST)
5. Bipolar symptoms mnemonic: - ANSWER D. distractibility
I. Indiscretion ( excessive involvement in pleasurable activities that
have a high potential for painful outcome)
G. Grandiosity or inflated self-esteem
, F. Flight of ideas or racing thoughts
A. Activities increase ( increase in goal directed activity or
psychomotor agitation)
S. Sleep deficit
T. Talkativeness ( pressured speech)
6. Bipolar facts: - ANSWER 1. most bipolar patients will not present when
manic or hypomanic.
2. may present with depression that may not respond to treatment.
7. Anxiety/possible questions: - ANSWER 1. would you describe yourself as a
worrier?
2. Have you ever had a panic or anxiety attack?
3. Are you uncomfortable in social situations?
4. Have you any special fears, such as fear of insects?
5. what does the client do to try to relieve the anxiety
6. does the client self medicate with drugs/ alcohol
8. Chief complaint: - ANSWER Document the problem in the patient's words/
are symptoms: affective/ cognitive/ physical
seek permission to consult with family member
9. History of presenting problems: - ANSWER duration of problem (s)
What other things were going on in their life when they started to have
problems.
,10.Precipitating factors: - ANSWER 1. exacerbating factors
2. triggers
3. connecting events
4. causality
11.Social History: - ANSWER 1. changes in role or social function
2. history of abuse and victimization
12.Social and developmental history: - ANSWER 1. identify who played roles
in person's life.
2. Who are presently involved.
3. Social support
13.Family genogram: - ANSWER biological: eval autosomal dominant genetic
inheritance which is rare: present in more than one generation
~autosomal recessive- expressed in one generation
process: examine family patterns of communication and relating.
14.Social history continued: - ANSWER 1. friendships/ relationships with
service providers
2. religious groups and/or clergy
3. history re: intimate relationships
4. status of interpersonal relationships
5. are important people in client's life- loving vs angry
6. involvement of family or other's in client's care
7. client's living situation
, 8. occupational status
9. educational/training status
10. financial situation
11. difficulties of activities of daily living
15.Family history: - ANSWER 1. family members with mental illness
2. unusual symptoms and behaviors
3. substance abuse/use
16.Personal Evaluation - ANSWER evaluate strengths, hobbies, and area of
pride/expertise/ competence- coping stratagies
17.Spirituality: - ANSWER 1. named religion or beliefs
2. source of strength and hope
3. source of comfort?
18.Past psychiatric history: - ANSWER 1. previous psychiatric care
2. experiences with hospitalization
3. past treatment
4. medications
5. names of previous therapist (written consent needed to consult with previous
therapist and get records)
19.Symptoms of obsessive compulsive disorder: - ANSWER 1. constantly
washing hands
2. constantly checking things
