BARKLEY PMHNP Exam 1 Updated Exam 2026
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Exam Questions (Actual Exam 2026-2027)
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Harriet is a well-established business woman who provides for her family. She was
recently arrested for stealing over $10,000 worth of merchandise from the mall. When
Harriet is asked to describe her behavior, she says: "It just comes on me quickly, and
when it's done, I feel really good." She also describes how she grew up poor and sees
the theft as a way to "even the score" against those with "empty wealth." Which of the
following does not meet the diagnostic criteria for kleptomania?
Harriet views her shoplifting as a righteous act.
Harriet's stealing is described as pleasurable.
Harriet is well-off and can support her family's needs.
Harriet's stealing is described as impulsive. - ANSWERS-Although the patient may be
rationalizing her behavior as a righteous act, patients with kleptomania do not commit
theft to express anger or vengeance. Kleptomania is characterized as failing to resist
the impulse to steal, and the stolen objects are typically not needed. The act of stealing,
which usually is performed alone, gives the person gratification.
When completing the CAGE questionnaire with a suspected alcohol abuser, which of
the following questions would you most likely ask?
1. "Do you ever feel like you can't stop drinking after you start?"
2. "Do you drink at work?"
3. "Have you ever felt bad about your drinking?"
4. "Have you ever gotten sick from drinking?" - ANSWERS-Asking if a person has ever
felt bad about his or her drinking addresses the "guilt" component of the CAGE
questionnaire. The CAGE questionnaire consists of C (Cut down: Have you ever felt
,you should cut down on your drinking?), A (Annoyed: Have people annoyed you by
criticizing your drinking?), G (Guilty: Have you ever felt bad or guilty about your
drinking?), and E (Eye Opener: Have you ever had a drink first thing in the morning to
steady your nerves or to get rid of a hangover?). Questions regarding drinking at work,
getting sick, and being unable to stop drinking do not fall within the guidelines of the
CAGE questionnaire.
Which of these patients would be at lowest risk for suicide?
1. A 62-year-old Caucasian female with bipolar disorder
2. A 32-year-old African-American male with alcohol use disorder
3. A 26-year-old Latina female with schizophrenia
4. A 73-year-old Caucasian male with major depressive disorder - ANSWERS-Females
and certain minority groups are less likely to commit suicide than males and Caucasian
individuals. Hence, although 10%-15% of all patients with schizophrenia commit suicide,
a Latina female with schizophrenia would be at relatively low risk for suicide. A 62-year-
old Caucasian female with bipolar disorder would be at higher risk, as older patients are
more likely to complete suicide. Older Caucasian men have the highest suicide rate of
any age and race, and patients with major depressive disorder account for 40%-60% of
all suicides. A young African-American male who has a history of abusing alcohol would
be at moderate risk, as 20% of all suicides had a history of alcohol use disorder.
Sally, a 28-year-old teacher, comes to your clinic. She says: "In the last few days, I've
developed this cramping pain in my stomach and this burning feeling whenever I
urinate." She asked her sexual partner, whom she began dating recently, if he had any
similar symptoms. He told her that he also feels a burning sensation during urination
and that his testicles "feel sore." Which of these is the most definitive test for the most
likely diagnosis?
1. Enzyme immunoassay methods
2. Fluorescent treponemal antibody absorption
3. Chlamydia culture
4. Nucleic acid amplification test using urine sample - ANSWERS-For a female patient
with symptoms such as cramping stomach pain and burning on urination or a male
patent with testicular tenderness, a chlamydia culture would be the definitive diagnostic
test when diagnosing chlamydia. Although enzyme immunoassay and nucleic acid
,amplification tests are also methods used to help diagnose chlamydia, these tests are
not the most definitive. Fluorescent treponemal antibody absorption is used to test for
syphilis, not chlamydia.
Jack, an 18-year-old male, was arrested for assaulting his high school classmate. When
asked what happened, Jack says, "he looked at me the wrong way," which sent him
"over the edge" and made him want to "utterly wreck him and everything he holds dear."
He says he "doesn't know what got into him" because he usually doesn't get that angry.
When you inquire if he felt any physical symptoms before he attacked, he says, "I felt all
tingly and my chest was tight." Based on your suspected diagnosis, which treatment
would not be effective?
1. Naltrexone
2. Fluoxetine
3. Trazodone
4. Propranolol - ANSWERS-The patient's aggressive impulses, coupled with tingling
and chest tightness preceding the attack, suggest intermittent explosive disorder (IED);
naltrexone and other opioid antagonists are not used to treat this condition. Fluoxetine
and other SSRIs are recommended as first-line treatment for IED. Trazodone and beta
blockers such as propranolol have likewise been shown to reduce aggressive behavior
in patients with IED.
You are a nurse practitioner, and you've noticed that your 35-year-old friend, Andrew,
has been drinking more than usual, causing him to miss work sporadically. Of the
following questions you can ask Andrew, which one is most closely aligned with the
National Institute on Alcohol Abuse and Alcoholism guidelines for determining alcohol-
related problems?
1. "How often do you have more than four drinks containing alcohol in a day?"
2. "How often do you have more than three drinks containing alcohol in a day?"
3. "Does your alcohol consumption exceed 10 standard drinks per week?"
4. "Does your alcohol consumption exceed seven standard drinks per week?" -
ANSWERS-According to the National Institute on Alcohol Abuse and Alcoholism, men
may be at risk for alcohol-related problems if they regularly drink more than four
alcoholic drinks per day or 14 standard drinks per week. Women may be at risk for
alcohol-related problems if they consume more than three drinks per day or more than
seven standard drinks per week.
, Since he was in a major car crash, George constantly replays the crash in his head. His
wife, Susana, tells you that he is less responsive when she talks to him and gets
anxious anytime he is near a highway. Suspecting that George is suffering from post-
traumatic stress disorder, which of the following would not be an immediate, effective
strategy for you to implement at this time?
1. Assessing and monitoring any suicidal thoughts
2. Suggesting she take him for a drive on the highway
3. Decreasing behaviors that are maladaptive and increase anxiety
4. Using adaptive strategies and mechanisms - ANSWERS-Although prolonged
exposure therapy is recommended for patients with post-traumatic stress disorder
(PTSD), therapy would not begin with immediately reintroducing the patient to the
stressful stimulus. Rather, therapy would begin with education and breathing retraining.
Monitoring suicidal thoughts, decreasing counterproductive behaviors, and using
adaptive strategies are all effective tools for immediate intervention in PTSD patients.
Decreased serotonin receptor activity and elevated dopamine in the basal ganglia are
most closely associated with which disorders?
1. Anxiety disorders
2. Thought disorders
3. Mood disorders
4. Depressive disorders - ANSWERS-Elevated dopamine in the basal ganglia and
decreased serotonin (5-HT) activity are most closely associated with thought disorders.
These two findings are not a definitive diagnosis for a thought disorder but aid in the
diagnostic process by ruling out other disorders. In mood disorders such as bipolar
disorder, multiple neurotransmitters are believed to be involved, including 5-HT,
norepinephrine, acetylcholine, gamma-amino-butyric acid, and peptides, with increased
dopamine activity leading to manic states. Serotonin is usually elevated in patients with
an anxiety disorder. Decreased levels of serotonin, norepinephrine, and dopamine are
all linked to symptoms of depression.
All of these are predisposing factors for delirium except:
WITH Recent Newest Verified And Well Analyzed
Exam Questions (Actual Exam 2026-2027)
Correct Detailed & Verified ANSWERS (100%
Accurate Solutions) ALREADY GRADED
A+||NEWEST VERSION Of The Exam Guarantee
Pass!!
Harriet is a well-established business woman who provides for her family. She was
recently arrested for stealing over $10,000 worth of merchandise from the mall. When
Harriet is asked to describe her behavior, she says: "It just comes on me quickly, and
when it's done, I feel really good." She also describes how she grew up poor and sees
the theft as a way to "even the score" against those with "empty wealth." Which of the
following does not meet the diagnostic criteria for kleptomania?
Harriet views her shoplifting as a righteous act.
Harriet's stealing is described as pleasurable.
Harriet is well-off and can support her family's needs.
Harriet's stealing is described as impulsive. - ANSWERS-Although the patient may be
rationalizing her behavior as a righteous act, patients with kleptomania do not commit
theft to express anger or vengeance. Kleptomania is characterized as failing to resist
the impulse to steal, and the stolen objects are typically not needed. The act of stealing,
which usually is performed alone, gives the person gratification.
When completing the CAGE questionnaire with a suspected alcohol abuser, which of
the following questions would you most likely ask?
1. "Do you ever feel like you can't stop drinking after you start?"
2. "Do you drink at work?"
3. "Have you ever felt bad about your drinking?"
4. "Have you ever gotten sick from drinking?" - ANSWERS-Asking if a person has ever
felt bad about his or her drinking addresses the "guilt" component of the CAGE
questionnaire. The CAGE questionnaire consists of C (Cut down: Have you ever felt
,you should cut down on your drinking?), A (Annoyed: Have people annoyed you by
criticizing your drinking?), G (Guilty: Have you ever felt bad or guilty about your
drinking?), and E (Eye Opener: Have you ever had a drink first thing in the morning to
steady your nerves or to get rid of a hangover?). Questions regarding drinking at work,
getting sick, and being unable to stop drinking do not fall within the guidelines of the
CAGE questionnaire.
Which of these patients would be at lowest risk for suicide?
1. A 62-year-old Caucasian female with bipolar disorder
2. A 32-year-old African-American male with alcohol use disorder
3. A 26-year-old Latina female with schizophrenia
4. A 73-year-old Caucasian male with major depressive disorder - ANSWERS-Females
and certain minority groups are less likely to commit suicide than males and Caucasian
individuals. Hence, although 10%-15% of all patients with schizophrenia commit suicide,
a Latina female with schizophrenia would be at relatively low risk for suicide. A 62-year-
old Caucasian female with bipolar disorder would be at higher risk, as older patients are
more likely to complete suicide. Older Caucasian men have the highest suicide rate of
any age and race, and patients with major depressive disorder account for 40%-60% of
all suicides. A young African-American male who has a history of abusing alcohol would
be at moderate risk, as 20% of all suicides had a history of alcohol use disorder.
Sally, a 28-year-old teacher, comes to your clinic. She says: "In the last few days, I've
developed this cramping pain in my stomach and this burning feeling whenever I
urinate." She asked her sexual partner, whom she began dating recently, if he had any
similar symptoms. He told her that he also feels a burning sensation during urination
and that his testicles "feel sore." Which of these is the most definitive test for the most
likely diagnosis?
1. Enzyme immunoassay methods
2. Fluorescent treponemal antibody absorption
3. Chlamydia culture
4. Nucleic acid amplification test using urine sample - ANSWERS-For a female patient
with symptoms such as cramping stomach pain and burning on urination or a male
patent with testicular tenderness, a chlamydia culture would be the definitive diagnostic
test when diagnosing chlamydia. Although enzyme immunoassay and nucleic acid
,amplification tests are also methods used to help diagnose chlamydia, these tests are
not the most definitive. Fluorescent treponemal antibody absorption is used to test for
syphilis, not chlamydia.
Jack, an 18-year-old male, was arrested for assaulting his high school classmate. When
asked what happened, Jack says, "he looked at me the wrong way," which sent him
"over the edge" and made him want to "utterly wreck him and everything he holds dear."
He says he "doesn't know what got into him" because he usually doesn't get that angry.
When you inquire if he felt any physical symptoms before he attacked, he says, "I felt all
tingly and my chest was tight." Based on your suspected diagnosis, which treatment
would not be effective?
1. Naltrexone
2. Fluoxetine
3. Trazodone
4. Propranolol - ANSWERS-The patient's aggressive impulses, coupled with tingling
and chest tightness preceding the attack, suggest intermittent explosive disorder (IED);
naltrexone and other opioid antagonists are not used to treat this condition. Fluoxetine
and other SSRIs are recommended as first-line treatment for IED. Trazodone and beta
blockers such as propranolol have likewise been shown to reduce aggressive behavior
in patients with IED.
You are a nurse practitioner, and you've noticed that your 35-year-old friend, Andrew,
has been drinking more than usual, causing him to miss work sporadically. Of the
following questions you can ask Andrew, which one is most closely aligned with the
National Institute on Alcohol Abuse and Alcoholism guidelines for determining alcohol-
related problems?
1. "How often do you have more than four drinks containing alcohol in a day?"
2. "How often do you have more than three drinks containing alcohol in a day?"
3. "Does your alcohol consumption exceed 10 standard drinks per week?"
4. "Does your alcohol consumption exceed seven standard drinks per week?" -
ANSWERS-According to the National Institute on Alcohol Abuse and Alcoholism, men
may be at risk for alcohol-related problems if they regularly drink more than four
alcoholic drinks per day or 14 standard drinks per week. Women may be at risk for
alcohol-related problems if they consume more than three drinks per day or more than
seven standard drinks per week.
, Since he was in a major car crash, George constantly replays the crash in his head. His
wife, Susana, tells you that he is less responsive when she talks to him and gets
anxious anytime he is near a highway. Suspecting that George is suffering from post-
traumatic stress disorder, which of the following would not be an immediate, effective
strategy for you to implement at this time?
1. Assessing and monitoring any suicidal thoughts
2. Suggesting she take him for a drive on the highway
3. Decreasing behaviors that are maladaptive and increase anxiety
4. Using adaptive strategies and mechanisms - ANSWERS-Although prolonged
exposure therapy is recommended for patients with post-traumatic stress disorder
(PTSD), therapy would not begin with immediately reintroducing the patient to the
stressful stimulus. Rather, therapy would begin with education and breathing retraining.
Monitoring suicidal thoughts, decreasing counterproductive behaviors, and using
adaptive strategies are all effective tools for immediate intervention in PTSD patients.
Decreased serotonin receptor activity and elevated dopamine in the basal ganglia are
most closely associated with which disorders?
1. Anxiety disorders
2. Thought disorders
3. Mood disorders
4. Depressive disorders - ANSWERS-Elevated dopamine in the basal ganglia and
decreased serotonin (5-HT) activity are most closely associated with thought disorders.
These two findings are not a definitive diagnosis for a thought disorder but aid in the
diagnostic process by ruling out other disorders. In mood disorders such as bipolar
disorder, multiple neurotransmitters are believed to be involved, including 5-HT,
norepinephrine, acetylcholine, gamma-amino-butyric acid, and peptides, with increased
dopamine activity leading to manic states. Serotonin is usually elevated in patients with
an anxiety disorder. Decreased levels of serotonin, norepinephrine, and dopamine are
all linked to symptoms of depression.
All of these are predisposing factors for delirium except:
