BARKLEY PMHNP PRACTICE EXAM 1
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📋 DOCUMENT OVERVIEW 87 Qs
This document, "BARKLEY PMHNP Practice Exam 1," covers various mental health topics, including
kleptomania, borderline personality disorder, depressive symptoms, Fairweather Model rehabilitation,
meningococcal vaccination, bipolar disorder misdiagnosis, and seasonal affective disorder. It provides 87
questions with correct answers and possible explanations, serving as a study aid for students preparing
for the Psychiatric Mental Health Nurse Practitioner (PMHNP) exam. Students can use this document to
review and reinforce their understanding of these mental health concepts, aiding in exam preparation
and confidence in applying their knowledge in real-world scenarios.
✓ Verified Answers ✓ Exam Ready ✓ Study Guide
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EXAM QUESTIONS
QUESTION 1
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.
CORRECT ANSWER
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.
QUESTION 2
Borderline personality disorder is not considered a differential diagnosis for conduct disorder, as
indicated by the patient's truancy, defiance of authority figures, fights with family members, poor
academic performance, sexual promiscuity, running away from home, and "tough guy" demeanor.
Oppositional defiant disorder, bipolar disorders, and adjustment disorders are all considered potential
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, differential diagnoses for conduct disorder, as are depressive disorders, attention-deficit/hyperactivity
disorder, and intermittent explosive disorder.
CORRECT ANSWER
Tony, a 16-year-old male, has been sent to your clinic for counseling. He has a long record of skipping
school, talking back to his teachers, and getting poor grades. His parents say he has often gotten in fights
with them, has frequently been caught sneaking girls into his room, and has run away from home on two
occasions. During the session, you notice Tony acts tough and aloof, not deigning to speak much. If you
suspect conduct disorder, which of the following conditions would you be least likely to include in your
differential diagnosis?
1. Borderline personality disorder
2. Oppositional defiant disorder
3. Adjustment disorder with disturbance of conduct
4. Bipolar disorder
QUESTION 3
Depressive symptoms are associated with decreased, not increased, levels of somatostatin in
cerebrospinal fluid. Patients with depression may exhibit a decreased thyroid-stimulating hormone
response to thyrotropin-releasing hormone, as well as hypersecretion of cortisol. Depressive
symptoms are also associated with irregularities in growth hormone release, such as reduced
nocturnal secretion and diurnal hypersecretion.
CORRECT ANSWER
Which of these lab findings would be least expected in a patient with depression?
1. Decreased nocturnal growth hormone secretion
2. Decreased thyroid-stimulating hormone response
3. Increased somatostatin in cerebrospinal fluid
4. Increased secretion of cortisol
QUESTION 4
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. Close observation should be
employed with patients who profess suicidal thoughts, are unable to commit to a "No Harm" contract,
or experience withdrawal.
CORRECT ANSWER
Jeremy, a suicidal inpatient, is under close observation. He is able to be observed at all times by hospital
staff during waking hours and when he sleeps, and is checked on every 15-30 minutes. Which of these
reasons would least indicate the need for this level of supervision?
1. Jeremy has expressed suicidal thoughts.
2. Jeremy experiences withdrawal from alcohol and cocaine.
3. Jeremy is ambivalent about his intent to commit suicide.
4. Jeremy was unable to commit to a "No Harm" contract.
QUESTION 5
The patient's recent involvement in risky pleasurable activity (e.g., unprotected sex), increase in goal-
driven activity at work, decreased need for sleep, and subjective experience of racing thoughts all
suggest a manic episode; as such, bupropion, an antidepressant, would not be considered because the
patient has not displayed the diagnostic criteria for a major depressive episode. Pharmacologic options
for the treatment of manic episodes include anticonvulsants (carbamazepine), antipsychotics
(haloperidol), and benzodiazepines (lorazepam).
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, CORRECT ANSWER
Adam, a 23-year-old male, is undergoing an STD test at your clinic. When you ask him why he is here, he
says, "I'm here because I've had this increased craving for sex. I've been picking up strangers in bars, not
caring about using protection ... I don't know what it is. For the last week, I've just felt really driven. Keep
throwing myself into my work, don't feel much need for sleep, feel like my thoughts are running a
marathon in my head." The patient lives a "clean life," clarifying that he does not abuse any substance,
"not even coffee or cigarettes." He also does not have a history of mental disorders. Given the most likely
diagnosis, which of these medications would you least likely recommend for Adam?
Lorazepam
Haloperidol
Carbamazepine
Bupropion
QUESTION 6
Lorazepam would not be the first choice to treat delirium in a dehydrated patient because
benzodiazepines may cause respiratory depression, especially in debilitated patients. Antipsychotics
such as haloperidol, quetiapine, and risperidone are considered the mainstay in managing agitation in
delirium patients; haloperidol is considered the standard of care, but newer agents such as quetiapine
and risperidone may be preferred due to reduced chance of side effects.
CORRECT ANSWER
You have determined that a patient's delirium stems from dehydration. As you begin treatment, you
realize the patient will require pharmacologic management for his agitation. Which of these agents would
be least appropriate in this situation?
Risperidone
Haloperidol
Quetiapine
Lorazepam
QUESTION 7
Most inpatients who develop a suicide plan and follow it have agreed to a "No Harm" contract. The
most common method of suicide among inpatients is hanging, not self-inflicted wounds. When
"unsolvable" problems at work, school, or home motivate the ideation, inpatients are most likely to
attempt suicide either within the first 5 days at the hospital or shortly after discharge, not after a
month. The rate of suicide among bipolar patients is relatively low, about 10%-15%, and risk would
be higher in patients with schizophrenia or an untreated anxiety disorder.
CORRECT ANSWER
Which of the following is true about suicide among inpatients?
Most patients who develop a suicide plan and follow it have agreed to a "No Harm" contract.
Self-inflicted wounds are the most common means of suicide.
Inpatients with bipolar disorder are most likely to commit suicide.
Patients who attempt suicide due to "unsolvable" problems usually do so after a month in care.
QUESTION 8
Auditory hallucinations, loss of memory, and lack of personal hygiene are all markers of the acute
phase of schizophrenia. Other signs and symptoms of this stage include illogical thinking,
inappropriate social behavior, catatonic excitement, and poor concentration. The premorbid phase is
indicated by depression, sleep disturbance, and bedwetting. The prodromal phase is characterized by
suspiciousness, inappropriate expression of feeling, and feelings of unreality. Lastly, the stable phase
is symptomatically similar to the prodromal phase.
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Page 3 of 29
85+ (Latest 2026 Edition) 100% Verified Q&A + Answer Key Solutions
100% Guarantee Pass
📋 DOCUMENT OVERVIEW 87 Qs
This document, "BARKLEY PMHNP Practice Exam 1," covers various mental health topics, including
kleptomania, borderline personality disorder, depressive symptoms, Fairweather Model rehabilitation,
meningococcal vaccination, bipolar disorder misdiagnosis, and seasonal affective disorder. It provides 87
questions with correct answers and possible explanations, serving as a study aid for students preparing
for the Psychiatric Mental Health Nurse Practitioner (PMHNP) exam. Students can use this document to
review and reinforce their understanding of these mental health concepts, aiding in exam preparation
and confidence in applying their knowledge in real-world scenarios.
✓ Verified Answers ✓ Exam Ready ✓ Study Guide
Trusted by thousands of students and professionals worldwide
EXAM QUESTIONS
QUESTION 1
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.
CORRECT ANSWER
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.
QUESTION 2
Borderline personality disorder is not considered a differential diagnosis for conduct disorder, as
indicated by the patient's truancy, defiance of authority figures, fights with family members, poor
academic performance, sexual promiscuity, running away from home, and "tough guy" demeanor.
Oppositional defiant disorder, bipolar disorders, and adjustment disorders are all considered potential
Trusted by thousands of students and professionals worldwide Page 1 of 29
, differential diagnoses for conduct disorder, as are depressive disorders, attention-deficit/hyperactivity
disorder, and intermittent explosive disorder.
CORRECT ANSWER
Tony, a 16-year-old male, has been sent to your clinic for counseling. He has a long record of skipping
school, talking back to his teachers, and getting poor grades. His parents say he has often gotten in fights
with them, has frequently been caught sneaking girls into his room, and has run away from home on two
occasions. During the session, you notice Tony acts tough and aloof, not deigning to speak much. If you
suspect conduct disorder, which of the following conditions would you be least likely to include in your
differential diagnosis?
1. Borderline personality disorder
2. Oppositional defiant disorder
3. Adjustment disorder with disturbance of conduct
4. Bipolar disorder
QUESTION 3
Depressive symptoms are associated with decreased, not increased, levels of somatostatin in
cerebrospinal fluid. Patients with depression may exhibit a decreased thyroid-stimulating hormone
response to thyrotropin-releasing hormone, as well as hypersecretion of cortisol. Depressive
symptoms are also associated with irregularities in growth hormone release, such as reduced
nocturnal secretion and diurnal hypersecretion.
CORRECT ANSWER
Which of these lab findings would be least expected in a patient with depression?
1. Decreased nocturnal growth hormone secretion
2. Decreased thyroid-stimulating hormone response
3. Increased somatostatin in cerebrospinal fluid
4. Increased secretion of cortisol
QUESTION 4
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. Close observation should be
employed with patients who profess suicidal thoughts, are unable to commit to a "No Harm" contract,
or experience withdrawal.
CORRECT ANSWER
Jeremy, a suicidal inpatient, is under close observation. He is able to be observed at all times by hospital
staff during waking hours and when he sleeps, and is checked on every 15-30 minutes. Which of these
reasons would least indicate the need for this level of supervision?
1. Jeremy has expressed suicidal thoughts.
2. Jeremy experiences withdrawal from alcohol and cocaine.
3. Jeremy is ambivalent about his intent to commit suicide.
4. Jeremy was unable to commit to a "No Harm" contract.
QUESTION 5
The patient's recent involvement in risky pleasurable activity (e.g., unprotected sex), increase in goal-
driven activity at work, decreased need for sleep, and subjective experience of racing thoughts all
suggest a manic episode; as such, bupropion, an antidepressant, would not be considered because the
patient has not displayed the diagnostic criteria for a major depressive episode. Pharmacologic options
for the treatment of manic episodes include anticonvulsants (carbamazepine), antipsychotics
(haloperidol), and benzodiazepines (lorazepam).
Trusted by thousands of students and professionals worldwide Page 2 of 29
, CORRECT ANSWER
Adam, a 23-year-old male, is undergoing an STD test at your clinic. When you ask him why he is here, he
says, "I'm here because I've had this increased craving for sex. I've been picking up strangers in bars, not
caring about using protection ... I don't know what it is. For the last week, I've just felt really driven. Keep
throwing myself into my work, don't feel much need for sleep, feel like my thoughts are running a
marathon in my head." The patient lives a "clean life," clarifying that he does not abuse any substance,
"not even coffee or cigarettes." He also does not have a history of mental disorders. Given the most likely
diagnosis, which of these medications would you least likely recommend for Adam?
Lorazepam
Haloperidol
Carbamazepine
Bupropion
QUESTION 6
Lorazepam would not be the first choice to treat delirium in a dehydrated patient because
benzodiazepines may cause respiratory depression, especially in debilitated patients. Antipsychotics
such as haloperidol, quetiapine, and risperidone are considered the mainstay in managing agitation in
delirium patients; haloperidol is considered the standard of care, but newer agents such as quetiapine
and risperidone may be preferred due to reduced chance of side effects.
CORRECT ANSWER
You have determined that a patient's delirium stems from dehydration. As you begin treatment, you
realize the patient will require pharmacologic management for his agitation. Which of these agents would
be least appropriate in this situation?
Risperidone
Haloperidol
Quetiapine
Lorazepam
QUESTION 7
Most inpatients who develop a suicide plan and follow it have agreed to a "No Harm" contract. The
most common method of suicide among inpatients is hanging, not self-inflicted wounds. When
"unsolvable" problems at work, school, or home motivate the ideation, inpatients are most likely to
attempt suicide either within the first 5 days at the hospital or shortly after discharge, not after a
month. The rate of suicide among bipolar patients is relatively low, about 10%-15%, and risk would
be higher in patients with schizophrenia or an untreated anxiety disorder.
CORRECT ANSWER
Which of the following is true about suicide among inpatients?
Most patients who develop a suicide plan and follow it have agreed to a "No Harm" contract.
Self-inflicted wounds are the most common means of suicide.
Inpatients with bipolar disorder are most likely to commit suicide.
Patients who attempt suicide due to "unsolvable" problems usually do so after a month in care.
QUESTION 8
Auditory hallucinations, loss of memory, and lack of personal hygiene are all markers of the acute
phase of schizophrenia. Other signs and symptoms of this stage include illogical thinking,
inappropriate social behavior, catatonic excitement, and poor concentration. The premorbid phase is
indicated by depression, sleep disturbance, and bedwetting. The prodromal phase is characterized by
suspiciousness, inappropriate expression of feeling, and feelings of unreality. Lastly, the stable phase
is symptomatically similar to the prodromal phase.
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Page 3 of 29
