ACTUAL EXAM 2026/2027 | Psych Tech
State Certification | Verified Q&A | Pass
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Section 1: Major Psychiatric Disorders
Q1: A 22-year-old male is brought to the emergency department by police after being found shouting at
invisible people on the street. He appears disheveled and states, "The government is transmitting
thoughts into my brain to control my actions." Which symptom is this patient exhibiting?
A. Visual hallucinations
B. Somatic delusions
C. Delusions of persecution [CORRECT]
D. Ideas of reference
Correct Answer: C
Rationale: The patient believes the government is controlling his actions, which constitutes a delusion of
persecution or control. Visual hallucinations involve seeing things, while somatic delusions involve false
beliefs about the body. Ideas of reference involve believing neutral events are personally significant.
Board Strategy: Identify the specific definition of the symptom described in the stem.
Q2: A patient diagnosed with Schizophrenia presents with a flat affect, poverty of speech, and an
inability to initiate goal-directed activities. The nurse documents these findings as which type of
symptoms?
A. Positive symptoms
B. Negative symptoms [CORRECT]
C. Cognitive symptoms
,D. Catatonic symptoms
Correct Answer: B
Rationale: Negative symptoms reflect a diminution or loss of normal functions, such as affect flattening,
alogia (poverty of speech), and avolition (lack of motivation). Positive symptoms include hallucinations
and delusions. Cognitive symptoms involve memory and attention deficits. Board Strategy: Associate
"taking away" or "loss" with negative symptoms; "adding" (hallucinations) with positive symptoms.
Q3: A patient with bipolar disorder is currently in a manic phase. Which behavior presents the greatest
immediate safety risk to the patient?
A. Rapid, pressured speech
B. Grandiose delusions
C. Hypersexuality and excessive spending [CORRECT]
D. Flight of ideas
Correct Answer: C
Rationale: While all are symptoms of mania, hypersexuality and excessive spending pose immediate
risks to physical safety (STIs, sexual victimization) and long-term financial/legal ruin. Rapid speech and
flight of ideas are communication issues; grandiosity is a thought disturbance. Board Strategy: When
asked for the "greatest risk," look for physical safety or life-threatening consequences.
Q4: A patient with major depressive disorder (MDD) states, "I wake up at 3:00 AM every morning and
can't get back to sleep." How should the technician document this sleep disturbance?
A. Initial insomnia
B. Middle insomnia
C. Terminal insomnia [CORRECT]
D. Hypersomnia
Correct Answer: C
,Rationale: Terminal insomnia, also known as early morning awakening, is characterized by waking up
earlier than intended and being unable to return to sleep. Initial insomnia is difficulty falling asleep.
Middle insomnia involves waking up during the night. Board Strategy: Know the specific terminology for
sleep patterns in mood disorders.
Q5: Which diagnostic criterion for Generalized Anxiety Disorder (GAD) distinguishes it from normal
worry?
A. The anxiety is focused on a specific object or situation.
B. The anxiety is difficult to control and present for more days than not for at least 6 months. [CORRECT]
C. The patient experiences panic attacks unexpectedly.
D. The anxiety is related to a recent stressful life event.
Correct Answer: B
Rationale: GAD requires excessive anxiety occurring more days than not for at least 6 months, and the
individual finds it difficult to control the worry. Specific objects indicate phobias; unexpected panic
attacks indicate Panic Disorder. Board Strategy: Differentiate GAD from specific phobias and panic
disorders by the duration and focus of the anxiety.
Q6: A patient with Post-Traumatic Stress Disorder (PTSD) is admitted after a car accident. The technician
notices the patient startles easily and is constantly scanning the environment for threats. These
symptoms are best described as:
A. Re-experiencing symptoms
B. Avoidance symptoms
C. Hyperarousal symptoms [CORRECT]
D. Dissociative symptoms
Correct Answer: C
Rationale: Hyperarousal symptoms include being easily startled, feeling tense or "on edge," and having
angry outbursts. Re-experiencing involves flashbacks/nightmares. Avoidance involves staying away from
, reminders. Board Strategy: Associate "scanning," "startle," and "edginess" with the hyperarousal cluster
of PTSD.
Q7: A patient with Obsessive-Compulsive Disorder (OCD) spends 3 hours a day washing their hands. The
patient states, "I know it doesn't make sense, but I have to do it or I will explode." This insight indicates:
A. Poor insight
B. Good or fair insight [CORRECT]
C. Absent insight/Delusional beliefs
D. Schizotypal traits
Correct Answer: B
Rationale: In OCD, if the patient recognizes that their obsessions are a product of their own mind and
are excessive or unreasonable (even if they cannot stop the compulsion), they have good or fair insight.
Poor insight involves believing the obsessions are likely true. Board Strategy: Distinguish OCD (ego-
dystonic) from psychosis (ego-syntonic/delusional).
Q8: Which personality disorder is characterized by a pervasive pattern of social inhibition, feelings of
inadequacy, and hypersensitivity to negative evaluation?
A. Schizoid Personality Disorder
B. Borderline Personality Disorder
C. Avoidant Personality Disorder [CORRECT]
D. Narcissistic Personality Disorder
Correct Answer: C
Rationale: Avoidant Personality Disorder involves a fear of rejection and criticism leading to social
restraint. Schizoid lacks desire for relationships. Borderline involves instability in mood and
relationships. Narcissistic involves grandiosity. Board Strategy: Look for the key phrase "hypersensitivity
to criticism" or "fear of rejection."