BARKLEY DRT 1 BARKLEY POST TEST
BARKLEY POST TEST PRACTICE EXAM
QUESTIONS AND ANSWERS 2026
QUESTIONS 1-20: PSYCHIATRIC ASSESSMENT & DIFFERENTIAL DIAGNOSIS
Q1. A 40-year-old male reports anxiety, palpitations, and fear of having another
panic attack. He avoids public spaces and has stopped riding the subway.
Which diagnosis best matches his symptoms?
A. Generalized anxiety disorder
B. Panic disorder with agoraphobia
C. Social anxiety disorder
D. Specific phobia
Correct ,,,,ANSWER,,,: B
Detailed Rationale: Panic disorder involves recurrent unexpected panic attacks
with persistent concern about future attacks. Agoraphobia involves avoidance of
places where escape might be difficult. This patient's fear of public spaces and
avoidance of the subway indicates agoraphobia secondary to panic disorder .
Q2. Which neurotransmitter is most closely associated with schizophrenia's
positive symptoms?
,A. Serotonin
B. Dopamine
C. GABA
D. Norepinephrine
Correct ,,,,ANSWER,,,: B
Detailed Rationale: Hyperactivity of dopaminergic pathways—particularly the
mesolimbic tract—contributes to positive symptoms such as hallucinations and
delusions. This forms the basis for antipsychotic medication mechanisms .
Q3. A PMHNP is teaching a client starting lithium. Which statement indicates
need for further teaching?
A. "I will drink plenty of water daily."
B. "I should notify my provider if I develop tremors or confusion."
C. "I can take over-the-counter NSAIDs for headache regularly."
D. "I should avoid becoming dehydrated."
Correct ,,,,ANSWER,,,: C
Detailed Rationale: NSAIDs (ibuprofen, naproxen) raise serum lithium levels by
reducing renal clearance, increasing toxicity risk. Patients should use
acetaminophen instead. Hydration and avoiding dehydration are correct
statements .
Q4. Which symptom best differentiates major depressive disorder from
bereavement?
,A. Tearfulness
B. Insomnia
C. Feelings of worthlessness and self-loathing
D. Sadness related to a recent loss
Correct ,,,,ANSWER,,,: C
Detailed Rationale: Pathologic depression includes pervasive guilt,
worthlessness, and self-loathing beyond normative grieving. Bereavement involves
sadness related to loss without the intense negative self-appraisal .
Q5. A PMHNP administers the AIMS (Abnormal Involuntary Movement Scale).
This tool screens for:
A. Neuroleptic malignant syndrome
B. Extrapyramidal tremor only
C. Tardive dyskinesia
D. Akathisia
Correct ,,,,ANSWER,,,: C
Detailed Rationale: The AIMS (Abnormal Involuntary Movement Scale) detects
late-onset involuntary movements (tardive dyskinesia) caused by chronic
antipsychotic use, particularly involving oral-facial muscles .
Q6. A 24-year-old female experiences mood swings and impulsive behavior
with unstable relationships. These features are most characteristic of:
, A. Bipolar II disorder
B. Borderline personality disorder
C. Histrionic personality disorder
D. Cyclothymic disorder
Correct ,,,,ANSWER,,,: B
Detailed Rationale: Borderline personality disorder (BPD) is characterized by
emotional dysregulation, impulsivity, unstable interpersonal relationships, identity
disturbance, and affective instability—often with splitting and fear of
abandonment .
Q7. A patient with major depressive disorder is started on an SSRI. Which early
side effect should the PMHNP educate the patient about?
A. Weight gain
B. Sexual dysfunction
C. Hypertension
D. Urinary retention
Correct ,,,,ANSWER,,,: B
Detailed Rationale: Sexual dysfunction (delayed ejaculation, anorgasmia,
decreased libido) is a common SSRI side effect, often emerging early in therapy.
Weight gain typically develops later, hypertension is unusual, and urinary retention
is more typical of anticholinergic drugs .
Q8. Which finding is most consistent with bipolar I disorder?
BARKLEY POST TEST PRACTICE EXAM
QUESTIONS AND ANSWERS 2026
QUESTIONS 1-20: PSYCHIATRIC ASSESSMENT & DIFFERENTIAL DIAGNOSIS
Q1. A 40-year-old male reports anxiety, palpitations, and fear of having another
panic attack. He avoids public spaces and has stopped riding the subway.
Which diagnosis best matches his symptoms?
A. Generalized anxiety disorder
B. Panic disorder with agoraphobia
C. Social anxiety disorder
D. Specific phobia
Correct ,,,,ANSWER,,,: B
Detailed Rationale: Panic disorder involves recurrent unexpected panic attacks
with persistent concern about future attacks. Agoraphobia involves avoidance of
places where escape might be difficult. This patient's fear of public spaces and
avoidance of the subway indicates agoraphobia secondary to panic disorder .
Q2. Which neurotransmitter is most closely associated with schizophrenia's
positive symptoms?
,A. Serotonin
B. Dopamine
C. GABA
D. Norepinephrine
Correct ,,,,ANSWER,,,: B
Detailed Rationale: Hyperactivity of dopaminergic pathways—particularly the
mesolimbic tract—contributes to positive symptoms such as hallucinations and
delusions. This forms the basis for antipsychotic medication mechanisms .
Q3. A PMHNP is teaching a client starting lithium. Which statement indicates
need for further teaching?
A. "I will drink plenty of water daily."
B. "I should notify my provider if I develop tremors or confusion."
C. "I can take over-the-counter NSAIDs for headache regularly."
D. "I should avoid becoming dehydrated."
Correct ,,,,ANSWER,,,: C
Detailed Rationale: NSAIDs (ibuprofen, naproxen) raise serum lithium levels by
reducing renal clearance, increasing toxicity risk. Patients should use
acetaminophen instead. Hydration and avoiding dehydration are correct
statements .
Q4. Which symptom best differentiates major depressive disorder from
bereavement?
,A. Tearfulness
B. Insomnia
C. Feelings of worthlessness and self-loathing
D. Sadness related to a recent loss
Correct ,,,,ANSWER,,,: C
Detailed Rationale: Pathologic depression includes pervasive guilt,
worthlessness, and self-loathing beyond normative grieving. Bereavement involves
sadness related to loss without the intense negative self-appraisal .
Q5. A PMHNP administers the AIMS (Abnormal Involuntary Movement Scale).
This tool screens for:
A. Neuroleptic malignant syndrome
B. Extrapyramidal tremor only
C. Tardive dyskinesia
D. Akathisia
Correct ,,,,ANSWER,,,: C
Detailed Rationale: The AIMS (Abnormal Involuntary Movement Scale) detects
late-onset involuntary movements (tardive dyskinesia) caused by chronic
antipsychotic use, particularly involving oral-facial muscles .
Q6. A 24-year-old female experiences mood swings and impulsive behavior
with unstable relationships. These features are most characteristic of:
, A. Bipolar II disorder
B. Borderline personality disorder
C. Histrionic personality disorder
D. Cyclothymic disorder
Correct ,,,,ANSWER,,,: B
Detailed Rationale: Borderline personality disorder (BPD) is characterized by
emotional dysregulation, impulsivity, unstable interpersonal relationships, identity
disturbance, and affective instability—often with splitting and fear of
abandonment .
Q7. A patient with major depressive disorder is started on an SSRI. Which early
side effect should the PMHNP educate the patient about?
A. Weight gain
B. Sexual dysfunction
C. Hypertension
D. Urinary retention
Correct ,,,,ANSWER,,,: B
Detailed Rationale: Sexual dysfunction (delayed ejaculation, anorgasmia,
decreased libido) is a common SSRI side effect, often emerging early in therapy.
Weight gain typically develops later, hypertension is unusual, and urinary retention
is more typical of anticholinergic drugs .
Q8. Which finding is most consistent with bipolar I disorder?
