ASWB Clinical DSM-5-TR Diagnosis & Mental Status Practice Questions
DSM-5-TR Diagnosis & Mental Status makes up 7 of every 50 questions on a Tigertest ASWB Clinical practice test. Here are 10 of the 28 questions on it, each with the answer and the reason.
Updated by the Tigertest team. Based on the ASWB Clinical content outline (2026 Examination Guidebook). Original questions; 50 per test, weighted like the real exam. Not affiliated with ASWB.
1. For most of the past year a client has been in a major depressive episode with ongoing hallucinations. Before the episode began, she had three weeks of hallucinations with no mood symptoms. The MOST likely diagnosis is:
- A.Delusional disorder
- B.Schizoaffective disorder
- C.Major depression with psychotic features
- D.Bipolar I disorder
Answer: B. Schizoaffective disorder needs a major mood episode alongside schizophrenia symptoms, plus delusions or hallucinations for at least two weeks without a mood episode. In depression with psychotic features, psychosis occurs only during the mood episode.
2. A client has had major depressive episodes and one five-day period of elevated mood, little sleep and fast speech that did not impair her work. The MOST likely diagnosis is:
- A.Cyclothymic disorder
- B.Major depressive disorder
- C.Bipolar I disorder
- D.Bipolar II disorder
Answer: D. Bipolar II requires at least one hypomanic episode and one major depressive episode, with no full manic episode. Hypomania raises mood and energy without marked impairment or hospitalization.
3. Under DSM-5-TR, a hypomanic episode requires symptoms lasting at least:
- A.4 consecutive days
- B.14 consecutive days
- C.2 consecutive days
- D.7 consecutive days
Answer: A. Hypomania requires abnormally elevated or irritable mood and increased energy most of the day for at least four consecutive days. Mania requires a week, or any duration if hospitalization is needed.
4. A 50-year-old firmly believes a coworker is poisoning his coffee. He has no hallucinations, and his work and home life are otherwise intact. The MOST likely diagnosis is:
- A.Paranoid personality disorder
- B.Schizoaffective disorder
- C.Delusional disorder
- D.Schizophrenia
Answer: C. Delusional disorder involves one or more delusions for at least a month without other schizophrenia symptoms, and functioning apart from the delusion is not markedly impaired. Paranoid personality disorder has suspicion but not a fixed delusion.
5. A client's mood swings from rage to despair within hours, usually after a fight with her partner, and she has a long pattern of unstable relationships. This MOST suggests:
- A.Cyclothymic disorder
- B.Histrionic personality disorder
- C.Borderline personality disorder
- D.Bipolar I disorder
Answer: C. Mood shifts lasting hours, triggered by interpersonal events and set within a lifelong pattern of unstable relationships and identity, point to borderline personality disorder. Bipolar episodes last days to weeks.
6. A 19-year-old has repeatedly broken the law, lied and shown no remorse. Antisocial personality disorder can be diagnosed only if he also had:
- A.Conduct disorder before age 15
- B.Two arrests before turning 13
- C.Depression in adolescence
- D.A head injury in early childhood
Answer: A. Antisocial personality disorder requires the person to be at least 18 with evidence of conduct disorder beginning before age 15. A younger person with the pattern is assessed for conduct disorder.
7. A 9-year-old is often defiant and argues with adults but has never hurt people or animals or destroyed property. This is MORE consistent with:
- A.Antisocial personality disorder
- B.Conduct disorder
- C.Intermittent explosive disorder
- D.Oppositional defiant disorder
Answer: D. Oppositional defiant disorder is a pattern of angry or irritable mood and argumentative, defiant behavior. Conduct disorder adds serious violations such as aggression, destruction, theft or serious rule breaking.
8. An 8-year-old has severe temper outbursts several times a week and is irritable nearly every day between them, for over a year. This MOST suggests:
- A.Adjustment disorder
- B.Disruptive mood dysregulation disorder
- C.Bipolar I disorder
- D.Oppositional defiant disorder
Answer: B. DMDD is chronic severe irritability with frequent outbursts, beginning before age 10. It was added partly to reduce the overdiagnosis of bipolar disorder in children.
9. A client develops low mood and poor sleep two months after a divorce, more than expected, and does not meet criteria for another disorder. The MOST fitting diagnosis is:
- A.Prolonged grief disorder
- B.Adjustment disorder with depressed mood
- C.Major depressive disorder
- D.Persistent depressive disorder
Answer: B. Adjustment disorder involves distress out of proportion to a stressor or impaired functioning, starting within three months of the stressor and not meeting criteria for another disorder.
10. A client with PTSD often feels as if she is outside her body watching herself. The specifier that fits is:
- A.With psychotic features
- B.With panic attacks
- C.With delayed expression
- D.With dissociative symptoms
Answer: D. PTSD with dissociative symptoms applies when the person also has persistent depersonalization or derealization. Delayed expression means full criteria were not met until at least six months after the event.
Practice all 28 dsm-5-tr diagnosis & mental status questions, and the rest of the 200-question bank, in the free ASWB Clinical training sets. Questions you miss come back until you have mastered them.
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