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NURS 6640 Final Exam All Verified Answers

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NURS 6640 Final Exam Psychotherapy Individ Walden University 

Question 1

A PMHNP has been treating a 9-year-old patient who was referred by her school. Students are
asked to raise their hands before speaking during group discussion, but the patient seems to blurt
out what she wants to say without being called on. She also interrupts other children while they
are talking instead of waiting her turn. When the patient gets frustrated, she has trouble
controlling her emotions and cries often. Based on the initial information provided, the first focus
by PMHNP is the child’s ____________.
A. memory
B. self regulation
C. language skills
D. social system

Question 2

The PMHNP is caring for a patient who experiences depression caused by the traumatic
experience of her dog passing away. She reports not being able to eat or sleep, and sometimes
doesn’t want to leave the house at all. Which statement is most appropriate for the PMHNP to
maximize the patient’s adaptive coping mechanisms?
A . “Think of something funny every time you feel sad.”
B . “My cat passed away last year, and it’s been hard to adjust to her being gone.”
C . “It’s important to be mindful of how you feel and then to determine what causes those feelings.”
D . B and C

Question 3

A PMHNP is using Gestalt therapy to communicate with a 50-year-old patient who is going
through a divorce. As he is calmly sharing the details of his divorce, the PMHNP notices that
Dave is tapping his fingers on his legs. What is an appropriate response by the PMHNP using the
technique of focusing?
A . “I noticed that your fingers were tapping. Can you give a voice to your fingers?”
B . “I’m going to ask you to exaggerate the movement of tapping your fingers.”
C . “Explore what is emerging in your body now. What are you experiencing right now?”
D . None of the above.

Question 4

The PMHNP is meeting with an older, female adult patient and her daughter. The patient has
early onset dementia. The daughter expresses concern, saying, “I don’t want you to just stick my
mother in a home and give her medicine. I’m worried that’s what people are going to want to
do.” What is the best response by the PMHNP to the daughter?
A . “Most of the time, institutionalization cannot be prevented.”
B . “The type of treatment depends on the stage of dementia and safety considerations.”
C . “Don’t worry; I do not believe in hospitalizing my patients.”
D . “The treatment decision will be up to your mother and what she wants.”

Question 5

A PMHNP is treating a 10-year-old boy who is exhibiting signs of aggression and attention
problems. What type of intervention will the PMHNP consider using a common elements
approach?
A . Behavioral
B . Cognitive
C . Pyschoeducational
D . All of the above

Question 6

A 35-year-old male patient is being treated for alcohol addiction. He asks for the PMHNP’s cell
phone number to use in case of an emergency. When the PMHNP responds that giving her
number would be against therapeutic rules, the patient threatens an act of violence to the
therapist. What would be the most appropriate response by the PMHNP?
A . Immediately report the threat to the local police department
B . Allow the patient to explore his feelings
C . Review the therapeutic treatment frame
D . Call the patient the next day to follow up

Question 7

The PMHNP is caring for an adult male patient whose wife left him several months ago. He
recently learned that his ex-wife is dating someone much younger. The man feels belittled, sad,
and lonely. He talks about trying to meet other women, but says, “I can’t compete with the
younger guys these days, with the cool clothes and the vegan diets. I’m bald and overweight, and
what woman is going to want to be with me?” How does the PMHNP help raise the man’s selfesteem?
A . Correcting cognitive distortions
B . Using role-playing techniques
C . Unraveling unconscious guilt
D . All of the above

Question 8

The PMHNP uses therapeutic communication skills while ensuring that the patient understands
that he has choices. The PMHNP comprehends and practices motivational interviewing. This is
best understood as which of the following?
A . Give the patient as much time needed to respond to questions and comments.
B . A statement that both challenges the patient’s resistance and offers an opportunity to discuss the issues allows the patient to argue with him/herself to help produce a desired change.
C . You must give full attention to the patient because nonverbal and verbal reactions are equally important.
D . The PMHNP should be ready with a response when communicating with the patient. She understands that silence is also a therapeutic response.

Question 9

The PMHNP is terminating treatment for a patient who has been receiving eye movement
desensitization and reprocessing (EMDR) therapy. What action does the PMHNP take at the final
session to terminate treatment?

A . Helps the patient create a future template
B . Discusses all issues that have been addressed
C . Asks the patient to take a new assessment
D . All of the above

Question 10

The PMHNP is assessing an older adult male patient with depression and comorbidities.
According to the medical chart, the patient takes medication to manage joint and bone pain. The
patient reports feeling “forgetful” and complains that he has a hard time remembering where he
puts things. What is the primary action by the PMHNP?
A . Collaborating with the patient’s caregiver to discuss a treatment approach
B . Prescribing an antidepressant to address the patient’s symptoms
C . Determining if the patient’s medications can be causing memory problems
D . All of the above

Question 11

A 21-year-old patient has been having trouble adjusting to college life. She tells the PMHNP that
she had five alcoholic drinks at a party this past weekend. She also acknowledges that she drank
the same amount of alcohol at a party the previous month. Based on this information, what
would the PMHNP most likely recommend?
A . Group therapy
B . Peer support
C . Hospitalization
D . None of the above

Question 12

The PMHNP is assessing a new geriatric patient who reports symptoms of depression. The
PMHNP wants to identify the patient’s symptom severity over time. Which assessment tool will
the PMHNP use to collect this data on the patient?
A . Mood Disorder Questionnaire
B . Montgomery-Asberg Depression Rating Scale
C . AB Clinician Depression Screen
D . Brief Psychiatric Rating Scale

Question 13

How does the PMHNP approach termination with the patient who has been receiving intermittent
therapy?
A . Uses the word “interrupt” instead of “terminate” with the patient
B . Requires the therapy be resumed in several months
C . Encourages the patient to check in with the PMHNP about his/her progress
D . A and C

Question 14

A 55-year-old patient recovering from substance abuse tells the PMHNP, “It’s impossible to meet
new people. I really hate being single.” Using existential psychotherapy, what might the PMHNP
say next?
A . “Where are you experiencing unhappiness in your body?
B . “So you feel frustrated and unhappy being single. Is that right?”
C . “Are you willing to say, ‘I’m having a hard time meeting people’?”
D . “What might help you to live a more meaningful life?”

Question 15

The PMHNP is assessing a patient who requires cognitive behavioral therapy (CBT). Which of
the following statements made by the PMHNP approach the termination phase for this patient?
A . “Although it’s your first session, we will discuss how termination of your treatment will go.”
B . “Now that you are feeling more stable, let’s talk about terminating these sessions.”
C . “We will wait to discuss terminating the treatment until you’ve attended at least five sessions.”
D . None of the above.

Question 16

The PMHNP is caring for a patient who is histrionic. Using the supportive psychodynamic
therapy model, what is the best statement made by the PMHNP?
A. “Express your emotion, and do not hold anything back. ”
B. “Let’s not think too much about emotion right now. Let’s focus on what got you upset in the first place. ”
C. A and B
D. None of the above

Question 17

The PMHNP uses the cognitive behavioral therapy model with Gerald, an older adult patient
who is being treated for depression and mood disorder. What will the PMHNP do with the
patient during the first three sessions?
A. Build a therapeutic alliance
B. Build behavioral skills to increase pleasant activities
C. Build cognitive skills to challenge negative thinking
D. Build social skills to improve problem solving

Question 18

A PMHNP is using emotion-focused therapy to help a 38-year-old patient who says, “I’ve been
feeling angry lately, but I’m not sure why.” The first attempt by the PMHNP is to say:
A. “Focus on your anger, take a deep breath, and allow an image to emerge. ”
B. “Sit in these two chairs to have a conversation with your anger. ”
C. “Please tell me in detail about your anger and confusion. ”
D. “Your experience of anger and confusion is normal. ”

Question 19

Following an attempted suicide, Mr. Durham was admitted to an acute psychiatric facility. After
4 weeks in treatment, he is preparing for discharge. He is beginning to miss individual and group
therapy sessions and has refused medications twice in the past 2 days. The PMHNP demonstrates
understanding in this phase by saying which of the following statements?
A. “It is your choice whether to continue to take your medications. ”
B. “Have you thought of how you will continue your treatment plans? ”
C. “Are you upset with someone here? Tell me more about this. ”
D. “Are you sure you no longer want to go to therapy? ”

Question 20

The PMHNP is communicating with a middle-aged male patient who has a history of addiction
to Percocet (acetaminophen/oxycodone). The patient suddenly yells, “I do not have a problem
with pain pills! I’ve never had an overdose and no one even knows that I take them unless I tell
them.” The PMHNP understands that there are phases of change and can best demonstrate
“focusing” by responding with:
A. “I sincerely commend you for being here and seeking treatment; this is a great first step. ”
B. “If no one knows about your substance usage, why are you here? ”
C. “Just because no one knows about your drug usage does not mean you do not have a problem. ”
D. “I am wondering if your use of pain medication has ever prompted you to seek medical attention. ”

Question 21

While assessing a patient using a humanistic-existential approach, a patient tells the PMHNP,
“For the past few weeks, I’ve felt anxious almost every single day.” What would be an
appropriate next step by the PMHNP?
A. Try to provide a diagnosis based on the patient’s description of daily anxiety
B. Give the patient some possible solutions they might use for feeling less anxious
C. Use traditional assessment procedures, such as giving a psychometric test
D. Encourage the patient to clarify by asking, “You constantly feel anxious? ”

Question 22

The PMHNP is working with a patient who describes having a painful and traumatic childhood
experience, which causes her to have anxiety as an adult. When asked how she manages her
anxiety, the patient dismisses it and denies that it is a problem. Using the supportive
psychotherapy approach, the PMHNP will do which of the following when assessing the
patient’s ego strength?
A. Identify the primary defenses the patient uses to ward off anxiety
B. Focus on the patient’s attachment to the anxiety and memories of her childhood
C. Identify whether the patient has an unresolved or disorganized attachment style
D. All of the above

Question 23

A 38-year-old patient tells the PMHNP that her father went to jail for selling drugs when she was
a child. The patient is visibly upset when discussing what happened. Using a humanisticexistential approach to psychotherapy, which of the following is the most appropriate response
by the PMHNP?
A. “How were you feeling at the time when that happened? ”
B. “What are you experiencing now as you share this story? ”
C. “Did you allow yourself to feel anger when your father left? ”
D. “Are able to let go of the painful emotions you felt as a
child? ”

Question 24

A PMHNP has been working with a 50-year-old patient who has a stressful job and goes to the
casino on weekends to play poker with his friends, which he says relieves his stress. Tim admits
that he sometimes misses work on Monday when he stays out too late at the casino on Sunday
nights. In addition, he once was an avid runner, and has given up running to spend more time
gambling.
True or false: According to the PMHNP, the desired goal after treatment is not complete
abstinence from gambling, but reaching a healthy level of the behavior.
True
False

Question 25

The PMHNP is interviewing a patient with a history of substance abuse. He has attempted to stop
abusing drugs three times before. He states to the PMHNP, “I just cannot change. How can you
help me?!” As it applies to change, the PMHNP understands the principle of evocation to mean:
A. The patient can choose to leave the program whenever he wants because changing is his choice.
B. The patient already has everything needed and the PMHNP would like to help him facilitate his own inner coping.
C. If the patient tries, he will one day become successful; he must not give up.
D. The patient must evolve and change with the times to successfully change his
way of thinking.

Question 26

The PMHNP is in the process of terminating treatment with a patient who witnessed the death of
her parent who used to sexually abuse her. What does the PMHNP understand about terminating
this patient?
A. The patient should be made aware that he/she may have trouble managing the trauma.
B. The patient will have to resume treatment with a different provider for further treatment.
C. The patient can be weaned off from therapy, but cannot receive treatment indefinitely.
D. The patient may need to have follow-up sessions every few months.

Question 27

The PMHNP has been providing interpersonal psychotherapy (IPT) for a patient who the
PMHNP observes implementing new ways of being, such as interacting more with peers and
being less isolated in social scenarios. The PMHNP understands that the patient is approaching
termination. How does the PMHNP address termination with this patient?
A. Give the patient an option about terminating the therapy
B. Allow the patient to bring up termination on his/her own
C. Embed the termination into the work of the therapeutic phase
D. None of the above

Question 28

A 19-year-old female patient named Anna, who was the victim of child abuse and neglect, is also
in treatment for substance abuse. At her most recent appointment, Anna confesses to the PMHNP
that she is having romantic fantasies about him, and explains the he is one of the few people she
trusts. She believes that he is interested in her as well. What is the most appropriate response by
the PMHNP in this situation?
A. Encourage her to focus on therapy and keep the conversation professional
B. Explain that he must terminate counseling because of the therapeutic frame
C. Guide the patient to examine her feelings and explore the underlying meaning
D. None of the above

Question 29

A 38-year-old patient has been having trouble communicating with his teenage daughter. Using a
solution-focused therapy approach, the PMHNP responds by saying, “When was a time that a
communication problem could have occurred, but did not?” In this case, what type of question is
the PMHNP asking?
A. Coping question
B. Joining question
C. Exception question
D. Miracle question

Question 30

The PMHNP is treating an older adult patient who reports symptoms of late-life anxiety. What
type of treatment(s) will the PMHNP consider?
A. Employ cognitive behavioral therapy
B. Use relaxation training
C. Initiate modular interventions
D. All of the above

Question 31

A cocaine-addicted female patient is entering residential treatment for substance abuse. Using the
10 guiding principles of recovery, an appropriate step by the PMHNP is to ______________.
A. Focus on the substance abuse problem before addressing any trauma
B. Integrate services that encompass mind, body, spirit, and community
C. Help the patient use fear of relapse to provide motivation for recovery
D. None of the above

Question 32

A PMHNP is using motivational interviewing (MI) with a 50-year-old patient named Dave to
commit to a healthy drug-free lifestyle. By using “change talk,” the PMHNP hopes to help the
patient build self-esteem and hope.
True or false: If Dave is resisting change, the PMHNP should challenge his resistance in order
for MI to be successful.

True
False

Question 33

A 21-year-old patient is worried about starting a new job. She talks about her fears of failure and
not making friends at the office. Using a person-centered approach, an appropriate response by
the PMHNP is to ______________.
A. Give the patient advice based on the therapist’s experiences
B. Persuade the patient to release her unfounded fears and worries
C. Ask the patient to reflect on and explore what she is experiencing
D. All of the above

Question 34

The PMHNP is initiating a plan of care for a patient who requires comprehensive psychotherapy
to manage his depression and mood disorder. Throughout the initial sessions, the patient reports
feeling as though he cannot be helped. The PMHNP is concerned about premature termination
initiated by the patient. What strategy can the PMHNP employ to prevent or reduce premature
termination?
A. Incorporate patient preferences as to the type of therapy used
B. Educate the patient about the duration and pattern of change
C. Foster a therapeutic alliance with the patient
D. All of the above

Question 35

A PMHNP has been treating a 14-year-old patient using interpersonal psychotherapy. The patient
has been depressed since the death of his grandmother. To help the patient recover, the PMHNP
has told the parents:
A. “Keep your expectations high to show that you believe in his abilities. ”
B. “Modify your expectations at home and school until the depression lifts. ”
C. “Don’t put expectations on him while he is showing signs of depression. ”
D. “Allow him to be an active participant by setting his own expectations. ”

Question 36

The PMHNP is caring for an older adult patient who presents with mixed dysphoric states and
whose daughter reports “is becoming more irritable more easily.” When talking with the patient,
the PMHNP also recognizes displays of cognitive dysfunction. Which treatment options will the
PMHNP most likely suggest?
A. Cognitive behavioral therapy (CBT)
B. Interpersonal psychotherapy (IPT)
C. Combination of CBT and IPT
D. Combination of CBT and medication

Question 37

The PMHNP is caring for a geriatric patient who expresses symptoms of gastrointestinal
problems, aches and pains, and loss of appetite. The patient reports feeling lonely, as more of his
friends have been passing away over the recent months and years. The PMHNP focuses on which
therapeutic approach for this patient?
A. Supportive therapy
B. Problem-solving therapy
C. Cognitive behavioral therapy
D. All of the above

Question 38

An 8-year-old has been having trouble making friends at school. His parents initiated treatment
when he also started acting out at home. Which is the most appropriate step that the PMHNP
takes during the assessment process when using an integrated approach?
A. Collect information from the patient, his parents, and school
B. Rule out medical issues that may affect behavior
C. Get a measure of the patient’s developmental level
D. All of the above

Question 39

A PMHNP is using interpersonal psychotherapy with a 40-year-old patient having relationship
problems with his extended family. The patient shares that he has been using the strategies they
identified to reduce his distress, but they have not been helping. He is frustrated and is
considering stopping treatment. What would be an appropriate step by the PMHNP?
A. Encourage the patient to continue treatment by using alternative strategies
B. Restart the process at the assessment phase to formulate a new treatment plan
C. Explain how the originally identified strategies will address the focus problem
D. None of the above

Question 40

The PMHNP is assessing a patient who has been receiving months of outpatient psychotherapy.
According to the PMHNP’s assessment, the patient is nearing the termination phase of their
therapeutic relationship because the patient’s symptoms have improved, and the patient shows
progress managing behaviors and decision-making abilities according to the diagnosis. How does
the PMHNP approach termination with this patient?
A. Address the termination phase with the patient at the last session
B. Manage termination issues as part of the treatment
C. Determine the PMHNP’s readiness to terminate the therapeutic relationship
D. None of the above

Question 41

When recalling the phases of change, the PMHNP demonstrates “open questioning” in the
“engagement” phase by making which statement?
A. “What plans have you made to make this change? ”
B. “What occurred to cause you to seek treatment? ”
C. “What concerns you the most about these subjects? ”
D. “What do you want do you want be different? ”

Question 42

A 12-year-old girl was referred for treatment after witnessing the physical abuse of her sibling by
their mother. The patient has been anxious and irritable since the experience. What evidencebased treatment would be most appropriate for the PMHNP to use?
A. Trauma-focused CBT
B. Interpersonal psychotherapy
C. Psychodynamic therapy
D. Behavioral parent training

Question 43

Linda is a 65-year-old patient who has completed initial treatment for alcohol addiction and
anxiety problems. She is motivated to continue her treatment gains and have a healthy lifestyle.
How would the PMHNP apply a mindfulness approach to this case?
A. Help Linda develop an awareness of triggers in order to have greater control over physical and emotional responses
B. Encourage Linda to have her husband and children participate in family therapy to facilitate her integration into the community
C. Ask Linda to do homework to elicit any other feelings related to her addictive behavior and evaluate her progress
D. All of the above

Question 44

The PMHNP assesses a 27-year-old patient named Jeff, who was a victim of child abuse and
neglect. Jeff says that he remembers a traumatic situation that he wants to share, but is having
trouble talking about it. Which statement made by the PMHNP demonstrates the use of emotionfocused therapy?
A. “Let’s see if we can come up with some ideas for you to feel safe telling your story. ”
B. “Jeff, it’s okay for you to not talk about your past here; this is a safe space, whether you feel like sharing or not. ”
C. “Jeff, can you tell me what was going on during your childhood that caused you to be a victim of neglect and abuse? ”
D. None of the above.

Question 45

The PMHNP is caring for an older patient with major depressive disorder, seasonal pattern. The
patient has been resolute about not taking medication to manage the depression brought on by his
illness, stating that it is against his yogic lifestyle. In addition to psychotherapy, what can the
PMHNP suggest to this patient?
A. “You may want to look into therapeutic oils and aromatherapy as an alternative to medication. ”
B. “Some patients have good results with medicine. Are you sure you don’t want to try it? ”
C “You can try taking natural supplements in addition to the medicine I prescribe. You. ”
D. All of the above.

Question 46

The PMHNP initiates feeling-state therapy to help a 25-year-old patient named Monique who has
a compulsive urge to exercise. Using the Feeling-State Addiction Protocol, what is an appropriate
next step the PMHNP should take after identifying the specific positive feeling linked with the
addictive behavior and its Positive Feeling Score level?
A. Evaluate the patient for having the coping skills to manage feelings
B. Perform eye movement sets until the Positive Feeling Score level drops
C. Locate and identify any physical sensations created by the positive feelings
D. Have the patient visualize performing the addictive behavior

Question 47

A patient’s depression is affecting her relationship with her spouse. What might the PMHNP ask
during the initial sessions of interpersonal psychotherapy treatment?
A. “What expectations do you have of your spouse? ”
B. “How is your depression affecting the relationship with your spouse? ”
C. “What changes would you and your spouse like to see in the relationship? ”
D. All of the above.

Question 48

A PMHNP is assessing a 60-year-old patient named Carlos. He has severe PTSD and mild
substance abuse issues. The most appropriate setting to treat Carlos would be a _________.
A. Primary health care setting with some specialized care
B. State psychiatric hospital and/or emergency room
C. Substance abuse treatment system
D. Mental health system of care

Question 49

The PMHNP continues to meet with Gerald, who is the patient with depression and mood
disorder. The PMHNP uses the CBT approach. Gerald is now meeting with the PMHNP for his
fifth session and feels comfortable with how the therapy works. What does the PMHNP plan to
do with Gerald over the course of the next several sessions?
A. Set treatment goals with Gerald
B. Identify barriers to treatment
C. Develop cognitive skills to challenge Gerald’s negative thinking
D. None of the above

Question 50

A PMHNP is treating a 25-year-old patient who has a compulsive urge to exercise to excess.
When asked to describe why she does so much exercise, she says, “I like the compliments I
receive from others on my new level of fitness, and the excitement of getting more attention.”
The PMHNP can use feeling-state therapy to help Monique ___________.
A. Return to a normal system of functioning
B. Break the feeling/behavior connection
C. Use more appropriate ways to satisfy needs
D. All of the above

Question 51

A 43-year-old single mother is seeing the PMHNP at the request of her sister. “My sister thinks I
need to come here to talk about my feelings,” the patient reports. The PMHNP learns that the
patient has three children from three different men, but is unable to collect appropriate child
support payments from any of the biological fathers. Additionally, the woman is barely able to
afford her apartment or utilities payments. What is the appropriate response from the PMHNP
when using the psychodynamic psychotherapy technique?
A. Suggesting that the patient goes to church to pray for God’s help
B. Telling the patient to write letters to the biological fathers requesting money
C. Suggesting that the patient seek professional legal help
D. Asking the patient why she thinks it is so hard to get the money she deserves

Question 52

The PMHNP meets with a 31-year-old woman who reports feeling as though she is “at her
breaking point” with work. The PMHNP learns that the woman works 12-hour days, including
one day on the weekend, because she is nervous about company layoffs. “I feel like I need to
work myself to death in order to prove that I am valuable to the organization,” the woman says.
Using the supportive psychodynamic therapy approach, how does the PMHNP respond?
A. “You need to find a new place to work. ”
B. “Who cares about getting laid off? Then you can collect unemployment benefits. ”
C. “I’m sure you have parents or a husband to take care of you if you lose your job. ”
D. “That must be a very tiring work schedule. How do you feel about working so much? ”

Question 53

A 13-year-old patient and his parents are meeting with a PMHNP. When the PMHNP says hello,
the boy just nods. His parents tell the PMHNP that he didn’t want to come to the session, but
they insisted. They explain that their son has been moody and depressed at home, but is still
getting good grades at school. Which of the following would be the best response by the
PMHNP?
A. Ask the patient to leave the room to speak with his parents
B. Tell the patient that he shouldn’t be upset at his parents
C. Compliment the patient on his academic achievement
D. All of the above

Question 54

The PMHNP is treating an older adult patient who reports experiencing nightmares associated
with an automobile accident he was in 20 years ago. As the PMHNP formulates the case using
the dynamic supportive therapy model, what questions will the PMHNP use during the session?
A. “What can you tell me about this room? ”
B. “You might benefit from a sleep aid. ”
C. “Let’s talk about what kinds of things are triggering you now. ”
D. “Do I have your permission to advocate for you with your primary care physician? ”

Question 55

The PMHNP is caring for an older adult patient who is in the acute phase of schizophrenia.
Which therapeutic model will the PMHNP employ with this patient?
A. Individual CBT
B. Group CBT
C. Both A and B
D. None of the above

Question 56

The PMHNP has been providing supportive psychodynamic psychotherapy to a patient and is
nearing the termination stage. The PMHNP will use which criteria for determining that the
patient is ready for termination?
A. Transference neurosis has been resolved.
B. Symptoms have improved.
C. Core conflicts have been reduced.
D. Self-analytic capacity has been developed.

Question 57

When completing this exam, did you comply with Walden University’s Code of Conduct
including the expectations for academic integrity?
Yes
No

Question 58

A patient is finishing the active treatment phase of interpersonal psychotherapy (IPT). After the
PMHNP reminds the patient that she has three sessions left, the patient says nothing, but looks
distressed. What would be the best reply by the PMHNP following IPT protocol?
A. “Maybe we should extend your active treatment phase. ”
B. “Remember that the end of treatment is not a time to grieve. ”
C. “Don’t worry. Finishing therapy means you’ve met your goals. ”
D. “You seem upset. Tell me what seems to be bothering you. ”

Question 59

The PMHNP has been treating a patient who is now being transferred to another provider. What
is the appropriate action made by the PMHNP?
A. Introducing the patient to the new provider
B. Leaving the door open for the patient to return at any time
C. Having the new provider come to a few sessions
D. A and C

Question 60

The PMHNP who practices motivational interviewing understands its relationship to patient
behaviors and/or outcomes to mean which of the following?
A. An increased use of motivational interviewing is linked to inconsistent behaviors in the patient. This is related to decreased client engagement and poor outcomes.
B. A decreased use of motivational interviewing is linked to more consistent behaviors in the patient. This is related to decreased client engagement and poor outcomes.
C. There is a higher incidence of inconsistent behaviors with motivational interviewing. This is related to client engagement and better outcomes.
D. There is a lower incidence of inconsistent behaviors with motivational interviewing. This is related to client engagement and better outcomes.

Question 61

A PMHNP is treating a 12-year-old girl who witnessed the physical abuse of her sibling. She has
been anxious and irritable since the experience. After speaking with the PMHNP, the patient says
she keeps having anxiety-causing thoughts about the experience. Using the PRACTICE
technique, which skill will best help the patient interrupt these negative thoughts?
A. Relaxation
B. Affect modulation
C. Enhancing safety
D. Trauma narrative

Question 62

The PMHNP is caring for a young adult patient with whom the PMHNP decides to use a
dynamic supportive therapy approach in addition to pharmacological intervention. Which
therapeutic action will the PMHNP take to employ the strategy of holding and containing the
patient?
A. Encouraging and nurturing the patient
B. Asking the patient how the patient feels
C. Discussing why the patient is not taking the medication as directed
D. Teaching the patient about medication side effects

Question 63

The PMHNP is meeting with a patient who has been diagnosed with depression. The patient is
having trouble adjusting to her new job and hasn’t made any new friends there. What would an
appropriate response be by the PMHNP using the interpersonal psychotherapy approach?
A. “For homework, please write a list of qualities you’d find in a good friend. ”
B. “Describe the friendships you had growing up, both as a child and teenager. ”
C. “Tell me more about why you’re having trouble making new friends at work. ”
D. All of the above.

Question 64

The PMHNP is initiating a plan of care for Holly, a 73-year-old female patient who has late-life
bipolar disorder and reports consuming alcoholic beverages four times per week. What is the
focus of Holly’s therapy going to be?
A. Managing health and substance abuse
B. Maintaining meaningful relationships
C. Skills for daily living
D. All of the above

Question 65

The PMHNP is interviewing a patient who is in the process of successfully completing a
substance abuse program. During the interview, the patient states, “I wish I was strong enough to
keep the same friends I had before I came here for treatment. I’m really afraid of being
discharged because I’ll probably run into my old friends again.” The PMHNP offers a complex
reflection when she states the following:
A. “You feel as though you are weak and you wish that you were strong. ”
B. “The thought of being discharged scares you because you don’t feel strong enough. ”
C. “You’d like to keep your old friends but know being around them may lead you to abuse substances again. ”
D. “You believe that you’ll run into your old friends if you’re discharged. ”

Question 66

In the planning phase of change, a 42-year-old male client who struggles with gambling
discusses how he plans to abstain from gambling. He tells the PMHNP, “I am no longer going to
carry cash to the casino because you can’t spend what you don’t have.” The PMHNP uses an
affirming communication skill when she states:
A. “Not gambling is a tough habit to break; not carrying cash is a big step in the right direction. ”
B. “Are you saying that you will still go to a casino: however, you will only have a debit card in terms of funds? ”
C. “This is a great technique, though it may not work if there is an ATM in the casino you go to. ”
D. “Why don’t we try to deal with your addiction to gambling before you go into a casino to decrease your temptation? ”

Question 67

A PMHNP is assessing a 40-year-old patient named Sarah who has a severe cocaine addiction
and mild depression. Using the four-quadrant model, what would be the most appropriate setting
to help the patient?
A. Primary health care settings with some specialized care
B. State psychiatric hospitals and emergency rooms
C. Substance abuse treatment system
D. The mental health system of care

Question 68

Mia is a 75-year-old patient who has completed initial treatment for depression. What might a
PMHNP ask Mia when using a solution-focused therapy approach?
A. “What specific improvements have you noticed in your mood since you made the call to see me? ”
B. “On a scale of 1–10 (with 1 being little to no improvement to 10 being a great deal of improvement) how much has your mood changed since we started working together? ”
C. “What needs to happen today in order for you to feel that is was a productive session? ”
D. All of the above.

Question 69

A PMHNP is using Gestalt therapy to communicate with a 42-year-old patient who is upset with
her mother. She says, “I want to tell her how hurt I feel when she doesn’t call me, but I don’t
want to upset her.” What technique can the PMHNP use to help Sasha express herself?
A. Language of responsibility
B. Empty-chair dialogue
C. Dreamwork
D. Focusing

Question 70

As part of the PMHNP’s role in the clinic, the PMHNP oversees students that gain clinical
experience at the agency. The student is instructed to use the supportive psychodynamic therapy
approach with the patient. Which action made by the student causes the PMHNP to intervene,
after observing the student interacting with the patient?
A. Focusing too heavily on defenses
B. Talking to the patient about the use of problem-solving strategies
C. Inviting the patient to emote about thoughts and fantasies
D. Asking the patient about the patient’s work stress

Question 71

The PMHNP is assessing a 30-year-old client who reports feeling stressed out due to his current
employment situation. When asked about how he manages this work-related stress, the patient
says that exercise helps him feel less anxious, so he often spends 2 or more hours at the gym
each night. After completing the patient assessment, the PMHNP has determined that an
existential psychotherapy approach may best benefit this client. What is the PMHNP’s goal in
employing this treatment approach?
A. Help the patient eliminate anxiety from his life
B. Help the patient be aware of his anxiety and embrace it
C. Help the patient find alternative ways to de-stress
D. None of the above

Question 72

When preparing to terminate a patient, what does the PMHNP do to organize thoughts about the
patient’s progress made during treatment?
A. Interviews the patient’s family, caregiver, or friends regarding the patient’s progress outside of the sessions
B. Reviews the patient’s file to identify issues and important themes that were highlighted throughout treatment
C. Requests a peer to review the patient’s file to double check that the PMHNP has not overlooked anything
D. All of the above

Question 73

The PMHNP uses the Adult Attachment Interview (AAI) with a male patient who reports having
had a difficult time being separated from his parents during his childhood. He explains that going
to school or visiting his relatives without his parents was troublesome. The PMHNP
characterizes the patient as unresolved/disorganized, according to his outcomes on the AAI.
What does the PMHNP anticipate from the patient?
A. He will have lapses in his memory of his childhood.
B. He will be able to describe his childhood in great detail.
C. He will need less active interventions.
D. None of the above.

Question 74

The PMHNP is terminating treatment with a patient who is aggressive and has a history of anger.
What does the PMHNP do when terminating treatment with this patient?
A. Makes a list of all the positive things the patient gained from treatment
B. Does not recognize the patient’s emotions so as to not encourage the onset of anger
C. Emphasizes and validates the patient’s feelings of anger that may emerge
D. Avoids upsetting the patient by keeping an open door policy

Question 75

The PMHNP is actively listening to Ms. Thomas who is detoxing from alcohol. Ms. Thomas is
currently discussing with the PMHNP the reasons why she feels guilty about her drinking. Ms.
Thomas tearfully states, “I have driven my family and friends away with this terrible habit. I
have no one left. I had more than enough chances and now my children won’t even talk to me.”
Which of the following statements demonstrate a simple reflection?
A. “You feel that your children have given you many chances. ”
B. “You believe that you have no one to support you through this. ”
C. “You feel that your use of alcohol is a terrible habit. ”
D. All the above.

Question 76

A 25-year-old female states, “I really need to lose weight. I know I’m the cause of our problems,
if I could just lose weight he might be more attracted to me. Then we could start a family and we
would be happy. I’m sure of it, right, we would definitely be happy!” Which statement shows the
PMHNP’s ability to apply “summarizing”?
A. “You believe that your weight is a cause of your marital problems. ”
B. “How would starting a family contribute to your overall happiness?
C. “You have identified your weight as a problem in your marriage and but believe that losing weight will gain happiness. ”
D. “Part of you believes that losing weight will bring you happiness, while the other part believes that may not be true. ”

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