NRNP6645 midterm exam 2021

nurs6645/ Nurs 6645

 

1

Question 1

According to Freud’s Psychosexual Stages framework a patient exhibiting excessive envy and jealousy failed to successfully manage anxiety during which stage?

 

A.            Oral

 

B.            Anal

 

C.            Latency

 

                Phallic/Oedipal

 

 

 

Question 2

The advanced practice psychiatric nurse psychotherapist is informed by the managed care company that authorization for additional treatment with a patient has been denied. The advanced practice psychiatric nurse is concerned stopping treatment will jeopardize the patient’s safety and realizes which of the following are ethical options?

 

A.            It is incumbent on the therapist to ensure that treatment continues.

 

B.            Stop treatment immediately.

 

C.            Attempt to work out a payment plan with the patient.

 

D.            A and C

 

 

uestion 3

Which of the following is consistent with the aims of supportive psychotherapy?

 

A.            Restructure defenses

 

B.            Strengthen defenses

 

C.            Promote problem-solving

 

D.            B and C

 

 

Question 4

Which of the following is consistent regarding termination in brief psychodynamic therapy?

 

A.            The termination date is set within 10 weeks of anticipated termination.

 

B.            The termination date is set in the beginning of treatment within 30 sessions

 

C.            The termination date is set in the beginning of treatment within 60 sessions.

 

D.            The termination date is flexible and is set mutually by the therapist and patient once major issues have been addressed.

 

 

Question 5

In therapy groups where group members gain through receiving help from group members and giving help to group members, which of Yalom’s therapeutic benefits is being realized?

 

A.            Altruism

 

B.            Catharsis

 

C.            Imparting Information

 

D.            Development of socializing techniques

 

 

Question 6

The skilled psychotherapist assists the patient to stay in the Resilience Zone. Which of the following symptoms are consistent with hypoarousal?

 

A.            Pain, anxiety, fatigue

 

B.            Emptiness, emotional paralysis, emotional numbness

 

C.            Euphoria, irritability, panic

 

D.            Angry outbursts, anxiety, exhaustion

 

 

Question 7

According to Peplau’s Interpersonal Relations Model for nursing, a cornerstone for the psychotherapeutic process is understanding, assessing, and managing which of the following?

 

A.            Anger

 

B.            Anxiety

 

C.            Resilience

 

D.            Holism

 

 

Question 8

According to Freud, failure to successfully accomplish the tasks of learning independence and control is associated with which of the following problematic traits?

 

A.            Excessive dependency

 

B.            Orderliness

 

C.            Sexual identity issues

 

D.            Excessive guilt

 

 

Question 9

The advanced practice psychiatric nurse may intervene as appropriate with agencies or persons in order to advocate for the patient; do for the patient what he or she cannot do for self, always with an aim toward maximum independence and growth which is consistent with which basic strategy of dynamic supportive therapy?

 

A.            Make connections

 

B.            Encourage patient activity

 

C.            Manipulate the environment

 

D.            Maximize adaptive coping mechanisms

 

 

Question 10

Optimal family development is thought to take place in which of the following circumstances?

 

A.            Family members are differentiated, anxiety is low, and partners maintain emotional contact with their own families.

 

B.            Family members lack differentiation, anxiety is low, and partners maintain emotional contact with their own families.

 

C.            Family members are differentiated, anxiety is moderate, and partners reduce emotional contact with their parents and siblings.

 

D.            Family members lack differentiation, avoid anxiety and partners avoid emotional contact with parents and siblings.

 

 

Question 11

The therapist using a CBT approach in which the therapist encourages the patient to investigate whether their thoughts are based on facts or assumptions is known as which of the following?

 

A.            Labeling of Distortions

 

B.            Questioning the Evidence

 

C.            Advantages and Disadvantages

 

D.            Examining Options and Alternatives

 

 

Question 12

Cultural relativity (Horowitz, 1982) refers to

 

A.            How we relate to those from other culture

 

B.            Similarities between various cultures

 

C.            Differences between Eastern and Western cultures

 

D.            Behavior considered normal or abnormal depends on social and cultural norms.

                               

 

 

uestion 13

Patients who would not be considered ideal candidates for psychoanalytic psychotherapy are which of the following?

 

A.            Patients with primarily primitive defenses

 

B.            Patients with primarily mature defense mechanisms

 

C.            Patients with neurotic to healthy personality organization.

 

D.            Patients with the capability to engage in a therapeutic alliance

 

 

Question 14

During the initial phase of family therapy one person is identified as “the problem”. The family therapist challenges linearity by which of the following?

 

A.            Asking the children how they would fix or deal with the problem person.

 

B.            Asking the person identified as the problem to meet privately prior to the next meeting.

 

C.            Asking the person identified as the problem how they think the problem could be fixed.

 

D.            Asking how others in the family are involved in or effected by “the problem”.

 

 

Question 15

Yalom states the group therapy analogue to relationship in individual therapy is which of the following?

 

A.            Universality

 

B.            Cohesiveness

 

C.            Social microcosm

 

D.            The corrective emotional experience

 

 

Question 16

The nurse psychotherapist realizes that “true presence” in a therapeutic relationship involves which of the following? Check all that apply.

 

A.            Listening to what is important to the patient.

 

B.            Listening to what the meaning of a situation is in the moment.

 

C.            “Being with” the patient rather than “doing to” the patient.

 

D.            Acceptance, nonjudgmental attitude and empathy.

 

 

Question 17

Which of the following is not consistent with clinical practice guidelines for use of psychodynamic therapy for various psychiatric disorders?

 

A.            Panic-focused psychodynamic psychotherapy is recommended as an initial treatment for Panic Disorder

 

B.            No RCTs support use of psychodynamic therapy for Obsessive-Compulsive Disorder.

 

C.            Psychodynamic therapy is considered a first-line treatment for Schizophrenia

 

D.            Psychodynamic therapy is a therapeutic treatment option for Major Depressive Disorder.

Question 18

The advanced practice psychiatric nurse who assists the patient to maintain eye contact appropriately, shaking hands appropriately, appropriate language in public is doing which of the following?

 

A.            Social Skills Training

 

B.            Shame-Attacking Exercises

 

C.            Guided Contingency Management

 

D.            Examining Options and Alternatives

 

 

Question 19

Evidenced based guidelines for patient treatment are based on which of the following?

 

A.            Consensus of expert panel

 

B.            Systematic reviews of case studies.

 

C.            Systematic reviews of randomized controlled studies (RTC).

 

D.            A and C

 

 

Question 28

 

Schizoid personality is a pathological outcome associated with which of Erickson’s psychosocial stages?

 

A.            Autonomy vs. self-doubt

 

B.            Industry vs. inferiority

 

C.            Identity vs. role confusion

 

D.            Intimacy vs. isolation

Question 29

Which of the following is not consistent cross-cultural research related to mental health and mental illness.

 

A.            Culture determines what is considered a psychiatric disorder.

 

B.            Neurobiological mechanisms linked to stress and trauma vary across cultures.

 

C.            Individuals from different cultural backgrounds vary in their interoceptive awareness.

 

D.            Individuals from different cultural backgrounds are similar in their interoceptive awareness.

Question 30

The CBT therapist asks the patient “On a scale of 1 to 10 how would you rate your level of depression today?” “And how does that compare to 2 months ago?” This is an example of what type of question type in Socratic Dialogue?

 

A.            Application question

 

B.            Analysis question

 

C.            Evaluation question

 

D.            This would not be a question consistent with Socratic Dialogue.

Question 31

In general, the lower the patient is on Maslow’s hierarchy of needs

 

A.            The less active the therapist must be.

 

B.            The more active the therapist must be.

 

C.            The more neutral the therapist must be.

 

D.            The more enmeshed the therapist must be.

Question 32

Strategies for working with anxiety are central to all therapy approaches. Which strategy would be consistent with a behavioral therapy approach?

 

A.            Restructuring

 

B.            Interpretations

 

C.            Desensitization

 

D.            Exploring wishes

Which technique would be helpful to use with individuals who blame themselves for most bad outcomes?

 

A.            Reattribution

 

B.            Decatastrophizing

 

C.            Advantages and Disadvantages

 

D.            Examining options and alternatives

Question 34

The quality of the therapeutic relationship is most closely linked to which school of therapy?

 

A.            Freudian

 

B.            Gestalt

 

C.            CBT

 

D.            None of the above

Question 35

Which of the following is a responsible way for the therapist to safely set appropriate limits on availability.

 

A.            The therapist just needs to notify either in person or by mail that they will not be available at certain times.

 

B.            The therapist has an answering machine that clearly states that if this is an emergency, the ???? patient should go to the ED or call a crises hotline.

 

C.            Ask another therapist to cover for vacations and time off, as this is for emergency only ???? specifics about patients should not be shared.

 

D.            Both A and B

Question 36

A patient being treated with supportive psychodynamic psychotherapy has been missing sessions and coming late when coming to sessions. The advanced practice psychiatric nurse recognizes this behavior as which of the following?

 

A.            Avoidance

 

B.            A sign the patient has met goals.

 

C.            The patient is ready to talk about termination of therapy.

 

D.            The patient is bored because the sessions have not been very interesting.

 

Question 41

 

According to Yalom, which of the following is consistent with the therapeutic benefit of imitative behavior?

 

A.            Imitative behavior generally plays a more important role in early stages of a group.

 

B.            Imitative behavior may allow an individual to experiment with a new behavior.

 

C.            Finding out what we are not is progress toward finding out what we are.

 

D.            All of the above

Question 42

A group member becomes angry with the group leader accusing the leader of being too controlling and showing favoritism. This behavior is consistent with which of Yalom’s therapeutic factors?

 

A.            Catharsis

 

B.            Interpersonal learning

 

C.            Development of socializing techniques

 

D.            Question 43

Family dialogue is encouraged.

 

A.            Genogram

 

B.            Family schema

 

C.            Family drawing

 

D.            Family sculpting

 

Question 44

An advanced practice psychiatric nurse is sued for continuing to work with a patient despite the treatment not working. The advanced practice psychiatric nurse realizes that which of the following will be considered in this case?

 

A.            Was the standard of care followed?

 

B.            Was there harm to the patient?

 

C.            This is a frivolous lawsuit. The advanced practice psychiatric nurse cannot be sued for this.

 

D.            A and B

 

Question 53

 

Groups with a greater sense of solidarity exhibit which of the following? Check all that apply.

 

A.            Higher rate of attendance

 

B.            Acceptance for a variable level of active participation

 

C.            A concrete system for measuring cohesiveness

 

D.            A and B

Question 54

A group of co-occurring, relatively invariant symptoms found in a specific cultural group, community or context, which may or may not be recognized as an illness within the culture but such cultural patterns of distress and features of illness may be recognizable by the outside observer is known as which of the following?

 

A.            Cultural syndrome

 

B.            Cultural formulation

 

C.            Cultural idiom of distress

 

D.            Cultural explanation or perceived cause

Question 55

The therapist using a CBT approach says to the patient: “You say you become depressed. Explain to me what depressed feels like to you.” This is an example of what question type in Socratic Dialogue?

 

A.            Memory question

 

B.            Translation question

 

C.            Application question

 

D.            Interpretation question

                               

Question 56

Which of the following is not consistent with the resilience model proposed by Miller-Kraus?

 

A.            This resilience model is based on neurophysiology.

 

B.            The resilience zone in an internal state of adaptability and flexibility.

 

C.            We feel our best when we have a strong sympathetic system to regulate emotions.

 

D.            We feel our best and deal effectively with life when we are in our resilience zone.

Question 57

Bowen emphasized the family therapist

 

A.            Remain neutral, focus on content

 

B.            Focus on metacommunication

 

C.            Create a psychodrama

 

D.            Become immersed in the family dynamics

Question 58

Which of the following is true about the CBT cognitive processes of primary and secondary thinking?

 

A.            Primary thinking recognizes the indeterminate, negative and irrational thinking as forever part of human action.

 

B.            Secondary thinking recognizes the indeterminate, negative and irrational thinking as foremost.

 

C.            Primary thinking views the social and cultural world in determinate, positive and rational terms.

 

D.            B and C

Question 59

Which of the following is consistent with literature regarding suicide. Check all that apply.

                A.            Assessing patient safety is of paramount importance for the advanced practice psychiatric nurse during the initial patient contact.

                B.            More that half of those who commit suicide do not have known mental health problem.

                C.            The highest risk factor for suicide is a relationship problem.

                D.            Suicidality can be assessed by using reliable and valid self-report questionnaires.

Question 60

In supportive psychodynamic psychotherapy the content of the sessions most often focuses on which of the following?

                A.            Feelings and defenses

                B.            Life stresses and feelings

                C.            Life stresses and problem-solving

                D.            B and C

Question 61

The focus of therapy in brief psychodynamic psychotherapy is on which of the following?

                A.            The focus is on structured homework assignments.

                B.            The focus in on the rupture of the therapeutic alliance

                C.            The focus in on transference that naturally occurs during the sessions.

                D.            The focus is on interpersonal relationships outside of the therapeutic relationship.

Question 62

Common patterns of behavior and experience derived from the settings in which people live is known as which of the following?

                A.            Race

                B.            Culture

                C.            Ethnicity

                D.            Family structure

uestion 63

During the initial contact with an individual seeking family therapy it is important for the family therapist to:

                A.            Identify the presenting problem and arrange a consultation with everyone living in the family household.

                B.            Identify the presenting problem and arrange a consultation with the caller to ensure family therapy is really necessary.

                C.            Identify the presenting problem and arrange to meet with the caller and the family member that is creating most of the problem.

                D.            Identify the presenting problem and arrange a consultation with the parents of the family to develop a therapeutic alliance and strategy for fixing the problem.

 

Question 64

In a family session a teenager whose parents deny him a night out states angrily “See they never let me do anything!” The advanced practice psychiatric nurse using a Cognitive Behavioral Family Therapy framework recognizes this as cognitive distortion known as:

                A.            Labeling and mislabeling

                B.            Overgeneralization

                C.            Personalization

                D.            Magnification and minimization

Question 65

A basic strategy of dynamic supportive therapy in which the advanced practice psychiatric nurse assists the patient with reality testing, problem-solving, impulse control, affect modulation, interpersonal awareness, social skills, and empathy is most specifically known as which of the following?

                A.            Manage transference

                B.            Lend psychic structure

                C.            Hold and contain the patient

                D.            Foster and protect the therapeutic alliance.

                                Question 66

Controlled studies of psychotherapy outcome have shown which of the following?

                A.            The average person typically does not engage in psychotherapy

                B.            The average person who receives psychotherapy is significantly improved.

                C.            The average person who receives psychotherapy shows no significant improvement.

                D.            The average person who receives psychotherapy shows some improvement, but results are not statistically significant.

 

Question 67

Which of the following best describes the difference between standards of care and practice guidelines?

                A.            Practice guidelines are legally binding while standards of care are not.

                B.            Standards of care are legally binding while practice guidelines are not.

                C.            There is no difference between standards of care and practice guidelines.

                D.            Practice guidelines should be followed as written while standards of care are more flexible.

Question 68

Which of the following is true regarding the difference between brief and long-term psychodynamic psychotherapy?

                A.            Brief psychotherapy is more effective than long-term psychodynamic psychotherapy.

                B.            Long-term psychodynamic psychotherapy is more effective than brief psychotherapy.

                C.            There is no qualitative difference between brief and long-term psychodynamic psychotherapy.

                D.            Brief and long-term psychodynamic psychotherapy cannot be compared.

 

 

 

Question 76

In classical psychodynamic therapy the therapist’s role is which of the following?

                A.            Objective

                B.            Subjective

                C.            Participant-Observer

                D.            Enmeshed

 

                               

Question 77

In relational psychodynamic psychotherapy the therapist helps the patient with which of the following?

 

A.            To understand the patient’s impact on others.

 

B.            To deepen the patient’s understanding of others.

 

C.            Both A and B

 

D.            Neither A nor B is consistent with the focus of relational psychodynamic psychotherapy.

Question 78

If a health care professional terminates treatment because of managed care failure to authorize the session who is liable for harm based upon abandonment of the treatment.

                A.            The health care provider

                B.            The managed care company.

                C.            The individual at the managed care company who failed to authorize necessary treatment.

                D.            All of the above.

                               

Question 79

The advanced practice psychiatric nurse working with a patient from another culture is recommended to do which of the following?

 

A.            Ask the individual how he or she feels about working with you.

 

B.            Automatically refer patient to a provider of the same or similar culture.

 

C.            Research the individual’s culture and let the patient know you are an expert in that culture.

The Advanced practice psychiatric nurse explains her own culture to the patient to minimize misunderstandings.

uestion 80

The change agent in relational psychodynamic therapy is which of the following?

                A.            Insight

                B.            Mindfulness

                C.            Wish/defense conflicts

                D.            Emotional communication and affect regulation

Question 81

An engaged cohesive therapeutic relationship is necessary in all psychotherapies except which of the following?

                A.            Cognitive therapy

                B.            Behavioral therapy

                C.            Systems-oriented psychotherapy

                D.            None of the above

 

 

1 points  

Question 82

Which of the following is not consistent with practice guides?

                A.            Practice guidelines are legally binding

                B.            Practice guidelines are recommendations for care only.

                C.            Practice guidelines should be tailored to individual patient needs.

                D.            Practice guidelines are official statements that summarize research findings and appropriate management for specific problems. he advanced practice psychiatric nurse is meeting with a patient who in the process of an unwanted divorce. The patient endorses persistent suicidal ideations, with strong intent. The advanced practice psychiatric nurse recognizes the patient is at high suicide risk and recommends which of the following?

                A.            Develop a crisis plan and give emergency numbers.

                B.            Hospital psychiatric admission and suicide precautions.

                C.            Refer to intensive outpatient therapy and give emergency numbers.

                D.            Develop a no-suicide contract and provide emergency numbers.

 

Question 84

Factors that distinguish psychodynamic therapy from cognitive behavioral therapy include which of the following factors.

                A.            Emphasis on the past; Focus on expression of emotion; Emphasis on transference

                B.            Focus on here and now, focus on current relationships, exploration of intra psychic issues.

                C.            Emphasis on here and now; exploring and working with resistance to treatment, the working alliance.

                D.            Identification of patterns in actions, thoughts, feelings, experiences; Focus on current relationships.

Question 85

Recommending or prescribing specific readings related to the individual’s difficulties is known as which of the following?

                A.            Cognitive Rehearsal

                B.            Mind-Reading

                C.            Bibliotherapy

                D.            Reattribution

uestion 86

During the middle phase of family therapy treatment much of the treatment is devoted to which of the following:

                A.            Identifying major conflicts and focusing on structures that perpetuate them.

                B.            The therapist serving as a conduit for most of the communication to keep conflict at a minimum during the session.

                C.            Helping the family members to deal more constructively with each other in the sessions.

                D.            Preventing family members from feeling anxiety as they are working through their issues.

Question 87

When working with a client of unfamiliar culture the advanced practice psychiatric nurse asks the client how he or she feels about working with you. This demonstrates which of the following?

                A.            Insecurity on the side of advanced practice psychiatric nurse and confuses the focus of the relationship.

                B.            Respect and may open up a dialogue about the experience for the patient.

                C.            Ignorance on the side of the advanced practice psychiatric nurse and undermines the therapeutic relationship

                D.            A novice mistake, the patient should be transferred to a provider of similar culture

 

Question 94

It is important for the new nurse psychotherapist to become comfortable with which of the following?

                A.            Learning to be directive to help the patient feel better.

                B.            Letting the psychotherapeutic process unfold over time.

                C.            Helping the patient feel better is the main goal of psychotherapy

                D.            Building a therapeutic toolbox for a variety of “fix it” solutions for a variety of problems.

Question 95

A patient comments at the end of their group therapy how important it was for them to have observed the improvement of others. This is consistent with which of Yalom’s therapeutic factors?

                A.            Altruism

                B.            Universality

                C.            Instillation of hope

                D.            Imparting of information

Question 96

Cross-cultural research supports which of the following?

                A.            Culture determines what is considered a psychiatric disorder

                B.            Neurobiological mechanisms linked to stress and trauma are consistent across cultures

                C.            Neurobiological mechanisms linked to stress and trauma vary across cultures

                D.            A and B

                E.            A and C

Question 97

In supportive psychotherapy where the patient is functioning at a child-like level in significant domains of life which basic strategy of dynamic supportive therapy would most likely be used?

                A.            Be a good parent

                B.            Foster and protect the therapeutic alliance

                C.            Hold and contain the patient

                D.            Provide a role model for identification

Question 98

Hildegard Peplau developed the psychodynamic interpersonal model for psychiatric nursing based on which theorist’s framework?

                A.            Eric Erickson

                B.            Sigmund Freud

                C.            Margaret Mahler

                D.            Harry Stack Sullivan

Question 99

In patients with chronic hyperarousal their Resilience Zone may be too narrow. Strategies to widen the Resilience Zone would include which of the following?

                A.            Exercise, decreasing caffeine intake, and imagery

                B.            Relaxation exercises, increasing caffeine intake and imagery

                C.            Both A and B

                D.            None of the above because actually their Resilience Zone is too wide.

Question 100

We all have preconceptions that are brought into every situation. As a nurse psychotherapist it is important to do which of the following?

 

A.            Eliminate all preconceptions before meeting with the patient.

 

B.            Always be transparent with the patient regarding any preconceptions.

 

C.            Be aware of preconceptions, what they are and how they influence our work.

 

D.            Discuss preconceptions you have with the patient as others likely have similar preconceptions about the patient.