nrnp6645 midterm exam 2022 latest all 100 answers

NRNP-6645-18-Psychotherapy Mult Modalities-2022-Spring

 

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Question 1

A Hispanic woman whose mother recently died reports that she continues to hear the voice of her deceased mother. The advanced practice psychiatric nurse considering the woman’s Hispanic culture determines which of the following?

 

A.           The woman is likely grieving according to her Hispanic social norms.

 

B.           The woman is psychotic as Hispanic people tend to somaticize conflicts.

 

C.           The woman is psychotic and needs to be hospitalized for further evaluation.

 

D.           The woman is clearly psychotic, and the advanced practice psychiatric nurse prescribes an antipsychotic medication.

Question 2

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 3

Which of the following is inconsistent with Socratic Dialogue basic rules for the therapist?

 

A.           The collaborative dialogue is goal-directed and specific.

 

B.           The therapist may use everyday experiences as therapeutic metaphors.

 

C.           Self-disclosure is frequently used to motivate the patient in problem solving.

 

D.           Socratic Dialogue questions should be framed in a way to elicit an affirmative response.

                            

 

 

Question 4

The decision to use supportive psychotherapy should be based on which of the following? Check all that apply.

 

A.           Recent losses

 

B.           Present coping skills

 

C.           The patient’s ego strength and weaknesses

 

D.           Highest level of functioning previously achieved

Question 5

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 6

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 7

The power of family therapy comes from

 

A.           Focusing on dysfunctional emotions

 

B.           Ignoring dysfunctional emotions

 

C.           Bringing parents and children together to transform their interactions.

 

D.           Clearly identifying fault and restructuring

Question 8

When working with a couple the therapist observes the wife seems to have more power in the relationship and the husband seems disengaged. The advanced practice psychiatric nurse can safely assume which of the following based on the couple’s Appalachian culture/roots?

 

A.           This is a culturally consistent framework where the wife is typically the decision maker in the family.

 

B.           This is not culturally consistent with Appalachian norms and is an issue for the couple’s therapy.

 

C.           The couple is aware of the gender inequality in the family and is fine with it.

 

D.           The advanced practice psychiatric nurse cannot assume any of the above and needs to further assess roles in the relationship.

s Question 9

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.           The corrective recapitulation of the primary family group.

Question 10

The novice advanced practice psychiatric nurse working as a new nurse psychotherapist may become increasingly aware of being incompetent as progress is made. According to the Stages of Learning model the advanced practice psychiatric nurse is in which stage of learning?

 

A.           Unconscious incompetency

 

B.           Conscious incompetency

 

C.           Conscious competency

 

D.           Unconscious competency

Question 11

Accepting a multitude of exits from and entries into the family system is a key emotional process of transition in which Family Life Cycle stage?

 

A.           Families in later life

 

B.           Leaving home: single young adults.

 

C.           Launching children and moving on.

 

D.           The joining of families through marriage: the new couple.

Question 12

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 13

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 14

A family has been court-ordered to family therapy. The family does not want to participate in therapy. The advanced practice psychiatric nurse using a solution focused therapy model would most likely do which of the following?

 

A.           Ask them what the minimum is that they need to do to satisfy the court order.

 

B.           Review the case and offer suggestions for solving the issue.

 

C.           Acknowledge the forced nature of the therapy and encourage them to use this as an opportunity to grow together as a family.

 

D.           Refuse to see them as clearly, they don’t want to be there, and therapy won’t help them.

Question 15

In psychodynamic case formulation three personality organization levels have been identified along a continuum. A patient who primarily uses primitive defenses is likely to be in which personality range?

 

A.           Healthy

 

B.           Neurotic

 

C.           Psychotic

 

D.           Borderline

Question 16

Over the past 40 years many controlled studies of psychotherapy outcome have demonstrated which of the following?

 

A.           The outcome from group therapy is virtually identical to that of individual therapy.

 

B.           The outcome from group therapy is slightly less than outcome of individual therapy.

 

C.           The outcome from group therapy is significantly better than outcomes of individual therapy

 

D.           The outcome from group therapy is significantly less than outcomes of individual therapy.

 

Question 17

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 18

According to Erikson’s Psychosocial stages failure to successfully resolve trust vs mistrust conflict is associated with which of the following pathological outcomes?

 

A.           Psychosis, addictions, depression

 

B.           Paranoia, obsessions, compulsions

 

C.           Phobias, psychosomatic disorders

 

D.           Inertia, creative inhibition

 

 

Question 19

While working with a patient who exhibits parasuicidal behaviors of cutting, the advanced practice psychiatric nurse has the patient sign a no-suicide contract. Which of the following is true from a legal perspective about a no-suicidal contract?

 

A.           This is a legally binding document

 

B.           It proves the therapist has good clinical judgment.

 

C.           It absolves the therapist of any responsibility should the patient commit suicide.

 

D.           It is not a substitute for good clinical judgment; accurate assessment is imperative.

 

Question 20

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.

Question 21

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 22

Cognitive Behavioral Therapy (CBT) interventions focus on

 

A.           The person’s relationships and family dynamics

 

B.           The person’s thoughts, beliefs, or behaviors

 

C.           The person’s understanding of how the past gets triggered and plays out in the present

 

D.           The person’s body, beliefs, images, and emotions to process trauma

Question 23

The CBT therapist working with a patient who is distraught because they did not get a job they really wanted. The individual is helped to identify how to use what appears to be a negative situation to his or her advantage. This technique is known as which of the following?

 

A.           Cognitive rehearsal

 

B.           Paradox or Exaggeration

 

C.           Turning Adversity to Advantage

 

D.           Decatastrophizing

Question 24

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 25

Which of the following is consistent research related to resilience and posttraumatic growth?

 

A.           Resilience and posttraumatic growth are inversely related.

 

B.           There is a curvilinear relationship between posttraumatic growth and resilience.

 

C.           Moderate resilience and emotional intelligence is associated with the most growth.

 

D.           All of the above

Question 26

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 27

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.

uestion 28

A situation in which a person’s zeal to avoid feared abandonments is such that the person inadvertently creates the very situation that he or she is trying so hard to avoid is an example of what is clinically known as which of the following?

 

A.           Resistance

 

B.           Transference

 

C.           Self-fulfilling prophecy

 

D.           Cyclical psychodynamics

uestion 29

Which of the following types of questions is not one the seven basic types of questions in Socratic dialogue?

 

A.           History questions

 

B.           Memory questions

 

C.           Analysis questions

 

D.           Application questions

Question 30

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 31

Which of the following is not consistent with therapeutic process of the corrective recapitulation of the primary family group in group psychotherapy?

 

A.           The therapeutic value is that early familial conflicts are simply relived.

 

B.           The therapeutic value is that early familial conflicts are relived correctively.

 

C.           Fixed roles must be constantly explored and challenged.

 

D.           Working out problems in the group setting is also working through unfinished business from long ago.

Question 32

A therapist has decided to terminate treatment for a patient due to the patient continuing to miss scheduled appointments. The therapist should do which of the following?

 

A.           Write a termination letter indicating only that the therapy is being terminated effective immediately.

 

B.           Send a termination letter to the patient indicating therapist concern, reason for termination, reason for patient to continue in treatment and referral to another provider if patient wants to continue in treatment and put a copy of this in the patient chart.

 

C.           Make sure patient not in crisis and refer to a specific provider.

 

D.           B and C

Question 33

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 34

Family dialogue is encouraged.

 

A.           Genogram

 

B.           Family schema

 

C.           Family drawing

 

D.           Family sculpting

Question 35

According to Bowen, lack of differentiation in a family may be manifest as

 

A.           Emotional overinvolvement

 

B.           Emotional distance

 

C.           Reactive Children

 

D.           A and C

 

E.           A, B, and C

 

Question 36

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 37

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

                            

 

Question 38

Which of the following is not consistent with the underlying assumptions of psychodynamic psychotherapy?

 

A.           What has happened in the past determines what we do today.

 

B.           Psychodynamic psychotherapy is rooted in developmental theory

 

C.           By changing one’s thoughts, emotions and behaviors can be changed.

 

D.           Through understanding the past, the individual is impowered to make more conscious decisions.

Question 39

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 40

Role play in the context of the therapy session is an example of which of the following behavioral techniques:

 

A.           Bibliotherapy

 

B.           Behavioral rehearsal

 

C.           Contingency management

 

D.           Cognitive restructuring

Question 41

According to Freud’s Psychosexual stages development of sexual identity occurs during what age range?

 

A.           18 months to 3 years

 

B.           3 years to 6 years

 

C.           6 years to 12 years

 

D.           13 years to 20 years

Question 42

A descriptive/biological approach of specialized knowledge that treats individuals as members of a diagnostic group is based on

 

A.           A biomedical model

 

B.           A holistic model

 

C.           A recovery model

 

D.           A resilience model

Question 43

The capacity to be alone is known as which of the following?

 

A.           Oneness

 

B.           Autonomy

 

C.           Independence

 

D.           Object constancy

Question 44

According to Mahler’s stages of separation-individuation the phase of “normal autism” occurs during what age range?

 

A.           Birth to 1 month

 

B.           10 to 16 months

 

C.           16 to 24 months

 

D.           24 to 36 months

 

Question 45

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 46

Diverting conflict between two people by involving a third is known as the concept of:

 

A.           Emotional reactivity

 

B.           Relationship triangles

 

C.           Differentiation of self

 

D.           Enmeshment

uestion 47

What distinguishes psychoanalytic therapy from other types of therapies?

 

A.           The focus on problem-solving

 

B.           The focus on irrational thoughts

 

C.           The focus on dreams and wishes

 

D.           The deep analysis of the patient relationship with the therapist.

Question 48

The idea that nothing happens by chance, that every thought and all behavior has a cause refers to which of the following concepts?

 

A.           Id vs ego conflict

 

B.           Super ego actions to censor and restrain

 

C.           Psychic determinism

 

D.           Ego synchrony

uestion 49

?The challenges of a family therapist in working with families of different culture include which of the following? Check all that apply.

 

A.           Learning to respect diversity in each unique family.

 

B.           Developing a sensitivity to some of the issues faced by those in other cultures.

 

C.           Learning to recognize the therapist’s own blind spots and biases.

 

D.           Becoming an expert on ethnicity.

Question 50

When assessing families of a different culture from the therapist for treatment, the therapist should consider which of the following with respect to culture?

 

A.           The therapist should consider the unique subculture of the family.

 

B.           The therapist should consider assumptions of the larger cultural background of the family.

 

C.           The therapist should ask the family to share their experiences and traditions

 

D.           All of the above

Question 51

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 52

The advanced practice psychiatric nurse realizes which of the following regarding workbook exercises in therapy?

 

A.           Workbook exercises are only an adjunct to treatment.

 

B.           Workbook exercises simplify the real work in therapy.

 

C.           Treatment manuals consistently correlate positively with treatment outcome.

 

D.           Use of workbook exercises and approaches promotes creativity and flexibility in the therapeutic process.

Question 53

The advanced practice psychiatric nurse solution focused therapy with a family will do which of the following?

 

A.           Focus on the etiology of the problem

 

B.           Focus on problem formation

 

C.           Clearly define the problem for the family and then focus on potential solutions for the family.

 

D.           Help the family amplify exceptions to their problem and recognize effective solutions already in their repertoire.

Question 54

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 55

Borderline pathology is thought to evolve from problems in which of Mahler’s stages of separation-individualization?

 

A.           Practicing

 

B.           Consolidation

 

C.           Differentiation

 

D.           Rapprochement

Question 56

A patient involved in expressive psychotherapy is having intense emotional reactions to painful experiences that have been expressed. This is known as which of the following?

 

A.           Immediacy

 

B.           Abreaction

 

C.           Differentiation

 

D.           Rapprochement

Question 57

The advanced practice psychiatric nurse is working with a couple using a Cognitive Behavioral Family Therapy model. The wife states her husband must be having an affair because he comes home late from work. The advanced practice psychiatric nurse recognizes this as the cognitive distortion known as:

 

A.           Personalization

 

B.           Selective Abstraction

 

C.           Dichotomous thinking

 

D.           Arbitrary Inference

Question 58

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 59

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

 

A.           Insight

 

B.           Interpretation of past experiences

 

C.           Exploration of genetic roots of the problem

 

D.           Mindfulness

Question 60

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 61

The focus of exploration in relational psychodynamic therapy includes which of the following?

 

A.           Then and there

 

B.           Wish/defense conflicts

 

C.           Here and now

 

D.           Sex/and or aggression

Question 62

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 63

Which of the following is true about working with dreams?

 

A.           Dream interpretation is a left-brain endeavor.

 

B.           Dreams represent past conflicts and work is on past conflicts

 

C.           Dreams are the brain’s attempt to process and integrate daily information.

 

D.           Dream symbol books are useful for dream work due to universal meaning of dreams.

Question 64

A group member is relieved to realize that others in the group share feelings of incompetency similar to his own. This is an example of which of the following therapeutic factors?

 

A.           Altruism

 

B.           Universality

 

C.           Imparting of information

 

D.           Development of socializing techniques

uestion 65

The aim in relational psychodynamic therapy is which of the following?

 

A.           Make the unconscious conscious

 

B.           Resolve ruptures in the therapeutic alliance.

 

C.           Provide interpretation based on past experiences

 

D.           Provide interpretation of wish/defense conflicts.

Question 66

Recognizing that many factors may have contributed to a patient’s current situation is an example of which of the following?

 

A.           Biomedical model

 

B.           Psychosocial framework

 

C.           Overdeterminism

 

D.           Resiliency

Question 67

Internal resources include which of the following?

 

A.           Internal resources are more tangible than external resources

 

B.           Internal resources consist of the person’s ability to manage primarily negative emotions

 

C.           Internal resources include the person’s ability to self-soothe, demonstrate adequate impulse control, and regulate moods.

 

D.           Are intuitive and easily measured

Question 68

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 69

According to the treatment hierarchy framework for practice adapted from Davis & Weiss (2004)

 

A.           The client must first envision where they want to be prior to moving forward

 

B.           Processing is the key to stabilization and future visioning

 

C.           Increasing internal resources leads to increasing external resources

 

D.           Resources must be procured and stabilization guaranteed before trauma can be processed.

Question 70

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 71

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