PSYCHOTHERAPY FOR THE ADVANCED
PRACTICE PSYCHIATRIC NURSE
A HOW-TO GUIDE FOR EVIDENCE-BASED
PRACTICE
3RD EDITION
• AUTHOR(S)KATHLEEN WHEELER
TEST BANK
1️⃣
Reference
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Stem
A 34-year-old client with chronic depression presents for the
first psychotherapy session and asks, “Are you my therapist or
my nurse?” The PMHNP must clarify role boundaries while
establishing trust. Which initial response most closely aligns
,with a nurse-psychotherapist framework that prioritizes
informed consent, role clarity, and therapeutic alliance?
Options
A. “As a nurse, I’ll manage your medications; psychotherapy can
be handled later by another clinician.”
B. “I’m a nurse-psychotherapist; I provide both nursing care and
psychotherapy. Let’s review what that means, what I can offer,
and what you can expect.”
C. “I’m mostly here to listen — tell me everything; we’ll figure
out the rest as we go.”
D. “I can do therapy today, but first sign this general consent
form and we’ll start immediately.”
Correct answer
B
Rationale — Correct
Option B clearly names the integrated role, provides immediate
role clarity, and invites collaborative informed consent—
aligning with the chapter’s emphasis on explicit role definition,
scope, and building alliance. It also orients the client to
expectations, which is foundational in early sessions.
Rationales — Incorrect
A. Delegates psychotherapy and risks fragmenting care; it fails
to clarify the integrated nurse-psychotherapist role.
C. While empathic, it lacks role definition and informed
consent; it’s vague about scope and limits.
D. Prioritizes administrative procedure over explanation;
,starting therapy without adequate role discussion and informed
consent is premature.
Teaching point
Clarify integrated nursing-psychotherapy role and expectations
at intake.
Citation
Wheeler, K. (2023). Psychotherapy for the Advanced Practice
Psychiatric Nurse (3rd ed.). Ch. 1.
2️⃣
Reference
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Stem
During an intake, a client discloses trauma history but becomes
tearful and says they don’t want to “relive it” today. The
PMHNP recognizes the need to be trauma-informed while
completing a clinical assessment. Which approach best
balances safety, assessment needs, and trauma-sensitivity?
Options
A. Persist with a full trauma history now because it’s essential
for accurate diagnosis.
B. Avoid any mention of trauma in documentation to protect
the client’s privacy.
C. Acknowledge distress, pause the trauma exploration, obtain
, safety information, and negotiate a plan for future trauma
work.
D. Reassure the client that the therapist will push through
feelings now so the client won’t avoid treatment later.
Correct answer
C
Rationale — Correct
Option C reflects trauma-informed practice: validating distress,
prioritizing safety and stabilization, and collaboratively planning
future exploration—consistent with the chapter’s emphasis on
pacing assessment and honoring client readiness.
Rationales — Incorrect
A. Forcing a detailed trauma history risks retraumatization;
assessment should be paced.
B. Omitting necessary clinical information from records is
ethically and clinically problematic.
D. Encouraging immediate exposure without stabilization is
potentially harmful and misaligned with trauma-sensitive care.
Teaching point
Prioritize safety and collaborate on pacing when trauma
surfaces during assessment.
Citation
Wheeler, K. (2023). Psychotherapy for the Advanced Practice
Psychiatric Nurse (3rd ed.). Ch. 1.
PRACTICE PSYCHIATRIC NURSE
A HOW-TO GUIDE FOR EVIDENCE-BASED
PRACTICE
3RD EDITION
• AUTHOR(S)KATHLEEN WHEELER
TEST BANK
1️⃣
Reference
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Stem
A 34-year-old client with chronic depression presents for the
first psychotherapy session and asks, “Are you my therapist or
my nurse?” The PMHNP must clarify role boundaries while
establishing trust. Which initial response most closely aligns
,with a nurse-psychotherapist framework that prioritizes
informed consent, role clarity, and therapeutic alliance?
Options
A. “As a nurse, I’ll manage your medications; psychotherapy can
be handled later by another clinician.”
B. “I’m a nurse-psychotherapist; I provide both nursing care and
psychotherapy. Let’s review what that means, what I can offer,
and what you can expect.”
C. “I’m mostly here to listen — tell me everything; we’ll figure
out the rest as we go.”
D. “I can do therapy today, but first sign this general consent
form and we’ll start immediately.”
Correct answer
B
Rationale — Correct
Option B clearly names the integrated role, provides immediate
role clarity, and invites collaborative informed consent—
aligning with the chapter’s emphasis on explicit role definition,
scope, and building alliance. It also orients the client to
expectations, which is foundational in early sessions.
Rationales — Incorrect
A. Delegates psychotherapy and risks fragmenting care; it fails
to clarify the integrated nurse-psychotherapist role.
C. While empathic, it lacks role definition and informed
consent; it’s vague about scope and limits.
D. Prioritizes administrative procedure over explanation;
,starting therapy without adequate role discussion and informed
consent is premature.
Teaching point
Clarify integrated nursing-psychotherapy role and expectations
at intake.
Citation
Wheeler, K. (2023). Psychotherapy for the Advanced Practice
Psychiatric Nurse (3rd ed.). Ch. 1.
2️⃣
Reference
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Stem
During an intake, a client discloses trauma history but becomes
tearful and says they don’t want to “relive it” today. The
PMHNP recognizes the need to be trauma-informed while
completing a clinical assessment. Which approach best
balances safety, assessment needs, and trauma-sensitivity?
Options
A. Persist with a full trauma history now because it’s essential
for accurate diagnosis.
B. Avoid any mention of trauma in documentation to protect
the client’s privacy.
C. Acknowledge distress, pause the trauma exploration, obtain
, safety information, and negotiate a plan for future trauma
work.
D. Reassure the client that the therapist will push through
feelings now so the client won’t avoid treatment later.
Correct answer
C
Rationale — Correct
Option C reflects trauma-informed practice: validating distress,
prioritizing safety and stabilization, and collaboratively planning
future exploration—consistent with the chapter’s emphasis on
pacing assessment and honoring client readiness.
Rationales — Incorrect
A. Forcing a detailed trauma history risks retraumatization;
assessment should be paced.
B. Omitting necessary clinical information from records is
ethically and clinically problematic.
D. Encouraging immediate exposure without stabilization is
potentially harmful and misaligned with trauma-sensitive care.
Teaching point
Prioritize safety and collaborate on pacing when trauma
surfaces during assessment.
Citation
Wheeler, K. (2023). Psychotherapy for the Advanced Practice
Psychiatric Nurse (3rd ed.). Ch. 1.
