PSYCHOTHERAPY FOR THE ADVANCED
PRACTICE PSYCHIATRIC NURSE
A HOW-TO GUIDE FOR EVIDENCE-BASED
PRACTICE
3RD EDITION
• AUTHOR(S)KATHLEEN WHEELER
TEST BANK
1
Reference
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Stem (PMHNP level)
A 34-year-old woman new to your outpatient clinic describes
chronic, treatment-resistant panic symptoms and reports
repeated dismissive comments from prior providers. During the
intake, she asks, “Will you take me seriously?” As a nurse
psychotherapist working within Wheeler’s relationship-based
,framework, which initial therapeutic stance and action best
promote safety and engagement while preparing for evidence-
based treatment planning?
A. Provide immediate psychoeducation about panic disorder
and a CBT homework sheet to demonstrate a clear, directive
plan.
B. Validate her experience, briefly acknowledge the pattern of
dismissal, and collaboratively invite her to prioritize immediate
concerns and goals for treatment.
C. Offer reassurance that medications will reduce panic and
schedule a psychopharmacology visit before any psychotherapy
is started.
D. Refer her to a trauma specialist because repeated dismissive
treatment implies complex trauma that you are not prepared to
treat.
Correct answer
B
Rationales
Correct (B): Validation and collaborative goal-setting align with
Wheeler’s relationship- and resilience-based framework,
establishing therapeutic alliance and safety before selecting
specific modalities. This approach addresses prior invalidation,
supports engagement, and allows subsequent evidence-based
treatment planning.
Incorrect (A): Immediate directive CBT homework without
establishing alliance may be premature given her history of
,being dismissed and risks harming engagement.
Incorrect (C): Prioritizing medication without attending to
alliance and patient concerns may replicate prior dismissive
patterns; integrated planning is preferable.
Incorrect (D): Automatic referral without assessment and
alliance building may abandon therapeutic responsibility and
miss patient preference; trauma is possible but requires
assessment.
Teaching point (≤20 words)
Start with validation and shared goals to build alliance before
prescribing specific psychotherapy tasks.
Citation (Simplified APA)
Wheeler, K. (2020). Psychotherapy for the Advanced Practice
Psychiatric Nurse (3rd ed.). Ch. 1.
2
Reference
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Stem (PMHNP level)
A PMHNP is designing a new clinic pathway to ensure culturally
responsive psychotherapy. According to Wheeler’s framework
emphasizing holistic and culturally informed practice, what
element should be built into the clinic’s intake and care
pathway to operationalize cultural and trauma-informed care?
, A. A standardized diagnostic checklist to be completed by
clinicians prior to seeing the patient.
B. A structured intake that includes narrative elicitation of the
patient’s cultural identity, explanatory models, and prior
treatment experiences.
C. A strict manualized protocol that all therapists must follow
regardless of patient background to ensure treatment fidelity.
D. An algorithm that assigns therapy modality based solely on
the primary DSM diagnosis.
Correct answer
B
Rationales
Correct (B): Eliciting the patient’s narrative, cultural identity,
and treatment history embodies Wheeler’s holistic, culturally
sensitive framework and informs tailored, trauma-informed
interventions.
Incorrect (A): Checklists alone miss relational and narrative
information essential for culturally responsive care.
Incorrect (C): Rigid manuals may undermine cultural tailoring
and therapeutic flexibility; fidelity is important but must be
balanced with individualization.
Incorrect (D): Modality assignment solely by DSM diagnosis
ignores cultural context, trauma history, and therapeutic
relationship.
PRACTICE PSYCHIATRIC NURSE
A HOW-TO GUIDE FOR EVIDENCE-BASED
PRACTICE
3RD EDITION
• AUTHOR(S)KATHLEEN WHEELER
TEST BANK
1
Reference
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Stem (PMHNP level)
A 34-year-old woman new to your outpatient clinic describes
chronic, treatment-resistant panic symptoms and reports
repeated dismissive comments from prior providers. During the
intake, she asks, “Will you take me seriously?” As a nurse
psychotherapist working within Wheeler’s relationship-based
,framework, which initial therapeutic stance and action best
promote safety and engagement while preparing for evidence-
based treatment planning?
A. Provide immediate psychoeducation about panic disorder
and a CBT homework sheet to demonstrate a clear, directive
plan.
B. Validate her experience, briefly acknowledge the pattern of
dismissal, and collaboratively invite her to prioritize immediate
concerns and goals for treatment.
C. Offer reassurance that medications will reduce panic and
schedule a psychopharmacology visit before any psychotherapy
is started.
D. Refer her to a trauma specialist because repeated dismissive
treatment implies complex trauma that you are not prepared to
treat.
Correct answer
B
Rationales
Correct (B): Validation and collaborative goal-setting align with
Wheeler’s relationship- and resilience-based framework,
establishing therapeutic alliance and safety before selecting
specific modalities. This approach addresses prior invalidation,
supports engagement, and allows subsequent evidence-based
treatment planning.
Incorrect (A): Immediate directive CBT homework without
establishing alliance may be premature given her history of
,being dismissed and risks harming engagement.
Incorrect (C): Prioritizing medication without attending to
alliance and patient concerns may replicate prior dismissive
patterns; integrated planning is preferable.
Incorrect (D): Automatic referral without assessment and
alliance building may abandon therapeutic responsibility and
miss patient preference; trauma is possible but requires
assessment.
Teaching point (≤20 words)
Start with validation and shared goals to build alliance before
prescribing specific psychotherapy tasks.
Citation (Simplified APA)
Wheeler, K. (2020). Psychotherapy for the Advanced Practice
Psychiatric Nurse (3rd ed.). Ch. 1.
2
Reference
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Stem (PMHNP level)
A PMHNP is designing a new clinic pathway to ensure culturally
responsive psychotherapy. According to Wheeler’s framework
emphasizing holistic and culturally informed practice, what
element should be built into the clinic’s intake and care
pathway to operationalize cultural and trauma-informed care?
, A. A standardized diagnostic checklist to be completed by
clinicians prior to seeing the patient.
B. A structured intake that includes narrative elicitation of the
patient’s cultural identity, explanatory models, and prior
treatment experiences.
C. A strict manualized protocol that all therapists must follow
regardless of patient background to ensure treatment fidelity.
D. An algorithm that assigns therapy modality based solely on
the primary DSM diagnosis.
Correct answer
B
Rationales
Correct (B): Eliciting the patient’s narrative, cultural identity,
and treatment history embodies Wheeler’s holistic, culturally
sensitive framework and informs tailored, trauma-informed
interventions.
Incorrect (A): Checklists alone miss relational and narrative
information essential for culturally responsive care.
Incorrect (C): Rigid manuals may undermine cultural tailoring
and therapeutic flexibility; fidelity is important but must be
balanced with individualization.
Incorrect (D): Modality assignment solely by DSM diagnosis
ignores cultural context, trauma history, and therapeutic
relationship.
