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
A 28-year-old client with persistent depressive symptoms asks
whether psychotherapy or medication would be better. You are
an experienced nurse psychotherapist working in integrated
care. Which initial response most aligns with Wheeler’s
,framework for collaborative, evidence-based practice and
supports shared decision-making?
A. Recommend starting an SSRI immediately and schedule a
medication follow-up in two weeks.
B. Explain both psychotherapy and medication benefits, assess
client preferences and treatment history, and propose a
collaborative plan.
C. Advise psychotherapy first because medications only mask
symptoms and are not evidence-based for depression.
D. Refer the client to psychiatry for medication because
prescribing is outside the nurse psychotherapist role.
Correct answer
B
Rationales
Correct (B): This integrates evidence-based options, elicits client
preference, and uses collaborative planning—core elements of
Wheeler’s framework emphasizing shared decision-making and
interdisciplinary care. It preserves the therapeutic alliance and
addresses clinical judgment.
A: Premature—prescribing without a collaborative discussion or
assessment of preferences/formulation contradicts the model.
C: Inaccurate and biased—minimizes evidence for
pharmacotherapy; not consistent with balanced, evidence-
based practice.
D: Often unnecessary—many nurse psychotherapists have
,scope to coordinate care; automatic referral neglects
collaborative role and may fragment care.
Teaching point
Shared decision-making anchors planning and preserves
therapeutic alliance.
Citation
Wheeler, K. (2023). Psychotherapy for the Advanced Practice
Psychiatric Nurse (3rd ed.). Ch. 1.
2
Reference
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Stem
During an intake, a client discloses past childhood sexual abuse
but minimizes its impact. As a nurse psychotherapist using a
trauma-informed lens, what immediate clinician action best fits
Wheeler’s recommended approach?
A. Probe for detailed descriptions to clarify the trauma history
for diagnosis.
B. Validate the client’s disclosure, assess current safety and
triggers, and offer stabilization resources.
C. Document the brief disclosure and proceed directly to
standard CBT techniques for mood.
, D. Suggest group therapy focused on abuse survivors before
doing individual stabilization.
Correct answer
B
Rationales
Correct (B): Trauma-informed practice prioritizes validation,
safety assessment, and stabilization—core to Wheeler’s
framework—before detailed trauma processing. This protects
the client and supports alliance.
A: Risky and premature—eliciting graphic details can re-
traumatize without proper preparation.
C: Dismissive—moving to protocolized CBT ignores trauma
needs and may worsen symptoms.
D: Premature—group therapy may be helpful later but requires
readiness and stabilization first.
Teaching point
Prioritize validation, safety, and stabilization in trauma
disclosures.
Citation
Wheeler, K. (2023). Psychotherapy for the Advanced Practice
Psychiatric Nurse (3rd ed.). Ch. 1.
3
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
A 28-year-old client with persistent depressive symptoms asks
whether psychotherapy or medication would be better. You are
an experienced nurse psychotherapist working in integrated
care. Which initial response most aligns with Wheeler’s
,framework for collaborative, evidence-based practice and
supports shared decision-making?
A. Recommend starting an SSRI immediately and schedule a
medication follow-up in two weeks.
B. Explain both psychotherapy and medication benefits, assess
client preferences and treatment history, and propose a
collaborative plan.
C. Advise psychotherapy first because medications only mask
symptoms and are not evidence-based for depression.
D. Refer the client to psychiatry for medication because
prescribing is outside the nurse psychotherapist role.
Correct answer
B
Rationales
Correct (B): This integrates evidence-based options, elicits client
preference, and uses collaborative planning—core elements of
Wheeler’s framework emphasizing shared decision-making and
interdisciplinary care. It preserves the therapeutic alliance and
addresses clinical judgment.
A: Premature—prescribing without a collaborative discussion or
assessment of preferences/formulation contradicts the model.
C: Inaccurate and biased—minimizes evidence for
pharmacotherapy; not consistent with balanced, evidence-
based practice.
D: Often unnecessary—many nurse psychotherapists have
,scope to coordinate care; automatic referral neglects
collaborative role and may fragment care.
Teaching point
Shared decision-making anchors planning and preserves
therapeutic alliance.
Citation
Wheeler, K. (2023). Psychotherapy for the Advanced Practice
Psychiatric Nurse (3rd ed.). Ch. 1.
2
Reference
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Stem
During an intake, a client discloses past childhood sexual abuse
but minimizes its impact. As a nurse psychotherapist using a
trauma-informed lens, what immediate clinician action best fits
Wheeler’s recommended approach?
A. Probe for detailed descriptions to clarify the trauma history
for diagnosis.
B. Validate the client’s disclosure, assess current safety and
triggers, and offer stabilization resources.
C. Document the brief disclosure and proceed directly to
standard CBT techniques for mood.
, D. Suggest group therapy focused on abuse survivors before
doing individual stabilization.
Correct answer
B
Rationales
Correct (B): Trauma-informed practice prioritizes validation,
safety assessment, and stabilization—core to Wheeler’s
framework—before detailed trauma processing. This protects
the client and supports alliance.
A: Risky and premature—eliciting graphic details can re-
traumatize without proper preparation.
C: Dismissive—moving to protocolized CBT ignores trauma
needs and may worsen symptoms.
D: Premature—group therapy may be helpful later but requires
readiness and stabilization first.
Teaching point
Prioritize validation, safety, and stabilization in trauma
disclosures.
Citation
Wheeler, K. (2023). Psychotherapy for the Advanced Practice
Psychiatric Nurse (3rd ed.). Ch. 1.
3
