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 34-year-old patient with chronic depressive symptoms asks
during the second therapy session whether the nurse can
prescribe medication in addition to providing psychotherapy.
The nurse psychotherapist must decide how to respond to
,preserve the therapeutic alliance while clarifying role and
scope. Which response best balances transparency, scope of
practice, and collaborative care?
Options
A. “Yes — I can prescribe medication and manage it entirely
here; we’ll combine both treatments.”
B. “I don’t prescribe; I can refer you to a prescriber and
continue psychotherapy independently.”
C. “I can prescribe if you want, but will not discuss medication
during therapy sessions.”
D. “I can prescribe and, if we agree it’s appropriate, coordinate
your medication with other providers and integrate that into
the treatment plan.”
Correct answer
D
Rationale — Correct
D transparently states prescribing capability while emphasizing
coordination and integration of care — reflecting the nurse
psychotherapist role that bridges psychotherapy and psychiatric
nursing responsibilities when within scope and competence. It
preserves alliance, supports shared decision-making, and aligns
with a collaborative framework.
Rationale — Incorrect
A is risky because it assumes sole management without
clarifying competence, collaborative planning, or informed
consent.
,B needlessly fragments care and undermines integrated
treatment options when the nurse may appropriately
coordinate prescribing.
C separates medication from psychotherapy inappropriately
and risks fragmented care and ethical boundary issues.
Teaching Point
Clarify scope, competence, and coordinate care collaboratively.
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 intake, a client discloses trauma history and appears
visibly distressed. The nurse psychotherapist must determine
immediate next steps that reflect trauma-informed care and
ethical safety assessment. Which action best reflects those
priorities?
Options
A. Proceed with a full psychodynamic formulation to explore
early attachment patterns immediately.
B. Conduct a brief safety and stabilization assessment, validate
, distress, and negotiate pacing of trauma exploration.
C. Reassure the client that discussing trauma now will always
lead to symptom reduction.
D. Immediately refer the client to an external trauma specialist
and discontinue psychotherapy intake.
Correct answer
B
Rationale — Correct
B prioritizes safety and stabilization, validates the client, and
negotiates pacing — core aspects of trauma-informed practice
and ethical care outlined in the framework for nursing
psychotherapists. It balances assessment with alliance and
prevents premature, potentially destabilizing interventions.
Rationale — Incorrect
A is premature and may retraumatize without stabilization.
C offers an unsubstantiated assurance and misrepresents
therapeutic process.
D may be unnecessarily abrupt and harm alliance if the nurse
could provide stabilization and coordinated referral.
Teaching Point
Prioritize safety, stabilization, and collaborative pacing in
trauma disclosures.
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
1
Reference
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Stem
A 34-year-old patient with chronic depressive symptoms asks
during the second therapy session whether the nurse can
prescribe medication in addition to providing psychotherapy.
The nurse psychotherapist must decide how to respond to
,preserve the therapeutic alliance while clarifying role and
scope. Which response best balances transparency, scope of
practice, and collaborative care?
Options
A. “Yes — I can prescribe medication and manage it entirely
here; we’ll combine both treatments.”
B. “I don’t prescribe; I can refer you to a prescriber and
continue psychotherapy independently.”
C. “I can prescribe if you want, but will not discuss medication
during therapy sessions.”
D. “I can prescribe and, if we agree it’s appropriate, coordinate
your medication with other providers and integrate that into
the treatment plan.”
Correct answer
D
Rationale — Correct
D transparently states prescribing capability while emphasizing
coordination and integration of care — reflecting the nurse
psychotherapist role that bridges psychotherapy and psychiatric
nursing responsibilities when within scope and competence. It
preserves alliance, supports shared decision-making, and aligns
with a collaborative framework.
Rationale — Incorrect
A is risky because it assumes sole management without
clarifying competence, collaborative planning, or informed
consent.
,B needlessly fragments care and undermines integrated
treatment options when the nurse may appropriately
coordinate prescribing.
C separates medication from psychotherapy inappropriately
and risks fragmented care and ethical boundary issues.
Teaching Point
Clarify scope, competence, and coordinate care collaboratively.
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 intake, a client discloses trauma history and appears
visibly distressed. The nurse psychotherapist must determine
immediate next steps that reflect trauma-informed care and
ethical safety assessment. Which action best reflects those
priorities?
Options
A. Proceed with a full psychodynamic formulation to explore
early attachment patterns immediately.
B. Conduct a brief safety and stabilization assessment, validate
, distress, and negotiate pacing of trauma exploration.
C. Reassure the client that discussing trauma now will always
lead to symptom reduction.
D. Immediately refer the client to an external trauma specialist
and discontinue psychotherapy intake.
Correct answer
B
Rationale — Correct
B prioritizes safety and stabilization, validates the client, and
negotiates pacing — core aspects of trauma-informed practice
and ethical care outlined in the framework for nursing
psychotherapists. It balances assessment with alliance and
prevents premature, potentially destabilizing interventions.
Rationale — Incorrect
A is premature and may retraumatize without stabilization.
C offers an unsubstantiated assurance and misrepresents
therapeutic process.
D may be unnecessarily abrupt and harm alliance if the nurse
could provide stabilization and coordinated referral.
Teaching Point
Prioritize safety, stabilization, and collaborative pacing in
trauma disclosures.
Citation
Wheeler, K. (2023). Psychotherapy for the Advanced Practice
Psychiatric Nurse (3rd ed.). Ch. 1.
