NSG527 / NSG 527 Midterm Exam (2026 Update):
Psychopathology, Theories, & Advanced Clinical
Modalities | Questions and Verified Answers |
Wilkes
NSG 527 Midterm Exam: Most Difficult Questions (1-50)
Section 1: Existential Therapy (Questions 1-15)
1. A client in existential therapy repeatedly states, "I feel like I'm just going
through the motions. None of it really matters." According to Yalom, this client
is most directly grappling with which of the four "givens of existence"?
A) Freedom
B) Isolation
C) Death
D) Meaninglessness
Correct Answer: D) Meaninglessness
Rationale: Yalom's four givens are death, freedom, isolation, and
meaninglessness. The client's statement about nothing "really mattering" is a
direct expression of the existential concern regarding the search for purpose and
meaning in a seemingly indifferent universe .
2. An existential therapist is working with a client who is struggling to decide
whether to leave an unfulfilling marriage. The therapist focuses on helping the
client recognize that they are the author of their own life and must own the
consequences of their choice. This intervention primarily addresses which of
Yalom's givens?
A) Death
B) Meaninglessness
,C) Freedom
D) Isolation
Correct Answer: C) Freedom
Rationale: Freedom, in the existential sense, is tied to responsibility. The client is
"condemned to freedom" and must choose, knowing they are responsible for the
world they create for themselves through their decisions. The therapist's focus on
authorship and consequence directly targets this .
3. According to existential therapy, the three modes of being-in-the-world
are Eigenwelt, Mitwelt, and Umwelt. A client who has recently immigrated and
is struggling to find a community where they feel they belong is experiencing a
primary disturbance in which mode?
A) Eigenwelt (the inner self)
B) Mitwelt (the social world)
C) Umwelt (the natural environment)
D) The "between" world
Correct Answer: B) Mitwelt
Rationale: Mitwelt refers to the world of relationships and one's social sphere.
Difficulty finding a community and a sense of belonging is a fundamental
disturbance in this mode of being .
4. In existential therapy, a distinction is made between normal guilt and
neurotic guilt. A patient who is consumed by self-blame for having once, in
childhood, wished a sibling would go away, despite having no current ill will, is
likely experiencing:
A) Ontological guilt
B) Normal guilt based on an actual ethical breach
C) Neurotic guilt arising from a fantasized transgression
D) Existential anxiety
Correct Answer: C) Neurotic guilt arising from a fantasized transgression
Rationale: Neurotic guilt stems from imagined or fantasized violations or from not
living up to one's own potential, rather than from a concrete, unethical action .
5. Which of the following statements best captures the goal of existential
therapy?
,A) To help the client understand the unconscious conflicts stemming from
childhood.
B) To assist the client in modifying maladaptive thought patterns.
C) To enable the client to live authentically and take responsibility for their
choices.
D) To help the client move from environmental support to self-support through
awareness.
Correct Answer: C) To enable the client to live authentically and take
responsibility for their choices.
Rationale: Existential therapy is phenomenological and person-centered, aiming
to help clients experience life freely, make authentic decisions, and take
responsibility for their actions or inactions. Option D is the goal of Gestalt
therapy .
6. Rollo May and Irvin Yalom, key founders of the American school of existential
therapy, would most likely view a client's acute anxiety not as a symptom to be
eliminated, but as:
A) A sign of a chemical imbalance needing immediate medication.
B) A condition of living that is inevitable and can be a gateway to self-awareness.
C) A clear indicator of a repressed childhood trauma.
D) A maladaptive thought pattern to be challenged and restructured.
Correct Answer: B) A condition of living that is inevitable and can be a gateway to
self-awareness.
Rationale: In existential thought, anxiety is seen as a fundamental part of the
human condition that arises from confronting the givens of existence. It is not
pathological in itself but can be a catalyst for growth and authentic living .
7. The primary function of the existential therapist is to:
A) Interpret the client's unconscious drives.
B) Understand the client's subjective world.
C) Teach the client coping skills for their anxiety.
D) Confront the client's irrational beliefs.
Correct Answer: B) Understand the client's subjective world.
Rationale: The therapeutic relationship in existential therapy is built on
understanding the client's unique, lived, subjective experience (phenomenology) .
, 8. A client in existential therapy is facing a terminal diagnosis. The therapist
helps them to fully acknowledge their fear of non-existence while also finding
meaning in the time they have left. This work directly addresses which of
Yalom's givens?
A) Freedom
B) Isolation
C) Death
D) Meaninglessness
Correct Answer: C) Death
Rationale: The given of death involves the tension between the awareness of
mortality and the wish to continue living. Facing death authentically is often a
prerequisite for living life fully and meaningfully .
9. The concept that individuals are "thrown into a universe with no inherent
meaning" and must therefore create their own meaning is a central theme in
the work of which existential thinker, and is most closely related to Yalom's
given of:
A) Viktor Frankl; Isolation
B) Rollo May; Death
C) Irvin Yalom; Meaninglessness
D) Frederick Perls; Freedom
Correct Answer: C) Irvin Yalom; Meaninglessness
Rationale: Yalom posits that the struggle for meaning is a fundamental human
concern, arising from the awareness that the universe itself is devoid of pre-
ordained purpose. The client must create their own meaning .
10. An existential therapist would most likely interpret a client's deep-seated
fear of being alone as a manifestation of which existential given?
A) Freedom
B) Death
C) Meaninglessness
D) Isolation
Correct Answer: D) Isolation
Rationale: Existential isolation refers to the unbridgeable gap between oneself
Psychopathology, Theories, & Advanced Clinical
Modalities | Questions and Verified Answers |
Wilkes
NSG 527 Midterm Exam: Most Difficult Questions (1-50)
Section 1: Existential Therapy (Questions 1-15)
1. A client in existential therapy repeatedly states, "I feel like I'm just going
through the motions. None of it really matters." According to Yalom, this client
is most directly grappling with which of the four "givens of existence"?
A) Freedom
B) Isolation
C) Death
D) Meaninglessness
Correct Answer: D) Meaninglessness
Rationale: Yalom's four givens are death, freedom, isolation, and
meaninglessness. The client's statement about nothing "really mattering" is a
direct expression of the existential concern regarding the search for purpose and
meaning in a seemingly indifferent universe .
2. An existential therapist is working with a client who is struggling to decide
whether to leave an unfulfilling marriage. The therapist focuses on helping the
client recognize that they are the author of their own life and must own the
consequences of their choice. This intervention primarily addresses which of
Yalom's givens?
A) Death
B) Meaninglessness
,C) Freedom
D) Isolation
Correct Answer: C) Freedom
Rationale: Freedom, in the existential sense, is tied to responsibility. The client is
"condemned to freedom" and must choose, knowing they are responsible for the
world they create for themselves through their decisions. The therapist's focus on
authorship and consequence directly targets this .
3. According to existential therapy, the three modes of being-in-the-world
are Eigenwelt, Mitwelt, and Umwelt. A client who has recently immigrated and
is struggling to find a community where they feel they belong is experiencing a
primary disturbance in which mode?
A) Eigenwelt (the inner self)
B) Mitwelt (the social world)
C) Umwelt (the natural environment)
D) The "between" world
Correct Answer: B) Mitwelt
Rationale: Mitwelt refers to the world of relationships and one's social sphere.
Difficulty finding a community and a sense of belonging is a fundamental
disturbance in this mode of being .
4. In existential therapy, a distinction is made between normal guilt and
neurotic guilt. A patient who is consumed by self-blame for having once, in
childhood, wished a sibling would go away, despite having no current ill will, is
likely experiencing:
A) Ontological guilt
B) Normal guilt based on an actual ethical breach
C) Neurotic guilt arising from a fantasized transgression
D) Existential anxiety
Correct Answer: C) Neurotic guilt arising from a fantasized transgression
Rationale: Neurotic guilt stems from imagined or fantasized violations or from not
living up to one's own potential, rather than from a concrete, unethical action .
5. Which of the following statements best captures the goal of existential
therapy?
,A) To help the client understand the unconscious conflicts stemming from
childhood.
B) To assist the client in modifying maladaptive thought patterns.
C) To enable the client to live authentically and take responsibility for their
choices.
D) To help the client move from environmental support to self-support through
awareness.
Correct Answer: C) To enable the client to live authentically and take
responsibility for their choices.
Rationale: Existential therapy is phenomenological and person-centered, aiming
to help clients experience life freely, make authentic decisions, and take
responsibility for their actions or inactions. Option D is the goal of Gestalt
therapy .
6. Rollo May and Irvin Yalom, key founders of the American school of existential
therapy, would most likely view a client's acute anxiety not as a symptom to be
eliminated, but as:
A) A sign of a chemical imbalance needing immediate medication.
B) A condition of living that is inevitable and can be a gateway to self-awareness.
C) A clear indicator of a repressed childhood trauma.
D) A maladaptive thought pattern to be challenged and restructured.
Correct Answer: B) A condition of living that is inevitable and can be a gateway to
self-awareness.
Rationale: In existential thought, anxiety is seen as a fundamental part of the
human condition that arises from confronting the givens of existence. It is not
pathological in itself but can be a catalyst for growth and authentic living .
7. The primary function of the existential therapist is to:
A) Interpret the client's unconscious drives.
B) Understand the client's subjective world.
C) Teach the client coping skills for their anxiety.
D) Confront the client's irrational beliefs.
Correct Answer: B) Understand the client's subjective world.
Rationale: The therapeutic relationship in existential therapy is built on
understanding the client's unique, lived, subjective experience (phenomenology) .
, 8. A client in existential therapy is facing a terminal diagnosis. The therapist
helps them to fully acknowledge their fear of non-existence while also finding
meaning in the time they have left. This work directly addresses which of
Yalom's givens?
A) Freedom
B) Isolation
C) Death
D) Meaninglessness
Correct Answer: C) Death
Rationale: The given of death involves the tension between the awareness of
mortality and the wish to continue living. Facing death authentically is often a
prerequisite for living life fully and meaningfully .
9. The concept that individuals are "thrown into a universe with no inherent
meaning" and must therefore create their own meaning is a central theme in
the work of which existential thinker, and is most closely related to Yalom's
given of:
A) Viktor Frankl; Isolation
B) Rollo May; Death
C) Irvin Yalom; Meaninglessness
D) Frederick Perls; Freedom
Correct Answer: C) Irvin Yalom; Meaninglessness
Rationale: Yalom posits that the struggle for meaning is a fundamental human
concern, arising from the awareness that the universe itself is devoid of pre-
ordained purpose. The client must create their own meaning .
10. An existential therapist would most likely interpret a client's deep-seated
fear of being alone as a manifestation of which existential given?
A) Freedom
B) Death
C) Meaninglessness
D) Isolation
Correct Answer: D) Isolation
Rationale: Existential isolation refers to the unbridgeable gap between oneself
