NRNP 6645 Psychotherapy Midterm Exam Prep –
SECOND VERSION (100 Actual Practice Questions
with Verified Answers) | Walden University Week 6 |
2026-2027Update | Graded A+
1. A client with major depressive disorder says, "I'm a failure at everything." Using CBT, the
PMHNP's best initial response is:
A. "That's not true, you have many successes."
B. "What evidence do you have for and against that thought?"
C. "Let's focus on your childhood instead."
D. "I agree, you seem very stuck."
Answer: B. "What evidence do you have for and against that thought?"
Socratic questioning examines evidence for cognitive distortions without direct reassurance.
2. In psychodynamic therapy, a client who develops romantic feelings toward the therapist is
experiencing:
A. Positive countertransference
B. Erotic transference
C. Resistance
D. Working through
Answer: B. Erotic transference
Erotic transference involves intense feelings rooted in early attachment relationships.
3. A PMHNP using DBT with a client who self-harms by cutting. The FIRST priority is:
A. Analyze childhood trauma
B. Target life-threatening behaviors
C. Improve interpersonal effectiveness
D. Enhance mindfulness
Answer: B. Target life-threatening behaviors
DBT hierarchically prioritizes life-threatening behaviors first, then therapy-interfering
behaviors.
4. According to Bowen, the tendency to choose a partner with a similar level of
differentiation is called:
A. Nuclear family emotional process
,B. Family projection process
C. Multigenerational transmission process
D. Emotional cutoff
Answer: A. Nuclear family emotional process
Nuclear family emotional process includes marital conflict, dysfunction in one spouse, or
impairment of a child.
5. A client with generalized anxiety disorder asks, "What if I lose my job and become
homeless?" The PMHNP asks, "What is the most likely outcome based on past
experience?" This addresses:
A. Catastrophizing
B. Mind reading
C. Emotional reasoning
D. Labeling
Answer: A. Catastrophizing
Decatastrophizing examines realistic probabilities versus worst-case scenarios.
6. In group therapy, a member who never speaks except to agree with the leader may be
demonstrating:
A. Universality
B. Compliance as resistance
C. Altruism
D. Vicarious learning
Answer: B. Compliance as resistance
Superficial agreement can avoid genuine engagement and emotional risk-taking.
7. A PMHNP using MI hears a client say, "I need to change, but I'm not ready yet." The
PMHNP responds, "You see both reasons to change and reasons to wait." This is:
A. Simple reflection
B. Double-sided reflection
C. Amplified reflection
D. Affirmation
Answer: B. Double-sided reflection
Double-sided reflection acknowledges ambivalence without pushing for change.
8. Which DBT skill involves listing pros and cons of tolerating vs. not tolerating distress?
A. ACCEPTS
B. IMPROVE
C. Pros and cons
D. TIPP
, Answer: C. Pros and cons
Pros and cons compares short-term vs. long-term consequences of tolerating distress.
9. A client with panic disorder experiences derealization during panic. The PMHNP explains
this as:
A. A sign of psychosis
B. A common symptom of anxiety
C. Medication side effect
D. Brain damage
Answer: B. A common symptom of anxiety
Psychoeducation normalizes depersonalization/derealization as autonomic nervous system
responses.
10. In structural family therapy, the therapist joining the family's language, affect, and style
is called:
A. Tracking
B. Mimesis
C. Reframing
D. Unbalancing
Answer: B. Mimesis
Mimesis builds rapport by adapting to the family's communication patterns.
11. A client with borderline personality disorder in DBT says, "My therapist hates me
because I was late." The PMHNP recognizes this as:
A. Mindfulness
B. Emotion mind
C. Reasonable mind
D. Wise mind
Answer: B. Emotion mind
Emotion mind is ruled by feelings without rational input, common in BPD.
12. In MI, asking "What would be different in your life if you made this change?" elicits:
A. Sustain talk
B. Change talk
C. Resistance
D. Ambivalence
Answer: B. Change talk
Evocative questions about benefits of change elicit desire, ability, reasons, and need.
13. A PMHNP using prolonged exposure for PTSD notices the client's SUDS score does not
decrease between sessions. This suggests:
SECOND VERSION (100 Actual Practice Questions
with Verified Answers) | Walden University Week 6 |
2026-2027Update | Graded A+
1. A client with major depressive disorder says, "I'm a failure at everything." Using CBT, the
PMHNP's best initial response is:
A. "That's not true, you have many successes."
B. "What evidence do you have for and against that thought?"
C. "Let's focus on your childhood instead."
D. "I agree, you seem very stuck."
Answer: B. "What evidence do you have for and against that thought?"
Socratic questioning examines evidence for cognitive distortions without direct reassurance.
2. In psychodynamic therapy, a client who develops romantic feelings toward the therapist is
experiencing:
A. Positive countertransference
B. Erotic transference
C. Resistance
D. Working through
Answer: B. Erotic transference
Erotic transference involves intense feelings rooted in early attachment relationships.
3. A PMHNP using DBT with a client who self-harms by cutting. The FIRST priority is:
A. Analyze childhood trauma
B. Target life-threatening behaviors
C. Improve interpersonal effectiveness
D. Enhance mindfulness
Answer: B. Target life-threatening behaviors
DBT hierarchically prioritizes life-threatening behaviors first, then therapy-interfering
behaviors.
4. According to Bowen, the tendency to choose a partner with a similar level of
differentiation is called:
A. Nuclear family emotional process
,B. Family projection process
C. Multigenerational transmission process
D. Emotional cutoff
Answer: A. Nuclear family emotional process
Nuclear family emotional process includes marital conflict, dysfunction in one spouse, or
impairment of a child.
5. A client with generalized anxiety disorder asks, "What if I lose my job and become
homeless?" The PMHNP asks, "What is the most likely outcome based on past
experience?" This addresses:
A. Catastrophizing
B. Mind reading
C. Emotional reasoning
D. Labeling
Answer: A. Catastrophizing
Decatastrophizing examines realistic probabilities versus worst-case scenarios.
6. In group therapy, a member who never speaks except to agree with the leader may be
demonstrating:
A. Universality
B. Compliance as resistance
C. Altruism
D. Vicarious learning
Answer: B. Compliance as resistance
Superficial agreement can avoid genuine engagement and emotional risk-taking.
7. A PMHNP using MI hears a client say, "I need to change, but I'm not ready yet." The
PMHNP responds, "You see both reasons to change and reasons to wait." This is:
A. Simple reflection
B. Double-sided reflection
C. Amplified reflection
D. Affirmation
Answer: B. Double-sided reflection
Double-sided reflection acknowledges ambivalence without pushing for change.
8. Which DBT skill involves listing pros and cons of tolerating vs. not tolerating distress?
A. ACCEPTS
B. IMPROVE
C. Pros and cons
D. TIPP
, Answer: C. Pros and cons
Pros and cons compares short-term vs. long-term consequences of tolerating distress.
9. A client with panic disorder experiences derealization during panic. The PMHNP explains
this as:
A. A sign of psychosis
B. A common symptom of anxiety
C. Medication side effect
D. Brain damage
Answer: B. A common symptom of anxiety
Psychoeducation normalizes depersonalization/derealization as autonomic nervous system
responses.
10. In structural family therapy, the therapist joining the family's language, affect, and style
is called:
A. Tracking
B. Mimesis
C. Reframing
D. Unbalancing
Answer: B. Mimesis
Mimesis builds rapport by adapting to the family's communication patterns.
11. A client with borderline personality disorder in DBT says, "My therapist hates me
because I was late." The PMHNP recognizes this as:
A. Mindfulness
B. Emotion mind
C. Reasonable mind
D. Wise mind
Answer: B. Emotion mind
Emotion mind is ruled by feelings without rational input, common in BPD.
12. In MI, asking "What would be different in your life if you made this change?" elicits:
A. Sustain talk
B. Change talk
C. Resistance
D. Ambivalence
Answer: B. Change talk
Evocative questions about benefits of change elicit desire, ability, reasons, and need.
13. A PMHNP using prolonged exposure for PTSD notices the client's SUDS score does not
decrease between sessions. This suggests:
