ACTUAL EXAM QUESTIONS WITH DETAILED DETAILED ANSWERS WITH
STUDY GUIDE EXPERT VERIFIED FOR GUARANTEED PASS/ALREADY
GRADED A+
Elisabeth is a 30-year-old who presents for psychotherapy. Elisabeth's eight-month-old daughter died
suddenly in the night two years ago. The coroner determined the death was sudden infant death
syndrome (SIDS). Elisabeth is a critical care nurse and is having difficulty understanding how her baby
died so suddenly and without warning. She feels like she should have detected some symptoms of
distress and feels guilty that her attempts at cardiopulmonary resuscitation (CPR) did not revive her baby.
She also has disturbing memories of finding her baby dead in the crib. The psychiatric mental health
nurse practitioner (PMHNP) selects EMDR as a psychotherapeutic approach.
Which of the following responses are congruent with EMDR? Select all that apply.
"Identify the 10 most disturbing experiences in your life?"
"Imagine yourself in a safe train that is speeding by upsetting scenery."
"Choose a preferred statement, such - DETAILED ANSWER-"Identify the 10 most disturbing
experiences in your life?"
"Imagine yourself in a safe train that is speeding by upsetting scenery."
"Choose a preferred statement, such as I did the best I could to counter your statement that the death is
your fault."
"As you think about the death, how do the words I did my best feel now?"
"Can a mother be guilty of her child's death when there are no symptoms of distress?"
,Rationale: A client's history of disturbing events that might be related to the trauma might also be targeted
for processing (client history and treatment planning). Clients are taught ways to relax and calm
themselves to cope with distressing arousal. A safe train speeding by distressing scenery may help the
client feel safe during EMDR (preparation). Having the client identify a negative belief associated with the
event and a preferred statement helps support positive cognition (assessment). Repeating positive
cognition after distress strengthens positive cognition (installing and strengthening positive cognition).
When processing is stuck, the therapist may pose a question to simulate the connection to a positive
cognition (installing and strengthening positive cognition). cognitive-behavioral therapy - DETAILED
ANSWER-focus on how well individuals can adapt cognitively and functionally to their environments
-short-term, structured, goal-oriented form of psychotherapy
-stresses necessity of challenging maladaptive thoughts that lead to behavioral problems
-first emerged in 1955
-most widely practiced psychotherapy
-help clients recognize and address cognitive distortions
• by Albert Ellis, widely known as the grandfather of cognitive behavior therapy
-Beck
• originally trained in psychoanalysis, pioneered cognitive therapy in the 1960s, through his
research on depression
• also developed the popular Depression Inventory instrument
CBT Relationship to Nursing Theory - DETAILED ANSWER--Orem's self-care deficit nursing theory
• provides a framework to view CBT as a supportive intervention
• fosters effective self-care behaviors
-Roy's Adaptation Theory
• premise that individuals use coping mechanisms to adapt to stimuli, both internal and external
• share underpinnings with CBT.
Indications for CBT - DETAILED ANSWER--treatment of a wide range of diagnoses
• depression
• anxiety disorders
• substance use disorders
• eating disorders
,• severe mental illness
• PTSD
Principles of CBT include: - DETAILED ANSWER--way an ind cognitively structures thoughts about
self & the world determines how the ind feels & behaves
-Dysfunctional thoughts are rooted in irrational assumptions
-Dysfunctional thinking and learned patterns of maladaptive behavior contribute to psychological
problems
-Ind's can learn more adaptive behaviors which can relieve symptoms & improve quality of life
-CBT is (+) & stresses collaboration & active participation
-CBT includes action plans in the form of therapy homework
Role of the Psychotherapist in CBT - DETAILED ANSWER--using a structured, collaborative
approach to help clients recognize and reevaluate cognitive distortions
-help clients:
• better understand the behaviors of others
• develop improved coping skills
-Psychoeducation
-Homework
• to help clients reinforce & build on what was learned during the therapy session
motivational interviewing (MI) - DETAILED ANSWER--helps individuals prepare for change
-person-centered, evidence-based approach to behavior change
-using a collaborative, goal-oriented communication style
-empowers clients to draw on their meanings & capacities to facilitate change
• addressing issues with ambivalence and resistance
-grew out of William R. Miller's clinical practice working with clients with substance use disorders in the
1980s
• collaborated with Stephen Rollnick to write book: Motivational interviewing
, Indications for MI - DETAILED ANSWER--reduction of substance use and health promotion
-improving medication adherence in clients with schizophrenia
MI Guiding Principles - DETAILED ANSWER--acceptance
-empathy
-compassion
-respect of client autonomy
-acknowledgment of the client's strengths & efforts
-Spirit of MI
• Partnership, compassion, acceptance, evocation
MI Role of the Psychotherapist - DETAILED ANSWER-represented by the mnemonic RULE:
Resist the righting reflex
Understand the patient's motivation
Listen to the patient
Empower the patient
OARS - DETAILED ANSWER-Communication skills for MI:
-Open questions
• cannot be answered with a yes or no, require elaboration
-Affirming
• provide encouragement, are (+) comments on a client's strengths or efforts
-Reflecting
• mirror the content or feelings explicitly or implicitly stated by the client
• convey empathy, demonstrate listening, highlight emotions & beliefs, • provide opportunities for
the client to elaborate on their concerns