NRNP 6645 Psychotherapy Midterm & Final Study Guide
2026 | Complete Review | Graded A+
Original Questions, Correct Answers & Rationales
Instructions: Select the one best answer for each question.
Question 1
A patient tells the PMHNP, "I always fail at everything, so there is no point in trying." Which
psychotherapy approach would most directly target this pattern of thinking?
A. Psychoanalytic therapy
B. Cognitive behavioral therapy
C. Gestalt therapy
D. Supportive therapy
Correct Answer: B. Cognitive behavioral therapy
Rationale: CBT identifies and challenges maladaptive automatic thoughts and cognitive
distortions that contribute to emotional distress and dysfunctional behavior.
Question 2
Which principle is most characteristic of person-centered therapy?
A. Interpretation of unconscious conflicts
B. Therapist confrontation of irrational beliefs
C. Unconditional positive regard
D. Systematic exposure to feared stimuli
Correct Answer: C. Unconditional positive regard
Rationale: Carl Rogers' person-centered approach emphasizes empathy, congruence, and
unconditional positive regard as core therapeutic conditions.
Question 3
,A patient with borderline personality disorder frequently engages in self-injury during periods of
intense emotional distress. Which therapy is particularly appropriate?
A. Dialectical behavior therapy
B. Classical psychoanalysis
C. Reality therapy
D. Aversion therapy
Correct Answer: A. Dialectical behavior therapy
Rationale: DBT was developed to address severe emotion dysregulation and suicidal or self-
harming behaviors and emphasizes distress tolerance, emotion regulation, mindfulness, and
interpersonal effectiveness.
Question 4
The primary purpose of the therapeutic alliance is to:
A. Eliminate the need for a formal treatment plan
B. Establish a collaborative relationship that supports treatment
C. Allow the clinician to make all treatment decisions
D. Prevent patients from discussing difficult emotions
Correct Answer: B. Establish a collaborative relationship that supports treatment
Rationale: A strong therapeutic alliance promotes trust, collaboration, engagement, and
adherence to psychotherapy.
Question 5
A therapist asks, "What evidence supports the belief that everyone is judging you?" This
intervention is most consistent with:
A. CBT
B. Gestalt therapy
C. Psychoanalysis
D. Existential therapy
Correct Answer: A. CBT
Rationale: CBT uses guided discovery and examination of evidence to help patients evaluate
and modify distorted thinking.
, Question 6
Which technique is most associated with motivational interviewing?
A. Arguing with the patient about substance use
B. Developing discrepancy between current behavior and personal goals
C. Interpreting childhood conflicts
D. Giving repeated direct advice
Correct Answer: B. Developing discrepancy between current behavior and personal goals
Rationale: MI helps patients recognize discrepancies between their current behaviors and their
personally held values or goals, increasing motivation for change.
Question 7
Which statement best reflects the spirit of motivational interviewing?
A. "You need to stop drinking immediately."
B. "I know what is best for you."
C. "What concerns you most about your current drinking?"
D. "You should follow my treatment plan."
Correct Answer: C. "What concerns you most about your current drinking?"
Rationale: MI uses collaboration, empathy, open-ended questions, and exploration of
ambivalence rather than confrontation or coercion.
Question 8
A patient says, "I don't think my depression is serious enough to require treatment." The PMHNP
responds, "Part of you feels treatment may not be necessary, while another part is tired of feeling
this way." This is an example of:
A. Reflection of ambivalence
B. Interpretation
C. Confrontation
D. Cognitive restructuring
Correct Answer: A. Reflection of ambivalence
2026 | Complete Review | Graded A+
Original Questions, Correct Answers & Rationales
Instructions: Select the one best answer for each question.
Question 1
A patient tells the PMHNP, "I always fail at everything, so there is no point in trying." Which
psychotherapy approach would most directly target this pattern of thinking?
A. Psychoanalytic therapy
B. Cognitive behavioral therapy
C. Gestalt therapy
D. Supportive therapy
Correct Answer: B. Cognitive behavioral therapy
Rationale: CBT identifies and challenges maladaptive automatic thoughts and cognitive
distortions that contribute to emotional distress and dysfunctional behavior.
Question 2
Which principle is most characteristic of person-centered therapy?
A. Interpretation of unconscious conflicts
B. Therapist confrontation of irrational beliefs
C. Unconditional positive regard
D. Systematic exposure to feared stimuli
Correct Answer: C. Unconditional positive regard
Rationale: Carl Rogers' person-centered approach emphasizes empathy, congruence, and
unconditional positive regard as core therapeutic conditions.
Question 3
,A patient with borderline personality disorder frequently engages in self-injury during periods of
intense emotional distress. Which therapy is particularly appropriate?
A. Dialectical behavior therapy
B. Classical psychoanalysis
C. Reality therapy
D. Aversion therapy
Correct Answer: A. Dialectical behavior therapy
Rationale: DBT was developed to address severe emotion dysregulation and suicidal or self-
harming behaviors and emphasizes distress tolerance, emotion regulation, mindfulness, and
interpersonal effectiveness.
Question 4
The primary purpose of the therapeutic alliance is to:
A. Eliminate the need for a formal treatment plan
B. Establish a collaborative relationship that supports treatment
C. Allow the clinician to make all treatment decisions
D. Prevent patients from discussing difficult emotions
Correct Answer: B. Establish a collaborative relationship that supports treatment
Rationale: A strong therapeutic alliance promotes trust, collaboration, engagement, and
adherence to psychotherapy.
Question 5
A therapist asks, "What evidence supports the belief that everyone is judging you?" This
intervention is most consistent with:
A. CBT
B. Gestalt therapy
C. Psychoanalysis
D. Existential therapy
Correct Answer: A. CBT
Rationale: CBT uses guided discovery and examination of evidence to help patients evaluate
and modify distorted thinking.
, Question 6
Which technique is most associated with motivational interviewing?
A. Arguing with the patient about substance use
B. Developing discrepancy between current behavior and personal goals
C. Interpreting childhood conflicts
D. Giving repeated direct advice
Correct Answer: B. Developing discrepancy between current behavior and personal goals
Rationale: MI helps patients recognize discrepancies between their current behaviors and their
personally held values or goals, increasing motivation for change.
Question 7
Which statement best reflects the spirit of motivational interviewing?
A. "You need to stop drinking immediately."
B. "I know what is best for you."
C. "What concerns you most about your current drinking?"
D. "You should follow my treatment plan."
Correct Answer: C. "What concerns you most about your current drinking?"
Rationale: MI uses collaboration, empathy, open-ended questions, and exploration of
ambivalence rather than confrontation or coercion.
Question 8
A patient says, "I don't think my depression is serious enough to require treatment." The PMHNP
responds, "Part of you feels treatment may not be necessary, while another part is tired of feeling
this way." This is an example of:
A. Reflection of ambivalence
B. Interpretation
C. Confrontation
D. Cognitive restructuring
Correct Answer: A. Reflection of ambivalence
