Walden University NURS 6640 Midterm Exam (pdf) | 2026/2027 |
Psychotherapy Q&A | Psychotherapy
**1. A 35-year-old patient seeks treatment for depression and anxiety after
an abusive relationship. To help empower the patient, the PMHNP wants to
teach the safe-place exercise to create a feeling of calm. In order to walk the
patient through the exercise, the PMHNP first says:**
A) "Identify an image of a safe place that makes you feel calm."
B) "Think about the things that cause you anxiety and let them go."
C) "Take a deep breath and start to relax with each new breath."
D) "Picture a beautiful beach and describe to me what you see."
**Correct Answer: A**
**Rationale:** The safe-place exercise begins by having the patient identify
an image of a safe place that evokes feelings of calm. This establishes the
foundation for the guided imagery exercise and empowers the patient to
access a sense of safety. The PMHNP should allow the patient to choose their
own safe place rather than imposing one.
---
**2. The PMHNP is working with a patient who has dissociative disorder and
requests pharmacological interventions for dealing with her trauma. What
education does the PMHNP provide to the patient regarding medication
therapy?**
A) "Medication alone will cure your dissociative symptoms."
B) "Medication is not effective for dissociative disorders."
C) "The medication may provide symptom relief, but you still need
psychotherapy."
,D) "Medication should be avoided in dissociative disorders."
**Correct Answer: C**
**Rationale:** Medication may provide symptom relief for associated
conditions such as depression or anxiety, but psychotherapy remains the
primary treatment for dissociative disorders. The PMHNP should educate the
patient that medication complements, but does not replace, psychotherapy.
---
**3. The patient attempts the PMHNP's sleep hygiene recommendations for 2
weeks, but does not make any progress mitigating nightmares and
hyperarousal. Which behavioral strategy does the PMHNP suggest next?**
A) Imagery rehearsal therapy
B) Progressive muscle relaxation
C) Cognitive restructuring for sleep-related thoughts
D) All of the above
**Correct Answer: D**
**Rationale:** When sleep hygiene alone is insufficient, a combination of
behavioral strategies may be needed. Imagery rehearsal therapy,
progressive muscle relaxation, and cognitive restructuring can all address
nightmares and hyperarousal.
---
,**4. After informing a prospective patient about limits of confidentiality, the
patient consents to the "conditions" of confidentiality and signs an informed
consent form. Several weeks later, a lawyer representing the patient's
spouse for a court case asks the PMHNP for the disclosure of information
about the patient. The PMHNP should:**
A) Disclose all requested information to the lawyer
B) Refuse to disclose any information without a court order
C) Limit disclosure to the extent legally possible
D) Consult with the patient before disclosing any information
**Correct Answer: C**
**Rationale:** The PMHNP should limit disclosure to the extent legally
possible. Without a court order or patient consent, the therapist should
protect patient confidentiality while complying with legal requirements.
---
**5. The PMHNP meets with an adolescent patient who has depression and
often presents with resistance when discussing his parent's divorce. For the
past couple of sessions, the patient has been quiet, sometimes refusing to
speak. To further support the therapeutic relationship, the PMHNP:**
A) Observes and points out the behavior
B) Ignores the silence and continues with the session
C) Ends the session early
D) Confronts the patient about the resistance
**Correct Answer: A**
, **Rationale:** Observing and pointing out the behavior in a non-judgmental
manner can help the adolescent become aware of their patterns and open up
communication. This approach supports the therapeutic relationship without
being confrontational.
---
**6. A PMHNP is caring for a 21-year-old woman who is suffering from anxiety
and is having difficulty managing stress. Which of the following would be an
appropriate step by the PMHNP?**
A) Asking the patient what she does to relieve anxiety
B) Giving the patient basic stress management activities
C) Developing a plan together that is not overwhelming
D) All of the above
**Correct Answer: D**
**Rationale:** A comprehensive approach to anxiety management includes
assessing the patient's current coping strategies, providing stress
management education, and collaboratively developing a manageable plan.
All of these steps are appropriate and support patient empowerment.
---
**7. The PMHNP is working with a 56-year-old man who is being seen
because of his anxiety and depression. During the therapy sessions, the
PMHNP assists the patient in discussing his experiences and expanding on
his thoughts and feelings. He tells the PMHNP stories about how he used to
be teased by his coworkers at the office for becoming too anxious in large
Psychotherapy Q&A | Psychotherapy
**1. A 35-year-old patient seeks treatment for depression and anxiety after
an abusive relationship. To help empower the patient, the PMHNP wants to
teach the safe-place exercise to create a feeling of calm. In order to walk the
patient through the exercise, the PMHNP first says:**
A) "Identify an image of a safe place that makes you feel calm."
B) "Think about the things that cause you anxiety and let them go."
C) "Take a deep breath and start to relax with each new breath."
D) "Picture a beautiful beach and describe to me what you see."
**Correct Answer: A**
**Rationale:** The safe-place exercise begins by having the patient identify
an image of a safe place that evokes feelings of calm. This establishes the
foundation for the guided imagery exercise and empowers the patient to
access a sense of safety. The PMHNP should allow the patient to choose their
own safe place rather than imposing one.
---
**2. The PMHNP is working with a patient who has dissociative disorder and
requests pharmacological interventions for dealing with her trauma. What
education does the PMHNP provide to the patient regarding medication
therapy?**
A) "Medication alone will cure your dissociative symptoms."
B) "Medication is not effective for dissociative disorders."
C) "The medication may provide symptom relief, but you still need
psychotherapy."
,D) "Medication should be avoided in dissociative disorders."
**Correct Answer: C**
**Rationale:** Medication may provide symptom relief for associated
conditions such as depression or anxiety, but psychotherapy remains the
primary treatment for dissociative disorders. The PMHNP should educate the
patient that medication complements, but does not replace, psychotherapy.
---
**3. The patient attempts the PMHNP's sleep hygiene recommendations for 2
weeks, but does not make any progress mitigating nightmares and
hyperarousal. Which behavioral strategy does the PMHNP suggest next?**
A) Imagery rehearsal therapy
B) Progressive muscle relaxation
C) Cognitive restructuring for sleep-related thoughts
D) All of the above
**Correct Answer: D**
**Rationale:** When sleep hygiene alone is insufficient, a combination of
behavioral strategies may be needed. Imagery rehearsal therapy,
progressive muscle relaxation, and cognitive restructuring can all address
nightmares and hyperarousal.
---
,**4. After informing a prospective patient about limits of confidentiality, the
patient consents to the "conditions" of confidentiality and signs an informed
consent form. Several weeks later, a lawyer representing the patient's
spouse for a court case asks the PMHNP for the disclosure of information
about the patient. The PMHNP should:**
A) Disclose all requested information to the lawyer
B) Refuse to disclose any information without a court order
C) Limit disclosure to the extent legally possible
D) Consult with the patient before disclosing any information
**Correct Answer: C**
**Rationale:** The PMHNP should limit disclosure to the extent legally
possible. Without a court order or patient consent, the therapist should
protect patient confidentiality while complying with legal requirements.
---
**5. The PMHNP meets with an adolescent patient who has depression and
often presents with resistance when discussing his parent's divorce. For the
past couple of sessions, the patient has been quiet, sometimes refusing to
speak. To further support the therapeutic relationship, the PMHNP:**
A) Observes and points out the behavior
B) Ignores the silence and continues with the session
C) Ends the session early
D) Confronts the patient about the resistance
**Correct Answer: A**
, **Rationale:** Observing and pointing out the behavior in a non-judgmental
manner can help the adolescent become aware of their patterns and open up
communication. This approach supports the therapeutic relationship without
being confrontational.
---
**6. A PMHNP is caring for a 21-year-old woman who is suffering from anxiety
and is having difficulty managing stress. Which of the following would be an
appropriate step by the PMHNP?**
A) Asking the patient what she does to relieve anxiety
B) Giving the patient basic stress management activities
C) Developing a plan together that is not overwhelming
D) All of the above
**Correct Answer: D**
**Rationale:** A comprehensive approach to anxiety management includes
assessing the patient's current coping strategies, providing stress
management education, and collaboratively developing a manageable plan.
All of these steps are appropriate and support patient empowerment.
---
**7. The PMHNP is working with a 56-year-old man who is being seen
because of his anxiety and depression. During the therapy sessions, the
PMHNP assists the patient in discussing his experiences and expanding on
his thoughts and feelings. He tells the PMHNP stories about how he used to
be teased by his coworkers at the office for becoming too anxious in large
