Midterm Exam Review: NSG 527 / NSG527
Psychopathology, Theories, and Advanced Clinical Modalities
Wilkes University Passan School of Nursing | 2026-2027 Curriculum
75 Questions | Multiple Choice (A-D) | One Correct Answer Each | Rated A
Section 1: Foundational Theories and Conceptual Frameworks (Q1-Q15)
Q1: According to Viktor Frankl, what is the primary motivational force in human beings that existential psychotherapy
seeks to address?
A. A. The pursuit of pleasure and avoidance of pain
B. B. The search for meaning and purpose in life
C. C. The need for unconditional positive regard from others
D. D. The drive toward self-actualization and personal growth
Correct Answer: B
Rationale: Viktor Frankl, a founder of existential psychotherapy and logotherapy, posited that the primary motivational force is the will
to meaning, or the search for purpose. This distinguishes his approach from Freud (pleasure drives) and Maslow (self-actualization).
Frankl developed this through his experiences in Nazi concentration camps, arguing that even in suffering, individuals can find meaning.
This is foundational to NSG 527 at Wilkes University.
Q2: A PMHNP is working with a client who expresses profound fear of death and struggles to find purpose after retiring
from a 40-year career. Using Yalom's existential givens, which given is MOST prominent?
A. A. Freedom and Responsibility
B. B. Existential Isolation
C. C. Death
D. D. Meaninglessness
Correct Answer: C
Rationale: Yalom identified four givens of existence: Death, Freedom, Existential Isolation, and Meaninglessness. The explicit fear of
death most directly relates to the existential given of Death. Yalom taught that confronting mortality is essential before one can truly
live authentically. While meaninglessness is closely related, the death anxiety is explicitly stated and takes priority. This distinction is a
core NSG 527 competency.
Q3: Which statement BEST describes the concept of Eigenwelt in existential psychotherapy?
A. A. The relationship between oneself and the natural environment
B. B. The relationship between oneself and other people
C. C. The relationship with ourselves
D. D. The relationship between oneself and the transcendent dimension
Correct Answer: C
Rationale: Eigenwelt, meaning own-world, refers to the relationship with oneself in the Binswanger existential framework. It
encompasses self-awareness, self-acceptance, and the capacity for authentic self-reflection. Mitwelt describes the social world, Umwelt
the natural environment, and Uberwelt the spiritual dimension. Understanding these forms of the world is a core theoretical
competency in NSG 527.
Q4: A PMHNP using existential therapy asks a post-cancer client: How do you want to live the rest of your life? Which
existential theme is being addressed?
, A. A. Aloneness
B. B. Meaning
C. C. Awareness
D. D. Freedom and Responsibility
Correct Answer: B
Rationale: The therapist is addressing the theme of Meaning, which refers to the struggle for a sense of meaning and purpose. After a
life-threatening experience, clients often re-evaluate what gives their life significance. While freedom and responsibility are relevant,
the specific question about how the client wants to live addresses the search for meaning, central to Rollo May and Yalom existential
psychotherapy. This therapeutic technique aligns with NSG 527 competencies at Wilkes University.
Q5: According to existential psychotherapy, from what source does anxiety primarily arise?
A. A. Unresolved childhood conflicts and repressed memories
B. B. Our personal need to survive and preserve our being
C. C. Distorted cognitive patterns and irrational beliefs
D. D. Neurochemical imbalances in the brain
Correct Answer: B
Rationale: In existential psychotherapy, anxiety arises from our personal need to survive and preserve our being. This distinguishes
existential anxiety from neurotic anxiety. Existential anxiety is viewed as an inevitable condition of living, not a pathological symptom
to be eliminated. Rollo May argued this anxiety can be transformative when faced directly. This contrasts with psychodynamic,
cognitive, and biological frameworks, all compared in NSG 527.
Q6: A PMHNP using Gestalt therapy works with a client who states: I feel completely stuck and cannot move forward. In
Gestalt therapy, what is this client experiencing?
A. A. Unfinished business from childhood
B. B. The impasse
C. C. Top dog/under-dog conflict
D. D. Retroflection
Correct Answer: B
Rationale: The impasse in Gestalt therapy is the point where a person does not progress in self-support maturity but continues to
manipulate their environment to survive. Clients at the impasse may play helpless, angry, or whatever it takes to get support rather
than developing internal self-support. Perls described this as a deadlock. Being stuck directly corresponds to the impasse. This is a key
NSG 527 learning objective.
Q7: Which statement is MOST accurate regarding the goals of Gestalt therapy?
A. A. The goal is intellectual understanding of why problems developed
B. B. The goal is awareness and restoring the natural state of self-regulation
C. C. The goal is to eliminate symptoms through systematic desensitization
D. D. The goal is to restructure distorted cognitive patterns
Correct Answer: B
Rationale: Frederick and Laura Perls, founders of Gestalt therapy, explicitly stated the goal is NOT intellectual understanding or the why
of problems. The goal is awareness and restoring the natural state of self-regulation, focusing on the present moment, body posture,
habits, and beliefs. This distinguishes Gestalt from psychodynamic, behavioral, and cognitive therapies. Understanding this distinction
is a core NSG 527 competency.
Q8: A PMHNP asks a client to imagine their critical parent in an empty chair and speak directly to them. Which Gestalt
technique is being used?
A. A. Dreamwork
B. B. Fantasy game
C. C. Empty chair technique
D. D. Top dog/under-dog exercise
, Correct Answer: C
Rationale: The empty chair technique is a signature Gestalt method where clients address an empty chair as if a significant person were
sitting there, facilitating direct expression of unresolved feelings and promoting awareness of internal conflicts. Dreamwork involves
re-enacting dreams in present tense. Fantasy games explore imaginative scenarios. Top dog/under-dog addresses internal self-conflict.
The empty chair technique is a core therapeutic skill in NSG 527.
Q9: In Gestalt therapy, moving from environmental support to self-support means:
A. A. Transitioning from inpatient to outpatient care
B. B. Developing internal resources to regulate emotions rather than relying on external manipulation of others
C. C. Replacing family support with peer support groups
D. D. Shifting from therapist-directed to client-directed sessions
Correct Answer: B
Rationale: Moving from environmental support to self-support is a central Gestalt goal meaning the client develops internal capacity
for self-regulation and psychological need fulfillment rather than manipulating the environment or other people. Perls emphasized
accepting personal responsibility and ownership of experiences including consequences of actions. This concept is fundamental to
understanding Gestalt therapy in NSG 527.
Q10: Which statement is MOST consistent with the existential view of freedom and responsibility?
A. A. People are shaped primarily by unconscious drives and childhood experiences
B. B. People are free to choose their life direction and are responsible for their actions and inactions
C. C. People are products of their genetic makeup and biological predispositions
D. D. People are determined by social and environmental forces beyond their control
Correct Answer: B
Rationale: Existential psychotherapy, through Rollo May and Yalom, emphasizes that people are free to shape their destiny and
responsible for their own actions and inactions. While conditions influence people, individuals always have choices within those
conditions. This contrasts with psychodynamic, biological, and social determinism. In NSG 527, PMHNPs help clients recognize freedom
and accept responsibility for authentic living.
Q11: A PMHNP creates a warm, nonjudgmental atmosphere and accepts the client without conditions. Which humanistic
concept is demonstrated?
A. A. Accurate empathy
B. B. Unconditional positive regard
C. C. Congruence
D. D. Self-actualization
Correct Answer: B
Rationale: Unconditional positive regard, developed by Carl Rogers, involves accepting and supporting the client without judgment or
conditions of worth, creating a safe environment for exploration. While accurate empathy and congruence are part of Rogers
therapeutic triad, accepting without conditions directly corresponds to unconditional positive regard. Self-actualization is the innate
drive toward growth. These concepts are foundational in NSG 527.
Q12: In Gestalt therapy, the top dog/under-dog technique addresses which phenomenon?
A. A. Conflict between the client and therapist
B. B. Internal conflict between the dominating and yielding aspects of the self
C. C. Power struggles between family members
D. D. Tension between conscious desires and societal expectations
Correct Answer: B
Rationale: The top dog/under-dog technique addresses internal conflict: the top dog is the demanding, controlling, moralistic part while
the under-dog is the defensive, excuse-making, compliant part. Perls used this to help clients become aware of internal splits and
integrate polarities. It is not about client-therapist conflict, family dynamics, or societal tension. This is a key NSG 527 learning
objective.
Psychopathology, Theories, and Advanced Clinical Modalities
Wilkes University Passan School of Nursing | 2026-2027 Curriculum
75 Questions | Multiple Choice (A-D) | One Correct Answer Each | Rated A
Section 1: Foundational Theories and Conceptual Frameworks (Q1-Q15)
Q1: According to Viktor Frankl, what is the primary motivational force in human beings that existential psychotherapy
seeks to address?
A. A. The pursuit of pleasure and avoidance of pain
B. B. The search for meaning and purpose in life
C. C. The need for unconditional positive regard from others
D. D. The drive toward self-actualization and personal growth
Correct Answer: B
Rationale: Viktor Frankl, a founder of existential psychotherapy and logotherapy, posited that the primary motivational force is the will
to meaning, or the search for purpose. This distinguishes his approach from Freud (pleasure drives) and Maslow (self-actualization).
Frankl developed this through his experiences in Nazi concentration camps, arguing that even in suffering, individuals can find meaning.
This is foundational to NSG 527 at Wilkes University.
Q2: A PMHNP is working with a client who expresses profound fear of death and struggles to find purpose after retiring
from a 40-year career. Using Yalom's existential givens, which given is MOST prominent?
A. A. Freedom and Responsibility
B. B. Existential Isolation
C. C. Death
D. D. Meaninglessness
Correct Answer: C
Rationale: Yalom identified four givens of existence: Death, Freedom, Existential Isolation, and Meaninglessness. The explicit fear of
death most directly relates to the existential given of Death. Yalom taught that confronting mortality is essential before one can truly
live authentically. While meaninglessness is closely related, the death anxiety is explicitly stated and takes priority. This distinction is a
core NSG 527 competency.
Q3: Which statement BEST describes the concept of Eigenwelt in existential psychotherapy?
A. A. The relationship between oneself and the natural environment
B. B. The relationship between oneself and other people
C. C. The relationship with ourselves
D. D. The relationship between oneself and the transcendent dimension
Correct Answer: C
Rationale: Eigenwelt, meaning own-world, refers to the relationship with oneself in the Binswanger existential framework. It
encompasses self-awareness, self-acceptance, and the capacity for authentic self-reflection. Mitwelt describes the social world, Umwelt
the natural environment, and Uberwelt the spiritual dimension. Understanding these forms of the world is a core theoretical
competency in NSG 527.
Q4: A PMHNP using existential therapy asks a post-cancer client: How do you want to live the rest of your life? Which
existential theme is being addressed?
, A. A. Aloneness
B. B. Meaning
C. C. Awareness
D. D. Freedom and Responsibility
Correct Answer: B
Rationale: The therapist is addressing the theme of Meaning, which refers to the struggle for a sense of meaning and purpose. After a
life-threatening experience, clients often re-evaluate what gives their life significance. While freedom and responsibility are relevant,
the specific question about how the client wants to live addresses the search for meaning, central to Rollo May and Yalom existential
psychotherapy. This therapeutic technique aligns with NSG 527 competencies at Wilkes University.
Q5: According to existential psychotherapy, from what source does anxiety primarily arise?
A. A. Unresolved childhood conflicts and repressed memories
B. B. Our personal need to survive and preserve our being
C. C. Distorted cognitive patterns and irrational beliefs
D. D. Neurochemical imbalances in the brain
Correct Answer: B
Rationale: In existential psychotherapy, anxiety arises from our personal need to survive and preserve our being. This distinguishes
existential anxiety from neurotic anxiety. Existential anxiety is viewed as an inevitable condition of living, not a pathological symptom
to be eliminated. Rollo May argued this anxiety can be transformative when faced directly. This contrasts with psychodynamic,
cognitive, and biological frameworks, all compared in NSG 527.
Q6: A PMHNP using Gestalt therapy works with a client who states: I feel completely stuck and cannot move forward. In
Gestalt therapy, what is this client experiencing?
A. A. Unfinished business from childhood
B. B. The impasse
C. C. Top dog/under-dog conflict
D. D. Retroflection
Correct Answer: B
Rationale: The impasse in Gestalt therapy is the point where a person does not progress in self-support maturity but continues to
manipulate their environment to survive. Clients at the impasse may play helpless, angry, or whatever it takes to get support rather
than developing internal self-support. Perls described this as a deadlock. Being stuck directly corresponds to the impasse. This is a key
NSG 527 learning objective.
Q7: Which statement is MOST accurate regarding the goals of Gestalt therapy?
A. A. The goal is intellectual understanding of why problems developed
B. B. The goal is awareness and restoring the natural state of self-regulation
C. C. The goal is to eliminate symptoms through systematic desensitization
D. D. The goal is to restructure distorted cognitive patterns
Correct Answer: B
Rationale: Frederick and Laura Perls, founders of Gestalt therapy, explicitly stated the goal is NOT intellectual understanding or the why
of problems. The goal is awareness and restoring the natural state of self-regulation, focusing on the present moment, body posture,
habits, and beliefs. This distinguishes Gestalt from psychodynamic, behavioral, and cognitive therapies. Understanding this distinction
is a core NSG 527 competency.
Q8: A PMHNP asks a client to imagine their critical parent in an empty chair and speak directly to them. Which Gestalt
technique is being used?
A. A. Dreamwork
B. B. Fantasy game
C. C. Empty chair technique
D. D. Top dog/under-dog exercise
, Correct Answer: C
Rationale: The empty chair technique is a signature Gestalt method where clients address an empty chair as if a significant person were
sitting there, facilitating direct expression of unresolved feelings and promoting awareness of internal conflicts. Dreamwork involves
re-enacting dreams in present tense. Fantasy games explore imaginative scenarios. Top dog/under-dog addresses internal self-conflict.
The empty chair technique is a core therapeutic skill in NSG 527.
Q9: In Gestalt therapy, moving from environmental support to self-support means:
A. A. Transitioning from inpatient to outpatient care
B. B. Developing internal resources to regulate emotions rather than relying on external manipulation of others
C. C. Replacing family support with peer support groups
D. D. Shifting from therapist-directed to client-directed sessions
Correct Answer: B
Rationale: Moving from environmental support to self-support is a central Gestalt goal meaning the client develops internal capacity
for self-regulation and psychological need fulfillment rather than manipulating the environment or other people. Perls emphasized
accepting personal responsibility and ownership of experiences including consequences of actions. This concept is fundamental to
understanding Gestalt therapy in NSG 527.
Q10: Which statement is MOST consistent with the existential view of freedom and responsibility?
A. A. People are shaped primarily by unconscious drives and childhood experiences
B. B. People are free to choose their life direction and are responsible for their actions and inactions
C. C. People are products of their genetic makeup and biological predispositions
D. D. People are determined by social and environmental forces beyond their control
Correct Answer: B
Rationale: Existential psychotherapy, through Rollo May and Yalom, emphasizes that people are free to shape their destiny and
responsible for their own actions and inactions. While conditions influence people, individuals always have choices within those
conditions. This contrasts with psychodynamic, biological, and social determinism. In NSG 527, PMHNPs help clients recognize freedom
and accept responsibility for authentic living.
Q11: A PMHNP creates a warm, nonjudgmental atmosphere and accepts the client without conditions. Which humanistic
concept is demonstrated?
A. A. Accurate empathy
B. B. Unconditional positive regard
C. C. Congruence
D. D. Self-actualization
Correct Answer: B
Rationale: Unconditional positive regard, developed by Carl Rogers, involves accepting and supporting the client without judgment or
conditions of worth, creating a safe environment for exploration. While accurate empathy and congruence are part of Rogers
therapeutic triad, accepting without conditions directly corresponds to unconditional positive regard. Self-actualization is the innate
drive toward growth. These concepts are foundational in NSG 527.
Q12: In Gestalt therapy, the top dog/under-dog technique addresses which phenomenon?
A. A. Conflict between the client and therapist
B. B. Internal conflict between the dominating and yielding aspects of the self
C. C. Power struggles between family members
D. D. Tension between conscious desires and societal expectations
Correct Answer: B
Rationale: The top dog/under-dog technique addresses internal conflict: the top dog is the demanding, controlling, moralistic part while
the under-dog is the defensive, excuse-making, compliant part. Perls used this to help clients become aware of internal splits and
integrate polarities. It is not about client-therapist conflict, family dynamics, or societal tension. This is a key NSG 527 learning
objective.
