Latest 2026/2027 NRNP 6645 MIDTERM EXAM PRACTICE — 100
QUESTIONS WITH ANSWERS & RATIONALES
1. A patient has difficulty identifying and describing emotional experiences. Which
supportive psychodynamic intervention is most appropriate?
A. Encourage the patient to identify and label feelings
B. Immediately interpret unconscious conflicts
C. Challenge every irrational belief
D. Use systematic desensitization
Correct Answer: A. Encourage the patient to identify and label feelings
RATIONALE: Helping patients recognize and verbalize emotions can reduce alexithymia
and improve emotional awareness.
2. Which concept is most closely associated with psychodynamic psychotherapy?
A. Exposure to feared stimuli
B. Unconscious processes influencing behavior
C. Behavioral reinforcement schedules
D. Cognitive restructuring only
Correct Answer: B. Unconscious processes influencing behavior
RATIONALE: Psychodynamic approaches emphasize unconscious processes, defenses, early
experiences, and interpersonal patterns.
3. What distinguishes psychoanalytic therapy from many other psychotherapy
approaches?
A. Exclusive focus on current symptoms
B. Exclusive use of behavioral homework
C. Exploration of unconscious processes and the therapeutic relationship
D. Avoidance of patient history
Correct Answer: C. Exploration of unconscious processes and the therapeutic
relationship
, RATIONALE: Psychoanalytic therapy emphasizes unconscious motivations, developmental
experiences, transference, and the therapeutic relationship.
4. A patient repeatedly arrives late to psychotherapy sessions. From a psychodynamic
perspective, this behavior may warrant exploration as:
A. Resistance or avoidance
B. Successful termination
C. Improved coping
D. Behavioral extinction
Correct Answer: A. Resistance or avoidance
RATIONALE: Repeated lateness can represent avoidance, resistance, ambivalence, or
another clinically meaningful pattern that should be explored rather than assumed.
5. Which intervention is most characteristic of cognitive behavioral therapy?
A. Free association
B. Interpretation of dreams as the primary intervention
C. Identification and restructuring of maladaptive thoughts
D. Analysis of childhood psychosexual stages exclusively
Correct Answer: C. Identification and restructuring of maladaptive thoughts
RATIONALE: CBT addresses relationships among thoughts, emotions, and behaviors and
uses cognitive restructuring to modify maladaptive thinking.
6. A CBT therapist asks, “What evidence supports this thought, and what evidence does
not?” This is an example of:
A. Free association
B. Questioning the evidence
C. Role reversal
D. Catharsis
Correct Answer: B. Questioning the evidence
, RATIONALE: Questioning evidence helps patients evaluate whether automatic thoughts are
based on facts, assumptions, or cognitive distortions.
7. A patient says, “I failed this exam, so I will never succeed at anything.” Which cognitive
distortion is most evident?
A. Overgeneralization
B. Thought blocking
C. Projection
D. Sublimation
Correct Answer: A. Overgeneralization
RATIONALE: The patient generalizes from one negative event to a broad conclusion about
future success.
8. Which statement best describes Socratic questioning in CBT?
A. The therapist tells the patient which beliefs are correct
B. The therapist helps the patient examine and evaluate their own thoughts
C. The therapist avoids discussing thoughts
D. The therapist focuses exclusively on childhood experiences
Correct Answer: B. The therapist helps the patient examine and evaluate their own
thoughts
RATIONALE: Socratic questioning encourages patients to critically examine their
assumptions rather than simply accepting the therapist's interpretation.
9. Which intervention is most consistent with behavioral therapy?
A. Free association
B. Exposure and response prevention
C. Dream interpretation
D. Analysis of transference only
Correct Answer: B. Exposure and response prevention
, RATIONALE: Behavioral therapy uses learning principles and behavioral interventions such
as exposure and response prevention.
10. A patient with a phobia gradually encounters the feared stimulus in a controlled
therapeutic setting. This is known as:
A. Exposure therapy
B. Projection
C. Transference
D. Interpretation
Correct Answer: A. Exposure therapy
RATIONALE: Exposure therapy involves planned contact with feared stimuli to reduce
avoidance and anxiety.
11. Which statement about supportive psychotherapy is most accurate?
A. It always requires intensive interpretation of unconscious conflicts
B. It can emphasize strengthening coping and adaptive functioning
C. It prohibits practical problem-solving
D. It is limited to patients with personality disorders
Correct Answer: B. It can emphasize strengthening coping and adaptive functioning
RATIONALE: Supportive therapy focuses on maintaining or improving functioning, coping,
reality testing, interpersonal skills, and adaptation.
12. A patient has limited ability to manage daily responsibilities and needs significant
therapeutic support. Which supportive strategy may be appropriate?
A. Provide structure and support while promoting independence
B. Encourage complete dependency on the therapist
C. Avoid discussing functioning
D. Focus exclusively on dream analysis
Correct Answer: A. Provide structure and support while promoting independence
QUESTIONS WITH ANSWERS & RATIONALES
1. A patient has difficulty identifying and describing emotional experiences. Which
supportive psychodynamic intervention is most appropriate?
A. Encourage the patient to identify and label feelings
B. Immediately interpret unconscious conflicts
C. Challenge every irrational belief
D. Use systematic desensitization
Correct Answer: A. Encourage the patient to identify and label feelings
RATIONALE: Helping patients recognize and verbalize emotions can reduce alexithymia
and improve emotional awareness.
2. Which concept is most closely associated with psychodynamic psychotherapy?
A. Exposure to feared stimuli
B. Unconscious processes influencing behavior
C. Behavioral reinforcement schedules
D. Cognitive restructuring only
Correct Answer: B. Unconscious processes influencing behavior
RATIONALE: Psychodynamic approaches emphasize unconscious processes, defenses, early
experiences, and interpersonal patterns.
3. What distinguishes psychoanalytic therapy from many other psychotherapy
approaches?
A. Exclusive focus on current symptoms
B. Exclusive use of behavioral homework
C. Exploration of unconscious processes and the therapeutic relationship
D. Avoidance of patient history
Correct Answer: C. Exploration of unconscious processes and the therapeutic
relationship
, RATIONALE: Psychoanalytic therapy emphasizes unconscious motivations, developmental
experiences, transference, and the therapeutic relationship.
4. A patient repeatedly arrives late to psychotherapy sessions. From a psychodynamic
perspective, this behavior may warrant exploration as:
A. Resistance or avoidance
B. Successful termination
C. Improved coping
D. Behavioral extinction
Correct Answer: A. Resistance or avoidance
RATIONALE: Repeated lateness can represent avoidance, resistance, ambivalence, or
another clinically meaningful pattern that should be explored rather than assumed.
5. Which intervention is most characteristic of cognitive behavioral therapy?
A. Free association
B. Interpretation of dreams as the primary intervention
C. Identification and restructuring of maladaptive thoughts
D. Analysis of childhood psychosexual stages exclusively
Correct Answer: C. Identification and restructuring of maladaptive thoughts
RATIONALE: CBT addresses relationships among thoughts, emotions, and behaviors and
uses cognitive restructuring to modify maladaptive thinking.
6. A CBT therapist asks, “What evidence supports this thought, and what evidence does
not?” This is an example of:
A. Free association
B. Questioning the evidence
C. Role reversal
D. Catharsis
Correct Answer: B. Questioning the evidence
, RATIONALE: Questioning evidence helps patients evaluate whether automatic thoughts are
based on facts, assumptions, or cognitive distortions.
7. A patient says, “I failed this exam, so I will never succeed at anything.” Which cognitive
distortion is most evident?
A. Overgeneralization
B. Thought blocking
C. Projection
D. Sublimation
Correct Answer: A. Overgeneralization
RATIONALE: The patient generalizes from one negative event to a broad conclusion about
future success.
8. Which statement best describes Socratic questioning in CBT?
A. The therapist tells the patient which beliefs are correct
B. The therapist helps the patient examine and evaluate their own thoughts
C. The therapist avoids discussing thoughts
D. The therapist focuses exclusively on childhood experiences
Correct Answer: B. The therapist helps the patient examine and evaluate their own
thoughts
RATIONALE: Socratic questioning encourages patients to critically examine their
assumptions rather than simply accepting the therapist's interpretation.
9. Which intervention is most consistent with behavioral therapy?
A. Free association
B. Exposure and response prevention
C. Dream interpretation
D. Analysis of transference only
Correct Answer: B. Exposure and response prevention
, RATIONALE: Behavioral therapy uses learning principles and behavioral interventions such
as exposure and response prevention.
10. A patient with a phobia gradually encounters the feared stimulus in a controlled
therapeutic setting. This is known as:
A. Exposure therapy
B. Projection
C. Transference
D. Interpretation
Correct Answer: A. Exposure therapy
RATIONALE: Exposure therapy involves planned contact with feared stimuli to reduce
avoidance and anxiety.
11. Which statement about supportive psychotherapy is most accurate?
A. It always requires intensive interpretation of unconscious conflicts
B. It can emphasize strengthening coping and adaptive functioning
C. It prohibits practical problem-solving
D. It is limited to patients with personality disorders
Correct Answer: B. It can emphasize strengthening coping and adaptive functioning
RATIONALE: Supportive therapy focuses on maintaining or improving functioning, coping,
reality testing, interpersonal skills, and adaptation.
12. A patient has limited ability to manage daily responsibilities and needs significant
therapeutic support. Which supportive strategy may be appropriate?
A. Provide structure and support while promoting independence
B. Encourage complete dependency on the therapist
C. Avoid discussing functioning
D. Focus exclusively on dream analysis
Correct Answer: A. Provide structure and support while promoting independence
