NRNP 6645 FINAL EXAM – EXAM QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALE | 2027 Q&A |
INSTANT DOWNLOAD PDF
1. A patient in psychotherapy says, “I keep thinking that I am a failure, so there is no
point in trying.” Which CBT intervention most directly addresses this statement?
A. Free association
B. Dream interpretation
C. Cognitive restructuring
D. Paradoxical intention
Rationale: Cognitive restructuring helps the patient identify automatic negative thoughts,
examine the evidence supporting them, and develop more balanced interpretations. The other
approaches are associated with different therapeutic models.
2. In Beck’s cognitive model, which component is most likely to occur automatically
in response to a stressful event?
A. Automatic thought
B. Core therapeutic contract
C. Behavioral reinforcement
D. Developmental milestone
Rationale: Automatic thoughts are rapid interpretations that arise in response to situations and
can influence emotional and behavioral responses. Core beliefs are deeper, more enduring
assumptions.
3. A patient believes, “If I make one mistake at work, everyone will think I am
incompetent.” Which cognitive distortion is most evident?
A. Personalization
B. All-or-nothing thinking
C. Emotional reasoning
D. Selective abstraction
Rationale: The patient is viewing performance in extreme terms, with one mistake interpreted as
complete incompetence. This reflects all-or-nothing thinking.
4. During CBT, a patient reports feeling anxious whenever entering a crowded
store. The therapist asks the patient to record the situation, automatic thoughts,
emotions, and resulting behavior. What is the primary purpose of this exercise?
A. Establishing transference
B. Identifying unconscious conflicts
,C. Measuring attachment style
D. Identifying relationships among thoughts, emotions, and behaviors
Rationale: CBT uses structured monitoring to help patients recognize patterns connecting
situations, cognitions, emotions, and behaviors. This information guides subsequent cognitive
and behavioral interventions.
5. A therapist asks a patient, “What evidence supports the belief that everyone is
judging you?” Which CBT technique is being used?
A. Exposure
B. Socratic questioning
C. Free association
D. Role reversal
Rationale: Socratic questioning uses guided questions to help patients examine assumptions and
arrive at more balanced conclusions rather than simply being told what to believe.
6. A patient with social anxiety avoids speaking during meetings because of fear of
embarrassment. Which behavioral intervention is most consistent with CBT?
A. Interpretation of childhood dreams
B. Exploration of existential meaning
C. Gradual exposure to feared situations
D. Analysis of family hierarchy
Rationale: Gradual exposure allows patients to confront feared situations in a planned and
tolerable sequence while reducing avoidance and learning that anxiety can decrease without
escape.
7. A patient repeatedly says, “I should never feel anxious.” The therapist helps the
patient recognize that anxiety is an understandable emotion and focuses on
responding effectively to it. This approach primarily promotes:
A. Acceptance of emotional experiences
B. Suppression of uncomfortable emotions
C. Dependence on the therapist
D. Avoidance of distressing situations
Rationale: Contemporary cognitive and behavioral approaches often emphasize accepting
internal experiences while changing ineffective responses to them. Suppression and avoidance
can maintain psychological distress.
8. Which feature most clearly distinguishes behavioral activation from simple
supportive counseling?
, A. It focuses primarily on childhood experiences.
B. It avoids assigning activities between sessions.
C. It emphasizes therapist interpretation of dreams.
D. It systematically increases engagement in meaningful and reinforcing activities.
Rationale: Behavioral activation targets withdrawal and inactivity by helping patients schedule
and gradually increase activities that provide mastery, connection, or pleasure.
9. A patient with depression has stopped exercising, socializing, and participating in
hobbies. Which initial intervention is most consistent with behavioral activation?
A. Asking the patient to analyze childhood relationships
B. Developing a realistic schedule of gradually increasing activities
C. Encouraging the patient to wait until motivation returns
D. Exploring unconscious symbolism in dreams
Rationale: Behavioral activation does not require motivation to appear first. Planned,
achievable activities can increase reinforcement and gradually improve mood and functioning.
10. In CBT, a core belief is best described as:
A. A temporary emotional reaction
B. A behavioral consequence
C. A deeply held, enduring belief about oneself, others, or the world
D. A specific therapeutic homework assignment
Rationale: Core beliefs are fundamental assumptions that influence interpretation of
experiences. They are generally more enduring and global than situation-specific automatic
thoughts.
11. A patient with borderline personality disorder frequently engages in self-injury
during periods of intense emotional distress. Which psychotherapy has the
strongest emphasis on teaching distress tolerance, emotion regulation,
mindfulness, and interpersonal effectiveness?
A. Dialectical behavior therapy
B. Psychoanalysis
C. Supportive-expressive therapy
D. Classical conditioning
Rationale: Dialectical behavior therapy combines acceptance and change strategies and
specifically teaches mindfulness, distress tolerance, emotion regulation, and interpersonal
effectiveness skills.
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALE | 2027 Q&A |
INSTANT DOWNLOAD PDF
1. A patient in psychotherapy says, “I keep thinking that I am a failure, so there is no
point in trying.” Which CBT intervention most directly addresses this statement?
A. Free association
B. Dream interpretation
C. Cognitive restructuring
D. Paradoxical intention
Rationale: Cognitive restructuring helps the patient identify automatic negative thoughts,
examine the evidence supporting them, and develop more balanced interpretations. The other
approaches are associated with different therapeutic models.
2. In Beck’s cognitive model, which component is most likely to occur automatically
in response to a stressful event?
A. Automatic thought
B. Core therapeutic contract
C. Behavioral reinforcement
D. Developmental milestone
Rationale: Automatic thoughts are rapid interpretations that arise in response to situations and
can influence emotional and behavioral responses. Core beliefs are deeper, more enduring
assumptions.
3. A patient believes, “If I make one mistake at work, everyone will think I am
incompetent.” Which cognitive distortion is most evident?
A. Personalization
B. All-or-nothing thinking
C. Emotional reasoning
D. Selective abstraction
Rationale: The patient is viewing performance in extreme terms, with one mistake interpreted as
complete incompetence. This reflects all-or-nothing thinking.
4. During CBT, a patient reports feeling anxious whenever entering a crowded
store. The therapist asks the patient to record the situation, automatic thoughts,
emotions, and resulting behavior. What is the primary purpose of this exercise?
A. Establishing transference
B. Identifying unconscious conflicts
,C. Measuring attachment style
D. Identifying relationships among thoughts, emotions, and behaviors
Rationale: CBT uses structured monitoring to help patients recognize patterns connecting
situations, cognitions, emotions, and behaviors. This information guides subsequent cognitive
and behavioral interventions.
5. A therapist asks a patient, “What evidence supports the belief that everyone is
judging you?” Which CBT technique is being used?
A. Exposure
B. Socratic questioning
C. Free association
D. Role reversal
Rationale: Socratic questioning uses guided questions to help patients examine assumptions and
arrive at more balanced conclusions rather than simply being told what to believe.
6. A patient with social anxiety avoids speaking during meetings because of fear of
embarrassment. Which behavioral intervention is most consistent with CBT?
A. Interpretation of childhood dreams
B. Exploration of existential meaning
C. Gradual exposure to feared situations
D. Analysis of family hierarchy
Rationale: Gradual exposure allows patients to confront feared situations in a planned and
tolerable sequence while reducing avoidance and learning that anxiety can decrease without
escape.
7. A patient repeatedly says, “I should never feel anxious.” The therapist helps the
patient recognize that anxiety is an understandable emotion and focuses on
responding effectively to it. This approach primarily promotes:
A. Acceptance of emotional experiences
B. Suppression of uncomfortable emotions
C. Dependence on the therapist
D. Avoidance of distressing situations
Rationale: Contemporary cognitive and behavioral approaches often emphasize accepting
internal experiences while changing ineffective responses to them. Suppression and avoidance
can maintain psychological distress.
8. Which feature most clearly distinguishes behavioral activation from simple
supportive counseling?
, A. It focuses primarily on childhood experiences.
B. It avoids assigning activities between sessions.
C. It emphasizes therapist interpretation of dreams.
D. It systematically increases engagement in meaningful and reinforcing activities.
Rationale: Behavioral activation targets withdrawal and inactivity by helping patients schedule
and gradually increase activities that provide mastery, connection, or pleasure.
9. A patient with depression has stopped exercising, socializing, and participating in
hobbies. Which initial intervention is most consistent with behavioral activation?
A. Asking the patient to analyze childhood relationships
B. Developing a realistic schedule of gradually increasing activities
C. Encouraging the patient to wait until motivation returns
D. Exploring unconscious symbolism in dreams
Rationale: Behavioral activation does not require motivation to appear first. Planned,
achievable activities can increase reinforcement and gradually improve mood and functioning.
10. In CBT, a core belief is best described as:
A. A temporary emotional reaction
B. A behavioral consequence
C. A deeply held, enduring belief about oneself, others, or the world
D. A specific therapeutic homework assignment
Rationale: Core beliefs are fundamental assumptions that influence interpretation of
experiences. They are generally more enduring and global than situation-specific automatic
thoughts.
11. A patient with borderline personality disorder frequently engages in self-injury
during periods of intense emotional distress. Which psychotherapy has the
strongest emphasis on teaching distress tolerance, emotion regulation,
mindfulness, and interpersonal effectiveness?
A. Dialectical behavior therapy
B. Psychoanalysis
C. Supportive-expressive therapy
D. Classical conditioning
Rationale: Dialectical behavior therapy combines acceptance and change strategies and
specifically teaches mindfulness, distress tolerance, emotion regulation, and interpersonal
effectiveness skills.
