NRNP 6645 MIDTERM EXAM FINAL EXAM QUESTIONS
AND ANSWERS PRACTICE QUESTIONS WITH SOLUTIONS
NEWEST 2026/2027 EXAM| ALREADY GRADED A+
1. A patient with major depressive disorder reports persistent sadness,
anhedonia, fatigue, and feelings of worthlessness for 3 months. Which
psychotherapy approach primarily focuses on identifying and modifying
distorted automatic thoughts?
A. Psychodynamic therapy
B. Cognitive behavioral therapy
C. Interpersonal therapy
D. Supportive therapy
Correct Answer: B. Cognitive behavioral therapy
Rationale: Cognitive behavioral therapy (CBT) identifies maladaptive automatic
thoughts and cognitive distortions and helps patients replace them with more
adaptive patterns of thinking and behavior.
2. Which therapeutic principle is most important during the initial psychiatric
interview?
A. Immediately challenge irrational beliefs
B. Establish a therapeutic alliance
C. Interpret unconscious conflicts
D. Provide extensive psychoeducation before assessment
Correct Answer: B. Establish a therapeutic alliance
Rationale: A strong therapeutic alliance promotes trust, engagement,
communication, and treatment adherence and is foundational to effective
psychotherapy.
,3. A patient states, “Everyone at work thinks I am incompetent.” The clinician
asks, “What evidence do you have that everyone thinks this?” Which CBT
technique is being used?
A. Free association
B. Cognitive restructuring
C. Dream interpretation
D. Exposure therapy
Correct Answer: B. Cognitive restructuring
Rationale: Cognitive restructuring involves examining the evidence supporting
maladaptive thoughts and developing more balanced interpretations.
4. Which statement best describes transference?
A. The clinician develops feelings toward the patient
B. The patient projects feelings from significant past relationships onto the
clinician
C. The patient intentionally manipulates the clinician
D. The clinician unconsciously avoids difficult topics
Correct Answer: B. The patient projects feelings from significant past
relationships onto the clinician
Rationale: Transference occurs when patients unconsciously redirect emotions and
expectations associated with previous relationships onto the therapist.
5. Countertransference refers to:
A. The patient's resistance to therapy
B. The patient's projection of childhood conflicts
C. The clinician's emotional responses toward the patient
D. The therapist's interpretation of dreams
Correct Answer: C. The clinician's emotional responses toward the patient
,Rationale: Countertransference involves the clinician's emotional reactions to the
patient, which can arise from the clinician's own experiences or from interactions
within the therapeutic relationship.
6. Which psychotherapy is most directly associated with identifying unconscious
conflicts and examining early developmental experiences?
A. Psychoanalytic therapy
B. Behavioral activation
C. Solution-focused therapy
D. Motivational interviewing
Correct Answer: A. Psychoanalytic therapy
Rationale: Psychoanalytic therapy emphasizes unconscious processes, early
relationships, defense mechanisms, and unresolved developmental conflicts.
7. A patient with panic disorder avoids shopping malls because of fear of
experiencing another panic attack. Which intervention is most consistent with
exposure-based CBT?
A. Encourage complete avoidance until anxiety resolves
B. Gradually expose the patient to feared situations
C. Interpret the patient's childhood dreams
D. Focus exclusively on family relationships
Correct Answer: B. Gradually expose the patient to feared situations
Rationale: Exposure therapy reduces avoidance and fear by helping patients
repeatedly and safely confront feared stimuli or situations.
8. Which intervention is characteristic of behavioral activation?
A. Increasing engagement in meaningful and rewarding activities
B. Exploring unconscious sexual conflicts
, C. Analyzing dream symbolism
D. Encouraging emotional dependence on the therapist
Correct Answer: A. Increasing engagement in meaningful and rewarding
activities
Rationale: Behavioral activation targets depression by increasing participation in
activities that provide accomplishment, pleasure, connection, and reinforcement.
9. Which statement best represents an open-ended therapeutic question?
A. “Are you depressed?”
B. “Did you sleep last night?”
C. “Tell me what has been happening since your symptoms began.”
D. “You are feeling anxious, correct?”
Correct Answer: C. “Tell me what has been happening since your symptoms
began.”
Rationale: Open-ended questions encourage patients to provide detailed
information and facilitate exploration of thoughts, emotions, and experiences.
10. A psychiatric clinician says, “It sounds like you felt rejected when your
partner did not call.” This is an example of:
A. Interpretation
B. Reflection of feeling
C. Confrontation
D. Reframing
Correct Answer: B. Reflection of feeling
Rationale: Reflection of feeling identifies and communicates the emotional
experience expressed or implied by the patient.
11. Which response demonstrates therapeutic empathy?
AND ANSWERS PRACTICE QUESTIONS WITH SOLUTIONS
NEWEST 2026/2027 EXAM| ALREADY GRADED A+
1. A patient with major depressive disorder reports persistent sadness,
anhedonia, fatigue, and feelings of worthlessness for 3 months. Which
psychotherapy approach primarily focuses on identifying and modifying
distorted automatic thoughts?
A. Psychodynamic therapy
B. Cognitive behavioral therapy
C. Interpersonal therapy
D. Supportive therapy
Correct Answer: B. Cognitive behavioral therapy
Rationale: Cognitive behavioral therapy (CBT) identifies maladaptive automatic
thoughts and cognitive distortions and helps patients replace them with more
adaptive patterns of thinking and behavior.
2. Which therapeutic principle is most important during the initial psychiatric
interview?
A. Immediately challenge irrational beliefs
B. Establish a therapeutic alliance
C. Interpret unconscious conflicts
D. Provide extensive psychoeducation before assessment
Correct Answer: B. Establish a therapeutic alliance
Rationale: A strong therapeutic alliance promotes trust, engagement,
communication, and treatment adherence and is foundational to effective
psychotherapy.
,3. A patient states, “Everyone at work thinks I am incompetent.” The clinician
asks, “What evidence do you have that everyone thinks this?” Which CBT
technique is being used?
A. Free association
B. Cognitive restructuring
C. Dream interpretation
D. Exposure therapy
Correct Answer: B. Cognitive restructuring
Rationale: Cognitive restructuring involves examining the evidence supporting
maladaptive thoughts and developing more balanced interpretations.
4. Which statement best describes transference?
A. The clinician develops feelings toward the patient
B. The patient projects feelings from significant past relationships onto the
clinician
C. The patient intentionally manipulates the clinician
D. The clinician unconsciously avoids difficult topics
Correct Answer: B. The patient projects feelings from significant past
relationships onto the clinician
Rationale: Transference occurs when patients unconsciously redirect emotions and
expectations associated with previous relationships onto the therapist.
5. Countertransference refers to:
A. The patient's resistance to therapy
B. The patient's projection of childhood conflicts
C. The clinician's emotional responses toward the patient
D. The therapist's interpretation of dreams
Correct Answer: C. The clinician's emotional responses toward the patient
,Rationale: Countertransference involves the clinician's emotional reactions to the
patient, which can arise from the clinician's own experiences or from interactions
within the therapeutic relationship.
6. Which psychotherapy is most directly associated with identifying unconscious
conflicts and examining early developmental experiences?
A. Psychoanalytic therapy
B. Behavioral activation
C. Solution-focused therapy
D. Motivational interviewing
Correct Answer: A. Psychoanalytic therapy
Rationale: Psychoanalytic therapy emphasizes unconscious processes, early
relationships, defense mechanisms, and unresolved developmental conflicts.
7. A patient with panic disorder avoids shopping malls because of fear of
experiencing another panic attack. Which intervention is most consistent with
exposure-based CBT?
A. Encourage complete avoidance until anxiety resolves
B. Gradually expose the patient to feared situations
C. Interpret the patient's childhood dreams
D. Focus exclusively on family relationships
Correct Answer: B. Gradually expose the patient to feared situations
Rationale: Exposure therapy reduces avoidance and fear by helping patients
repeatedly and safely confront feared stimuli or situations.
8. Which intervention is characteristic of behavioral activation?
A. Increasing engagement in meaningful and rewarding activities
B. Exploring unconscious sexual conflicts
, C. Analyzing dream symbolism
D. Encouraging emotional dependence on the therapist
Correct Answer: A. Increasing engagement in meaningful and rewarding
activities
Rationale: Behavioral activation targets depression by increasing participation in
activities that provide accomplishment, pleasure, connection, and reinforcement.
9. Which statement best represents an open-ended therapeutic question?
A. “Are you depressed?”
B. “Did you sleep last night?”
C. “Tell me what has been happening since your symptoms began.”
D. “You are feeling anxious, correct?”
Correct Answer: C. “Tell me what has been happening since your symptoms
began.”
Rationale: Open-ended questions encourage patients to provide detailed
information and facilitate exploration of thoughts, emotions, and experiences.
10. A psychiatric clinician says, “It sounds like you felt rejected when your
partner did not call.” This is an example of:
A. Interpretation
B. Reflection of feeling
C. Confrontation
D. Reframing
Correct Answer: B. Reflection of feeling
Rationale: Reflection of feeling identifies and communicates the emotional
experience expressed or implied by the patient.
11. Which response demonstrates therapeutic empathy?
