Psychotherapy Midterm Exam
NRNP 6645 • 2025 Practice Examination
100 Multiple-Choice Questions with Answers & Rationales
Psychotherapy • PMHNP Practice • Clinical Ethics
Original independent study resource. Not an official Walden University assessment, actual
exam, or professor-verified question bank.
Page 1 of 29
,Table of Contents
Section 1: Foundations of Psychotherapy & Therapeutic Relationships 3
Section 2: Psychodynamic, Humanistic & Existential Approaches 7
Section 3: Cognitive-Behavioral & Behavioral Therapies 11
Section 4: Family, Group & Couples Therapy 15
Section 5: Psychopharmacology & Integrated Treatment 19
Section 6: Special Populations, Trauma & Cultural Considerations 23
Section 7: Ethical, Legal & Professional Practice Issues 27
Page 2 of 29
, Section 1: Foundations of Psychotherapy & Therapeutic
Relationships
Q1: A client says, “You’re the first clinician who has really listened.” Which response
best supports the alliance?
A. “That means you should follow my advice.”
B. “I understand you better than anyone else.”
C. “Let’s move on to your diagnosis.”
D. “I’m glad you feel heard. What has been most helpful so far?” [CORRECT]
Correct Answer: D
Rationale: A reflective, collaborative response strengthens alliance without encouraging dependency
or claiming special status.
Q2: A client repeatedly arrives late and says the therapist reminds them of a critical
parent. What is the most useful initial response?
A. Confront the client for being disrespectful
B. Immediately terminate treatment
C. Explore the client’s experience of the relationship with curiosity and without defensiveness
[CORRECT]
D. Tell the client the comparison is irrational
Correct Answer: C
Rationale: The reaction may provide clinically useful relational information; explore it safely rather
than retaliating or dismissing it.
Q3: A clinician notices feeling unusually protective of one client and making
exceptions to policy. What should the clinician do?
A. Continue because the feelings prove strong rapport
B. Reflect on possible countertransference, seek supervision, and restore consistent
boundaries [CORRECT]
C. Share personal contact information
D. Avoid documenting the exceptions
Correct Answer: B
Rationale: Self-awareness and supervision help manage countertransference and protect
professional boundaries.
Q4: Which is an example of an open-ended therapeutic question?
A. “What was going through your mind when that happened?” [CORRECT]
B. “You were angry, weren’t you?”
C. “Did you take the medication?”
D. “You feel better now, correct?”
Correct Answer: A
Rationale: Open-ended questions invite narrative and meaning rather than limiting the client to
yes/no answers.
Page 3 of 29
NRNP 6645 • 2025 Practice Examination
100 Multiple-Choice Questions with Answers & Rationales
Psychotherapy • PMHNP Practice • Clinical Ethics
Original independent study resource. Not an official Walden University assessment, actual
exam, or professor-verified question bank.
Page 1 of 29
,Table of Contents
Section 1: Foundations of Psychotherapy & Therapeutic Relationships 3
Section 2: Psychodynamic, Humanistic & Existential Approaches 7
Section 3: Cognitive-Behavioral & Behavioral Therapies 11
Section 4: Family, Group & Couples Therapy 15
Section 5: Psychopharmacology & Integrated Treatment 19
Section 6: Special Populations, Trauma & Cultural Considerations 23
Section 7: Ethical, Legal & Professional Practice Issues 27
Page 2 of 29
, Section 1: Foundations of Psychotherapy & Therapeutic
Relationships
Q1: A client says, “You’re the first clinician who has really listened.” Which response
best supports the alliance?
A. “That means you should follow my advice.”
B. “I understand you better than anyone else.”
C. “Let’s move on to your diagnosis.”
D. “I’m glad you feel heard. What has been most helpful so far?” [CORRECT]
Correct Answer: D
Rationale: A reflective, collaborative response strengthens alliance without encouraging dependency
or claiming special status.
Q2: A client repeatedly arrives late and says the therapist reminds them of a critical
parent. What is the most useful initial response?
A. Confront the client for being disrespectful
B. Immediately terminate treatment
C. Explore the client’s experience of the relationship with curiosity and without defensiveness
[CORRECT]
D. Tell the client the comparison is irrational
Correct Answer: C
Rationale: The reaction may provide clinically useful relational information; explore it safely rather
than retaliating or dismissing it.
Q3: A clinician notices feeling unusually protective of one client and making
exceptions to policy. What should the clinician do?
A. Continue because the feelings prove strong rapport
B. Reflect on possible countertransference, seek supervision, and restore consistent
boundaries [CORRECT]
C. Share personal contact information
D. Avoid documenting the exceptions
Correct Answer: B
Rationale: Self-awareness and supervision help manage countertransference and protect
professional boundaries.
Q4: Which is an example of an open-ended therapeutic question?
A. “What was going through your mind when that happened?” [CORRECT]
B. “You were angry, weren’t you?”
C. “Did you take the medication?”
D. “You feel better now, correct?”
Correct Answer: A
Rationale: Open-ended questions invite narrative and meaning rather than limiting the client to
yes/no answers.
Page 3 of 29
