NR605 MIDTERM E
UPDATED ACTUAL EXAM QUESTIONS AND CORRECT
ANSWERS
Question 1.
Treatment Hierarchy Framework
ANSWER
therapeutic aims at the base of the model must be addressed before the client can move up
the triangle
Top: Stabilization
Internal resources
External resources
Bottom: Foundational needs
Question 2.
Supportive Psychotherapy
ANSWER
-an approach used to help clients who are experiencing emotional distress or problems in
living
-appropriate for clients experiencing specific stressful situations:
• psychotic personality organization
• preoccupied or overly emotional attachment style
• those with immature defenses
-goals of therapy: problem-solving, management of feelings and life stressors, and symptom
relief
-used for:
• stabilization
• resource building
• anxiety reduction
• problem-solving
-Therapeutic Techniques: providing comfort, encouragement and reassurance, and empathic
listening
,Question 3.
early forces of psychotherapy
ANSWER
Behaviorism
-focuses on observable behavior
Psychoanalysis
-studies the unconscious mind
Humanistic-existential
-focuses on individual free will
Question 4.
Juanita is a 17-year-old who has been in therapy for 3 months for major depressive disorder. Her
mother is requesting a copy of her psychotherapy notes so she can better understand the progress
her daughter is making. Juanita has indicated that she is "ok" with her mom accessing the notes. Is the
therapist obligated to provide the psychotherapy notes?
Yes, no client authorization necessary
Yes with written authorization from the client
No
ANSWER
No
Rationale: Even though the client may authorize the release of notes to her parent, the
therapist is not obligated to release the process notes to the client or her mother if they feel it
is not in the best interest of the client.
Question 5.
setting for psychotherapy
ANSWER
-Create a warm, welcoming, and safe environment
-tissues available
-clock where it is visible by both therapist and client
-ensure client and provider safety
-Therapist should avoid sitting behind a desk
• instead sit 3-4 ft. away but not directly across from client.
-Office uses neutral de cor
,Question 6.
Ruben is a 36-year-old who has been in therapy for 5 months. He is in the process of divorcing his wife
of 12 years and is seeking custody of his daughter. His attorney has requested copies of his
psychotherapy notes to use in support of the custody hearing. Can the therapist choose to share the
psychotherapy notes?
Yes, no client authorization necessary
Yes with written authorization from the client
No
ANSWER
Yes with written authorization from the client
Rationale: the client must provide written authorization for his notes to be shared with his
attorney.
Question 7.
Mateo is a 19-year-old transgender male who presents for therapy. He states that his gender identity is
incongruent with his sex assigned at birth. He has transitioned to dressing as a man, goes by Mateo,
his chosen name, and uses he/him pronouns at school and home. He states that he becomes very
angry when people use his "dead" name or wrong pronoun. He states that he tries to correct the
person, but he gets very frustrated when he must correct the same person repeatedly. The psychiatric
mental
ANSWER
"It's ok if you are angry when people use your dead name."
"I accept your gender identity and I understand that it is difficult when you interact with people
who don't accept who you are."
"It sounds like when people repeatedly use your dead name, you feel like they do not respect
you."
Rationale: Accurate empathic understanding helps the client to value their experiencing and
increase their confidence in pursuing a course of action. The therapist can express
genuineness, or congruence, towards the client. As the psychotherapist openly expresses
feelings, thoughts, and reactions with the client, trust will be generated, and therapy will occur.
During client-centered therapy, the therapist should refrain from offering extensive advice and
allow the client to drive the therapy session but may paraphrase the client's statements and
repeat them to help the client clarify feelings and actions.
, Question 8.
humanistic-existential approach
ANSWER
-foundational to psychiatric mental health nursing
• central tenets of holism, self-actualization, and the therapeutic alliance
-places emphasis on understanding human experience
• focusing on the client rather than the symptom
-Interventions seek to increase client self-awareness and self-understanding
-Holistic
• assumes an interrelationship between the client's psychological, biological, social, and
spiritual dimensions
Question 9.
suicide
ANSWER
-a leading cause of death in the U.S.
-In 2020, suicide was the:
• 12th leading cause of death overall
• 2nd leading cause of death among individuals between the ages of 10 and 34
• 3rd leading cause of death among individuals between the ages of 35 and 44
-clients with mental health diagnoses such as mood disorders, psychotic disorders, and
substance use disorder are at particularly high risk
• 50% of those who die by suicide do not have a previous psychiatric history
Question 10.
Hildegard Peplau therapeutic relationship six nurse roles
ANSWER
• Stranger: Nurse creates an environment to build trust
• Teacher: Nurse imparts relevant knowledge and provides instructions and training
• Resource person: Nurse provides specific information needed by the client, answers
questions, and interprets clinical data
• Counselor: Nurse helps the client understand and integrate meaning into life's circumstances,
provides guidance and encouragement for change
• Surrogate: Nurse helps clarify domains of dependence, interdependence, and independence
and acts as an advocate for the client
• Leader: Helps client take maximum responsibility for meeting treatment goals
UPDATED ACTUAL EXAM QUESTIONS AND CORRECT
ANSWERS
Question 1.
Treatment Hierarchy Framework
ANSWER
therapeutic aims at the base of the model must be addressed before the client can move up
the triangle
Top: Stabilization
Internal resources
External resources
Bottom: Foundational needs
Question 2.
Supportive Psychotherapy
ANSWER
-an approach used to help clients who are experiencing emotional distress or problems in
living
-appropriate for clients experiencing specific stressful situations:
• psychotic personality organization
• preoccupied or overly emotional attachment style
• those with immature defenses
-goals of therapy: problem-solving, management of feelings and life stressors, and symptom
relief
-used for:
• stabilization
• resource building
• anxiety reduction
• problem-solving
-Therapeutic Techniques: providing comfort, encouragement and reassurance, and empathic
listening
,Question 3.
early forces of psychotherapy
ANSWER
Behaviorism
-focuses on observable behavior
Psychoanalysis
-studies the unconscious mind
Humanistic-existential
-focuses on individual free will
Question 4.
Juanita is a 17-year-old who has been in therapy for 3 months for major depressive disorder. Her
mother is requesting a copy of her psychotherapy notes so she can better understand the progress
her daughter is making. Juanita has indicated that she is "ok" with her mom accessing the notes. Is the
therapist obligated to provide the psychotherapy notes?
Yes, no client authorization necessary
Yes with written authorization from the client
No
ANSWER
No
Rationale: Even though the client may authorize the release of notes to her parent, the
therapist is not obligated to release the process notes to the client or her mother if they feel it
is not in the best interest of the client.
Question 5.
setting for psychotherapy
ANSWER
-Create a warm, welcoming, and safe environment
-tissues available
-clock where it is visible by both therapist and client
-ensure client and provider safety
-Therapist should avoid sitting behind a desk
• instead sit 3-4 ft. away but not directly across from client.
-Office uses neutral de cor
,Question 6.
Ruben is a 36-year-old who has been in therapy for 5 months. He is in the process of divorcing his wife
of 12 years and is seeking custody of his daughter. His attorney has requested copies of his
psychotherapy notes to use in support of the custody hearing. Can the therapist choose to share the
psychotherapy notes?
Yes, no client authorization necessary
Yes with written authorization from the client
No
ANSWER
Yes with written authorization from the client
Rationale: the client must provide written authorization for his notes to be shared with his
attorney.
Question 7.
Mateo is a 19-year-old transgender male who presents for therapy. He states that his gender identity is
incongruent with his sex assigned at birth. He has transitioned to dressing as a man, goes by Mateo,
his chosen name, and uses he/him pronouns at school and home. He states that he becomes very
angry when people use his "dead" name or wrong pronoun. He states that he tries to correct the
person, but he gets very frustrated when he must correct the same person repeatedly. The psychiatric
mental
ANSWER
"It's ok if you are angry when people use your dead name."
"I accept your gender identity and I understand that it is difficult when you interact with people
who don't accept who you are."
"It sounds like when people repeatedly use your dead name, you feel like they do not respect
you."
Rationale: Accurate empathic understanding helps the client to value their experiencing and
increase their confidence in pursuing a course of action. The therapist can express
genuineness, or congruence, towards the client. As the psychotherapist openly expresses
feelings, thoughts, and reactions with the client, trust will be generated, and therapy will occur.
During client-centered therapy, the therapist should refrain from offering extensive advice and
allow the client to drive the therapy session but may paraphrase the client's statements and
repeat them to help the client clarify feelings and actions.
, Question 8.
humanistic-existential approach
ANSWER
-foundational to psychiatric mental health nursing
• central tenets of holism, self-actualization, and the therapeutic alliance
-places emphasis on understanding human experience
• focusing on the client rather than the symptom
-Interventions seek to increase client self-awareness and self-understanding
-Holistic
• assumes an interrelationship between the client's psychological, biological, social, and
spiritual dimensions
Question 9.
suicide
ANSWER
-a leading cause of death in the U.S.
-In 2020, suicide was the:
• 12th leading cause of death overall
• 2nd leading cause of death among individuals between the ages of 10 and 34
• 3rd leading cause of death among individuals between the ages of 35 and 44
-clients with mental health diagnoses such as mood disorders, psychotic disorders, and
substance use disorder are at particularly high risk
• 50% of those who die by suicide do not have a previous psychiatric history
Question 10.
Hildegard Peplau therapeutic relationship six nurse roles
ANSWER
• Stranger: Nurse creates an environment to build trust
• Teacher: Nurse imparts relevant knowledge and provides instructions and training
• Resource person: Nurse provides specific information needed by the client, answers
questions, and interprets clinical data
• Counselor: Nurse helps the client understand and integrate meaning into life's circumstances,
provides guidance and encouragement for change
• Surrogate: Nurse helps clarify domains of dependence, interdependence, and independence
and acts as an advocate for the client
• Leader: Helps client take maximum responsibility for meeting treatment goals
