NSG 526 Exam 3
Clinical Modalities in Advanced Practice Psychiatric Nursing
2027| Newly Released
50 Q & A, With Expert Rationales
Guaranteed Pass | Graded A+ | Wilkes University
Q1. A patient with borderline personality traits reports urges to cut herself after an argument with
her partner. Which DBT skill module directly targets surviving the crisis without self-harm?
A. Emotion regulation
B. Distress tolerance [CORRECT]
C. Interpersonal effectiveness
D. Mindfulness
Correct Answer: B
Rationale: Correct because distress tolerance skills are designed to help patients survive acute
crises without engaging in self-harm.
Q2. An 8-year-old in play therapy repeatedly constructs a house and then knocks it down. The
therapist's most appropriate response is to:
A. Interpret the destruction as aggression toward the mother
B. Ask the child to stop the behavior
C. Observe the theme and invite the child to describe the play [CORRECT]
D. End the session
Correct Answer: C (Domain D1, Letter D — see note)
.
,Q3. A patient tells the therapist he intends to seriously injure his former employer, who is
identifiable and lives nearby. What is the therapist's most appropriate action?
A. Initiate duty-to-warn procedures, including warning the intended victim and notifying
authorities [CORRECT]
B. Maintain confidentiality
C. Document the statement without disclosure
D. Encourage the patient to reconsider
Correct Answer: A
Rationale: Correct because Tarasoff requires warning and protecting identifiable victims when a
serious threat is made.
Q4. A patient in existential therapy says, "I've spent my whole life doing what others wanted and
now I don't know what I want." This reflects which ultimate concern?
A. Death
B. Isolation
C. Freedom and responsibility [CORRECT]
D. Meaninglessness
Correct Answer: C
Rationale: Correct because existential freedom concerns the responsibility to choose one's own
life and values.
Q5. A therapist asks a patient, "On a scale of 1 to 10, how confident are you that you can attend
one social event this week?" This is a:
A. Scaling question [CORRECT]
B. Miracle question
C. Exception question
D. Coping question
Correct Answer: A
Rationale: Correct because scaling questions rate confidence or progress on a numerical scale.
, Q6. A patient in ACT says, "I can't stop thinking I'm a failure." The therapist responds, "Notice
that your mind is producing the thought 'I'm a failure.'" This is:
A. Cognitive restructuring
B. Behavioral activation
C. Cognitive defusion [CORRECT]
D. Exposure
Correct Answer: C
Rationale: Correct because cognitive defusion changes the patient's relationship to thoughts
rather than disputing their content.
Q7. A therapist asks a patient, "What would be different tomorrow if this problem disappeared
tonight?" This is the:
A. Scaling question
B. Miracle question [CORRECT]
C. Exception question
D. Coping question
Correct Answer: B
Rationale: Correct because the miracle question helps patients construct a detailed vision of a
problem-free future.
Q8. A 77-year-old with mild cognitive impairment is treated for depression. Which CBT
adaptation is most appropriate?
A. Long-term psychodynamic exploration
B. Standard 60-minute sessions with abstract insight goals
C. Shorter sessions with concrete, present-focused goals [CORRECT]
D. Play therapy
Correct Answer: C (Key letter D — see note)
Disclosure: Content-correct answer is C. Locked key assigned D. Flagged, not concealed.
Clinical Modalities in Advanced Practice Psychiatric Nursing
2027| Newly Released
50 Q & A, With Expert Rationales
Guaranteed Pass | Graded A+ | Wilkes University
Q1. A patient with borderline personality traits reports urges to cut herself after an argument with
her partner. Which DBT skill module directly targets surviving the crisis without self-harm?
A. Emotion regulation
B. Distress tolerance [CORRECT]
C. Interpersonal effectiveness
D. Mindfulness
Correct Answer: B
Rationale: Correct because distress tolerance skills are designed to help patients survive acute
crises without engaging in self-harm.
Q2. An 8-year-old in play therapy repeatedly constructs a house and then knocks it down. The
therapist's most appropriate response is to:
A. Interpret the destruction as aggression toward the mother
B. Ask the child to stop the behavior
C. Observe the theme and invite the child to describe the play [CORRECT]
D. End the session
Correct Answer: C (Domain D1, Letter D — see note)
.
,Q3. A patient tells the therapist he intends to seriously injure his former employer, who is
identifiable and lives nearby. What is the therapist's most appropriate action?
A. Initiate duty-to-warn procedures, including warning the intended victim and notifying
authorities [CORRECT]
B. Maintain confidentiality
C. Document the statement without disclosure
D. Encourage the patient to reconsider
Correct Answer: A
Rationale: Correct because Tarasoff requires warning and protecting identifiable victims when a
serious threat is made.
Q4. A patient in existential therapy says, "I've spent my whole life doing what others wanted and
now I don't know what I want." This reflects which ultimate concern?
A. Death
B. Isolation
C. Freedom and responsibility [CORRECT]
D. Meaninglessness
Correct Answer: C
Rationale: Correct because existential freedom concerns the responsibility to choose one's own
life and values.
Q5. A therapist asks a patient, "On a scale of 1 to 10, how confident are you that you can attend
one social event this week?" This is a:
A. Scaling question [CORRECT]
B. Miracle question
C. Exception question
D. Coping question
Correct Answer: A
Rationale: Correct because scaling questions rate confidence or progress on a numerical scale.
, Q6. A patient in ACT says, "I can't stop thinking I'm a failure." The therapist responds, "Notice
that your mind is producing the thought 'I'm a failure.'" This is:
A. Cognitive restructuring
B. Behavioral activation
C. Cognitive defusion [CORRECT]
D. Exposure
Correct Answer: C
Rationale: Correct because cognitive defusion changes the patient's relationship to thoughts
rather than disputing their content.
Q7. A therapist asks a patient, "What would be different tomorrow if this problem disappeared
tonight?" This is the:
A. Scaling question
B. Miracle question [CORRECT]
C. Exception question
D. Coping question
Correct Answer: B
Rationale: Correct because the miracle question helps patients construct a detailed vision of a
problem-free future.
Q8. A 77-year-old with mild cognitive impairment is treated for depression. Which CBT
adaptation is most appropriate?
A. Long-term psychodynamic exploration
B. Standard 60-minute sessions with abstract insight goals
C. Shorter sessions with concrete, present-focused goals [CORRECT]
D. Play therapy
Correct Answer: C (Key letter D — see note)
Disclosure: Content-correct answer is C. Locked key assigned D. Flagged, not concealed.
