Exam (elaborations) NUR 6650 final exam

Exam (elaborations) NUR 6650 final exam In a group therapy session for adolescents, a 15-year-old patient says he has trouble making conversation with people he does not know well. Based on the principle of development of socializing techniques, what explicit approach might the PMHNP take? Selected Answer: C. Have group members conduct a role play to practice making conversation  Question 2 1 out of 1 points One group member is identified by the PMHNP as the monopolist of the group. Which behavior does the PMHNP believe this member is most likely to display? Selected Answer: B. Talking excessively and inserting him- or herself into conversations even when they do not involve him or her  Question 3 1 out of 1 points During a first group therapy session, a member is outgoing and participates actively. Based on this information, what is an appropriate prediction about this group member by the PMHNP? Selected Answer: B. The member may be influential in the group.  Question 4 1 out of 1 points A 21-year-old client with narcissistic traits is noted to continuously disrupt the group by speaking while others are speaking. It becomes evident that the client is purposely disrupting the group and decreasing the group’s productivity. What does the PMHNP identify as a cause of the client’s behavior? Selected Answer: A. The client has a fear of losing his or her identity.  Question 5 1 out of 1 points Harold Wyman is a 74-year-old man who is trying to mend a relationship with his adult daughter. Based on his intake assessment, the PMHNP believes that the father has depression. The daughter and Harold meet with the PMNHP, and the daughter explains that her father always appears mopey and withdrawn and refuses to do anything about it. When asked, the father reports feeling sad all the time. Which action will the PMNHP employ with Harold using the interpersonal NUR 6650 final exam psychotherapy approach throughout the various sessions? Selected Answer: D. All of the above  Question 6 1 out of 1 points A PMHNP is leading a group therapy session for patients with substance abuse problems. After a productive session in which all members participated, the following week was not as productive. In order to help the group members assume responsibility for evaluating the meeting, what is an appropriate comment for the PMHNP to make? Selected Answer: A. “How would you compare today’s meeting with last week’s?”  Question 7 1 out of 1 points During the “mid-group debrief” the clinical supervisor focused on the following areas with the two counselors except: Selected Answer: B. The mistakes that they made in the group and how they can fix them.  Question 8 1 out of 1 points The social microcosm theory is a theory that relates to group composition. In accordance with this theory, the PMHNP is aware that the group must consist of which of the following? Selected Answer: A. Males and females of different ages, education levels, socioeconomic statuses, and professions  Question 9 0 out of 1 points Peter, a successful businessman, is introduced to the group during the twelfth week. Following Peter’s introduction, Joseph, a long-term member in the group, begins to lead the group and discuss all of the things that he has personally accomplished. In what way does the PMHNP correctly interpret Joseph’s behavior? Selected Answer: Joseph wants to show Peter how much he has grown since joining the group.  Question 10 0 out of 1 points The PMHNP conducts a specialized individual interview with a patient named Sandy. During this interview, Sandy expresses her want of the other members to like her, and she has a deep dread for the first group meeting. How does the PMHNP correctly interpret Sandy’s interpersonal circumplex? Selected Answer: D. Sandy is likely to prematurely view members of the group as hostile.  Question 11 1 out of 1 points When discussing the role of the consultant in the parenting group session, Dr. Carlson explains that the consultant should use several skills in order to help keep the group going and should enable group members to become very engaged with one another. The consultant should use all of the following skills to achieve this, except: Selected Answer: C. Achieving the pre-determined agenda by manipulating questions and session content  Question 12 1 out of 1 points A PMHNP is meeting with parents and their 10-year-old child. The child is having trouble paying attention at school and has been getting easily frustrated at home when doing homework, which often results in everyone arguing. What step might the PMHNP take as part of a family-centered, solution-oriented approach? Selected Answer: D. All of the above  Question 13 0 out of 1 points The PMHNP is meeting with an adult woman and her father, who is 85 years old. The father stays quiet most of the session. The daughter explains he is mad at her for “bringing him to a see a shrink.” The daughter reports that things have been tense in the house since her father moved in. The father has a history of depression, though he does not take any medication for it. In addition, lately the father seems to never sleep. “I hear him rummaging around in the kitchen, the garage, the living room, at all hours of the night. Sometimes he’ll nap during the day, but not much. This is putting a strain on my marriage, because my husband can’t sleep with all of this going on.” Which therapeutic approach does the PMHNP identify as most appropriate for the 85-year-old father? Selected Answer: C. Reminiscence and life review therapy  Question 14 1 out of 1 points During an initial meeting, a PMHNP spends time speaking with a patient who suffers from social anxiety. The therapist finds the patient extremely loud and overbearing. The PMHNP’s negative feelings continue no matter how hard he or she tries to feel differently toward the patient. What is the most appropriate next step by the PMHNP? Selected Answer: C. Refer the patient to another therapist who has a suitable therapy group  Question 15 1 out of 1 points A patient has had a problem with substance use and has been receiving treatment for addiction. Which additional step might the PMHMP suggest to help the patient maintain abstinence from drugs during and after treatment? Selected Answer: A. Narcotics Anonymous  Question 16 0 out of 1 points The leader begins a group meeting by doing the “names activity.” At the completion of the activity, the leader explains that the activity is useful for all of the following reasons, except: Selected Answer: A. To help individuals see how unique they are and how they “personalize” themselves through unique variations of their name.  Question 17 1 out of 1 points A 36-year-old client attends group therapy regularly but is consistently tardy. The client explains that job and family obligations interfere with attendance to the group. What is the most appropriate intervention by the PMHNP? Selected Answer: B. Explain to the client that he or she has been referred to individual therapy  Question 18 0 out of 1 points Group participation is an important aspect of how successful group therapy will be. The PMHNP recognizes that the gender of group participants can play a role in the likelihood of group participation. Which statement about gender and group composition does the PMHNP take into account? Selected Answer: D. Women in evenly mixed groups are equally as active as they are in all-female groups.  Question 19 0 out of 1 points When the counselor discussed assertiveness with the group members, she began the session by providing definitions and asking group members to line up consistent with where they feel they are currently in terms of assertiveness. Why did she do this? Selected Answer: A. To encourage individuals to adjust where they are in terms of assertiveness by having less assertive people change their spot in line  Question 20 1 out of 1 points A patient in group therapy named Ted shares personal information for the first time. He seems nervous but continues to talk. How might the PMHNP use nonverbal positive reinforcement to support Ted’s feeling more comfortable? Selected Answer: C. Leaning forward and nodding as Ted shares his story  Question 21 1 out of 1 points Members of a therapy group have been meeting for several months. During group therapy, a patient is bossy and controlling. During this week’s session, she is confronted by another group member about her behavior and replies, “This is not how I normally act. You are not my family and friends. I don’t act the same way around them.” What can the PMHNP deduce from her behavior? Selected Answer: B. She is displaying her true interpersonal behavior.  Question 22 1 out of 1 points A PNHNP is holding a group therapy session for a father and his 10-year-old son, whom the father explains has been acting out lately. The son says, “He is always telling me what to do and never listens when I have an idea.” Which solution would the PMHNP most likely suggest as an approach to the problem? Selected Answer: A. Role-playing exercises  Question 23 0 out of 1 points A PMHNP is treating a patient in individual therapy and thinks the patient may be a good candidate for group therapy. The patient is motivated to start group therapy, which meets twice a month. Then the patient adds, “I can come to the first two meetings, but then will be away on business for at least a month, maybe longer. But then I can come to the at least one meeting before my next trip.” Based on this information, what is the most likely recommendation by the PMHNP? Selected Answer: Give her the go-ahead to start group therapy immediately while she is motivated  Question 24 1 out of 1 points Members of a therapy group have been meeting for several weeks. While a member named Margaret is talking about how her spouse ignores her when she tries to tell him what to do, another member named Nicole interrupts and says, “Maybe he thinks you are being bossy.” Margaret replies by saying, “At least I’m not an alcoholic like you are!” What is an appropriate response by the PMHNP? Selected Answer: D. All of the above  Question 25 1 out of 1 points A 9-year-old child who witnessed a fatal car accident has come to therapy with her parents to get treatment. The child has been irritable since the event and has not wanted to talk about it. Utilizing a trauma-focused cognitive behavior therapy (TFCBT) approach, the PMHNP has reviewed skills that the parents may use to help their child at home. Based on the PMHNP’s suggestion, which is a statement the parents might make after the child has a temper tantrum? Selected Answer: B. “We are impressed with how quickly you calmed yourself after you were upset.”  Question 26 0 out of 1 points During the first group meeting, a client states, “I am here because I am very shy. I don’t mesh well with others and I rarely get invitations to go anywhere.” Which statement about the client’s reason for seeking help and treatment best applies? Selected Answer: C. The client is aware of his or her current issue and will do very well in group therapy.  Question 27 1 out of 1 points A client is observed discussing many problems and complaints during group therapy. However, when other group members attempt to offer advice, the client does not accept it. Based on this observation, what can the PMHNP determine about the client? Selected Answer: C. The client is a help-rejecting client and will continue to present problems and then refuse the help of others.  Question 28 1 out of 1 points During a group therapy session, a member comments that another member named Ted had no compassion. Ted replies, “Why does it matter if I care one way or another. I can’t solve their problems.” The other member starts crying and blames Ted for this. He shrugs and answers, “I don’t understand why you are crying.” Based on this information, what is the most likely determination the PMHNP can make about Ted? Selected Answer: C. He is protecting himself from group behaviors/emotions.  Question 29 1 out of 1 points Jane has been attending group therapy for the past year; she and the therapist have determined that she has met her goals. Jane has been arriving to group late or not coming to group at all. How does the PMHNP correctly interpret Jane’s behavior? Selected Answer: D. Jane is showing signs of regression due to the termination phase.  Question 30 1 out of 1 points A PMHNP is treating an 8-year-old child who was at a cousin’s house during a domestic violence situation. Using a common factors model, the PMHNP wants to pay attention to cultivating the relationship with the parents and child. After the child talks about how nervous he or she has been since witnessing the trauma, what is an appropriate response by the PMHNP? Selected Answer: D. All of the above  Question 31 1 out of 1 points The PMHNP is meeting with a married couple. The husband is 81 years old, and the wife is 78 years old. They tell the PMHNP that many of their friends have passed away over the last couple of years, and it’s making them feel sentimental about their lives and the fact that they are getting older. Hearing this, the PMHNP uses a life review approach with the couple. What action will the PMHNP employ? Selected Answer: C. Having the husband and wife recall the happy and sad times they had in their lifetime  Question 32 0 out of 1 points A patient in group therapy for people dealing with panic disorder is describing a recent panic attack. He says, “During this attack, I felt like I was dying.” What is an appropriate response by the PMHNP using didactic instruction? Selected Answer: D. All of the above  Question 33 1 out of 1 points A patient in group therapy discloses her concern about feeling suicidal again in the future. Using the principle of universality, what is an appropriate step by the PMHNP? Selected Answer: A. Encourage other members who have similar concerns to share their feelings  Question 34 0 out of 1 points The PMHNP recognizes that extragroup behavior involves behavior that occurs outside of the group or during subgrouping. Which statement best describes extragroup behavior as it pertains to group therapy? Selected Answer: D. Extragroup behavior can occur in all levels of group therapy.  Question 35 1 out of 1 points In a group therapy session for patients with anxiety problems, a patient named Eve was afraid to disclose to the other members that she was a victim of sexual abuse. She kept the secret for months, although she hinted at it to other members. During a meeting, another member tried to pressure Eve to disclose her secret, but she was flustered and not ready to share. What is an appropriate response by the PMHNP? Selected Answer: D. Tell the group it is OK that Eve does not yet feel safe enough to share  Question 36 1 out of 1 points During his second group therapy session, a member, who was quiet the previous week, becomes very judgmental. He criticizes another member by saying, “Mary, you are always late because you don’t respect our group.” Then he adds, “In fact, all of you are disrespectful and uncaring.” What is an appropriate step by the PMHNP? Selected Answer: D. All of the above  Question 37 1 out of 1 points A patient who has been depressed is seeing a PMHNP for individual therapy. The patient explains that he has been avoiding most social activities for the past few months. He is divorced and has joint custody of his 10-year-old daughter. Based on this information, what recommendation by the PMHNP would most benefit the patient? Selected Answer: B. Group therapy  Question 38 1 out of 1 points Following the PMHNP’s cancellation of a group session, he or she notices a decrease in compliance and attendance within the group. What does the PMHNP identify as the group’s reason for noncompliance? Selected Answer: B. The group members may believe that the group is not important to the PMHNP.  Question 39 1 out of 1 points A PNHNP is holding a group therapy session. Today, several members have expressed fears about being unlovable. Based on this information, what is an appropriate step by the PMHNP to raise the members’ self-esteem? Selected Answer: D. All of the above  Question 40 0 out of 1 points A patient named Tyrone was nervous sharing personal information with the group. To compensate, he makes comments on other members’ problems as if he were the therapist. Another member of the group asked him, “Do you think you’re better than everyone here?” What might the PMHNP help Tyrone gain from this exchange? Selected Answer: A. Understanding of his transference problem  Question 41 0 out of 1 points A PMHNP is creating a therapy group and is including a patient with borderline personality disorder. Which action would most likely reduce the patient’s chance of separation anxiety? Selected Answer: D. All of the above  Question 42 0 out of 1 points The anticipation of the first meeting among psychotherapy group attendees may cause feelings of dread and uneasiness among clients. How does the PMHNP demonstrate awareness and promote the success of this first psychotherapy meeting? Selected Answer: D. By asking each member what his or her fears are as he or she joins the group  Question 43 1 out of 1 points For several months, a patient in group therapy always participated in conversation but only shared positive stories about her own life. During the next session, she finally confessed that she has been depressed and cutting herself. What is the best response by the PMHNP? Selected Answer: C. “You must feel comfortable with the group now to share this with us.”  Question 44 0 out of 1 points Two PMHNPs are in charge of a therapy group that has experienced several maladaptive interpersonal dramas lately. One of the patients has been described by other members as argumentative. After a particularly awkward session, one of the therapists feels that his own interpersonal distortion of the session may be clouding his observation. What is an appropriate step by that PMHNP? Selected Answer: D. Suggest that the argumentative group member come to individual therapy  Question 45