NURS 6640 Midterm Exam Questions with Answers - Latest Update 2023/2024 (100% VERIFIED)

The PMHNP is treating a 35-year-old male officer in the military. He discloses that both of his parents are deceased and that he loved them. However, he says that he had feelings of inadequacy because his parents held him to a standard that he could never achieve. He went on to say that nothing he did ever felt good enough. The PMHNP assesses that this patient has perfect creases in his uniform with no strings or tags out of place; she also notices that he has perfect posture and questions him about ritualistic behaviors. She suspects that this patient has maladaptive responses to the expectations placed on him as a teenager and young adult. Which statements made by the patient would verify the PMHNP’s suspicion? 2. A . “I typically don’t listen to anyone. I take care of my own wants and needs so I feel like no one can judge me or criticize me, period.” B . “I don’t mean to hurt other people’s feelings. When people cry or say that I have made them upset in some way, that’s not my fault; some people are just sensitive.” C . “I like to listen to the beat of my own drum; I don’t mind spending most of my days alone. I don’t need recognition or praise; I would just like to be left alone.” 10 D . “I believe in systems; I have to have order and rules in my everyday life. If a task must be completed, I will often complete it myself versus depending on someone else.” 1 points QUESTION 30 1. The patient attempts the PMHNP’s sleep hygiene recommendations for 2 weeks, but does not make any progress mitigating nightmares and hyperarousal. Which behavioral strategy does the PMHNP suggest next? 2. A . Progressive muscle relaxation exercises B . Paradoxical interventions C . Biofeedback D . All of the above 1 points QUESTION 31 1. The PMHNP is working with a patient who experiences anxiety around her parents that later leads to poor impulse control. What will the PMHNP do to employ psychodynamic psychotherapy properly for this patient? 2. A . Emphasize the past B . Focus on expressions of emotion C . Identify patterns in relationships D . All of the above 1 points QUESTION 32 1. The PMHNP is working with a 56-year-old man who is being seen because of his anxiety and depression. During the therapy sessions, the PMHNP assists the patient in discussing his experiences and expanding on his thoughts and feelings. He tells the PMHNP stories about how he used to be teased by his coworkers at the office for becoming too anxious in large conference rooms. The PMHNP listens to the patient and helps focus on his strengths to promote self-understanding. Which principle best accounts for the PMHNP’s interactions with the patient? 2. A . Therapeutic communication B . Maintaining the frame C Working with resistance 11 . D . None of the above 1 points QUESTION 33 1. The PMHNP is conducting a peer review of another PMHNP’s medical charts. Upon review, the PMHNP notes that the peer often begins patient sessions late, as well as ends them later than scheduled. The PMHNP also found a comment in the chart regarding the patient sending text messages while in the middle of the session. Based on these findings, the feedback that the PMHNP will provide to the peer involves which therapeutic principle? 2. A . Assessing safety B . Applying therapeutic communication C . Using empathy D . Maintaining the frame 32.The PMHNP is mentoring a student. After working with a patient during a session, the student laments about all the things she should have, or could have, said to the patient. “I feel guilty that I didn’t speak up more about the patient’s concern toward her son,” says the student. The PMHNP understands that the student is exhibiting signs of which therapeutic concept? 1 points QUESTION 34 1. During cognitive behavioral therapy (CBT), a 64-year-old male patient states, “I get so frustrated sometimes and I just blow up at everybody!” Which response by the PMHNP demonstrates translation of Socratic dialogue (SD)? 2. A . “Please explain how this affects the relationship with your wife.” B . “When you say blow up, what exactly does blow up mean and how does it feel to you?” C . “What coping methods have you used in the past during times of frustration?” D . “So you blow up when you become frustrated?” 1 points QUESTION 35 1. During a therapy session the patient is asked how she currently deals with stress, and she says, “Well, I don’t. I just let it build and build.” The PMHNP responds by asking how well this has been working out for her. The patient states, “Well, to be honest, it just feels like I’m drowning, you know what I mean.” Illustrating idiosyncratic meaning, the PMHNP responds with: 12 2. A . “Would you say you feel like you are suffocating?” B . “No, I am not sure what you are saying. Can you please explain?” C . “Sort of like a fish out of water?” D . “When you say, ‘I just can’t breathe,’ you do understand, that is a form of anxiety?” 1 points QUESTION 36 1. A PMHNP is preparing confidentiality forms for his patients. What is the most appropriate first step he should take? 2. A . Talk to potential patients to get their feedback and suggestions B . Research his profession’s ethics code and state/federal laws C . Use current patient interactions to decide what matters most D . All of the above 1 points QUESTION 37 1. During a therapy session with an 18-year-old female the PMHNP learns that she has lived in six different foster homes in the last 24 months. She states that her mother is in a correctional facility for drug abuse and prostitution. During the assessment, the PMHNP notices multiple superficial cuts to each wrist. The patient appears tearful, withdrawn, and never makes direct eye contact. The PMHNP believes that this patient may have feelings of insecurities as well as abandonment issues and is aware that which diagnosis is likely possible? 2. A . Narcissistic personality disorder B . Obsessive-compulsive personality disorder C . Borderline personality disorder D . Paranoid personality disorder 1 points QUESTION 38 1. A 62-year-old patient has been diagnosed with borderline personality disorder. Upon assessment, the PMHNP learns that he participates in spending sprees and occasional binge eating, accompanied by rapid changes in self-image. Which evidence-based psychotherapeutic model does the PMHNP identify as effective and beneficial? 13 A . Cognitive behavioral therapy B . Supportive therapy C . Dialectical behavior therapy D . Expressive therapy 1 points QUESTION 39 1. The PMHNP is working with an adult patient who has somatic complaints caused by a history of childhood abuse. As part of the therapeutic process, what does the PMHNP do to assess and organize a trauma history? 2. A . Interview the patient’s family members B . Construct a timeline of the patient’s life C . Review the patient’s current stressors D . Debrief with the patient 1 points QUESTION 40 1. An initial evaluation reveals that an 11-year-old patient has moved to a new school after her parents’ recent divorce, and is having trouble making friends. The patient has normal mental status and exhibits appropriate behavior. What is the most appropriate scale for the PMHNP to use to get more information? 2. A . Young Mania Rating Scale B . Hamilton Anxiety Rating Scale C . Dissociative Experiences Scale D . Impact of Event Scale 1 points QUESTION 41 1. A middle-aged man who works over 50 hours a week is being seen for depression and anger management. He states, “I am even more frustrated when I come home and my wife wants to argue about stupid stuff. All I want to do is come home, take a shower, and eat. Is that too much to ask?” The PMHNP explains that people can be assertive, aggressive, and passive. She encourages the patient to be more assertive and begins role-play with 14 assertive training. The PMHNP determines that the patient is beginning to understand when he states: 2. A . “I am tired, I work very hard all day to support you and this family!” B . “I come home and all you do is argue, but I don’t care.” C . “I don’t know what I did. Why are you acting like this?!” D . “I feel frustrated when I come home and we argue.” 1 points QUESTION 42 1. The PMHNP employs psychodynamic psychotherapy with a patient who experiences anxiety and depression. As the process enters the psychoanalytic end of the psychodynamic continuum, the PMNHP will focus on: 2. A . Interpreting unconscious conflict in the patient B . Restoring the patient’s functioning and stabilization C . Reducing the patient’s anxiety D . Strengthening the patient’s defenses 1 points QUESTION 43 1. A 16-year-old female patient has had a stable therapeutic relationship with the PMHNP for several months. The PMHNP notices what appears to be fresh cigarette burns on the patient’s arm. When asked, the patient admits to this self-injurious behavior. Although the patient is still depressed, her mood seems to be somewhat better this week. True or false: The PMHNP would most likely consider this patient stabilized and ready to move to Stage II. True False 1 points QUESTION 44 1. The PMHNP is working with a patient who seems dissatisfied with the therapeutic relationship. The PMHNP invites the patient to discuss her feelings regarding the PMHNP openly and honestly. It becomes clear to the PMHNP that they are experiencing an alliance rupture. How does the PMHNP repair the therapeutic alliance? 2. A . Responding to the patient in a nondefensive manner and accepting responsibility for the PMHNP’s part in the tension B Emphasizing with the patient’s experiences and validating the patient for 15 . bringing it up C . Considering changing the goals of the patient’s treatment D . All of the above 1 points QUESTION 45 1. When a PMHNP is seeing a patient for the first time, what is an important step to assure that the patient and provider understand the limits of their discussion? 2. A . Assure the patient that she is safe to discuss her secrets B . Talk about the importance of being truthful and open C . Have a discussion about the confidentiality and its limits D . Mention the possible need for selective selfdisclosure 1 points QUESTION 46 1. The PMHNP is caring for a patient with dissociated self-state that the PMHNP identifies as being associated with traumatic experiences in the patient’s past. What approach does the PMHNP use with the patient that is crucial to the psychodynamic therapy process? 2. A . Assisting the patient to experience and accept the various dimensions of the self through enhanced awareness of the traumatic states B . Becoming a co-participant in the co-construction of the relationship with the patient, rather than an outside observer C . Making associations between an event or situation and the patient’s feelings D . Providing empathy, understanding, and soothing to help the patient identify the other self-states 1 points QUESTION 47 1. A PMHNP is treating a 50-year-old patient who suffers from depression. When he was growing up, he was often responsible for taking care of his three younger siblings. Since then, the patient puts other people’s needs before his own. Based on this information, the PMHNP would conclude that his interpersonal style is __________. A . overly nurturing B . nonassertive C . exploitable 16 D . vindictive 1 points QUESTION 48 1. The PMHNP is caring for a patient who seems to seek affection and attention from the PMHNP and others in the clinic, as well as displays heightened emotional responses to feelings of being excluded. What therapeutic approach does the PMHNP use to decrease autonomic arousal in the patient? 2. A . Group therapy B . Controlled confrontation C . A safe-place exercise D . Body and energy work 1 points QUESTION 49 1. The PMHNP has been assisting a shy and timid 23-year-old male patient struggling with esteem and self-concept issues. Over the weekend, this patient was given the task of completing an exercise that would usually cause him distress and shame, also called a shame-attacking exercise. The PMHNP determines that this task has successfully been achieved when the patient states: 2. A . “I was able to eat in public yesterday despite how loudly I chew.” B . “I confessed all of my infidelities to my ex-spouse yesterday.” C . “I calmly sat through a conversation with my spouse in which she confessed all of her infidelities to me.” D . “I journaled the shame and guilt that I’ve been feeling from my past that has been holding me back.” 1 points QUESTION 50 1. A PMHNP’s patients have already signed confidentiality agreements, including limits that will be imposed on confidentiality. Months later, the state’s laws have changed that affect confidentiality promises the PMHNP has already made. What is an appropriate step for the PMHNP to take after finding out this information? 2. A . Revise intake forms to align with state laws B . Review confidentiality revisions with 17 patients C . Have patients give informed consent again D . All of the above 1 points QUESTION 51 1. One of the strategies the PMHNP wants to try includes sleep restriction. What will the PMHNP suggest to follow sleep restriction therapy? 2. A . “Restrict sleep for 24 hours.” B . “Restrict the amount of time you spend in bed.” C . “Restrict the amount of exercise you do prior to going to bed.” D . “Restrict the amount of food you eat before bedtime.” 1 points QUESTION 52 1. The PMHNP is having a therapy session with Charlotte, a 20-year-old victim of date rape. The patient states, “I shouldn’t have been there; I should have just gone home. This was all my fault; how could I have been so stupid?” Using the Socratic method, what is the PMHNP’s best response? 2. A . “If this had happened to someone else with the exact same circumstances, would you say this was her fault?” B . “Can you recall exactly what stopped you from going home when you originally wanted to go home?” C . ”Have you shared these thoughts about what you should have done with anybody other than me?” D . “Do you understand that there is absolutely nothing that you could ever do to deserve to be treated the way you were treated?” 1 points QUESTION 53 1. The PMHNP is caring for a patient who has acute stress disorder after experiencing a traumatic event 1 week prior. The PMHNP wants to begin with a therapeutic framework that follows the adaptive information processing (AIP) model. What is the priority action for the PMHNP to take? 2. A . Focus on the patient’s safety and stabilization B . Help the patient process painful memories C . Encourage the patient to find ways to achieve personal growth D Assist the patient in planning for the futur