NRNP 6645 Final Exam Review Test Submission Exam - Week 11

The advanced practice psychiatric nurse encourages a patient with gambling addiction to develop a relapse prevention plan. Which of the following is true about a relapse prevention plan? Which of the following is consistent with the psychotherapeutic approach used by existential psychotherapists? Review Test Submission: Exam - Week 11 lOMoARcPSD| A Shame drives a person to engage in treatment while guilt drives a person to avoid . treatment. B Shame causes a person to perceive self as a failure and guilt causes avoidance of . treatment. C Guilt causes a person to perceive himself as a loser and shame drives a person to . avoid treatment. D Shame drives avoidance from treatment, Guilt often motivates a person to seek . treatment. A Relapse indicates treatment failure. . B Relapse is a persistent risk in addiction. . C Relapse is a characteristic of all chronic medical diseases. . D Relapse is the return to substance use or addictive behaviors after periods . of abstinence. A IPT is not an appropriate model for treating depression in older adults. . B This is a common IPT issue with older adults during the initial sessions. . C The advanced practice psychiatric nurse should consider using a standardized scale . to quantify the depression and use this to educate the patient and the family. D B and C . According to Dearing, Stuewig, and Tangney (2005), understanding the difference between guilt and shame and its impact on an individual’s motivation is critical to hope and the recovery process. Which of the following is true regarding guilt and shame? Which of the following is not consistent with what is known about relapse? The advanced practice psychiatric nurse proficient in Interpersonal Psychotherapy (IPT) is working with an older adult who does not realize she has depression. Which of the following is true? The patient in Dialectical Behavior Therapy (DBT) complains the skills being taught in DBT don’t work, struggles with keeping diary cards, and doing assigned homework. This is consistent with which stage of treatment within the DBT model? C The existential therapist presents broad existential themes but avoids in-depth . questioning. D The existential psychotherapist is free to draw on techniques from other . psychotherapeutic models . lOMoARcPSD| A Freedom . B Responsibili . ty C Authenticity . D Meaning . A In family-centered treatment, the family is the focus of treatment. . B Family- centered treatment is appropriate to improve family interactions. . C Family-centered treatment is appropriate to keep families engaged in services . D Family-centered treatment is appropriate to increase family knowledge about . mental health. A Focusing . B Body awareness . C Language of . responsibility The existential concept of an openness, readiness, and flexibility to grow and change, which necessitates a capacity to choose alternatives, and shape one’s own destiny as authors of creating their own world is which of the following? Which of the following is not consistent with a family-centered approach in child therapy? The Gestalt therapist notices the patient is fidgeting with fingers, legs are shaking and asks the patient “What are you experiencing right now in your body?” This is a type of creative experimentation known as which of the following? A Stage . 1 B Stage . 2 C Stage . 3 D Stage . 4 lOMoARcPSD| A Given concerns about relapse it would be important to meet with the patient just this . one time and just for 10 minutes but meet in your office. B Remind the patient that one of the rules is not having contact outside of therapy . sessions. C Agree to meet with patient alone in the group room to resolve any outstanding . concerns from the group. D Agree to meet with the patient at Starbucks briefly to discuss the unresolved issues, . but only this once and only for 10 minutes. A People are unique. . B The whole is greater than the sum of its parts. . C Mind, body, spirit work in a unified synergistic . fashion. D Dysfunctions such as a chemical imbalance . must be A People are unique. . B The whole is greater than the sum of its parts. . C Mind, body, spirit work in a unified synergistic . fashion. The advanced practice psychiatric nurse is working with a group of patients in an outpatient substance abuse treatment program. One patient comes to the advanced practice psychiatric nurse after the group session and asks if the advanced practice psychiatric nurse would meet at a nearby Starbucks to clarify a couple of questions that came up at the end of the session and fears relapse. Which of the following would be consistent with the traditional therapeutic frame? Which of the following statements would not be consistent with the humanistic-existential concept of “holism” ? Which of the following statements would not be consistent with the humanistic-existential concept of “holism” ? D Empty-chair dialogue . lOMoARcPSD| A Projection . B Retroflecti . on C Confluenc . e D Deflection . Stigma of mental illness in the elderly: A Has contributed to psychiatric symptoms being expressed with . physical symptoms. B Is much more severe in baby boomers than in other elderly cohorts. . C Is much less an issue in baby boomers than in other elderly cohorts . D Leads to more discussion of emotions in primary care settings. . The advanced practice psychiatric nurse encourages the older adult to recall long forgotten experiences, events which are memorable to the person. This is known as The advanced practice psychiatric nurse is working with a patient who states she believes her boss hates her. After some discussion, it is clear the patient has strong negative feelings towards her boss. The advanced practice psychiatric nurse working within a Gestalt framework, recognizes this as an interruption consistent with which of the following? The most effective treatment for SUD with or without co-morbid psychiatric disorders is: D Dysfunctions such as a chemical imbalance must be . identified. A Life Review Therapy (LRT) . B Reminiscence Therapy (RT) . C A Mindfulness Strategy . D Interpersonal Psychotherapy . (IPT) A Multidimensional addressing medical, psychosocial and mental . health issues B Trauma-informed care. . C 12-Step Peer Support Groups lOMoARcPSD| A Valuing the significance of relationships . B Recognizing generalized psychobiological attributes and . healthcare needs. C Minimizing focus on societal roles and gender expectations. . D All of the above . A Shame-Attacking . B Exposure Therapy . C Cognitive Rehearsal . D Guided relaxation and . meditation A j Drink a glass of water, tea, or . uice. B Name 6 colors you see wherever . you are. C Open and close your eyes. . D A and B on . A Somatic approaches . Positive substance use disorder treatment out-comes unique to women can be strengthened by which of the following. A specific type of CBT therapies aimed to reduce distress as a person experiences sensation with danger is known as which of the following? Which of the following are “Help Now!” skills? Select all that apply. Practice guidelines for complex trauma and dissociative identity disorder caution that which of the following may limit one’s ability to heal. . D Cognitive Behavioral Therapy . lOMoARcPSD| A Conduct Disorders . B Anxiety and Depression . C Depression and Psychosis . D Attention Deficit-Hyperactivity . Disorders A Patients can fail in therapy. . B Patients are doing the best they can. • Question 20 of 101 • Moving to another question will save this response. Question 20 In following the rules for the Dialectical Behavior Therapy (DBT) therapist, the therapist would not do which of the following? A Recognize the therapist is human and fallible. . B Make every reasonable effort to provide competent treatment for the patient. . C Share the rules for the DBT therapist with the patient during orientation to the . therapy. D The therapist agrees to use consultation and allow the patient to view this . directly if desired. Research suggests that psychodynamic therapeutic approaches are effective for some children, particularly those with which of the following disorders? When using a Dialectical Behavior Therapy (DBT) approach with a patient with Borderline Personality Disorder the advanced practice psychiatric nurse knows which of the following is inconsistent DBT assumptions about patients? B Talk therapies focused on cognitive . understanding C EMDR . D A and C . lOMoARcPSD| A The patient is ready to focus on self-fulfillment . B The patient is ready to focus on self-efficacy . C The patient is ready to begin exposure . therapy. D The patient is ready to begin termination from . therapy. A The advanced practice psychiatric nurse needs to develop a checklist to determine . goals have been made and it is time to terminate. The advanced practice psychiatric nurse determines therapy goals attained, B terminate the therapeutic relationship, and schedule to meet the patient for coffee to . ease the transition out of therapy. C The advanced practice psychiatric nurse should set clear therapy goals, commend . patient on goal attainment and terminate the therapy. D Termination should occur by mutual decision between advanced practice psychiatric . nurse and patient based on the therapy goals attained. A The advanced practice psychiatric nurse needs to develop a checklist to determine . goals have been made and it is time to terminate. The advanced practice psychiatric nurse determines therapy goals attained, B terminate the therapeutic relationship, and schedule to meet the patient for coffee to . ease the transition out of therapy. C The advanced practice psychiatric nurse should set clear therapy goals, commend . patient on goal attainment and terminate the therapy. The patient in Dialectical Behavior Therapy with a history of self-harming through cutting, has shown progress in effectively using skills to manage urges integrating skills to manage emotions and behaviors with increased awareness of self. The advanced practice psychiatric nurse recognizes the patient is ready for which of the following? Strategies for terminating a therapy relationship with an older adult includes: Strategies for terminating a therapy relationship with an older adult includes: . C Patients need to do better, try harder and be more motived to change. . D Patients may not have caused all their problems, but they need to solve . them anyway. lOMoARcPSD| A Congruence . B Unconditional positive . regard C Accurate empathic . understanding D All of the above . A Stage . 1 B Stage . 2 C Stage . 3 D Stage . 4 The advanced practice psychiatric nurse using a Dialectical Behavior Therapy approach with a patient with Borderline Personality Disorder explains the four essential elements which includes all but which of the following? during treatment. . A Treatment needs to be readily accessible. . B Psychotropic medication should be stopped prior to treatment. . C Treatment does not need to be voluntary to be effective. . D Drug use during treatment must be monitored continuously as lapses may occur The person-centered therapist is expected to exhibit which of the following characteristics? The patient demonstrates the ability to regulate his emotions in such a way he can think through them. The advanced practice psychiatric nurse using a Dialectical Behavior Therapy approach recognizes this ability is consistent with which stage of treatment? Which of the following is not consistent with the Principles of Effective Treatment for Addiction according to the NIH? A Bi-weekly individual therapy sessions for the patient of about 1 hour each. . D Termination should occur by mutual decision between advanced practice psychiatric . nurse and patient based on the therapy goals attained. lOMoARcPSD| A Women seeking treatment for substance use disorder are more likely than men to . have experienced traumatic events. B Women are more apt to drop out of treatment than men. . C Women are less likely than men to seek mental health services. . D W . A Evidence suggests the substance use issues be addressed first as substances can . mask the issues and symptoms of PTSD. B Evidence suggests symptoms of PTSD be addressed before initiating any substance . abuse issues as PTSD symptoms are what typically trigger substance abuse. C Clinicians need to learn evidence-based treatment approaches to simultaneously . treat the underlying PTSA while addressing substance use. D Evidence suggests a low dose antipsychotic medication is most effective in treating . PTSD symptoms and can also minimize alcohol and other drug abuse. A Invite the patient to new ways of viewing a situation . B Guiding patient to develop more skills to achieve a greater . quality of life. C Engage the patient in change talk . D A and B . B Weekly group skills training sessions for the patient of 2.5 hours each. . C Skills coaching via telephone or other electronic means as needed by the patient to . manage I vivo situations D Team consultation to the therapist to maintain treatment fidelity and adherence . Evidence supports which of the following statements about women and addictions treatment? Which of the following statements would be consistent with Trauma-Informed Care when treating patients with comorbid PTSD and Substance Use Disorder? he advanced practice psychiatric nurse using Dialectical Behavior Therapy with a patient with borderline personality disorder uses persuasive dialogue to do which of the following? A patient whose husband had recently died suddenly expresses remorse regarding an argument they had shortly before his death. The Gestalt Therapist would likely use which of the following techniques to complete unfinished business? lOMoARcPSD| A Schizophrenia . B New onset depression . C Bipolar Affective Disorder . D Borderline Personality . Disorder A Aggression . B Conduct . Problems C Social . Withdrawal D All of the . above. A CPT . B CPT-PE . C EMDR therapy . D Pharmacological . interventions. Evidence supports use of Dialectical Behavior Therapy patients with which of the following diagnoses? Problems in the preschool child’s self-regulation has been tied to subsequent issues with which of the following? Which of the following would not be a first-line intervention for an individual with PTSD? The advanced practice psychiatric nurse working with children/adolescents in psychotherapy is aware of which of the following? A Focusing . B Dreamwork . C Empty-chair dialogue . D Language of . responsibility lOMoARcPSD| A Address safety issues . B Promote symptoms . stabilization C Process painful memories . D A and C . Humanistic-existential therapies focus more on process and this process is best described by which of the following? take not . A Shorter, more frequent sessions . B Summarizing previous sessions . C Quizzing patient on previous sessions . D Insist the patient bring a notebook and Using a psychodynamic psychotherapy stage oriented model for the treatment of trauma, the advanced practice psychiatric nurse would do which of the following in Stage 1? When doing psychotherapy with older adult’s accommodations which target cognitive symptoms and functional deficits include: A The content of the therapy . B The flow of action and reaction within the . session. C The pacing, timing, and tracking in the . session. D B and C . A The basic structure of psychotherapy with children aligns with principles of . psychotherapy for adults. B The basic structure of psychotherapy with children for the most part is not aligned . with principles of psychotherapy for adults. C Engaging with the family precedes engagement with the child or adolescent in the . first family meeting. D Typically children are exited to engage in psychotherapy to improve the home . situation. lOMoARcPSD| A Interruptions . B Figure and ground . C Layers of personality . D Organismic self- . regulatio A Emotions precede and underlie physical sensations of . trauma, B Physical sensations precede and underlie emotions of . trauma. C Physical sensations and emotional sensations occur . simultaneously. D None of the above have anything to do with TRM. . A Debriefing involves talking about the trauma immediately . after the event. B APA practice guidelines support use of debriefing due to . efficacy. C Debriefing may increase post trauma symptoms. . D Debriefing does not prevent PTSD. . A Artistic endeavors such as sculpting, drawing painting. . B Movement therapies such as dance. . C Tapping on acupressure points . D Cognitive skills such as thought stopping and guided . self-dialogue Dysfunctional processes, developed early in life that people employ in an attempt to meet their Needs, are referred to by the Gestalt therapist as which of the following? According to the Trauma Resiliency Model which of the following occurs? Which of the following is not consistent with what is currently known about debriefing? Stress inoculation therapy (SIT) can be helpful for patients with phobic avoidance due to trauma. The advanced practice psychiatric nurse using SIT would do which of the following? lOMoARcPSD| A Congruence . B Actualizing tendency . C Belief of human nature . D Accurate empathic . understanding A Validate the patient ‘s frustration while encouraging and reinforcing use . of skills. B Analyze the behaviors and consequences of the behaviors with the . patient. C Focus on behavioral control and management with emotions as a . contextual element. D All of the above . A Maintaining a therapeutic stance of neutrality. . B Maintaining a therapeutic stance of . anonymity. C Maintaining a therapeutic stance of non- . intrusiveness. D A and C . A Do nothing, maintaining the child’s privacy protects the therapeutic relationship. . B Decide what the parents need to know and give them a summary of the individual . The person-centered therapist who is genuine and authentic during the therapy session is exhibiting which psychological condition? The patient in Dialectical Behavior Therapy (DBT) expresses frustration that the skills taught don’t work, the process is taking too long, and is struggling to complete homework. The advanced practice psychiatric nurse using a DBT model would do which of the following? The therapeutic frame supports the clinician in which of the following ways? Select all that apply. One of the problems when meeting with children individually is that it can create secrets. Which of the following responses would the advanced practice psychiatric nurse do to address this concern? lOMoARcPSD| Others PPLs papers The therapeutic frame supports the clinician in which... 1. The therapeutic frame supports the clinician in which of the following ways? Select all that apply. A . Maintaining a therapeutic stance of neutrality. B . Maintaining a therapeutic stance of anonymity. C . Maintaining a therapeutic stance of nonintrusiveness. D . A and C 2. The advanced practice psychiatric nurse is working with a patient with who is chronically suicidal. The advanced practice psychiatric nurse using a Dialectical Behavior Therapy (DBT) approach realizes which of the following? A . Every time the patient has suicidal ideations hospitalization is recommended. B . To the chronically suicidal patient, hospitalization reinforces the status quo and abdicating the hard work of change. C . To the chronically suicidal patient hospitalization frequent hospitalizations allow a safe place to learn new coping behaviors and promote change. D . The Advanced practice psychiatric nurse should not be using DBT with a chronically suicidal patient. 3. The concept of resiliency in child therapies is in direct contrast to which traditional approach for treating children? A . Family inclusion B . The concept of recovery C . Problem-based therapy D . Interacting systems consideration 4. Stigma of mental illness in the elderly: A . Has contributed to psychiatric symptoms being expressed with physical symptoms. B . Is much more severe in baby boomers than in other elderly cohorts. C . Is much less an issue in baby boomers than in other elderly cohorts D . Leads to more discussion of emotions in primary care settings. 5. Which of the following is not consistent with the Psychoanalyst's perspective when treating and individual with a personality disorder? A . It is important to identify and then modify "core" problems when treating individuals with personality disorders. B . Personality structures are unconscious and thus mostly unavailable to the individual. session in with the child in the room. C Decide what the parents need to know and give them a summary privately to avoid . any awkwardness for the child. D Discuss with the child what he or she wants to share with the parents and facilitate . the process as needed. lOMoARcPSD| C . Personality products and processes are within the realm of awareness, accessible to the individual. D . Psychoanalytic therapy is an effective treatment for Borderline personality disorder 6. Which of the following statements would not be consistent with the humanistic-existential concept of "holism" ? A People are unique. . B . The whole is greater than the sum of its parts. C . Mind, body, spirit work in a unified synergistic fashion. D . Dysfunctions such as a chemical imbalance must be identified. 7. Which of the following is true about dream work from a Gestalt perspective? A . The individual tells the dream in past tense B . Elements of the dream are viewed using standardized dream symbol meaning. C . A dream diary is required to capture all elements of the team. D . The characters and objects in the dream are projections of the individual whose dream it is. 8. When the advanced practice psychiatric nurse builds a formulation when working with a child in therapy the advanced practice psychiatric nurse is doing which of the following? A . Formulation is a type of play therapy. B . Formulation is the child's diagnosis. C . The formulation explains the contexts of the child and family situation, the child's unique presentation, responses and narratives of the events that shaped the interpretation. D . The formulation is the treatment plan. 9. In providing psychoeducation to patient's in recovery, the advanced practice psychiatric nurse would not include which of the following? A . Recovery is a lifelong process of change B . A patient is considered recovered after 5 years free of substance use. C . Recovery encompasses dimensions of health, home, purpose and community. D . Recovery applies to recovery from mental disorder, substance use disorders and behavioral addictions. 10. Which best describes gerotranscendence? A Erik Erikson's ninth stage of development . B . Emphasizes ongoing growth over decrements C . Focuses on the transition to old-old (80 years and older). D . Focuses on letting go and coming to terms with end of one's life 11. The advanced practice psychiatric nurse is working with a group of patients in an outpatient substance abuse treatment program. One patient comes to the advanced practice psychiatric nurse after the group session and asks if the advanced practice psychiatric nurse would meet at a nearby Starbucks to clarify a couple of questions that came up at the end of the session and fears relapse. Which of the following would be consistent with the traditional therapeutic frame? A . Given concerns about relapse it would be important to meet with the patient just this one time and just for 10 minutes but meet in your office. B . Remind the patient that one of the rules is not having contact outside of therapy sessions. C . Agree to meet with patient alone in the group room to resolve any outstanding concerns from the group. D . Agree to meet with the patient at Starbucks briefly to discuss the unresolved issues, but only this once and only for 10 minutes. 12. The situation in which increasing amounts of a substance is needed to achieve the same desired effect is known as which of the following? lOMoARcPSD| A . Addiction B . Tolerance C . Withdraw al D . Dependen ce 13. Which of the following describes the basic neurobiological pathways of the reward system in the brain? A . Projections from the ventral tegmental area, through the median forebrain and terminate in the nucleus accumbens where there is a proliferation of dopamine neurons. B . Projections through the median forebrain, to the ventral tegmental area where there is a proliferation of dopamine neurons, to the nucleus accumbens. C . Projections from the nucleus accumbens to the median forebrains where there is a proliferation of dopamine neurons to the ventral tegmental area. D . Projections from the median forebrain through the ventral tegmental area to the nucleus accumbens where there is a proliferation of dopamine neurons. 14. Evidence supports use of Dialectical Behavior Therapy patients with which of the following diagnoses? A . Schizophrenia B . New onset depression C . Bipolar Affective Disorder D . Borderline Personality Disorder 15. The existential concept of an openness, readiness, and flexibility to grow and change, which necessitates a capacity to choose alternatives, and shape one's own destiny as authors of creating their own world is which of the following? A . Freedom B . Responsibili ty C . Authenticity D . Meaning 16. Using a psychodynamic psychotherapy stage oriented model for the treatment of trauma, the advanced practice psychiatric nurse would do which of the following in Stage 1? A . Address safety issues B . Promote symptoms stabilization C . Process painful memories D . A and C 17. The advanced practice psychiatric nurse is working with a patient who states she believes her boss hates her. After some discussion, it is clear the patient has strong negative feelings towards her boss. The advanced practice psychiatric nurse working within a Gestalt framework, recognizes this as an interruption consistent with which of the following? A Projection . B . Retroflecti on C . Confluenc e D . Deflection 18. The patient in Dialectical Behavior Therapy (DBT) expresses frustration that the skills taught don't work, the process is taking too long, and is struggling to complete homework. The advanced practice psychiatric nurse using a DBT model would do which of the following? A . Validate the patient 's frustration while encouraging and reinforcing use of skills. B . Analyze the behaviors and consequences of the behaviors with the patient. C . Focus on behavioral control and management with emotions as a contextual element. D . All of the above lOMoARcPSD| 19. An organized, consistent set of perceptions about the self, continually influenced by experience and its interpretation which includes self-worth, self-image and ideal self, is which key concept of person-centered therapy? A . Belief of human nature B . Self-concept C . Actualizing tendency D . Fully functioning person 20. The advanced practice psychiatric nurse using a Dialectical Behavior Therapy approach with a patient with Borderline Personality Disorder explains the four essential elements which includes all but which of the following? A . Bi-weekly individual therapy sessions for the patient of about 1 hour each. B . Weekly group skills training sessions for the patient of 2.5 hours each. C . Skills coaching via telephone or other electronic means as needed by the patient to manage I vivo situations D . Team consultation to the therapist to maintain treatment fidelity and adherence Share Question Answer & Explanation Solved by verified expert 1. The therapeutic frame supports the clinician in which of the following ways? Select all that apply. D . A and C Rationale: B is wrong because it should not be anonymous. Information should be disclosed. 2. The advanced practice psychiatric nurse is working with a patient with who is chronically suicidal. The advanced practice psychiatric nurse using a Dialectical Behavior Therapy (DBT) approach realizes which of the following? B . To the chronically suicidal patient, hospitalization reinforces the status quo and abdicating the hard work of change. Rationale: Dialectical behavior therapy (DBT) is a type of cognitive behavioral therapy that combines strategies like mindfulness, acceptance, and emotion regulation. 3. The concept of resiliency in child therapies is in direct contrast to which traditional approach for treating children? C . Problem-based therapy Rationale: Compared with the traditional study of child development, which has tended to portray 'normal' and 'abnormal' patterns, a resilience approach offers a more differentiated account. In professional practice, resilience means looking for strengths and opportunities to build on, rather than (or alongside) problems, deficits or psychopathology to be remedied or treated 4. Stigma of mental illness in the elderly: A . Has contributed to psychiatric symptoms being expressed with physical symptoms. Rationale: According to Sartorius, stigma leads to discrimination in the provision of services for physical health problems in older people with mental disorders. Health Science ScienceNursingNURSING NRNP 6645 lOMoARcPSD| 5. Which of the following is not consistent with the Psychoanalyst's perspective when treating and individual with a personality disorder? C . Personality products and processes are within the realm of awareness, accessible to the individual. Rationale: Each level of awareness has a role to play in shaping human behavior and thought. 6. Which of the following statements would not be consistent with the humanistic-existential concept of "holism" ? D . Dysfunctions such as a chemical imbalance must be identified. Rationale: Holism is the idea that various systems (e.g. physical, biological, social) should be viewed as wholes, not merely as a collection of parts. 7. Which of the following is true about dream work from a Gestalt perspective? D . The characters and objects in the dream are projections of the individual whose dream it is. Rationale: In Gestalt Therapy, the client is asked to play component parts of the dream. .It helps the client to feel the part of him/herself that he/she has disowned and has projected onto objects of the dream. Disowned parts of the self are in the unconscious, and integration is the work of therapy. 8. When the advanced practice psychiatric nurse builds a formulation when working with a child in therapy the advanced practice psychiatric nurse is doing which of the following? C . The formulation explains the contexts of the child and family situation, the child's unique presentation, responses and narratives of the events that shaped the interpretation. Rationale: Formulation is a concise statement of the case. Unlike summary, it is a discussion about alternative ideas about diagnosis, aetiology, treatment and prognosis and of the arguments for and against each alternative. 9. In providing psychoeducation to patient's in recovery, the advanced practice psychiatric nurse would not include which of the following? B . A patient is considered recovered after 5 years free of substance use. Rationale: Recovery is a lifelong process that can take years to achieve. 10. Which best describes gerotranscendence? A Erik Erikson's ninth stage of development . B . Emphasizes ongoing growth over decrements Rationale: The theory that older people transcend the limited opinions and views of life they once held or wisdom comes with age 11. The advanced practice psychiatric nurse is working with a group of patients in an outpatient substance abuse treatment program. One patient comes to the advanced practice psychiatric nurse after the group session and asks if the advanced practice psychiatric nurse would meet at a nearby Starbucks to clarify a couple of questions that came up at the end of the session and fears relapse. Which of the following would be consistent with the traditional therapeutic frame? C . Agree to meet with patient alone in the group room to resolve any outstanding concerns from the group. lOMoARcPSD| Rationale: This will prevent harm for the nurse and allows help from other patient from the group 12. The situation in which increasing amounts of a substance is needed to achieve the same desired effect is known as which of the following? B . Tolerance Rationale: A person may develop tolerance to a drug when the drug is used repeatedly. 13. Which of the following describes the basic neurobiological pathways of the reward system in the brain? A . Projections from the ventral tegmental area, through the median forebrain and terminate in the nucleus accumbens where there is a proliferation of dopamine neurons. Rationale: The reward pathway of the brain is connected to areas of the brain that control behavior and memory. It begins in the ventral tegmental area, where neurons release dopamine to make you feel pleasure. The brain begins to make connections between the activity and the pleasure, ensuring that we will repeat the behavior. 14. Evidence supports use of Dialectical Behavior Therapy patients with which of the following diagnoses? D . Borderline Personality Disorder Rationale: DBT may be used to treat suicidal and other self-destructive behaviors. 15. The existential concept of an openness, readiness, and flexibility to grow and change, which necessitates a capacity to choose alternatives, and shape one's own destiny as authors of creating their own world is which of the following? A . Freedom Rationale: Freedom allows person to choose alternatives. 16. Using a psychodynamic psychotherapy stage oriented model for the treatment of trauma, the advanced practice psychiatric nurse would do which of the following in Stage 1? C . Process painful memories Rationale: The first few sessions of psychotherapy typically focus on understanding and taking a good relationship history, from childhood up to adulthood. 17. The advanced practice psychiatric nurse is working with a patient who states she believes her boss hates her. After some discussion, it is clear the patient has strong negative feelings towards her boss. The advanced practice psychiatric nurse working within a Gestalt framework, recognizes this as an interruption consistent with which of the following? D . Deflection Rationale: Deflection is attempting to draw attention away from oneself and put that attention onto another person. All ages may engage in deflection. Children try to deflect blame when they are in trouble for negative actions by pointing out a different negative action that a sibling did. 18. The patient in Dialectical Behavior Therapy (DBT) expresses frustration that the skills taught don't work, the process is taking too long, and is struggling to complete homework. The advanced practice psychiatric nurse using a DBT model would do which of the following? lOMoARcPSD| D . All of the above Rationale: All choices are applicable 19. An organized, consistent set of perceptions about the self, continually influenced by experience and its interpretation which includes self-worth, self-image and ideal self, is which key concept of person-centered therapy? B . Self-concept Rationale: Self-concept is how a person perceive their behavior, abilities, and unique characteristics. 20. The advanced practice psychiatric nurse using a Dialectical Behavior Therapy approach with a patient with Borderline Personality Disorder explains the four essential elements which includes all but which of the following? A . Bi-weekly individual therapy sessions for the patient of about 1 hour each. Rationale: Individual therapy usually involves weekly one-to-one sessions with a DBT therapist. Each session lasts approximately 45-60 minutes. . Which of the following is not consistent with... 1. Which of the following is not consistent with recommendations for teaching Trauma Resiliency Model (TRM) skills? A. TRM self-care skills can be taught and used in any order. B. TRM skill may be taught in individual or group settings C. To teach TRM skills, the therapist should be adept at using the skills themself. D. Teaching TRM is cost effective as only one teacher is needed individually or with groups. 2. The advanced practice psychiatric nurse realizes a basic assumption of Dialectical Behavior Therapy (DBT) is that therapists treating the difficult patient need support. This support includes which of the following? lOMoARcPSD| A. The support is provided through case management B. The support is designed to focus on clinical issues of the patient C. The DBT therapist in solo practice does not need a consultation group for support. D. The support includes a consultation group to treat the therapist by using the same skills the patient is asked to use. 3. In working with an older adult patient in the termination phase the advanced practice psychiatric nurse suggests it may be helpful to teach family members ways to support the patient and prevent relapse. This demonstrates which of the following? A. A major HIPPA violation B. Lack of confidence in the patient and the therapeutic process of CBT C. An appropriate strategy to solidify a supportive network for the patient. D. Resistance to terminating the therapeutic relationship. 4. Which of the following is true about communication with children and adolescents? A. Communication is developmentally based. B. Offices should be free of toys or distractions. C. Speak to children in adult manner as it lets them know you take them seriously. D. Communicate at level lower than the child or adolescent to improve their self-esteem. lOMoARcPSD| 5. Practice guidelines for complex trauma and dissociative identity disorder caution that which of the following may limit one's ability to heal. A. Somatic approaches B. Talk therapies focused on cognitive understanding***** C. EMDR D. A and C 6. Which of the following trends life trends suggests advanced practice psychiatric nurse be prepared to provide mental health and illness treatment in a variety of community and nontraditional settings. A. More older men than women living alone. B. Greatest percentage of older adults living in nursing homes. C. Projected doubling of number of homeless adults between 2010 and 2050 D. More older adults preferring to leave their homes to seek other living arrangements. 7. Dialectical Behavior Therapists realize which of the following: A. Everyone with borderline personality has comorbid posttraumatic stress disorder (PTSD B. Everyone diagnosed with PTSD can be diagnosed with comorbid borderline personality disorder. C. There are important overlapping symptoms and neuropsychological correlates that PTSD and borderline personality disorder have in common. D. DBT should only be used with individuals diagnosed with personality disorder or those with chronic suicidal thoughts. lOMoARcPSD| 8. Research support that children with serious emotional disorders (SED) are likely to have which of the following? A. Children with SEDs are likely to be severely impaired B. Children with SEDs are likely to have many community agencies involved in their care and support. C. Children with SEDs are likely to have a comorbid disorder. D. A and C 9. Which of the following is a biologically based psychotherapy methodology used to treat patients who have experienced trauma? A. Trauma Resiliency Model B. Cognitive Behavioral Therapy C. Psychodynamic Psychotherapy D. Existential Psychotherapy 10. Which of the following is not consistent with a family-centered approach in child therapy? A. In family-centered treatment, the family is the focus of treatment. B. Family- centered treatment is appropriate to improve family interactions. C. Family-centered treatment is appropriate to keep families engaged in services D. Family-centered treatment is appropriate to increase family knowledge about mental health. 11. In working with children between the ages of about 7-11 years of age, the advanced practice psychiatric nurse would include activities consistent with which of stage of Piaget's stages of cognitive development? lOMoARcPSD| A. Sensorimotor B. Preoperational C. Formal operational D. Concrete operational 12. The advanced practice psychiatric nurse working with a patient with borderline personality disorder is aware that which of the following attachment styles has been highly correlated with Borderline personality disorder? A. Secure attachment style B. Unresolved attachment style C. Preoccupied attachment style D. Disorganized attachment style 13. Which of the following medications may be recommended for patients with insomnia due to PTSD? A. Any antidepressant can offer as first-line treatment in adults for PTSD. B. Non-benzodiazepines such as trazodone (Desyrel) C. Prazosin (Minipress) may be helpful if nightmares are present. D. B and C 14. According to the MacArthur Study of Successful Aging protective factors on mental and cognitive functioning and successful aging include: A. Positive mental attitude lOMoARcPSD| B. Regularly scheduled activities C. Exercise D. All the above 15. The advanced practice psychiatric nurse is working with the patient on maintaining treatment outcomes and developing a guide for surviving difficult times. These strategies are consistent with which phase in the CBT process? A. Introductory phase B. Middle phase C. Late middle phase D. Termination 16. Strategies for terminating a therapy relationship with an older adult includes: A. The advanced practice psychiatric nurse needs to develop a checklist to determine goals have been made and it is time to terminate. B. The advanced practice psychiatric nurse determines therapy goals attained, terminate the therapeutic relationship, and schedule to meet the patient for coffee to ease the transition out of therapy. C. The advanced practice psychiatric nurse should set clear therapy goals, commend patient on goal attainment and terminate the therapy. D. Termination should occur by mutual decision between advanced practice psychiatric nurse and patient based on the therapy goals attained. 17. The advanced practice psychiatric nurse using Dialectical Behavior Therapy with a patient with borderline personality disorder uses persuasive dialogue to do which of the following? A. Invite the patient to new ways of viewing a situation lOMoARcPSD| B. Guiding patient to develop more skills to achieve a greater quality of life. C. Engage the patient in change talk D. A and B 18. Which of the following would not be a first-line intervention for an individual with PTSD? A. CPT B. CPT-PE C. EMDR therapy D. Pharmacological interventions. 19. Emotion-Focused therapy integrates which of the following? A. Person-centered therapy and Gestalt therapy B. Gestalt therapy and Neuroscience research of emotions. C. Neuroscience research of emotions and Person-centered therapy. D. Person-centered therapy, Gestalt therapy and Neuroscience research of emotions. 20. Stress inoculation therapy (SIT) can be helpful for patients with phobic avoidance due to trauma. The advanced practice psychiatric nurse using SIT would do which of the following? A. Artistic endeavors such as sculpting, drawing painting. B. Movement therapies such as dance. C. Tapping on acupressure points lOMoARcPSD| D. Cognitive skills such as thought stopping and guided self-dialogue. 21. The purpose of Mindfulness-Based Stress Reduction in the older adult is A. To avoid using psychotropic medications B. To escape from stressful situations and relationships C. To learn to be present in the moment non-judgmentally. D. To avoid stigma of traditional psychotherapy 22. The stabilization skills and concepts that form the foundation of Trauma Resiliency Model stand alone as a model in and of itself called CRM. CRM stands for which of the following? A. Cognitive Restructuring Model B. Cognitive Resiliency Model C. Community Resiliency Model D. Cognitive Regeneration Model 23. Which of the following is not an underlying assumption that differentiates child therapies from adult psychotherapy? A. Family inclusion B. The concept of Recovery C. The concept of Resiliency D. Developmental considerations 24. Which of the following is consistent with a Common Elements approach? lOMoARcPSD| A. Common Elements involves use of individual treatment approaches that are part of many manualized treatment B. Evidenced-based strategy is viewed in light of the actual intervention as well as diagnostic category. C. The Common Elements method is seen as a transdiagnostic approach to treat a variety of common mental health issues. D. Is Common Elements method should not be used with child/adolescents with PTSD. 25. Functional status refers to A. A person's capacity to manage activities of daily living independently B. A person's positive perspective on their own capabilities C. A person's expected increase in dependency as one ages D. A person's expected decrease in independence as one ages 26. Which of the following is not true about self-regulation as it applies to therapy with children? A. Self-regulation is a developmental milestone of childhood in which the child controls behavior in the service of socially desirable conduct. B. Self-regulation is a pivotal developmental process of integrating emotion, memory and behavior. C. Self-regulation mechanisms from a neuroscience perspective are basic mechanisms predominantly located in the globus pallidus. D. Self-regulation issues are often seen in various child psychopathology. 27. Which of the following is not consistent with Eye Movement Desensitization and Reprocessing (EMDR) literature in treating PTSD? lOMoARcPSD| A. Treatment effects are long lasting. B. EMDR involves extended exposure C. EMDR treatment for trauma is less time intensive. D. The aim is to reduce the subject distress and strengthen adaptive beliefs related to the traumatic event. 28. Which of the following is true about Complementary and Alternative Medicine (CAM) Therapies and Older Adults? A. CAM therapies are a good alternative to conventional medicine B. CAM therapies can be used in conjunction with psychotherapy to provide effective, evidencebased treatments to older adults with psychiatric disorder. C. Evidence is unclear whether CAM therapies improve quality of life or wellness in older adults. D. Most middle age and older adults are reluctant to use CAM therapies for management of mental health concerns. 29. The advanced practice psychiatric nurse using a Dialectical Behavior Therapy approach with a patient with Borderline Personality Disorder explains the four essential elements which includes all but which of the following? A. Bi-weekly individual therapy sessions for the patient of about 1 hour each. B. Weekly group skills training sessions for the patient of 2.5 hours each. C. Skills coaching via telephone or other electronic means as needed by the patient to manage I vivo situations D. Team consultation to the therapist to maintain treatment fidelity and adherence 30. The primary source for constructive change in a humanistic-existential approach is which of the follow: lOMoARcPSD| A. The patient's motivation B. The therapist's structure C. The therapist-patient relationship D. The patient-family relationship 31. The advanced practice psychiatric nurse working with children/adolescents in psychotherapy is aware of which of the following? A. The basic structure of psychotherapy with children aligns with principles of psychotherapy for adults. B. The basic structure of psychotherapy with children for the most part is not aligned with principles of psychotherapy for adults. C. Engaging with the family precedes engagement with the child or adolescent in the first family meeting. D. Typically children are exited to engage in psychotherapy to improve the home situation. 32. When using a Dialectical Behavior Therapy (DBT) approach with a patient with Borderline Personality Disorder the advanced practice psychiatric nurse knows which of the following is inconsistent DBT assumptions about patients? A. Patients can fail in therapy. B. Patients are doing the best they can. C. Patients need to do better, try harder and be more motived to change. D. Patients may not have caused all their problems, but they need to solve them anyway. lOMoARcPSD| 33. A natural process whereby the individual is continually disturbed by the emergence of a need, strives to restore equilibrium by constantly reorganizing and adapting to changing circumstances in recognized by the Gestalt therapist as which of the following? A. Figure and ground B. Organismic self-regulation C. Layers of the personality D. None of the above 34. Which of the following does the advanced practice psychiatric nurse need to consider when treating older adults with Substance Use Disorders? A. Co-existing medical or psychiatric disorder B. Age-related physiological and psychological changes C. Collaboration with primary care providers D. All of the above 35. In following the rules for the Dialectical Behavior Therapy (DBT) therapist, the therapist would not do which of the following? A. Recognize the therapist is human and fallible. B. Make every reasonable effort to provide competent treatment for the patient. C. Share the rules for the DBT therapist with the patient during orientation to the therapy. D. The therapist agrees to use consultation and allow the patient to view this directly if desired. ??? 36. According to Dearing, Stuewig, and Tangney (2005), understanding the difference between guilt and shame and its impact on an individual's motivation is critical to hope and the recovery process. Which of the following is true regarding guilt and shame? lOMoARcPSD| A. Shame drives a person to engage in treatment while guilt drives a person to avoid treatment. B. Shame causes a person to perceive self as a failure and guilt causes avoidance of treatment. C. Guilt causes a person to perceive himself as a loser and shame drives a person to avoid treatment. D. Shame drives avoidance from treatment, Guilt often motivates a person to seek treatment. 37. Which of the following is true about use of medications and/or psychotherapy in treatment of PTSD? A. Medications alone can cure PTSD B. Medication may be a helpful as an adjunctive treatment but is not a first-line treatment C. Medication directly promotes new learning and processing. D. Medications assuage the guilt, grief and interpersonal difficulties specifically in patients with PTSD. 38. Research suggests that psychodynamic therapeutic approaches are effective for some children, particularly those with which of the following disorders? A. Conduct Disorders B. Anxiety and Depression C. Depression and Psychosis D. Attention Deficit-Hyperactivity Disorders 39. A Trauma Resiliency Model therapist encourages the patient to describe the "felt sense" of internal or external body sensations associated with resilience, stress, and release. This is known as which of the following Trauma Resiliency Model skills? A. lOMoARcPSD| Tracking B. Resourcing and resource intensification C. Grounding D. Gesturing 40. During your second CBT session with an older adult the patient expresses to you comfort with the CBT model and begins to ask questions about how the therapy works. This indicates which of the following? A. It is time to move to the middle phase of CBT B. This comment seems contradictory, perhaps the patient has a dementia. C. The patient is just trying to rush through the therapy, a type of resistance. D. The patient clearly needs at least one more introductory/early phase session. 41. Dysfunctional processes, developed early in life that people employ in an attempt to meet their Needs, are referred to by the Gestalt therapist as which of the following? A. Interruptions B. Figure and ground C. Layers of personality D. Organismic self-regulation 42. Using a Common elements approach with a child with ADHD who despite stimulant medication continues to exhibit frequent angry outbursts, opposition and aggression the advanced practice psychiatric nurse begin with which of the following? A. Stop the medication as it clearly is not working. lOMoARcPSD| B. Adjust medication as it clearly isn't working. C. Explore inpatient treatment where the environment could be more closely controlled and monitored. D. Review the best available evidence for behavioral, cognitive or psychoeducation intervention to augment the medication and address these behavioral/regulation issues. 43. When doing psychotherapy with older adult's accommodations which target cognitive symptoms and functional deficits include: A. Shorter, more frequent sessions B. Summarizing previous sessions C. Quizzing patient on previous sessions D. Insist the patient bring a notebook and take note 44. When doing psychotherapy with older adult's accommodations which target cognitive symptoms and functional deficits include: A. Shorter, more frequent sessions B. Summarizing previous sessions C. Quizzing patient on previous sessions D. Insist the patient bring a notebook and take note 45. The underlying assumptions of Trauma Resiliency Model therapy include which of the following? A. Human response to threat are subcortical in nature. B. Response to trauma is likely transient and should go away with or without treatment. lOMoARcPSD| C. The mind has no bias; thus, we make sense of the world in a symmetrical manner. D. Current psychiatric concepts adequately account for the impact of multiple or long-term 46. Addiction is now recognized as which of the following? A. A preventable personality disorder B. A family disorder due to poor parenting C. A volitional behavior that can be managed independently' D. A primary disease of the brain's neurocircuitry. 47. The advanced practice psychiatric nurse is using a Dialectical Behavior Therapy (DBT) approach with a patient who has experienced trauma. In which stage of the DBT model would the advanced practice psychiatric nurse begin exposure therapy? A. Stage 1 B. Stage 2 C. Stage 3 D. Stage 4