NU 665C Exam Study Guide: Psychotherapy with Multiple
Modalities
Section 1: Foundational Principles & Therapeutic Alliance
1. Question: A PMHNP is conducting an initial assessment with a new client. The client
appears guarded and states, "I'm not sure I can trust you yet." The NP's best response,
demonstrating an understanding of the therapeutic alliance, is:
a) "You can trust me; everything you say is confidential."
b) "It's completely normal to feel that way. Trust is something we will build together
over time."
c) "Why do you feel that way? Have you had bad experiences with therapists before?"
d) "Without trust, this process won't work, so we need to address that immediately."
ANSWER ✓ b) "It's completely normal to feel that way. Trust is something we will build
together over time." This response validates the client's feeling, normalizes it, and
frames the alliance as a collaborative process, which is the cornerstone of effective
therapy.
2. Question: The concept of "unconditional positive regard" is most closely associated
with which theorist?
a) Sigmund Freud
b) Aaron Beck
c) Carl Rogers
d) Marsha Linehan
ANSWER ✓ c) Carl Rogers. This is a core condition in Client-Centered Therapy,
emphasizing the therapist's acceptance and support of the client regardless of what
they say or do.
3. Question: A PMHNP maintains a non-judgmental stance, demonstrates authenticity,
and shows an accurate understanding of the client's feelings. These behaviors best
describe:
a) Transference and Countertransference
b) The Core Conditions of the Therapeutic Alliance (Empathy, Congruence, UPR)
c) Cognitive Restructuring
d) Behavioral Activation
ANSWER ✓ b) The Core Conditions of the Therapeutic Alliance (Empathy, Congruence,
UPR). These are the essential qualities a therapist must embody to foster a strong
therapeutic relationship.
,4. Question: During a session, a client begins to react to the PMHNP as if they are their
critical parent. This phenomenon is known as:
a) Countertransference
b) Projection
c) Transference
d) Resistance
ANSWER ✓ c) Transference. This is the client's redirection of feelings about a significant
person onto the therapist.
5. Question: A PMHNP feels an unusually strong urge to rescue a client from all their
problems. The NP should first:
a) Discuss this urge openly with the client to show vulnerability.
b) Seek supervision or consultation to explore countertransference.
c) Ignore the feeling as it is unprofessional.
d) Transfer the client to another provider.
ANSWER ✓ b) Seek supervision or consultation to explore countertransference. This is a
professional and ethical approach to managing the therapist's own emotional reactions.
Section 2: Psychodynamic Psychotherapy
6. Question: The primary goal of psychodynamic therapy is to:
a) Identify and change cognitive distortions.
b) Make the unconscious conscious.
c) Extinguish maladaptive behaviors.
d) Increase mindful awareness.
ANSWER ✓ b) Make the unconscious conscious. Psychodynamic theory posits that
bringing unconscious conflicts and motivations into awareness allows for resolution and
healing.
7. Question: A client who consistently arrives late to sessions, forgets to pay, and
changes the subject when discussing emotionally charged topics is most likely
demonstrating:
a) Cognitive dissonance
b) Resistance
c) Reaction formation
d) Intellectualization
ANSWER ✓ b) Resistance. Resistance is any behavior that opposes the process of
therapy and avoids confronting unconscious material.
8. Question: A PMHNP interprets that a client's intense anger at their boss may be
related to unresolved anger toward their father. This technique is known as:
, a) Free association
b) Working through
c) Linking
d) Dream analysis
ANSWER ✓ c) Linking. This connects the client's current feelings or behaviors to past
experiences or relationships.
9. Question: Which defense mechanism involves reverting to an earlier stage of
development when faced with stress?
a) Regression
b) Repression
c) Displacement
d) Sublimation
ANSWER ✓ a) Regression. For example, an adult throwing a tantrum like a child.
10. Question: In psychodynamic therapy, the "working through" process involves:
a) The initial assessment and diagnosis.
b) The repeated examination and interpretation of conflicts to achieve lasting change.
c) The termination phase of therapy.
d) Setting goals and building rapport.
ANSWER ✓ b) The repeated examination and interpretation of conflicts to achieve
lasting change. It is the ongoing, deep work that follows an initial insight.
Section 3: Cognitive Behavioral Therapy (CBT)
11. Question: The fundamental premise of CBT is that:
a) Our thoughts influence our feelings and behaviors.
b) Our unconscious drives determine our actions.
c) Our environment solely shapes who we are.
d) The therapeutic relationship is the sole agent of change.
ANSWER ✓ a) Our thoughts influence our feelings and behaviors. CBT focuses on
identifying and modifying dysfunctional thought patterns to change emotional and
behavioral responses.
12. Question: A client thinks, "I completely failed that presentation. Everyone must think
I'm a total idiot." This is an example of what type of cognitive distortion?
a) Mind Reading
b) Catastrophizing
c) All-or-Nothing Thinking
d) Overgeneralization
Modalities
Section 1: Foundational Principles & Therapeutic Alliance
1. Question: A PMHNP is conducting an initial assessment with a new client. The client
appears guarded and states, "I'm not sure I can trust you yet." The NP's best response,
demonstrating an understanding of the therapeutic alliance, is:
a) "You can trust me; everything you say is confidential."
b) "It's completely normal to feel that way. Trust is something we will build together
over time."
c) "Why do you feel that way? Have you had bad experiences with therapists before?"
d) "Without trust, this process won't work, so we need to address that immediately."
ANSWER ✓ b) "It's completely normal to feel that way. Trust is something we will build
together over time." This response validates the client's feeling, normalizes it, and
frames the alliance as a collaborative process, which is the cornerstone of effective
therapy.
2. Question: The concept of "unconditional positive regard" is most closely associated
with which theorist?
a) Sigmund Freud
b) Aaron Beck
c) Carl Rogers
d) Marsha Linehan
ANSWER ✓ c) Carl Rogers. This is a core condition in Client-Centered Therapy,
emphasizing the therapist's acceptance and support of the client regardless of what
they say or do.
3. Question: A PMHNP maintains a non-judgmental stance, demonstrates authenticity,
and shows an accurate understanding of the client's feelings. These behaviors best
describe:
a) Transference and Countertransference
b) The Core Conditions of the Therapeutic Alliance (Empathy, Congruence, UPR)
c) Cognitive Restructuring
d) Behavioral Activation
ANSWER ✓ b) The Core Conditions of the Therapeutic Alliance (Empathy, Congruence,
UPR). These are the essential qualities a therapist must embody to foster a strong
therapeutic relationship.
,4. Question: During a session, a client begins to react to the PMHNP as if they are their
critical parent. This phenomenon is known as:
a) Countertransference
b) Projection
c) Transference
d) Resistance
ANSWER ✓ c) Transference. This is the client's redirection of feelings about a significant
person onto the therapist.
5. Question: A PMHNP feels an unusually strong urge to rescue a client from all their
problems. The NP should first:
a) Discuss this urge openly with the client to show vulnerability.
b) Seek supervision or consultation to explore countertransference.
c) Ignore the feeling as it is unprofessional.
d) Transfer the client to another provider.
ANSWER ✓ b) Seek supervision or consultation to explore countertransference. This is a
professional and ethical approach to managing the therapist's own emotional reactions.
Section 2: Psychodynamic Psychotherapy
6. Question: The primary goal of psychodynamic therapy is to:
a) Identify and change cognitive distortions.
b) Make the unconscious conscious.
c) Extinguish maladaptive behaviors.
d) Increase mindful awareness.
ANSWER ✓ b) Make the unconscious conscious. Psychodynamic theory posits that
bringing unconscious conflicts and motivations into awareness allows for resolution and
healing.
7. Question: A client who consistently arrives late to sessions, forgets to pay, and
changes the subject when discussing emotionally charged topics is most likely
demonstrating:
a) Cognitive dissonance
b) Resistance
c) Reaction formation
d) Intellectualization
ANSWER ✓ b) Resistance. Resistance is any behavior that opposes the process of
therapy and avoids confronting unconscious material.
8. Question: A PMHNP interprets that a client's intense anger at their boss may be
related to unresolved anger toward their father. This technique is known as:
, a) Free association
b) Working through
c) Linking
d) Dream analysis
ANSWER ✓ c) Linking. This connects the client's current feelings or behaviors to past
experiences or relationships.
9. Question: Which defense mechanism involves reverting to an earlier stage of
development when faced with stress?
a) Regression
b) Repression
c) Displacement
d) Sublimation
ANSWER ✓ a) Regression. For example, an adult throwing a tantrum like a child.
10. Question: In psychodynamic therapy, the "working through" process involves:
a) The initial assessment and diagnosis.
b) The repeated examination and interpretation of conflicts to achieve lasting change.
c) The termination phase of therapy.
d) Setting goals and building rapport.
ANSWER ✓ b) The repeated examination and interpretation of conflicts to achieve
lasting change. It is the ongoing, deep work that follows an initial insight.
Section 3: Cognitive Behavioral Therapy (CBT)
11. Question: The fundamental premise of CBT is that:
a) Our thoughts influence our feelings and behaviors.
b) Our unconscious drives determine our actions.
c) Our environment solely shapes who we are.
d) The therapeutic relationship is the sole agent of change.
ANSWER ✓ a) Our thoughts influence our feelings and behaviors. CBT focuses on
identifying and modifying dysfunctional thought patterns to change emotional and
behavioral responses.
12. Question: A client thinks, "I completely failed that presentation. Everyone must think
I'm a total idiot." This is an example of what type of cognitive distortion?
a) Mind Reading
b) Catastrophizing
c) All-or-Nothing Thinking
d) Overgeneralization
