Walden University NURS 6640 Final Exam (pdf) | 2026/2027 |
Psychotherapy Q&A | Psychotherapy
**1. A PMHNP is using Gestalt therapy to communicate with a 50-year-old
patient who is going through a divorce. As he is calmly sharing the details of
his divorce, the PMHNP notices that Dave is tapping his fingers on his legs.
What is an appropriate response by the PMHNP using the technique of
focusing?**
A) "I noticed that your fingers were tapping. Can you give a voice to your
fingers?"
B) "Why are you tapping your fingers?"
C) "Stop tapping your fingers and focus on what you are saying."
D) "You seem calm, but your fingers are tapping. That seems contradictory."
**Correct Answer: A**
**Rationale:** In Gestalt therapy, the focusing technique involves drawing
attention to the patient's physical sensations or nonverbal behaviors to
increase awareness. By noticing the finger tapping and asking the patient to
give a voice to his fingers, the PMHNP helps the patient connect with present
experience. This approach is non-judgmental and invites exploration.
---
**2. A PMHNP has been treating a 9-year-old patient who was referred by her
school. Students are asked to raise their hands before speaking during group
discussion, but the patient seems to blurt out what she wants to say without
being called on. She also interrupts other children while they are talking
instead of waiting her turn. When the patient gets frustrated, she has trouble
controlling her emotions and cries often. Based on the initial information
provided, the first focus by the PMHNP is the child's:**
,A) Cognitive development
B) Self-regulation
C) Social skills
D) Academic performance
**Correct Answer: B**
**Rationale:** The child is exhibiting difficulty with impulse control,
emotional regulation, and frustration tolerance. These are core components
of self-regulation. Before addressing cognitive, social, or academic issues,
the PMHNP should focus on helping the child develop self-regulation skills,
which will provide a foundation for other areas of functioning.
---
**3. The PMHNP is caring for a patient who experiences depression caused
by the traumatic experience of her dog passing away. She reports not being
able to eat or sleep, and sometimes doesn't want to leave the house at all.
Which statement is most appropriate for the PMHNP to maximize the
patient's adaptive coping mechanisms?**
A) "You should try to eat and sleep better."
B) "It's important to be mindful of how you feel and then to determine what
causes those feelings."
C) "You need to get out of the house more."
D) "Your dog wouldn't want you to be this sad."
**Correct Answer: B**
,**Rationale:** This statement validates the patient's feelings while
encouraging self-awareness and insight. It empowers the patient to identify
triggers and develop adaptive coping strategies. The other options are
directive, dismissive, or guilt-inducing.
---
**4. A 35-year-old male patient is being treated for alcohol addiction. He asks
for the PMHNP's cell phone number to use in case of an emergency. When
the PMHNP responds that giving her number would be against therapeutic
rules, the patient threatens an act of violence to the therapist. What would
be the most appropriate response by the PMHNP?**
A) Immediately report the threat to the local police department
B) Ignore the threat as an expression of frustration
C) Discuss the threat with the patient in the next session
D) Terminate the therapeutic relationship
**Correct Answer: A**
**Rationale:** A threat of violence is a serious concern that triggers the duty
to protect. The PMHNP should immediately report the threat to the local
police department to ensure safety. This is consistent with legal and ethical
obligations to protect both the therapist and potential victims.
---
**5. The PMHNP is meeting with an older, female adult patient and her
daughter. The patient has early onset dementia. The daughter expresses
concern, saying, "I don't want you to just stick my mother in a home and give
, her medicine. I'm worried that's what people are going to want to do." What
is the best response by the PMHNP to the daughter?**
A) "We would never do that to your mother."
B) "The type of treatment depends on the stage of dementia and safety
considerations."
C) "You need to trust that we will do what's best."
D) "That's not what we do here."
**Correct Answer: B**
**Rationale:** This response validates the daughter's concern while
providing education about the individualized nature of dementia care. It
acknowledges that treatment decisions are based on clinical factors and
safety considerations, rather than a predetermined plan.
---
**6. A 25-year-old female states, "I really need to lose weight. I know I'm the
cause of our problems. If I could just lose weight he might be more attracted
to me. Then we could start a family and we would be happy. I'm sure of it,
right, we would definitely be happy!" Which statement shows the PMHNP's
ability to apply "summarizing"?**
A) "You are feeling hopeless about your marriage."
B) "You have identified your weight as a problem in your marriage but
believe that losing weight will gain happiness."
C) "You should focus on your health, not just your weight."
D) "It sounds like you are blaming yourself for everything."
Psychotherapy Q&A | Psychotherapy
**1. A PMHNP is using Gestalt therapy to communicate with a 50-year-old
patient who is going through a divorce. As he is calmly sharing the details of
his divorce, the PMHNP notices that Dave is tapping his fingers on his legs.
What is an appropriate response by the PMHNP using the technique of
focusing?**
A) "I noticed that your fingers were tapping. Can you give a voice to your
fingers?"
B) "Why are you tapping your fingers?"
C) "Stop tapping your fingers and focus on what you are saying."
D) "You seem calm, but your fingers are tapping. That seems contradictory."
**Correct Answer: A**
**Rationale:** In Gestalt therapy, the focusing technique involves drawing
attention to the patient's physical sensations or nonverbal behaviors to
increase awareness. By noticing the finger tapping and asking the patient to
give a voice to his fingers, the PMHNP helps the patient connect with present
experience. This approach is non-judgmental and invites exploration.
---
**2. A PMHNP has been treating a 9-year-old patient who was referred by her
school. Students are asked to raise their hands before speaking during group
discussion, but the patient seems to blurt out what she wants to say without
being called on. She also interrupts other children while they are talking
instead of waiting her turn. When the patient gets frustrated, she has trouble
controlling her emotions and cries often. Based on the initial information
provided, the first focus by the PMHNP is the child's:**
,A) Cognitive development
B) Self-regulation
C) Social skills
D) Academic performance
**Correct Answer: B**
**Rationale:** The child is exhibiting difficulty with impulse control,
emotional regulation, and frustration tolerance. These are core components
of self-regulation. Before addressing cognitive, social, or academic issues,
the PMHNP should focus on helping the child develop self-regulation skills,
which will provide a foundation for other areas of functioning.
---
**3. The PMHNP is caring for a patient who experiences depression caused
by the traumatic experience of her dog passing away. She reports not being
able to eat or sleep, and sometimes doesn't want to leave the house at all.
Which statement is most appropriate for the PMHNP to maximize the
patient's adaptive coping mechanisms?**
A) "You should try to eat and sleep better."
B) "It's important to be mindful of how you feel and then to determine what
causes those feelings."
C) "You need to get out of the house more."
D) "Your dog wouldn't want you to be this sad."
**Correct Answer: B**
,**Rationale:** This statement validates the patient's feelings while
encouraging self-awareness and insight. It empowers the patient to identify
triggers and develop adaptive coping strategies. The other options are
directive, dismissive, or guilt-inducing.
---
**4. A 35-year-old male patient is being treated for alcohol addiction. He asks
for the PMHNP's cell phone number to use in case of an emergency. When
the PMHNP responds that giving her number would be against therapeutic
rules, the patient threatens an act of violence to the therapist. What would
be the most appropriate response by the PMHNP?**
A) Immediately report the threat to the local police department
B) Ignore the threat as an expression of frustration
C) Discuss the threat with the patient in the next session
D) Terminate the therapeutic relationship
**Correct Answer: A**
**Rationale:** A threat of violence is a serious concern that triggers the duty
to protect. The PMHNP should immediately report the threat to the local
police department to ensure safety. This is consistent with legal and ethical
obligations to protect both the therapist and potential victims.
---
**5. The PMHNP is meeting with an older, female adult patient and her
daughter. The patient has early onset dementia. The daughter expresses
concern, saying, "I don't want you to just stick my mother in a home and give
, her medicine. I'm worried that's what people are going to want to do." What
is the best response by the PMHNP to the daughter?**
A) "We would never do that to your mother."
B) "The type of treatment depends on the stage of dementia and safety
considerations."
C) "You need to trust that we will do what's best."
D) "That's not what we do here."
**Correct Answer: B**
**Rationale:** This response validates the daughter's concern while
providing education about the individualized nature of dementia care. It
acknowledges that treatment decisions are based on clinical factors and
safety considerations, rather than a predetermined plan.
---
**6. A 25-year-old female states, "I really need to lose weight. I know I'm the
cause of our problems. If I could just lose weight he might be more attracted
to me. Then we could start a family and we would be happy. I'm sure of it,
right, we would definitely be happy!" Which statement shows the PMHNP's
ability to apply "summarizing"?**
A) "You are feeling hopeless about your marriage."
B) "You have identified your weight as a problem in your marriage but
believe that losing weight will gain happiness."
C) "You should focus on your health, not just your weight."
D) "It sounds like you are blaming yourself for everything."
