NRNP 6635 Week 6 Midterm Exam
Psychotherapy & Psychiatric Assessment Review
2026/2027 | 100 Questions with Answers &
Detailed Rationales | 100% Verified | A+ Graded
Question 1:
A 34-year-old patient reports feeling "stuck" in life and describes a pattern of
choosing unsupportive partners. During sessions, they frequently say, "I don't
know why I keep doing this to myself." The PMHNP recognizes this as an
opportunity to explore unconscious patterns. Which theoretical framework best
guides this exploration?
a. Cognitive-Behavioral Therapy
b. Dialectical Behavior Therapy
c. Psychodynamic Therapy
d. Interpersonal Therapy
Rationale: Psychodynamic therapy focuses on unconscious processes, early
developmental experiences, and repetitive relational patterns (transference) that
influence present behavior. The patient's pattern of choosing unsupportive partners
and lack of insight into their motivations aligns with psychodynamic exploration of
unconscious conflicts and defense mechanisms.
Question 2:
A patient with chronic low self-esteem states, "I'm a complete failure at everything
I try." The PMHNP identifies this as a cognitive distortion. Which type of
distortion is this?
a. Catastrophizing
b. All-or-Nothing Thinking
c. Mind Reading
d. Emotional Reasoning
Rationale: All-or-nothing thinking (dichotomous thinking) involves viewing
situations in extreme, black-and-white categories with no middle ground. The
,patient's statement "complete failure at everything" reflects this polarized cognitive
distortion, a core target in CBT cognitive restructuring.
Question 3:
A PMHNP is working with a patient who experienced childhood emotional
neglect. The patient struggles to form close relationships and becomes highly
anxious when partners express affection. Which theoretical concept BEST explains
this presentation?
a. Cognitive Schema
b. Attachment Theory
c. Behavioral Conditioning
d. Existential Isolation
Rationale: Attachment theory, developed by John Bowlby and Mary Ainsworth,
explains how early attachment experiences shape interpersonal patterns throughout
life. Childhood emotional neglect can lead to insecure attachment styles,
manifesting as anxiety in close relationships and difficulty trusting others.
Question 4:
A PMHNP is using cognitive-behavioral therapy (CBT) with a patient who has
panic disorder. The patient reports, "If I have a panic attack, I will die." Which
intervention is most consistent with CBT?
a. Exploring childhood trauma
b. Cognitive restructuring to challenge the catastrophic belief
c. Analyzing transference patterns
d. Encouraging regression
Rationale: CBT focuses on identifying and challenging maladaptive thoughts
(cognitive restructuring) and behaviors. The patient's catastrophic belief that a
panic attack will result in death is a cognitive distortion that should be challenged
and replaced with more realistic thinking.
,Question 5:
A patient with borderline personality disorder is working on emotional regulation
and distress tolerance. Which therapeutic modality is most appropriate?
a. Psychodynamic Therapy
b. Cognitive-Behavioral Therapy
c. Dialectical Behavior Therapy (DBT)
d. Interpersonal Therapy
Rationale: Dialectical Behavior Therapy (DBT), developed by Marsha Linehan,
was specifically designed for borderline personality disorder. It focuses on four
core skills: mindfulness, distress tolerance, emotion regulation, and interpersonal
effectiveness.
Question 6:
A 45-year-old patient with depression reports that nothing brings them pleasure
anymore and they feel hopeless about the future. Which CBT technique would be
most appropriate initially?
a. Cognitive restructuring
b. Behavioral activation
c. Exposure therapy
d. Thought stopping
Rationale: Behavioral activation is a core CBT technique for depression that
encourages patients to engage in pleasurable or meaningful activities to break the
cycle of withdrawal and depression. It is often more effective as an initial
intervention before cognitive restructuring.
Question 7:
A PMHNP is working with a patient who has a pattern of idealizing the therapist
and then becoming devaluing when feeling disappointed. This is an example of:
a. Splitting
b. Projection
c. Sublimation
d. Denial
, Rationale: Splitting is a primitive defense mechanism common in borderline
personality disorder where the individual sees people and situations as all good or
all bad, without integrating positive and negative qualities. This manifests as
alternating idealization and devaluation in relationships.
Question 8:
A 28-year-old patient reports anxiety about public speaking. The PMHNP uses a
technique where the patient imagines speaking in front of progressively larger
audiences while practicing relaxation. This approach is consistent with:
a. Systematic desensitization
b. Flooding
c. Cognitive restructuring
d. Behavioral activation
Rationale: Systematic desensitization is a behavioral therapy technique for anxiety
that involves creating a hierarchy of feared situations and pairing imaginal
exposure with relaxation techniques. It is based on the principle of reciprocal
inhibition.
Question 9:
A patient reports that they have not been able to leave their house for the past 6
months due to fear of having a panic attack. The PMHNP uses a technique where
the patient takes small steps, walking to the mailbox, then to the corner, and
eventually around the block. This technique is called:
a. Graduated exposure
b. Flooding
c. Response prevention
d. Cognitive restructuring
Rationale: Graduated exposure is a behavioral therapy technique that involves
gradually exposing the patient to feared stimuli in small, manageable steps. This
builds confidence and reduces anxiety through habituation.
Psychotherapy & Psychiatric Assessment Review
2026/2027 | 100 Questions with Answers &
Detailed Rationales | 100% Verified | A+ Graded
Question 1:
A 34-year-old patient reports feeling "stuck" in life and describes a pattern of
choosing unsupportive partners. During sessions, they frequently say, "I don't
know why I keep doing this to myself." The PMHNP recognizes this as an
opportunity to explore unconscious patterns. Which theoretical framework best
guides this exploration?
a. Cognitive-Behavioral Therapy
b. Dialectical Behavior Therapy
c. Psychodynamic Therapy
d. Interpersonal Therapy
Rationale: Psychodynamic therapy focuses on unconscious processes, early
developmental experiences, and repetitive relational patterns (transference) that
influence present behavior. The patient's pattern of choosing unsupportive partners
and lack of insight into their motivations aligns with psychodynamic exploration of
unconscious conflicts and defense mechanisms.
Question 2:
A patient with chronic low self-esteem states, "I'm a complete failure at everything
I try." The PMHNP identifies this as a cognitive distortion. Which type of
distortion is this?
a. Catastrophizing
b. All-or-Nothing Thinking
c. Mind Reading
d. Emotional Reasoning
Rationale: All-or-nothing thinking (dichotomous thinking) involves viewing
situations in extreme, black-and-white categories with no middle ground. The
,patient's statement "complete failure at everything" reflects this polarized cognitive
distortion, a core target in CBT cognitive restructuring.
Question 3:
A PMHNP is working with a patient who experienced childhood emotional
neglect. The patient struggles to form close relationships and becomes highly
anxious when partners express affection. Which theoretical concept BEST explains
this presentation?
a. Cognitive Schema
b. Attachment Theory
c. Behavioral Conditioning
d. Existential Isolation
Rationale: Attachment theory, developed by John Bowlby and Mary Ainsworth,
explains how early attachment experiences shape interpersonal patterns throughout
life. Childhood emotional neglect can lead to insecure attachment styles,
manifesting as anxiety in close relationships and difficulty trusting others.
Question 4:
A PMHNP is using cognitive-behavioral therapy (CBT) with a patient who has
panic disorder. The patient reports, "If I have a panic attack, I will die." Which
intervention is most consistent with CBT?
a. Exploring childhood trauma
b. Cognitive restructuring to challenge the catastrophic belief
c. Analyzing transference patterns
d. Encouraging regression
Rationale: CBT focuses on identifying and challenging maladaptive thoughts
(cognitive restructuring) and behaviors. The patient's catastrophic belief that a
panic attack will result in death is a cognitive distortion that should be challenged
and replaced with more realistic thinking.
,Question 5:
A patient with borderline personality disorder is working on emotional regulation
and distress tolerance. Which therapeutic modality is most appropriate?
a. Psychodynamic Therapy
b. Cognitive-Behavioral Therapy
c. Dialectical Behavior Therapy (DBT)
d. Interpersonal Therapy
Rationale: Dialectical Behavior Therapy (DBT), developed by Marsha Linehan,
was specifically designed for borderline personality disorder. It focuses on four
core skills: mindfulness, distress tolerance, emotion regulation, and interpersonal
effectiveness.
Question 6:
A 45-year-old patient with depression reports that nothing brings them pleasure
anymore and they feel hopeless about the future. Which CBT technique would be
most appropriate initially?
a. Cognitive restructuring
b. Behavioral activation
c. Exposure therapy
d. Thought stopping
Rationale: Behavioral activation is a core CBT technique for depression that
encourages patients to engage in pleasurable or meaningful activities to break the
cycle of withdrawal and depression. It is often more effective as an initial
intervention before cognitive restructuring.
Question 7:
A PMHNP is working with a patient who has a pattern of idealizing the therapist
and then becoming devaluing when feeling disappointed. This is an example of:
a. Splitting
b. Projection
c. Sublimation
d. Denial
, Rationale: Splitting is a primitive defense mechanism common in borderline
personality disorder where the individual sees people and situations as all good or
all bad, without integrating positive and negative qualities. This manifests as
alternating idealization and devaluation in relationships.
Question 8:
A 28-year-old patient reports anxiety about public speaking. The PMHNP uses a
technique where the patient imagines speaking in front of progressively larger
audiences while practicing relaxation. This approach is consistent with:
a. Systematic desensitization
b. Flooding
c. Cognitive restructuring
d. Behavioral activation
Rationale: Systematic desensitization is a behavioral therapy technique for anxiety
that involves creating a hierarchy of feared situations and pairing imaginal
exposure with relaxation techniques. It is based on the principle of reciprocal
inhibition.
Question 9:
A patient reports that they have not been able to leave their house for the past 6
months due to fear of having a panic attack. The PMHNP uses a technique where
the patient takes small steps, walking to the mailbox, then to the corner, and
eventually around the block. This technique is called:
a. Graduated exposure
b. Flooding
c. Response prevention
d. Cognitive restructuring
Rationale: Graduated exposure is a behavioral therapy technique that involves
gradually exposing the patient to feared stimuli in small, manageable steps. This
builds confidence and reduces anxiety through habituation.
