PSYCHOTHERAPY FOR THE ADVANCED
PRACTICE PSYCHIATRIC NURSE
A HOW-TO GUIDE FOR EVIDENCE-BASED
PRACTICE
3RD EDITION
• AUTHOR(S)KATHLEEN WHEELER
TEST BANK
1
Reference
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Stem
A newly graduated PMHNP is nervous about the first
psychotherapy session with a patient who has complex, chronic
mood symptoms. The clinician recalls Benner’s novice→expert
concept and wants to manage their anxiety while remaining
,therapeutically effective. Which therapist action best balances
patient-centered care and the clinician’s novice status?
A. Attempt a full psychodynamic interpretation in session to
demonstrate expertise.
B. Use a structured, collaborative problem-solving approach,
acknowledging limits and seeking supervision.
C. Refer the patient immediately for psychotherapy to a
psychologist because the PMHNP is a novice.
D. Focus primarily on medication management to reduce the
clinician’s responsibility in psychotherapy.
Correct answer
B
Rationales
Correct (B): Using a collaborative, problem-solving approach
aligns with nursing’s holistic, pragmatic strengths and Benner’s
framework — it allows the novice PMHNP to practice within
competence, seek supervision, and preserve alliance while
addressing immediate needs. This reflects Wheeler’s emphasis
on staged skill development and using nursing problem-solving
as a therapeutic scaffold.
Incorrect (A): Offering advanced psychodynamic interpretations
is premature for a novice and risks alliance rupture and
inaccurate formulation.
Incorrect (C): Automatic referral abdicates appropriate scope;
PMHNPs are trained to provide psychotherapy and can safely
work with supervision.
,Incorrect (D): Prioritizing medication avoids the
psychotherapeutic role and misses the holistic, relationship-
based interventions emphasized in the chapter.
Teaching point
Use collaborative problem-solving; acknowledge limits and
pursue supervision.
Citation
Wheeler, K. (2023). Psychotherapy for the Advanced Practice
Psychiatric Nurse (3rd ed.). Ch. 1.
2
Reference
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Stem
During supervision, a PMHNP reflects that in prior nursing roles
they were highly directive. A supervisor asks how that style
might affect psychotherapy alliance. What best describes an
evidence-based nursing stance in psychotherapy?
A. Maintain directive problem-solving; patients expect nurses to
tell them what to do.
B. Emphasize therapeutic presence, patience, and
empowerment—promoting patient autonomy.
C. Avoid emotional engagement to preserve professional
distance and objectivity.
, D. Use authoritative advice early to quickly reduce symptoms,
then transition to collaboration.
Correct answer
B
Rationales
Correct (B): Wheeler highlights nurses’ therapeutic use of self—
presence, patience, and empowerment—over directive
authority. Promoting autonomy fits the holistic model and
reduces counterproductive dependency.
Incorrect (A): Over-directiveness may undermine
empowerment and reinforce dependency.
Incorrect (C): Emotional disengagement undermines healing
presence; the chapter emphasizes authentic connection.
Incorrect (D): Prioritizing authority to reduce symptoms risks
creating dependence and is misaligned with the nurse-
psychotherapist stance.
Teaching point
Therapeutic presence and empowerment trump directive
authority.
Citation
Wheeler, K. (2023). Ch. 1.
3
PRACTICE PSYCHIATRIC NURSE
A HOW-TO GUIDE FOR EVIDENCE-BASED
PRACTICE
3RD EDITION
• AUTHOR(S)KATHLEEN WHEELER
TEST BANK
1
Reference
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Stem
A newly graduated PMHNP is nervous about the first
psychotherapy session with a patient who has complex, chronic
mood symptoms. The clinician recalls Benner’s novice→expert
concept and wants to manage their anxiety while remaining
,therapeutically effective. Which therapist action best balances
patient-centered care and the clinician’s novice status?
A. Attempt a full psychodynamic interpretation in session to
demonstrate expertise.
B. Use a structured, collaborative problem-solving approach,
acknowledging limits and seeking supervision.
C. Refer the patient immediately for psychotherapy to a
psychologist because the PMHNP is a novice.
D. Focus primarily on medication management to reduce the
clinician’s responsibility in psychotherapy.
Correct answer
B
Rationales
Correct (B): Using a collaborative, problem-solving approach
aligns with nursing’s holistic, pragmatic strengths and Benner’s
framework — it allows the novice PMHNP to practice within
competence, seek supervision, and preserve alliance while
addressing immediate needs. This reflects Wheeler’s emphasis
on staged skill development and using nursing problem-solving
as a therapeutic scaffold.
Incorrect (A): Offering advanced psychodynamic interpretations
is premature for a novice and risks alliance rupture and
inaccurate formulation.
Incorrect (C): Automatic referral abdicates appropriate scope;
PMHNPs are trained to provide psychotherapy and can safely
work with supervision.
,Incorrect (D): Prioritizing medication avoids the
psychotherapeutic role and misses the holistic, relationship-
based interventions emphasized in the chapter.
Teaching point
Use collaborative problem-solving; acknowledge limits and
pursue supervision.
Citation
Wheeler, K. (2023). Psychotherapy for the Advanced Practice
Psychiatric Nurse (3rd ed.). Ch. 1.
2
Reference
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Stem
During supervision, a PMHNP reflects that in prior nursing roles
they were highly directive. A supervisor asks how that style
might affect psychotherapy alliance. What best describes an
evidence-based nursing stance in psychotherapy?
A. Maintain directive problem-solving; patients expect nurses to
tell them what to do.
B. Emphasize therapeutic presence, patience, and
empowerment—promoting patient autonomy.
C. Avoid emotional engagement to preserve professional
distance and objectivity.
, D. Use authoritative advice early to quickly reduce symptoms,
then transition to collaboration.
Correct answer
B
Rationales
Correct (B): Wheeler highlights nurses’ therapeutic use of self—
presence, patience, and empowerment—over directive
authority. Promoting autonomy fits the holistic model and
reduces counterproductive dependency.
Incorrect (A): Over-directiveness may undermine
empowerment and reinforce dependency.
Incorrect (C): Emotional disengagement undermines healing
presence; the chapter emphasizes authentic connection.
Incorrect (D): Prioritizing authority to reduce symptoms risks
creating dependence and is misaligned with the nurse-
psychotherapist stance.
Teaching point
Therapeutic presence and empowerment trump directive
authority.
Citation
Wheeler, K. (2023). Ch. 1.
3
