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 licensed PMHNP is starting weekly psychotherapy with
a client who presents with chronic depressive symptoms and
multiple medical comorbidities. The client asks for immediate
solutions to “feel normal again.” The PMHNP must decide how
to frame treatment goals in the first two sessions. Which
,therapist response best aligns with a holistic, nursing-based
psychotherapy framework described in the chapter?
A. Emphasize immediate symptom relief by focusing primarily
on medication management and refer psychotherapy to a
counselor.
B. Collaboratively explore the client’s priorities,
psychoeducation about symptom meaning, and co-create
staged goals that integrate medical, relational, and functional
aims.
C. Focus intake solely on psychiatric diagnosis and create a
standardized CBT protocol for depressive symptoms.
D. Encourage the client to wait for symptoms to remit naturally
while building a long-term psychodynamic exploration plan.
Correct answer
B
Rationales
Correct (B): Wheeler emphasizes a holistic model where
symptoms are viewed as meaningful communications; PMHNPs
co-create staged treatment aims addressing symptoms,
functioning, relationships, and medical context. This approach
integrates nursing problem-solving with collaborative goal
setting.
A: Prematurely privileging medication and referring out
neglects the nurse psychotherapist’s role and the holistic
integration of psychotherapeutic and medical care.
C: Solely using diagnosis-driven standardized CBT ignores the
,client’s broader context, medical comorbidities, and staged
aims recommended by Wheeler.
D: Waiting for natural remission while starting deep
psychodynamic work is misaligned with immediate needs and
staged intervention principles; it risks patient safety and
alliance.
Teaching point
Co-create staged, holistic goals integrating symptoms, function,
relationships, and medical context.
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 novice PMHNP reports intense anxiety
about “saying the wrong thing” in the first psychotherapy
session. Using Benner’s novice→expert perspective and the
chapter’s discussion of learning stages, which supervisory
strategy best helps the supervisee progress toward therapeutic
competence?
, A. Reassure the supervisee that anxiety will disappear with time
and advise minimal preparation to avoid overthinking.
B. Provide structured role-plays with feedback focused on
micro-skills, normalizing the “conscious incompetence” stage
and setting graduated competence goals.
C. Tell the supervisee to adopt an authoritative therapeutic
stance to reduce session variability.
D. Reduce patient load so the supervisee avoids first sessions
until fully confident.
Correct answer
B
Rationales
Correct (B): Wheeler links Benner’s model to stages of learning;
intentional practice, role-play, and incremental skill goals
support movement from conscious incompetence to conscious
competence. Supervision should normalize anxiety and build
specific skills.
A: Minimizing preparation risks perpetuating incompetence;
anxiety needs active management, not dismissal.
C: Advocating an authoritative stance conflicts with
empowerment-focused nursing psychotherapy and risks
harming the alliance.
D: Avoidance delays development; supervised, scaffolded
exposure is the recommended training path.
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 licensed PMHNP is starting weekly psychotherapy with
a client who presents with chronic depressive symptoms and
multiple medical comorbidities. The client asks for immediate
solutions to “feel normal again.” The PMHNP must decide how
to frame treatment goals in the first two sessions. Which
,therapist response best aligns with a holistic, nursing-based
psychotherapy framework described in the chapter?
A. Emphasize immediate symptom relief by focusing primarily
on medication management and refer psychotherapy to a
counselor.
B. Collaboratively explore the client’s priorities,
psychoeducation about symptom meaning, and co-create
staged goals that integrate medical, relational, and functional
aims.
C. Focus intake solely on psychiatric diagnosis and create a
standardized CBT protocol for depressive symptoms.
D. Encourage the client to wait for symptoms to remit naturally
while building a long-term psychodynamic exploration plan.
Correct answer
B
Rationales
Correct (B): Wheeler emphasizes a holistic model where
symptoms are viewed as meaningful communications; PMHNPs
co-create staged treatment aims addressing symptoms,
functioning, relationships, and medical context. This approach
integrates nursing problem-solving with collaborative goal
setting.
A: Prematurely privileging medication and referring out
neglects the nurse psychotherapist’s role and the holistic
integration of psychotherapeutic and medical care.
C: Solely using diagnosis-driven standardized CBT ignores the
,client’s broader context, medical comorbidities, and staged
aims recommended by Wheeler.
D: Waiting for natural remission while starting deep
psychodynamic work is misaligned with immediate needs and
staged intervention principles; it risks patient safety and
alliance.
Teaching point
Co-create staged, holistic goals integrating symptoms, function,
relationships, and medical context.
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 novice PMHNP reports intense anxiety
about “saying the wrong thing” in the first psychotherapy
session. Using Benner’s novice→expert perspective and the
chapter’s discussion of learning stages, which supervisory
strategy best helps the supervisee progress toward therapeutic
competence?
, A. Reassure the supervisee that anxiety will disappear with time
and advise minimal preparation to avoid overthinking.
B. Provide structured role-plays with feedback focused on
micro-skills, normalizing the “conscious incompetence” stage
and setting graduated competence goals.
C. Tell the supervisee to adopt an authoritative therapeutic
stance to reduce session variability.
D. Reduce patient load so the supervisee avoids first sessions
until fully confident.
Correct answer
B
Rationales
Correct (B): Wheeler links Benner’s model to stages of learning;
intentional practice, role-play, and incremental skill goals
support movement from conscious incompetence to conscious
competence. Supervision should normalize anxiety and build
specific skills.
A: Minimizing preparation risks perpetuating incompetence;
anxiety needs active management, not dismissal.
C: Advocating an authoritative stance conflicts with
empowerment-focused nursing psychotherapy and risks
harming the alliance.
D: Avoidance delays development; supervised, scaffolded
exposure is the recommended training path.
