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 34-year-old client with chronic depression tells you, in session
three, that they feel “seen” for the first time and asks whether
you think psychotherapy can “fix” them quickly. You are early in
building the relationship and the client is ambivalent about
medication. Which therapist response best aligns with a
,relationship-based nursing psychotherapy framework at this
stage?
A. Reassure the client that with focused work and attendance,
significant improvement generally occurs within a few sessions.
B. Normalize hope, outline a collaborative treatment plan
including realistic timelines, and invite the client’s goals into
shaping next steps.
C. Recommend immediate medication initiation because
psychotherapy alone is too slow for clinical depression.
D. Encourage the client to keep expectations low and focus only
on short-term symptom reduction.
Correct Answer
B
Rationales
Correct (B): This answer reflects Wheeler’s relationship-based
framework: validate the client’s hope, collaborate on goals,
integrate evidence-based treatment options, and maintain
realistic, joint planning early in therapy—strengthening alliance
and shared decision-making.
Incorrect (A): Overly reassuring rapid improvement is
premature and risks damaging alliance if expectations are
unmet.
Incorrect (C): Immediate medication may be appropriate in
some cases but presuming medication without collaborative
assessment undermines patient-centered, relationship-based
care.
,Incorrect (D): Discouraging hope is misaligned with resilience-
focused nursing psychotherapy and may weaken engagement.
Teaching Point
Validate hope; co-create realistic, goal-focused treatment plans
to strengthen alliance.
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 intake, a 19-year-old college student reports panic
attacks and a history of racial microaggressions. They ask
whether you understand how these experiences matter in
therapy. As a PMHNP integrating Wheeler’s framework, what
initial clinical stance most effectively attends to cultural context
and trauma-informed care?
A. Focus strictly on symptom frequency and severity metrics to
determine diagnosis first.
B. Adopt an empathic, curious stance that explores the meaning
of experiences within the client’s cultural context and safety
needs.
, C. Minimize discussion of race to avoid activating painful
memories; instead focus on coping skills.
D. Refer out to a culturally matched therapist immediately
without a brief collaborative assessment.
Correct Answer
B
Rationales
Correct (B): Wheeler emphasizes a cultural and trauma-
informed, relationship-based stance—listening with curiosity to
meaning and assessing safety and resilience before prioritizing
interventions.
Incorrect (A): Symptom measurement is useful but premature
narrow focus risks missing cultural/trauma dimensions central
to treatment planning.
Incorrect (C): Minimizing cultural trauma neglects essential
context, risks invalidation, and undermines alliance.
Incorrect (D): Immediate referral without initial assessment
may abandon the client and misses opportunity for therapeutic
engagement and collaborative planning.
Teaching Point
Begin with culturally attuned curiosity—assess meaning, safety,
and resilience before prioritizing interventions.
Citation
Wheeler, K. (2023). Psychotherapy for the Advanced Practice
Psychiatric Nurse (3rd ed.). Ch. 1.
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 34-year-old client with chronic depression tells you, in session
three, that they feel “seen” for the first time and asks whether
you think psychotherapy can “fix” them quickly. You are early in
building the relationship and the client is ambivalent about
medication. Which therapist response best aligns with a
,relationship-based nursing psychotherapy framework at this
stage?
A. Reassure the client that with focused work and attendance,
significant improvement generally occurs within a few sessions.
B. Normalize hope, outline a collaborative treatment plan
including realistic timelines, and invite the client’s goals into
shaping next steps.
C. Recommend immediate medication initiation because
psychotherapy alone is too slow for clinical depression.
D. Encourage the client to keep expectations low and focus only
on short-term symptom reduction.
Correct Answer
B
Rationales
Correct (B): This answer reflects Wheeler’s relationship-based
framework: validate the client’s hope, collaborate on goals,
integrate evidence-based treatment options, and maintain
realistic, joint planning early in therapy—strengthening alliance
and shared decision-making.
Incorrect (A): Overly reassuring rapid improvement is
premature and risks damaging alliance if expectations are
unmet.
Incorrect (C): Immediate medication may be appropriate in
some cases but presuming medication without collaborative
assessment undermines patient-centered, relationship-based
care.
,Incorrect (D): Discouraging hope is misaligned with resilience-
focused nursing psychotherapy and may weaken engagement.
Teaching Point
Validate hope; co-create realistic, goal-focused treatment plans
to strengthen alliance.
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 intake, a 19-year-old college student reports panic
attacks and a history of racial microaggressions. They ask
whether you understand how these experiences matter in
therapy. As a PMHNP integrating Wheeler’s framework, what
initial clinical stance most effectively attends to cultural context
and trauma-informed care?
A. Focus strictly on symptom frequency and severity metrics to
determine diagnosis first.
B. Adopt an empathic, curious stance that explores the meaning
of experiences within the client’s cultural context and safety
needs.
, C. Minimize discussion of race to avoid activating painful
memories; instead focus on coping skills.
D. Refer out to a culturally matched therapist immediately
without a brief collaborative assessment.
Correct Answer
B
Rationales
Correct (B): Wheeler emphasizes a cultural and trauma-
informed, relationship-based stance—listening with curiosity to
meaning and assessing safety and resilience before prioritizing
interventions.
Incorrect (A): Symptom measurement is useful but premature
narrow focus risks missing cultural/trauma dimensions central
to treatment planning.
Incorrect (C): Minimizing cultural trauma neglects essential
context, risks invalidation, and undermines alliance.
Incorrect (D): Immediate referral without initial assessment
may abandon the client and misses opportunity for therapeutic
engagement and collaborative planning.
Teaching Point
Begin with culturally attuned curiosity—assess meaning, safety,
and resilience before prioritizing interventions.
Citation
Wheeler, K. (2023). Psychotherapy for the Advanced Practice
Psychiatric Nurse (3rd ed.). Ch. 1.
