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: Role and Scope
Stem
A 34-year-old client with generalized anxiety seeks therapy
through your outpatient PMHNP clinic after a referral from their
PCP. You must decide how to describe your role in a first
session. Which therapist statement best balances professional
transparency, scope of practice, and collaborative care?
,A. “I’m trained in psychotherapy and will treat your anxiety with
sessions here; for any medication needs you should see a
psychiatrist.”
B. “I’m a nurse psychotherapist and an advanced practice
clinician; I will perform assessment, provide evidence-based
psychotherapy, and coordinate medication management with
you or your prescriber as needed.”
C. “I provide therapy only; for medications and diagnostics talk
to your primary care doctor and come back when you want
therapy.”
D. “I can do both therapy and medication; we’ll focus only on
whichever you prefer and won’t coordinate with other
clinicians.”
Correct answer
B
Rationale — Correct (3–4 sentences)
Statement B transparently communicates the nurse
psychotherapist’s dual competency in psychotherapy and the
capacity to coordinate care, aligning with the PMHNP
framework that integrates assessment, treatment planning,
psychotherapy delivery, and collaborative medication
management when within scope. It supports informed consent
and continuity of care while preserving the therapeutic alliance.
This framing is consistent with Wheeler’s emphasis on role
clarity and integrated practice.
,Rationales — Incorrect
A: Unduly separates psychotherapy from prescribing without
acknowledging the PMHNP’s integrated role; may fragment care
and undermine coordination.
C: Overly restrictive and potentially misleading about scope;
fails to offer collaboration or assessment responsibilities
expected of PMHNPs.
D: Vague and potentially risky—promising medication without
specifying coordination, scope, or safety processes is ethically
inappropriate.
Teaching point
Describe competencies clearly; offer integration and
coordination within your scope.
Citation
Wheeler, K. (2023). Psychotherapy for the Advanced Practice
Psychiatric Nurse (3rd ed.). Ch. 1.
2
Reference
Ch. 1 — Professional Identity and the Nurse-Therapist Stance
Stem
During early sessions a client repeatedly asks “Are you like other
therapists?” You want to communicate a professional stance
that supports alliance and clarifies expectations. Which
, response best reflects an advanced practice nurse-therapist
stance?
A. “I’m similar to other therapists; just tell me what you want
and I’ll do it.”
B. “I bring nursing, psychotherapeutic training, and medical
knowledge; we’ll work collaboratively, and I’ll use evidence-
based methods tailored to your goals.”
C. “I’m not like other therapists—I focus only on symptoms and
medications.”
D. “It doesn’t matter—therapy is whatever you want it to be.”
Correct answer
B
Rationale — Correct (3–4 sentences)
B articulates a clear, professional, and integrative stance—
combining nursing, psychotherapy, and medical perspectives—
while emphasizing collaboration and evidence-based tailoring
to the client’s goals. This supports boundaries, clarifies scope,
and fosters a therapeutic alliance consistent with Wheeler’s
model of nurse psychotherapist identity. It balances
transparency with therapeutic orientation.
Rationales — Incorrect
A: Overly passive and non-directional; fails to define
professional role or therapeutic approach.
C: Reductive and misrepresents the psychotherapeutic role;
risks damaging rapport and trust.
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: Role and Scope
Stem
A 34-year-old client with generalized anxiety seeks therapy
through your outpatient PMHNP clinic after a referral from their
PCP. You must decide how to describe your role in a first
session. Which therapist statement best balances professional
transparency, scope of practice, and collaborative care?
,A. “I’m trained in psychotherapy and will treat your anxiety with
sessions here; for any medication needs you should see a
psychiatrist.”
B. “I’m a nurse psychotherapist and an advanced practice
clinician; I will perform assessment, provide evidence-based
psychotherapy, and coordinate medication management with
you or your prescriber as needed.”
C. “I provide therapy only; for medications and diagnostics talk
to your primary care doctor and come back when you want
therapy.”
D. “I can do both therapy and medication; we’ll focus only on
whichever you prefer and won’t coordinate with other
clinicians.”
Correct answer
B
Rationale — Correct (3–4 sentences)
Statement B transparently communicates the nurse
psychotherapist’s dual competency in psychotherapy and the
capacity to coordinate care, aligning with the PMHNP
framework that integrates assessment, treatment planning,
psychotherapy delivery, and collaborative medication
management when within scope. It supports informed consent
and continuity of care while preserving the therapeutic alliance.
This framing is consistent with Wheeler’s emphasis on role
clarity and integrated practice.
,Rationales — Incorrect
A: Unduly separates psychotherapy from prescribing without
acknowledging the PMHNP’s integrated role; may fragment care
and undermine coordination.
C: Overly restrictive and potentially misleading about scope;
fails to offer collaboration or assessment responsibilities
expected of PMHNPs.
D: Vague and potentially risky—promising medication without
specifying coordination, scope, or safety processes is ethically
inappropriate.
Teaching point
Describe competencies clearly; offer integration and
coordination within your scope.
Citation
Wheeler, K. (2023). Psychotherapy for the Advanced Practice
Psychiatric Nurse (3rd ed.). Ch. 1.
2
Reference
Ch. 1 — Professional Identity and the Nurse-Therapist Stance
Stem
During early sessions a client repeatedly asks “Are you like other
therapists?” You want to communicate a professional stance
that supports alliance and clarifies expectations. Which
, response best reflects an advanced practice nurse-therapist
stance?
A. “I’m similar to other therapists; just tell me what you want
and I’ll do it.”
B. “I bring nursing, psychotherapeutic training, and medical
knowledge; we’ll work collaboratively, and I’ll use evidence-
based methods tailored to your goals.”
C. “I’m not like other therapists—I focus only on symptoms and
medications.”
D. “It doesn’t matter—therapy is whatever you want it to be.”
Correct answer
B
Rationale — Correct (3–4 sentences)
B articulates a clear, professional, and integrative stance—
combining nursing, psychotherapy, and medical perspectives—
while emphasizing collaboration and evidence-based tailoring
to the client’s goals. This supports boundaries, clarifies scope,
and fosters a therapeutic alliance consistent with Wheeler’s
model of nurse psychotherapist identity. It balances
transparency with therapeutic orientation.
Rationales — Incorrect
A: Overly passive and non-directional; fails to define
professional role or therapeutic approach.
C: Reductive and misrepresents the psychotherapeutic role;
risks damaging rapport and trust.
