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 35-year-old client with chronic anxiety says in session,
“My last therapist kept telling me my problems are all in my
head.” You, the nurse psychotherapist, note a strong empathic
connection but also the client’s skeptical tone. Which therapist
response best reflects a nursing-based, relationship-centered
framework that promotes engagement and preserves the
therapeutic frame?
,A. Reassure the client that their symptoms are “real” and that
psychotherapy will fix them.
B. Validate the client’s experience, invite elaboration about
prior therapy, and gently explore expectations for treatment.
C. Immediately provide psychoeducation describing diagnostic
criteria for anxiety disorders.
D. Challenge the client’s skepticism directly and point out
inconsistencies in their narrative.
Correct answer: B
Rationales — Correct: Validation and invitation to elaborate
strengthens alliance, integrates nursing’s relational stance, and
assesses prior treatment expectations without prematurely
teaching or confronting. It aligns with a framework that
foregrounds connection and collaborative meaning-making.
Incorrect A: Overly reassuring and promising a fix is premature
and can undermine realistic expectation-setting and informed
consent.
Incorrect C: Psychoeducation may be useful later but initiating
with didactic content risks minimizing the relational work
needed for engagement.
Incorrect D: Direct challenge early risks rupturing alliance and is
inconsistent with a relationship-based, trauma-informed stance.
Teaching point: Begin with validation and exploration to build
alliance before teaching or confronting.
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 client describes severe childhood
emotional neglect. You sense a need to balance safety,
assessment, and relationship building. Which initial approach
best aligns with Wheeler’s holistic, trauma-informed
framework?
A. Complete a thorough symptom checklist and risk
assessment, deferring relational exploration.
B. Offer empathic containment, conduct a focused safety
assessment, and begin to co-construct a formulation.
C. Use interpretive psychodynamic formulations immediately to
explore early attachment injuries.
D. Recommend immediate referral to group therapy to address
attachment issues.
Correct answer: B
Rationales — Correct: Combining empathic containment with
safety assessment and early collaborative formulation honors
trauma-informed practice and the nurse psychotherapist’s
relational, holistic role; it balances clinical risk and alliance.
Incorrect A: Purely administrative assessment without
relational containment may retraumatize and impair
engagement.
, Incorrect C: Deep interpretive work is premature before safety
and stabilization and may overwhelm the client.
Incorrect D: Immediate referral to group therapy bypasses
individualized safety planning and therapeutic readiness
assessment.
Teaching point: Prioritize safety and containment while
collaboratively formulating trauma history.
Citation: Wheeler, K. (2023). Psychotherapy for the Advanced
Practice Psychiatric Nurse (3rd ed.). Ch. 1.
3)
Reference: Ch. 1 — The Nurse Psychotherapist and a
Framework for Practice
Stem: A client discloses strong distress and asks the nurse
psychotherapist for advice about medication versus
psychotherapy. In line with the chapter’s emphasis on the nurse
role and integrated care, which response best demonstrates
appropriate scope and collaborative decision-making?
A. State that psychotherapy is usually superior and decline to
discuss medication.
B. Provide balanced information about both options and offer
to coordinate with the prescribing clinician or discuss integrated
care.
C. Immediately refer the client to psychiatry and discontinue
psychotherapy until medication is started.
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 35-year-old client with chronic anxiety says in session,
“My last therapist kept telling me my problems are all in my
head.” You, the nurse psychotherapist, note a strong empathic
connection but also the client’s skeptical tone. Which therapist
response best reflects a nursing-based, relationship-centered
framework that promotes engagement and preserves the
therapeutic frame?
,A. Reassure the client that their symptoms are “real” and that
psychotherapy will fix them.
B. Validate the client’s experience, invite elaboration about
prior therapy, and gently explore expectations for treatment.
C. Immediately provide psychoeducation describing diagnostic
criteria for anxiety disorders.
D. Challenge the client’s skepticism directly and point out
inconsistencies in their narrative.
Correct answer: B
Rationales — Correct: Validation and invitation to elaborate
strengthens alliance, integrates nursing’s relational stance, and
assesses prior treatment expectations without prematurely
teaching or confronting. It aligns with a framework that
foregrounds connection and collaborative meaning-making.
Incorrect A: Overly reassuring and promising a fix is premature
and can undermine realistic expectation-setting and informed
consent.
Incorrect C: Psychoeducation may be useful later but initiating
with didactic content risks minimizing the relational work
needed for engagement.
Incorrect D: Direct challenge early risks rupturing alliance and is
inconsistent with a relationship-based, trauma-informed stance.
Teaching point: Begin with validation and exploration to build
alliance before teaching or confronting.
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 client describes severe childhood
emotional neglect. You sense a need to balance safety,
assessment, and relationship building. Which initial approach
best aligns with Wheeler’s holistic, trauma-informed
framework?
A. Complete a thorough symptom checklist and risk
assessment, deferring relational exploration.
B. Offer empathic containment, conduct a focused safety
assessment, and begin to co-construct a formulation.
C. Use interpretive psychodynamic formulations immediately to
explore early attachment injuries.
D. Recommend immediate referral to group therapy to address
attachment issues.
Correct answer: B
Rationales — Correct: Combining empathic containment with
safety assessment and early collaborative formulation honors
trauma-informed practice and the nurse psychotherapist’s
relational, holistic role; it balances clinical risk and alliance.
Incorrect A: Purely administrative assessment without
relational containment may retraumatize and impair
engagement.
, Incorrect C: Deep interpretive work is premature before safety
and stabilization and may overwhelm the client.
Incorrect D: Immediate referral to group therapy bypasses
individualized safety planning and therapeutic readiness
assessment.
Teaching point: Prioritize safety and containment while
collaboratively formulating trauma history.
Citation: Wheeler, K. (2023). Psychotherapy for the Advanced
Practice Psychiatric Nurse (3rd ed.). Ch. 1.
3)
Reference: Ch. 1 — The Nurse Psychotherapist and a
Framework for Practice
Stem: A client discloses strong distress and asks the nurse
psychotherapist for advice about medication versus
psychotherapy. In line with the chapter’s emphasis on the nurse
role and integrated care, which response best demonstrates
appropriate scope and collaborative decision-making?
A. State that psychotherapy is usually superior and decline to
discuss medication.
B. Provide balanced information about both options and offer
to coordinate with the prescribing clinician or discuss integrated
care.
C. Immediately refer the client to psychiatry and discontinue
psychotherapy until medication is started.
