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 42-year-old woman with recurrent major depressive episodes
requests psychotherapy from you in addition to medication
management. She asks whether you, as her prescribing PMHNP,
can provide long-term psychotherapy. Considering professional
scope, therapeutic boundaries, and patient needs, which
,response best aligns with an ethical, evidence-based approach
to role integration?
Options
A. Agree to provide indefinite long-term psychotherapy and
medication because continuity with one clinician improves
outcomes.
B. Explain your competence in psychotherapy, discuss mutually
agreeable goals and time frame, and arrange supervision or
referral if long-term therapy is needed.
C. Decline to provide psychotherapy and refer immediately to a
specialist to avoid dual-role issues.
D. Offer brief supportive therapy only, telling the patient that
psychotherapy is outside your scope as a prescriber.
Correct Answer
B
Rationales
Correct Option (B): This response assesses competence, clarifies
scope and treatment frame, aligns with nurse psychotherapist
practice framework, preserves therapeutic alliance, and
proactively arranges supervision or referral if treatment needs
exceed competence. It balances integrated care and ethical
boundaries.
Incorrect Option (A): Prematurely offering indefinite long-term
therapy may exceed current competency or resources and fails
to set a therapeutic frame.
Incorrect Option (C): Immediate referral without assessing goals
,and competency may fragment care and needlessly undermine
the therapeutic relationship.
Incorrect Option (D): Asserting psychotherapy is outside scope
is often inaccurate for trained nurse psychotherapists and
reduces collaborative decision-making.
Teaching Point
Clarify competence, negotiate treatment frame, and arrange
supervision/referral when needed.
Citation
Wheeler, K. (2023). Psychotherapy for the Advanced Practice
Psychiatric Nurse (3rd ed.). Ch. 1.
2.
Reference
Ch. 1 — Professional Identity and the Nurse-Patient
Relationship
Stem
During the first psychotherapy session, a young man tells you
he Googled your clinical background and asks how your
personal values might affect therapy. Which therapist statement
best reflects ethical transparency and supports therapeutic
alliance while maintaining professional boundaries?
Options
A. “My personal values won’t influence therapy; I keep them
out of the room entirely.”
, B. “I’ll share how my approach may shape therapy and ask how
that fits with your values; let’s collaborate on goals.”
C. “I can tell you everything about my values so you can decide
if I’m the right therapist.”
D. “Your values are what matter; I’ll just do whatever you want.”
Correct Answer
B
Rationales
Correct Option (B): This balances transparency with
professional boundaries, invites client collaboration, and aligns
with Wheeler’s emphasis on therapist self-awareness and
negotiated goals.
Incorrect Option (A): Asserting absolute separation is unrealistic
and nontransparent, which can harm trust.
Incorrect Option (C): Oversharing personal values risks blurring
boundaries and shifting focus from the client.
Incorrect Option (D): Uncritical accommodation undermines
clinical judgment and therapeutic guidance.
Teaching Point
Be transparent about therapist stance while centering
collaborative goal setting.
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 Role and Scope
Stem
A 42-year-old woman with recurrent major depressive episodes
requests psychotherapy from you in addition to medication
management. She asks whether you, as her prescribing PMHNP,
can provide long-term psychotherapy. Considering professional
scope, therapeutic boundaries, and patient needs, which
,response best aligns with an ethical, evidence-based approach
to role integration?
Options
A. Agree to provide indefinite long-term psychotherapy and
medication because continuity with one clinician improves
outcomes.
B. Explain your competence in psychotherapy, discuss mutually
agreeable goals and time frame, and arrange supervision or
referral if long-term therapy is needed.
C. Decline to provide psychotherapy and refer immediately to a
specialist to avoid dual-role issues.
D. Offer brief supportive therapy only, telling the patient that
psychotherapy is outside your scope as a prescriber.
Correct Answer
B
Rationales
Correct Option (B): This response assesses competence, clarifies
scope and treatment frame, aligns with nurse psychotherapist
practice framework, preserves therapeutic alliance, and
proactively arranges supervision or referral if treatment needs
exceed competence. It balances integrated care and ethical
boundaries.
Incorrect Option (A): Prematurely offering indefinite long-term
therapy may exceed current competency or resources and fails
to set a therapeutic frame.
Incorrect Option (C): Immediate referral without assessing goals
,and competency may fragment care and needlessly undermine
the therapeutic relationship.
Incorrect Option (D): Asserting psychotherapy is outside scope
is often inaccurate for trained nurse psychotherapists and
reduces collaborative decision-making.
Teaching Point
Clarify competence, negotiate treatment frame, and arrange
supervision/referral when needed.
Citation
Wheeler, K. (2023). Psychotherapy for the Advanced Practice
Psychiatric Nurse (3rd ed.). Ch. 1.
2.
Reference
Ch. 1 — Professional Identity and the Nurse-Patient
Relationship
Stem
During the first psychotherapy session, a young man tells you
he Googled your clinical background and asks how your
personal values might affect therapy. Which therapist statement
best reflects ethical transparency and supports therapeutic
alliance while maintaining professional boundaries?
Options
A. “My personal values won’t influence therapy; I keep them
out of the room entirely.”
, B. “I’ll share how my approach may shape therapy and ask how
that fits with your values; let’s collaborate on goals.”
C. “I can tell you everything about my values so you can decide
if I’m the right therapist.”
D. “Your values are what matter; I’ll just do whatever you want.”
Correct Answer
B
Rationales
Correct Option (B): This balances transparency with
professional boundaries, invites client collaboration, and aligns
with Wheeler’s emphasis on therapist self-awareness and
negotiated goals.
Incorrect Option (A): Asserting absolute separation is unrealistic
and nontransparent, which can harm trust.
Incorrect Option (C): Oversharing personal values risks blurring
boundaries and shifting focus from the client.
Incorrect Option (D): Uncritical accommodation undermines
clinical judgment and therapeutic guidance.
Teaching Point
Be transparent about therapist stance while centering
collaborative goal setting.
Citation
Wheeler, K. (2023). Psychotherapy for the Advanced Practice
Psychiatric Nurse (3rd ed.). Ch. 1.
