1
NRNP 6645 Midterm Exam (Latest-2026/2027, 100 Q &
A) / NRNP 6645N Midterm Exam / NRNP6645 Midterm
Exam / NRNP-6645N Midterm Exam: Walden University
| 100% Verified Q & A |
Exam Questions & Answers
Question 1: The advanced practice psychiatric nurse may intervene as appropriate with agencies or
persons in order to advocate for the patient; do for the patient what he or she cannot do for self, always
with an aim toward maximum independence and growth. This is consistent with which basic strategy of
dynamic supportive therapy?
• A) Make connections
• B) Encourage patient activity
• C) Manipulate the environment
• D) Maximize adaptive coping mechanisms ✅
Rationale: This strategy focuses on helping the patient develop better coping skills and adapt to their
environment while promoting autonomy. It aligns with the supportive aspect of dynamic therapy where
the nurse actively assists the patient in managing their external world.
Question 2: Which of the following is consistent with literature regarding suicide? (Select all that apply)
• A) Assessing the patient is of paramount importance for the advanced practice psychiatric
nurse during the initial patient contact ✅
• B) Asking about suicide will plant the idea in the patient's mind
• C) Suicidal ideation is always a psychiatric emergency
• D) Suicidality can be assessed by using reliable and valid self-report questionnaires ✅
Rationale: Research indicates that direct assessment of suicidal thoughts does not increase risk and is
essential. Validated tools (e.g., Columbia-Suicide Severity Rating Scale) are effective for risk assessment.
Question 3: Common ancestry through which individuals have evolved shared values and customs is
known as which of the following?
,2
• A) Race
• B) Ethnicity ✅
• C) Culture
• D) Religion
Rationale: Ethnicity refers to a shared cultural heritage, ancestry, and often language, whereas culture
encompasses broader patterns of behavior and beliefs.
Question 4: The therapist using a CBT approach in which the therapist encourages the patient to
investigate whether their thoughts are based on facts or assumptions is known as which of the
following?
• A) Socratic questioning
• B) Questioning the evidence ✅
• C) Decentering
• D) Cognitive reframing
Rationale: "Questioning the evidence" is a specific CBT technique where the therapist helps the patient
examine the factual basis of their automatic thoughts.
Question 5: Which of the following is NOT consistent with the underlying assumptions of
psychodynamic psychotherapy?
• A) What happened in the past determines what we do today ✅
• B) Unconscious processes influence behavior
• C) Early childhood experiences shape personality
• D) Defense mechanisms protect against anxiety
Rationale: While past experiences are important, psychodynamic therapy emphasizes that present
behavior is influenced by unconscious processes and defenses, not that the past rigidly determines
current actions.
Question 6: The advanced practice psychiatric nurse is meeting with a patient who is in the process of
an unwanted divorce. The patient endorses persistent suicidal ideations with strong intent. The nurse
recognizes the patient is at high suicide risk and recommends which of the following?
• A) Outpatient therapy twice weekly
• B) Hospital psychiatric admission and suicide precautions ✅
,3
• C) Telephone crisis line referral
• D) Safety plan only
Rationale: Persistent suicidal ideation with strong intent requires immediate inpatient psychiatric care
to ensure safety.
Question 7: Which of the following assumptions would the therapist be safe in making about cultural
influences in a family?
• A) All families of the same ethnicity share identical values
• B) The cultural context of families is complicated by the fact that most families are influenced
by multiple contexts ✅
• C) Cultural influences are irrelevant to family therapy
• D) Acculturation is the same for all family members
Rationale: Families are often shaped by multiple intersecting cultural influences (e.g., ethnicity, religion,
socioeconomic status), making generalization inaccurate.
Question 8: The focus of exploration in a relational psychodynamic therapy includes which one of the
following?
• A) Childhood memories only
• B) The future
• C) Here and now ✅
• D) Dream interpretation
Rationale: Relational psychodynamic therapy emphasizes the current therapeutic relationship and
present interpersonal dynamics.
Question 9: The CBT therapist asks the patient, "On a scale of 0–10, how would you rate your
depression today? And how does that compare to 2 months ago?" This is an example of what type of
question in Socratic dialogue?
• A) Clarifying question
• B) Questioning the evidence
• C) Challenging the distortion
• D) This would not be a question consistent with Socratic Dialogue ✅
, 4
Rationale: Socratic dialogue involves guided discovery through open-ended questions about the
patient's thinking, not rating scales.
Question 10: Which of the following best describes the difference between standards of care and
practice guidelines?
• A) Standards of care are optional; practice guidelines are mandatory
• B) Standards of care are legally binding while practice guidelines are not ✅
• C) There is no difference
• D) Practice guidelines are set by courts; standards of care are set by professional organizations
Rationale: Standards of care are the minimum acceptable level of care and are legally binding; practice
guidelines are recommendations that allow flexibility.
Question 11: Strategies for working with anxiety are central to all therapy approaches. Which strategy
would be consistent with a behavioral therapy approach?
• A) Restructuring ✅
• B) Exploring unconscious conflicts
• C) Interpreting dreams
• D) Reframing family dynamics
Rationale: Behavioral approaches focus on restructuring maladaptive behaviors through techniques like
exposure, relaxation training, and behavior modification.
Question 12: According to Structural Family Therapy model, family structure refers to which of the
following?
• A) The family's physical living arrangements
• B) The way families are organized into subsystems separated by emotional boundaries ✅
• C) The family's communication patterns
• D) The family's socioeconomic status
Rationale: In Structural Family Therapy, family structure consists of subsystems (e.g., parental, sibling)
and boundaries that regulate interaction.
Question 13: "They probably think I am stupid" is an example of which type of cognitive distortion?
NRNP 6645 Midterm Exam (Latest-2026/2027, 100 Q &
A) / NRNP 6645N Midterm Exam / NRNP6645 Midterm
Exam / NRNP-6645N Midterm Exam: Walden University
| 100% Verified Q & A |
Exam Questions & Answers
Question 1: The advanced practice psychiatric nurse may intervene as appropriate with agencies or
persons in order to advocate for the patient; do for the patient what he or she cannot do for self, always
with an aim toward maximum independence and growth. This is consistent with which basic strategy of
dynamic supportive therapy?
• A) Make connections
• B) Encourage patient activity
• C) Manipulate the environment
• D) Maximize adaptive coping mechanisms ✅
Rationale: This strategy focuses on helping the patient develop better coping skills and adapt to their
environment while promoting autonomy. It aligns with the supportive aspect of dynamic therapy where
the nurse actively assists the patient in managing their external world.
Question 2: Which of the following is consistent with literature regarding suicide? (Select all that apply)
• A) Assessing the patient is of paramount importance for the advanced practice psychiatric
nurse during the initial patient contact ✅
• B) Asking about suicide will plant the idea in the patient's mind
• C) Suicidal ideation is always a psychiatric emergency
• D) Suicidality can be assessed by using reliable and valid self-report questionnaires ✅
Rationale: Research indicates that direct assessment of suicidal thoughts does not increase risk and is
essential. Validated tools (e.g., Columbia-Suicide Severity Rating Scale) are effective for risk assessment.
Question 3: Common ancestry through which individuals have evolved shared values and customs is
known as which of the following?
,2
• A) Race
• B) Ethnicity ✅
• C) Culture
• D) Religion
Rationale: Ethnicity refers to a shared cultural heritage, ancestry, and often language, whereas culture
encompasses broader patterns of behavior and beliefs.
Question 4: The therapist using a CBT approach in which the therapist encourages the patient to
investigate whether their thoughts are based on facts or assumptions is known as which of the
following?
• A) Socratic questioning
• B) Questioning the evidence ✅
• C) Decentering
• D) Cognitive reframing
Rationale: "Questioning the evidence" is a specific CBT technique where the therapist helps the patient
examine the factual basis of their automatic thoughts.
Question 5: Which of the following is NOT consistent with the underlying assumptions of
psychodynamic psychotherapy?
• A) What happened in the past determines what we do today ✅
• B) Unconscious processes influence behavior
• C) Early childhood experiences shape personality
• D) Defense mechanisms protect against anxiety
Rationale: While past experiences are important, psychodynamic therapy emphasizes that present
behavior is influenced by unconscious processes and defenses, not that the past rigidly determines
current actions.
Question 6: The advanced practice psychiatric nurse is meeting with a patient who is in the process of
an unwanted divorce. The patient endorses persistent suicidal ideations with strong intent. The nurse
recognizes the patient is at high suicide risk and recommends which of the following?
• A) Outpatient therapy twice weekly
• B) Hospital psychiatric admission and suicide precautions ✅
,3
• C) Telephone crisis line referral
• D) Safety plan only
Rationale: Persistent suicidal ideation with strong intent requires immediate inpatient psychiatric care
to ensure safety.
Question 7: Which of the following assumptions would the therapist be safe in making about cultural
influences in a family?
• A) All families of the same ethnicity share identical values
• B) The cultural context of families is complicated by the fact that most families are influenced
by multiple contexts ✅
• C) Cultural influences are irrelevant to family therapy
• D) Acculturation is the same for all family members
Rationale: Families are often shaped by multiple intersecting cultural influences (e.g., ethnicity, religion,
socioeconomic status), making generalization inaccurate.
Question 8: The focus of exploration in a relational psychodynamic therapy includes which one of the
following?
• A) Childhood memories only
• B) The future
• C) Here and now ✅
• D) Dream interpretation
Rationale: Relational psychodynamic therapy emphasizes the current therapeutic relationship and
present interpersonal dynamics.
Question 9: The CBT therapist asks the patient, "On a scale of 0–10, how would you rate your
depression today? And how does that compare to 2 months ago?" This is an example of what type of
question in Socratic dialogue?
• A) Clarifying question
• B) Questioning the evidence
• C) Challenging the distortion
• D) This would not be a question consistent with Socratic Dialogue ✅
, 4
Rationale: Socratic dialogue involves guided discovery through open-ended questions about the
patient's thinking, not rating scales.
Question 10: Which of the following best describes the difference between standards of care and
practice guidelines?
• A) Standards of care are optional; practice guidelines are mandatory
• B) Standards of care are legally binding while practice guidelines are not ✅
• C) There is no difference
• D) Practice guidelines are set by courts; standards of care are set by professional organizations
Rationale: Standards of care are the minimum acceptable level of care and are legally binding; practice
guidelines are recommendations that allow flexibility.
Question 11: Strategies for working with anxiety are central to all therapy approaches. Which strategy
would be consistent with a behavioral therapy approach?
• A) Restructuring ✅
• B) Exploring unconscious conflicts
• C) Interpreting dreams
• D) Reframing family dynamics
Rationale: Behavioral approaches focus on restructuring maladaptive behaviors through techniques like
exposure, relaxation training, and behavior modification.
Question 12: According to Structural Family Therapy model, family structure refers to which of the
following?
• A) The family's physical living arrangements
• B) The way families are organized into subsystems separated by emotional boundaries ✅
• C) The family's communication patterns
• D) The family's socioeconomic status
Rationale: In Structural Family Therapy, family structure consists of subsystems (e.g., parental, sibling)
and boundaries that regulate interaction.
Question 13: "They probably think I am stupid" is an example of which type of cognitive distortion?
