MSN 674 PMHNP Midterm Exam Mega Pack | 100+ Full Questions & Answers with Detailed Rationales
| 2026 Update - Northern Kentucky University.
🧠 PSYCHODYNAMIC, HUMANISTIC & EXISTENTIAL
Question 1
A patient in therapy begins to express intense anger toward the therapist that mirrors unresolved
feelings toward their father. The therapist recognizes this as an unconscious projection of past
relational dynamics.
Which concept best explains this phenomenon?
A. Countertransference
B. Transference
C. Projection
D. Displacement
Correct Answer: B. Transference
Explanation:
Transference occurs when the client unconsciously projects feelings from past relationships
onto the therapist. In this case, the patient is reacting to the therapist as if they were their father.
This is a core concept in psychodynamic therapy.
Question 2
A therapist encourages a patient to speak freely without censorship while carefully observing
recurring themes and emotional reactions toward the therapist.
Which therapeutic technique is being used?
A. Cognitive restructuring
B. Free association with transference analysis
C. Exposure therapy
D. Behavioral activation
Correct Answer: B. Free association with transference analysis
Explanation:
Psychodynamic therapy uses free association to access unconscious material and transference
analysis to interpret emotional projections onto the therapist.
,Question 3
A patient reports lifelong feelings of inadequacy and constantly compares themselves to siblings.
The therapist explores early childhood memories and family dynamics, including birth order.
Which therapeutic approach is most appropriate?
A. Gestalt therapy
B. Adlerian therapy
C. Existential therapy
D. CBT
Correct Answer: B. Adlerian therapy
Explanation:
Adlerian therapy focuses on inferiority feelings, belonging, and birth order, using early
recollections and lifestyle assessment to understand core beliefs.
Question 4
A patient diagnosed with terminal cancer asks, “What is the meaning of my life now?” The
therapist focuses on helping the patient explore purpose, mortality, and personal responsibility.
Which therapeutic approach is being used?
A. Psychoanalytic
B. Existential
C. Behavioral
D. DBT
Correct Answer: B. Existential
Explanation:
Existential therapy addresses death, freedom, isolation, and meaninglessness, helping patients
find meaning in difficult life situations.
Question 5
A therapist provides unconditional positive regard, empathy, and congruence while allowing the
client to guide the direction of sessions.
Which therapy is being practiced?
,A. CBT
B. Person-centered therapy
C. REBT
D. DBT
Correct Answer: B. Person-centered therapy
Explanation:
Carl Rogers’ approach is non-directive and based on UPR, empathy, and congruence,
emphasizing that the client already has the answers.
Question 6
A therapist asks a grieving patient to speak to an empty chair as if their deceased loved one were
present.
Which therapy is this technique associated with?
A. CBT
B. Gestalt
C. Psychodynamic
D. REBT
Correct Answer: B. Gestalt
Explanation:
Gestalt therapy uses the empty chair technique to help patients process unfinished emotional
experiences in the present moment.
🧠 COGNITIVE & BEHAVIORAL
Question 7
A patient says, “I am worthless.” The therapist asks the patient to examine evidence for and
against this belief and develop a more balanced thought.
Which therapy is being used?
A. REBT
B. CBT
, C. DBT
D. IPT
Correct Answer: B. CBT
Explanation:
CBT focuses on changing distorted thoughts through cognitive restructuring and evidence
evaluation.
Question 8
A therapist directly challenges a patient’s belief: “Everyone must like me or I am a failure,”
asking for logical and empirical evidence.
Which therapy is being used?
A. CBT
B. REBT
C. DBT
D. Gestalt
Correct Answer: B. REBT
Explanation:
REBT actively disputes irrational beliefs (the “3 musts”) using the ABCDE model, and is
more confrontational than CBT.
Question 9
A patient with borderline personality disorder engages in self-harm and unstable relationships.
The therapist focuses on distress tolerance, emotional regulation, and interpersonal effectiveness.
Which therapy is most appropriate?
A. CBT
B. DBT
C. IPT
D. Psychodynamic
Correct Answer: B. DBT
| 2026 Update - Northern Kentucky University.
🧠 PSYCHODYNAMIC, HUMANISTIC & EXISTENTIAL
Question 1
A patient in therapy begins to express intense anger toward the therapist that mirrors unresolved
feelings toward their father. The therapist recognizes this as an unconscious projection of past
relational dynamics.
Which concept best explains this phenomenon?
A. Countertransference
B. Transference
C. Projection
D. Displacement
Correct Answer: B. Transference
Explanation:
Transference occurs when the client unconsciously projects feelings from past relationships
onto the therapist. In this case, the patient is reacting to the therapist as if they were their father.
This is a core concept in psychodynamic therapy.
Question 2
A therapist encourages a patient to speak freely without censorship while carefully observing
recurring themes and emotional reactions toward the therapist.
Which therapeutic technique is being used?
A. Cognitive restructuring
B. Free association with transference analysis
C. Exposure therapy
D. Behavioral activation
Correct Answer: B. Free association with transference analysis
Explanation:
Psychodynamic therapy uses free association to access unconscious material and transference
analysis to interpret emotional projections onto the therapist.
,Question 3
A patient reports lifelong feelings of inadequacy and constantly compares themselves to siblings.
The therapist explores early childhood memories and family dynamics, including birth order.
Which therapeutic approach is most appropriate?
A. Gestalt therapy
B. Adlerian therapy
C. Existential therapy
D. CBT
Correct Answer: B. Adlerian therapy
Explanation:
Adlerian therapy focuses on inferiority feelings, belonging, and birth order, using early
recollections and lifestyle assessment to understand core beliefs.
Question 4
A patient diagnosed with terminal cancer asks, “What is the meaning of my life now?” The
therapist focuses on helping the patient explore purpose, mortality, and personal responsibility.
Which therapeutic approach is being used?
A. Psychoanalytic
B. Existential
C. Behavioral
D. DBT
Correct Answer: B. Existential
Explanation:
Existential therapy addresses death, freedom, isolation, and meaninglessness, helping patients
find meaning in difficult life situations.
Question 5
A therapist provides unconditional positive regard, empathy, and congruence while allowing the
client to guide the direction of sessions.
Which therapy is being practiced?
,A. CBT
B. Person-centered therapy
C. REBT
D. DBT
Correct Answer: B. Person-centered therapy
Explanation:
Carl Rogers’ approach is non-directive and based on UPR, empathy, and congruence,
emphasizing that the client already has the answers.
Question 6
A therapist asks a grieving patient to speak to an empty chair as if their deceased loved one were
present.
Which therapy is this technique associated with?
A. CBT
B. Gestalt
C. Psychodynamic
D. REBT
Correct Answer: B. Gestalt
Explanation:
Gestalt therapy uses the empty chair technique to help patients process unfinished emotional
experiences in the present moment.
🧠 COGNITIVE & BEHAVIORAL
Question 7
A patient says, “I am worthless.” The therapist asks the patient to examine evidence for and
against this belief and develop a more balanced thought.
Which therapy is being used?
A. REBT
B. CBT
, C. DBT
D. IPT
Correct Answer: B. CBT
Explanation:
CBT focuses on changing distorted thoughts through cognitive restructuring and evidence
evaluation.
Question 8
A therapist directly challenges a patient’s belief: “Everyone must like me or I am a failure,”
asking for logical and empirical evidence.
Which therapy is being used?
A. CBT
B. REBT
C. DBT
D. Gestalt
Correct Answer: B. REBT
Explanation:
REBT actively disputes irrational beliefs (the “3 musts”) using the ABCDE model, and is
more confrontational than CBT.
Question 9
A patient with borderline personality disorder engages in self-harm and unstable relationships.
The therapist focuses on distress tolerance, emotional regulation, and interpersonal effectiveness.
Which therapy is most appropriate?
A. CBT
B. DBT
C. IPT
D. Psychodynamic
Correct Answer: B. DBT
