NSG 526/ NSG526 Exam 1 V2 – Advanced Psychiatric Mental Health Nursing Practice 2026/2027 | Wilkes | Latest Questions & Verified Answers

NSG 526/ NSG526 Exam 1 V2 – Advanced Psychiatric Mental Health Nursing Practice 2026/2027 | Wilkes | Latest Questions & Verified Answers A nurse practitioner (NP) is discussing their role and responsibilities with a colleague. The colleague asks, "What determines the scope of practice for nurse practitioners?" What is the best response? A) National guidelines set by the American Association of Nurse Practitioners (AANP) B) The medical board's regulations C) The scope of practice is uniform across all states D) The scope of practice is determined by the laws and regulations of the state in which the NP practices D) The scope of practice is determined by the laws and regulations of the state in which the NP practices A patient reports experiencing auditory hallucinations. The nurse practitioner understands that these symptoms are most likely associated with dysfunction in which part of the brain? A) Frontal lobe B) Parietal lobe C) Temporal lobe D) Occipital lobe C) Temporal lobe A client becomes agitated during a therapy session after recounting an argument with their sibling at dinner. While discussing the incident, the client suddenly raises their voice and begins yelling at the therapist. What defense mechanism is the client most likely demonstrating? A) Projection B) Countertransference C) Displacement D) Transference D) Transference A patient consistently engages in behaviors that are problematic but expresses no awareness or concern about changing these behaviors. According to the stages of change model, which stage is this patient most likely in? A) Precontemplation B) Contemplation C) Action D) Maintenance A) Precontemplation Which nursing theorist developed the Interpersonal Relations Theory, which emphasizes the nurse-patient relationship as a foundation for nursing practice and identifies phases such as orientation, working, and termination? A) Jean Watson B) Hildegard Peplau C) Florence Nightingale D) Dorothea Orem B) Hildegard Peplau A patient becomes visibly upset during a session. Which of the following therapeutic communication techniques would be most appropriate for the nurse practitioner to use? A) "Tell me what it is that is upsetting you so I can understand you more." B) "Calm down, everything will be okay." C) "You shouldn't be so upset; it isn't that serious." D) "Let's move on to another topic for now." A) "Tell me what it is that is upsetting you so I can understand you more." During a therapy session, a patient acts seductively and asks the nurse practitioner out for dinner. As a professional response, the nurse practitioner should: A) Accept the invitation to maintain rapport with the patient B) Confront the patient about their inappropriate behavior C) Explore the meaning of their own countertransference in this situation D) Ignore the behavior and proceed with the session as planned C) Explore the meaning of their own countertransference in this situation A schizophrenic patient is under the care of both a psychiatrist and a general practitioner. Which condition is the general practitioner likely monitoring? A) Schizophrenia B) Diabetes C) Parkinson's disease D) Cardiovascular disease B) Diabetes A toddler consistently responds with "NO" when asked about toilet training. This behavior is indicative of which of Freud's psychosexual stages of development? A) Oral stage B) Anal stage C) Phallic stage D) Latency stage B) Anal stage During a clinical interview, a patient avoids making eye contact. The nurse practitioner notes this behavior but understands that they need more information before drawing any conclusions about the patient's emotional state or intentions. What is the most appropriate statement for the nurse practitioner to consider? A) "The patient is likely feeling anxious or guilty." B) "The patient is disrespectful and uninterested in the interview." C) "Avoiding eye contact may indicate a need for further exploration of the patient's feelings or cultural background." D) "The patient's lack of eye contact means they are hiding something." C) "Avoiding eye contact may indicate a need for further exploration of the patient's feelings or cultural background." The Transtheoretical Model of Change (TTM) describes the stages individuals go through when making behavioral changes. Which of the following stages involves a person who is actively taking steps to change their behavior and has made significant modifications? A) Precontemplation B) Contemplation C) Preparation D) Action D) Action When monitoring the progress of a patient's treatment for a chronic condition, which of the following factors would typically be considered EXCEPT: A) Efficacy B) Side effects C) Treatment D) Adherence C) Treatment The Abnormal Involuntary Movement Scale (AIMS) is primarily used to assess which of the following conditions in patients receiving antipsychotic medications? A) Depression B) Anxiety disorders C) Extrapyramidal symptoms D) Cognitive impairments C) Extrapyramidal symptoms When administering the Abnormal Involuntary Movement Scale (AIMS) to a patient, which of the following movements would the clinician specifically be assessing? A) Hand tremors B) Facial grimacing C) Mood swings D) Hallucinations B) Facial grimacing According to Freud's theory of psychosexual development, which stage is characterized by the child's focus on social relationships and skills rather than sexual interests? A) Oral stage B) Anal stage C) Phallic stage D) Latency stage D) Latency stage Freud proposed that the ego operates based on the reality principle. What does this mean? A) It seeks immediate gratification of desires. B) It mediates between the demands of the id and the constraints of reality. C) It focuses solely on moral standards. D) It functions only in the unconscious mind. B) It mediates between the demands of the id and the constraints of reality In Erikson's psychosocial development theory, which stage is characterized by the challenge of developing a sense of identity typically occurring during adolescence? A) Trust vs. Mistrust B) Autonomy vs. Shame and Doubt C) Identity vs. Role Confusion D) Intimacy vs. Isolation C) Identity vs. Role Confusion According to Erikson, which stage of psychosocial development is associated with the challenge of establishing intimate relationships and developing a sense of love, typically occurring in young adulthood? A) Generativity vs. Stagnation B) Intimacy vs. Isolation C) Industry vs. Inferiority D) Integrity vs. Despair B) Intimacy vs. Isolation A person who has just lost their job tells their friends that they are not worried about it and that they will find a better one soon, even though they are feeling anxious and upset. This is an example of which defense mechanism? A) Rationalization B) Denial C) Projection D) Suppression A) Rationalization A child who is upset about their parents' divorce starts to throw temper tantrums and exhibit behaviors typical of a younger child. This behavior is an example of which defense mechanism? A) Regression B) Displacement C) Sublimation D) Reaction Formation A) Regression During a therapy session, a patient expresses feelings of sadness and frustration about their life circumstances. The nurse responds, "I understand how you feel; many people experience these emotions." This response is an example of: A) Therapeutic communication B) Non-therapeutic communication C) Empathy D) Advice-giving B) Non-therapeutic communication A patient shares their fear of an upcoming medical procedure. The nurse responds, "It sounds like you're really scared about this. Can you tell me more about what specifically worries you?" This response is an example of: A) Minimizing B) Therapeutic communication C) Closed-ended questioning D) Interruption B) Therapeutic communication A nurse is helping a patient process their feelings about grief. The nurse says, "It's important to express your feelings during this difficult time. How do you feel when you think about your loss?" This statement demonstrates: A) Judgmental attitude B) Therapeutic communication C) Passive listening D) Non-therapeutic communication B) Therapeutic communication Harry Stack Sullivan's interpersonal theory emphasizes the importance of which of the following in the development of personality? A) Genetic predispositions B) Social interactions and relationships C) Unconscious drives D) Behavioral conditioning B) Social interactions and relationships Hildegard Peplau's theory of interpersonal relations in nursing focuses on the nurse-patient relationship. Which of the following phases does Peplau identify as the first stage of this relationship? A) Working phase B) Orientation phase C) Termination phase D) Resolution phase B) Orientation phase According to Sullivan, the development of the self-concept is largely influenced by: A) Biological factors B) Early childhood experiences C) Interpersonal relationships and feedback from others D) Environmental stressors C) Interpersonal relationships and feedback from others In Peplau's model, the nurse's role in the working phase of the relationship involves which of the following? A) Establishing rapport B) Identifying patient needs and goals C) Evaluating the outcomes of the patient's treatment D) Providing education on medication management B) Identifying patient needs and goals The nurse-client relationship is primarily built on which of the following principles? A) Professionalism and boundaries B) Personal friendships C) Family dynamics D) Financial incentives A) Professionalism and boundaries In the therapeutic nurse-client relationship, the nurse's role includes which of the following? A) Offering personal opinions about the patient's choices B) Establishing trust and rapport with the patient C) Keeping information confidential only when convenient D) Avoiding discussions about the patient's feelings B) Establishing trust and rapport with the patient Which phase of the nurse-client relationship involves the nurse assessing the patient's needs and setting mutual goals? A) Orientation phase B) Working phase C) Termination phase D) Assessment phase A) Orientation phase A nurse recognizes that a patient feels anxious and withdrawn due to their recent diagnosis. The nurse decides to sit quietly with the patient to offer support. This is an example of which aspect of the nurse-client relationship? A) Countertransference B) Empathy C) Transference D) Boundaries B) Empathy In the termination phase of the nurse-client relationship, which of the following actions is most appropriate for the nurse to take? A) Discuss personal feelings about the patient's progress; B) Reflect on the progress made and summarize the outcomes C) Avoid discussing the end of the relationship to prevent distress D) Suggest that the patient find a new therapist B) Reflect on the progress made and summarize the outcomes Hildegard Peplau expanded upon Harry Stack Sullivan's interpersonal theory by emphasizing the importance of which specific aspect in nursing practice? A) The unconscious mind B) Psychosexual stages of development C) The nurse-client relationship D) Behavioral conditioning C) The nurse-client relationship In a patient-centered care approach, the healthcare provider prioritizes which of the following strategies when interacting with patients? A) Directing patients on what they should do to improve their health B) Allowing patients to guide their own care by asking appropriate questions and encouraging reflection C) Making decisions for patients to ensure they follow medical advice D) Avoiding discussions about the patient's feelings or preferences B) Allowing patients to guide their own care by asking appropriate questions and encouraging reflection A therapist notices that a patient often talks about their childhood experiences, attributing their current anxiety to specific events from that time. The therapist interprets this as the patient trying to uncover unresolved conflicts. Which Freudian concept is the therapist applying in this situation? A) Defense mechanisms B) Transference C) Repression D) Psychosexual development C) Repression During a therapy session, a patient expresses anger towards their therapist for perceived negligence, even though the therapist has been attentive. The therapist recognizes that this behavior may be a projection of the patient's feelings toward a critical parent. Which Freudian concept is at play here? A) Rationalization B) Projection C) Displacement D) Sublimation B) Projection A client is discussing their desire for success and recognition, stating that they will do anything to achieve their goals, including manipulating others. The therapist identifies this behavior as an indication of a dominant id. How would Freud describe this situation in terms of personality structure? A) The id is in conflict with the superego. B) The ego is effectively mediating between the id and reality. C) The superego is preventing the id from achieving gratification. D) The id is operating in accordance with the moral standards of the superego. A) The id is in conflict with the superego. A patient frequently uses humor to cope with feelings of inadequacy and anxiety about a recent job loss. According to Freud, which defense mechanism is the patient employing? A) Denial B) Regression C) Sublimation D) Humor D) Humor In therapy, a patient reveals that they have a strong aversion to a coworker but cannot articulate why. They frequently express this hatred towards their boss instead. This behavior reflects which Freudian defense mechanism? A) Reaction formation B) Displacement C) Rationalization D) Regression B) Displacement Which theorist is responsible for CBT? Aaron Beck John, a 55-year-old man, has recently started volunteering at a local community center, finding it to be a fulfilling way to give back. However, Paul, a 58-year-old acquaintance, criticizes John's efforts and calls volunteering "a waste of time." According to Erik Erikson's stages of psychosocial development, which stage are John and Paul most likely displaying? A) Identity vs. Role Confusion B) Integrity vs. Despair C) Generativity vs. Stagnation D) Intimacy vs. Isolation C) Generativity vs. Stagnation A patient has lesions in the frontal lobe of their brain. Which of the following symptoms would be least likely to present in this patient? A) Panic B) Apathy C) Depression D) Irritability A) Panic A patient presents with anxiety-like symptoms. Which of the following conditions would you be least likely to consider as a potential cause? A) Hyperventilation Syndrome B) Hypoglycemia C) Hyperthyroidism D) Bell's Palsy D) Bell's Palsy A 45-year-old patient is diagnosed with Major Depressive Disorder (MDD), diabetes, and has recently experienced the death of a family member. Which of the following is the correct way to document these conditions according to DSM-5-TR standards? A) MDD, diabetes, bereavement B) Bereavement, MDD, diabetes C) Diabetes, bereavement, MDD D) MDD, bereavement, diabetes A) MDD, diabetes, bereavement A 3-year-old girl frequently says, "I can't do anything by myself!" when asked to complete tasks. According to Erik Erikson's stages of psychosocial development, which stage is she most likely struggling with? A) Trust vs. Mistrust B) Autonomy vs. Shame and Doubt C) Initiative vs. Guilt D) Industry vs. Inferiority B) Autonomy vs. Shame and Doubt According to the Holmes and Rahe Stress Scale, which of the following individuals would be expected to have the highest difficulty coping with life events based on the accumulated stress? A) Sarah, who recently started a new job and moved to a new city. B) John, who recently got married, bought a house, and is expecting a child. C) Maria, who experienced the death of her spouse, was hospitalized for a serious illness, and lost her job. D) David, who graduated from college and started a new career. C) Maria, who experienced the death of her spouse, was hospitalized for a serious illness, and lost her job. Who is credited with developing Interpersonal Theory, which emphasizes the role of interpersonal relationships in shaping personality and mental health? A) Sigmund Freud B) Erik Erikson C) Peplau D) Carl Rogers C) Peplau Which laboratory test is the primary screening tool for hypothyroidism? A) Free T3 B) Serum Thyroid-Stimulating Hormone (TSH) C) Thyroid Peroxidase Antibodies (TPO) D) Total T4 B) Serum Thyroid-Stimulating Hormone (TSH) In a patient with primary hypothyroidism, which of the following lab results would you expect to find? A) Elevated TSH and low Free T4 B) Low TSH and high Free T4 C) Normal TSH and elevated Free T4 D) Elevated TSH and normal Free T4 A) Elevated TSH and low Free T4