TESTBANK FOR PSYCHOTHERAPY FOR THE ADAVANCED PRACTICE
PSYCHIATRIC NURSE 3RD EDITION BY KATHLEEN WHEELER
,TABLE OF CONTENTS
Part I: Foundations of Psychotherapy Practice
Chapter 1. The Nurse Psychotherapist and a Framework for Practice
Questions 1–25
Chapter 2. The Neurophysiology of Trauma and Psychotherapy
Questions 26–50
Chapter 3. Assessment and Diagnosis
Questions 51–75
Chapter 4. The Initial Contact and Maintaining the Frame
Questions 76–100
Part II: Core Psychotherapy Approaches
Chapter 5. Supportive and Psychodynamic Psychotherapy
Questions 101–125
Chapter 6. Humanistic–Existential and Solution-Focused Approaches to Psychotherapy
Questions 126–150
Chapter 7. Cognitive Behavioral Therapy (CBT)
Questions 151–175
Chapter 8. Dialectical Behavior Therapy (DBT)
Questions 176–200
Chapter 9. Interpersonal Psychotherapy
Questions 201–225
Chapter 10. Motivational Interviewing
Questions 226–250
Chapter 11. Eye Movement Desensitization and Reprocessing (EMDR)
Questions 251–275
Chapter 12. Trauma Resiliency Model Therapy
Questions 276–300
Part III: Relationship and Systems-Based Therapies
,Chapter 13. Group Psychotherapy
Questions 301–325
Chapter 14. Family Therapy
Questions 326–350
Chapter 15. Couples Therapy
Questions 351–375
Part IV: Integrative and Specialized Treatment Approaches
Chapter 16. Psychotherapeutics: Re-uniting Psychotherapy and Psychopharmacotherapy
Questions 376–400
Chapter 17. Trauma-Informed Medication Management
Questions 401–425
Chapter 18. Integrative Medicine and Psychotherapy
Questions 426–450
Chapter 19. Therapeutic Approaches to Addictions
Questions 451–475
Part V: Psychotherapy Across the Lifespan and Special Populations
Chapter 20. Psychotherapeutic Approaches with Children and Adolescents
Questions 476–500
Chapter 21. Psychotherapy with Older Adults
Questions 501–525
Chapter 22. Psychotherapy with Survivors of Trauma
Questions 526–550
Chapter 23. Psychotherapy for Patients with Serious Mental Illness
Questions 551–575
Chapter 24. Termination and Ending the Therapeutic Relationship
Questions 576–600
Chapter 1: The Nurse Psychotherapist and a Framework for Practice
,Questions 1–25
Question 1
A PMHNP is developing a treatment plan for a patient with chronic depression, diabetes, and
significant family stress. Which approach best reflects Wheeler's framework for psychotherapy
practice?
A. Prioritizing psychiatric symptoms only
B. Focusing exclusively on psychodynamic interpretations
C. Utilizing a biopsychosocial framework to understand the patient holistically
D. Limiting treatment to pharmacologic interventions
Correct Answer: C
Rationale: Wheeler emphasizes a biopsychosocial approach that integrates biological,
psychological, social, cultural, developmental, and spiritual influences into assessment and
treatment planning.
Question 2
A patient states, "You remind me of my father, who was never emotionally available." The PMHNP
recognizes this statement as:
A. Countertransference
B. Transference
C. Projection
D. Resistance
Correct Answer: B
Rationale: Transference occurs when patients unconsciously redirect feelings and expectations
from past significant relationships onto the therapist.
Question 3
Research consistently identifies which factor as one of the strongest predictors of successful
psychotherapy outcomes?
A. Therapeutic alliance
B. Length of treatment
C. Therapist age
D. Specific diagnosis
Correct Answer: A
,Rationale: The therapeutic alliance is among the strongest predictors of positive psychotherapy
outcomes across theoretical orientations.
Question 4
A PMHNP notices feeling unusually protective toward a patient who resembles a younger sibling.
This reaction is most accurately described as:
A. Splitting
B. Resistance
C. Projection
D. Countertransference
Correct Answer: D
Rationale: Countertransference refers to emotional reactions experienced by the therapist toward
a patient based on the therapist's own experiences and relationships.
Question 5
Which statement best reflects evidence-based psychotherapy practice?
A. Treatment decisions should rely primarily on therapist intuition.
B. Research evidence should supersede patient preferences.
C. Clinical expertise, research evidence, and patient preferences should be integrated.
D. Manualized treatments should always be used regardless of circumstances.
Correct Answer: C
Rationale: Evidence-based practice integrates research findings, clinician expertise, and patient
values to optimize outcomes.
Question 6
A PMHNP intentionally uses empathy, active listening, and self-awareness to promote patient
growth. This demonstrates:
A. Therapeutic neutrality
B. Therapeutic use of self
C. Behavioral activation
D. Reflective supervision
Correct Answer: B
Rationale: Therapeutic use of self is a foundational nursing concept involving purposeful use of
one's personality and communication skills to facilitate healing.
,Question 7
Which ethical principle is most closely associated with maintaining patient confidentiality?
A. Justice
B. Autonomy
C. Beneficence
D. Fidelity
Correct Answer: D
Rationale: Fidelity refers to trustworthiness, loyalty, and honoring commitments, including
protection of confidential information.
Question 8
A PMHNP is assessing resilience. Which characteristic best reflects resilience?
A. Complete absence of stress
B. Ability to recover and adapt following adversity
C. Avoidance of emotional experiences
D. Dependence on external validation
Correct Answer: B
Rationale: Resilience involves adaptive functioning and recovery despite adversity or trauma.
Question 9
A patient consistently arrives late to psychotherapy sessions. What is the PMHNP's most
therapeutic initial response?
A. Immediately terminate treatment
B. Ignore the behavior
C. Explore the meaning and significance of the lateness
D. Increase session frequency
Correct Answer: C
Rationale: Repeated behaviors occurring within therapy may have psychological meaning and
should be explored therapeutically.
Question 10
Which statement best reflects cultural humility?
,A. Becoming an expert in every culture represented in one's practice
B. Assuming cultural knowledge based on ethnicity
C. Maintaining openness, self-reflection, and willingness to learn from patients
D. Avoiding cultural discussions
Correct Answer: C
Rationale: Cultural humility emphasizes lifelong self-reflection and recognition that patients are
experts on their own experiences.
Question 11
A PMHNP develops a treatment plan that considers genetics, trauma history, current
relationships, and socioeconomic stressors. This reflects:
A. Biological psychiatry
B. Medical model
C. Integrated case formulation
D. Behavioral conditioning
Correct Answer: C
Rationale: Integrated case formulation synthesizes multiple domains to understand the patient's
difficulties and strengths.
Question 12
Which common factor contributes significantly to positive psychotherapy outcomes?
A. Therapist gender
B. Hope
C. Insurance coverage
D. Session frequency
Correct Answer: B
Rationale: Hope is a powerful common therapeutic factor associated with improved treatment
outcomes.
Question 13
A patient reports improvement primarily because they feel understood and accepted by the
therapist. This improvement most likely reflects:
A. Cognitive restructuring
B. Exposure therapy
, C. Common therapeutic factors
D. Behavioral rehearsal
Correct Answer: C
Rationale: Common factors such as empathy, trust, acceptance, and therapeutic alliance
contribute substantially to improvement.
Question 14
The biopsychosocial model proposes that mental health conditions result from:
A. Biological factors alone
B. Psychological factors alone
C. Social factors alone
D. Interactions among biological, psychological, and social influences
Correct Answer: D
Rationale: The biopsychosocial model recognizes multiple interacting influences on health and
illness.
Question 15
A PMHNP notices personal biases emerging during treatment and actively reflects on them. This
practice primarily promotes:
A. Diagnostic efficiency
B. Therapeutic objectivity
C. Medication adherence
D. Behavioral reinforcement
Correct Answer: B
Rationale: Self-awareness helps therapists recognize biases and maintain objectivity.
Question 16
Clinical Case Study
A patient with borderline personality disorder initially idealizes the PMHNP and later states,
"You're just like everyone else—you don't care." This pattern is most consistent with:
A. Splitting
B. Projection
PSYCHIATRIC NURSE 3RD EDITION BY KATHLEEN WHEELER
,TABLE OF CONTENTS
Part I: Foundations of Psychotherapy Practice
Chapter 1. The Nurse Psychotherapist and a Framework for Practice
Questions 1–25
Chapter 2. The Neurophysiology of Trauma and Psychotherapy
Questions 26–50
Chapter 3. Assessment and Diagnosis
Questions 51–75
Chapter 4. The Initial Contact and Maintaining the Frame
Questions 76–100
Part II: Core Psychotherapy Approaches
Chapter 5. Supportive and Psychodynamic Psychotherapy
Questions 101–125
Chapter 6. Humanistic–Existential and Solution-Focused Approaches to Psychotherapy
Questions 126–150
Chapter 7. Cognitive Behavioral Therapy (CBT)
Questions 151–175
Chapter 8. Dialectical Behavior Therapy (DBT)
Questions 176–200
Chapter 9. Interpersonal Psychotherapy
Questions 201–225
Chapter 10. Motivational Interviewing
Questions 226–250
Chapter 11. Eye Movement Desensitization and Reprocessing (EMDR)
Questions 251–275
Chapter 12. Trauma Resiliency Model Therapy
Questions 276–300
Part III: Relationship and Systems-Based Therapies
,Chapter 13. Group Psychotherapy
Questions 301–325
Chapter 14. Family Therapy
Questions 326–350
Chapter 15. Couples Therapy
Questions 351–375
Part IV: Integrative and Specialized Treatment Approaches
Chapter 16. Psychotherapeutics: Re-uniting Psychotherapy and Psychopharmacotherapy
Questions 376–400
Chapter 17. Trauma-Informed Medication Management
Questions 401–425
Chapter 18. Integrative Medicine and Psychotherapy
Questions 426–450
Chapter 19. Therapeutic Approaches to Addictions
Questions 451–475
Part V: Psychotherapy Across the Lifespan and Special Populations
Chapter 20. Psychotherapeutic Approaches with Children and Adolescents
Questions 476–500
Chapter 21. Psychotherapy with Older Adults
Questions 501–525
Chapter 22. Psychotherapy with Survivors of Trauma
Questions 526–550
Chapter 23. Psychotherapy for Patients with Serious Mental Illness
Questions 551–575
Chapter 24. Termination and Ending the Therapeutic Relationship
Questions 576–600
Chapter 1: The Nurse Psychotherapist and a Framework for Practice
,Questions 1–25
Question 1
A PMHNP is developing a treatment plan for a patient with chronic depression, diabetes, and
significant family stress. Which approach best reflects Wheeler's framework for psychotherapy
practice?
A. Prioritizing psychiatric symptoms only
B. Focusing exclusively on psychodynamic interpretations
C. Utilizing a biopsychosocial framework to understand the patient holistically
D. Limiting treatment to pharmacologic interventions
Correct Answer: C
Rationale: Wheeler emphasizes a biopsychosocial approach that integrates biological,
psychological, social, cultural, developmental, and spiritual influences into assessment and
treatment planning.
Question 2
A patient states, "You remind me of my father, who was never emotionally available." The PMHNP
recognizes this statement as:
A. Countertransference
B. Transference
C. Projection
D. Resistance
Correct Answer: B
Rationale: Transference occurs when patients unconsciously redirect feelings and expectations
from past significant relationships onto the therapist.
Question 3
Research consistently identifies which factor as one of the strongest predictors of successful
psychotherapy outcomes?
A. Therapeutic alliance
B. Length of treatment
C. Therapist age
D. Specific diagnosis
Correct Answer: A
,Rationale: The therapeutic alliance is among the strongest predictors of positive psychotherapy
outcomes across theoretical orientations.
Question 4
A PMHNP notices feeling unusually protective toward a patient who resembles a younger sibling.
This reaction is most accurately described as:
A. Splitting
B. Resistance
C. Projection
D. Countertransference
Correct Answer: D
Rationale: Countertransference refers to emotional reactions experienced by the therapist toward
a patient based on the therapist's own experiences and relationships.
Question 5
Which statement best reflects evidence-based psychotherapy practice?
A. Treatment decisions should rely primarily on therapist intuition.
B. Research evidence should supersede patient preferences.
C. Clinical expertise, research evidence, and patient preferences should be integrated.
D. Manualized treatments should always be used regardless of circumstances.
Correct Answer: C
Rationale: Evidence-based practice integrates research findings, clinician expertise, and patient
values to optimize outcomes.
Question 6
A PMHNP intentionally uses empathy, active listening, and self-awareness to promote patient
growth. This demonstrates:
A. Therapeutic neutrality
B. Therapeutic use of self
C. Behavioral activation
D. Reflective supervision
Correct Answer: B
Rationale: Therapeutic use of self is a foundational nursing concept involving purposeful use of
one's personality and communication skills to facilitate healing.
,Question 7
Which ethical principle is most closely associated with maintaining patient confidentiality?
A. Justice
B. Autonomy
C. Beneficence
D. Fidelity
Correct Answer: D
Rationale: Fidelity refers to trustworthiness, loyalty, and honoring commitments, including
protection of confidential information.
Question 8
A PMHNP is assessing resilience. Which characteristic best reflects resilience?
A. Complete absence of stress
B. Ability to recover and adapt following adversity
C. Avoidance of emotional experiences
D. Dependence on external validation
Correct Answer: B
Rationale: Resilience involves adaptive functioning and recovery despite adversity or trauma.
Question 9
A patient consistently arrives late to psychotherapy sessions. What is the PMHNP's most
therapeutic initial response?
A. Immediately terminate treatment
B. Ignore the behavior
C. Explore the meaning and significance of the lateness
D. Increase session frequency
Correct Answer: C
Rationale: Repeated behaviors occurring within therapy may have psychological meaning and
should be explored therapeutically.
Question 10
Which statement best reflects cultural humility?
,A. Becoming an expert in every culture represented in one's practice
B. Assuming cultural knowledge based on ethnicity
C. Maintaining openness, self-reflection, and willingness to learn from patients
D. Avoiding cultural discussions
Correct Answer: C
Rationale: Cultural humility emphasizes lifelong self-reflection and recognition that patients are
experts on their own experiences.
Question 11
A PMHNP develops a treatment plan that considers genetics, trauma history, current
relationships, and socioeconomic stressors. This reflects:
A. Biological psychiatry
B. Medical model
C. Integrated case formulation
D. Behavioral conditioning
Correct Answer: C
Rationale: Integrated case formulation synthesizes multiple domains to understand the patient's
difficulties and strengths.
Question 12
Which common factor contributes significantly to positive psychotherapy outcomes?
A. Therapist gender
B. Hope
C. Insurance coverage
D. Session frequency
Correct Answer: B
Rationale: Hope is a powerful common therapeutic factor associated with improved treatment
outcomes.
Question 13
A patient reports improvement primarily because they feel understood and accepted by the
therapist. This improvement most likely reflects:
A. Cognitive restructuring
B. Exposure therapy
, C. Common therapeutic factors
D. Behavioral rehearsal
Correct Answer: C
Rationale: Common factors such as empathy, trust, acceptance, and therapeutic alliance
contribute substantially to improvement.
Question 14
The biopsychosocial model proposes that mental health conditions result from:
A. Biological factors alone
B. Psychological factors alone
C. Social factors alone
D. Interactions among biological, psychological, and social influences
Correct Answer: D
Rationale: The biopsychosocial model recognizes multiple interacting influences on health and
illness.
Question 15
A PMHNP notices personal biases emerging during treatment and actively reflects on them. This
practice primarily promotes:
A. Diagnostic efficiency
B. Therapeutic objectivity
C. Medication adherence
D. Behavioral reinforcement
Correct Answer: B
Rationale: Self-awareness helps therapists recognize biases and maintain objectivity.
Question 16
Clinical Case Study
A patient with borderline personality disorder initially idealizes the PMHNP and later states,
"You're just like everyone else—you don't care." This pattern is most consistent with:
A. Splitting
B. Projection
