NSG526 Final Exam V3 | NSG 526 Clinical
Modalities Adv. Psych | Wilkes University
1. A Psychiatric Mental Health Nurse Practitioner (PMHNP) is using Dialectical Behavior
Therapy (DBT) with a client diagnosed with Borderline Personality Disorder. Which of the
following is considered a core component of DBT?
A. Systematic desensitization
B. Family mapping and genograms
C. Uncovering unconscious conflicts
D. Mindfulness and distress tolerance
Answer: D
Rationale: DBT focuses on providing skills in four key areas: mindfulness, distress
tolerance, emotion regulation, and interpersonal effectiveness. This approach is specifically
designed to help clients manage intense emotions and decrease self-destructive behaviors.
The integration of acceptance and change is a fundamental principle of this modality.
2. According to Bowen Family Systems Theory, what is the term for a three-person emotional
configuration that serves as the smallest stable relationship system?
A. Triangulation
B. Differentiation
C. Enmeshment
,D. Nuclear family emotional process
Answer: A
Rationale: Triangulation occurs when a two-person system under stress recruits a third
person to decrease anxiety and stabilize the relationship. While it reduces immediate
tension, it often prevents the original two people from resolving their conflict. In family
therapy, the PMHNP works to ‘detriangulate’ these relationships to improve individual
functioning.
3. A client expresses a specific threat to harm a named individual during a therapy session.
Which legal principle primarily guides the PMHNP’s next action?
A. Beneficence
B. Autonomy
C. Duty to Warn (Tarasoff)
D. The Baker Act
Answer: C
Rationale: The Duty to Warn, derived from the Tarasoff v. Regents of the University of
California case, requires clinicians to protect identifiable victims from potential harm. This
legal obligation supersedes patient confidentiality when a credible threat of violence is
made. The PMHNP must follow state-specific statutes to notify both the potential victim
and law enforcement.
, 4. During a Cognitive Behavioral Therapy (CBT) session, the PMHNP asks the client to look at
the evidence for and against their belief that ‘everyone hates me.’ This technique is known
as:
A. Flooding
B. Free Association
C. Cognitive Restructuring
D. Paradoxical Intention
Answer: C
Rationale: Cognitive restructuring involves identifying, challenging, and changing
irrational or maladaptive thoughts. By examining the evidence, the client learns to replace
cognitive distortions with more realistic and balanced perspectives. This process is a
cornerstone of the CBT model in treating depression and anxiety.
5. In the context of trauma-informed care, what does the ‘Window of Tolerance’ represent?
A. The optimal zone of arousal where emotions can be processed
B. The degree of medication side effects a patient can handle
C. The time limit for a therapy session
D. The period before a crisis becomes irreversible
Answer: A
Modalities Adv. Psych | Wilkes University
1. A Psychiatric Mental Health Nurse Practitioner (PMHNP) is using Dialectical Behavior
Therapy (DBT) with a client diagnosed with Borderline Personality Disorder. Which of the
following is considered a core component of DBT?
A. Systematic desensitization
B. Family mapping and genograms
C. Uncovering unconscious conflicts
D. Mindfulness and distress tolerance
Answer: D
Rationale: DBT focuses on providing skills in four key areas: mindfulness, distress
tolerance, emotion regulation, and interpersonal effectiveness. This approach is specifically
designed to help clients manage intense emotions and decrease self-destructive behaviors.
The integration of acceptance and change is a fundamental principle of this modality.
2. According to Bowen Family Systems Theory, what is the term for a three-person emotional
configuration that serves as the smallest stable relationship system?
A. Triangulation
B. Differentiation
C. Enmeshment
,D. Nuclear family emotional process
Answer: A
Rationale: Triangulation occurs when a two-person system under stress recruits a third
person to decrease anxiety and stabilize the relationship. While it reduces immediate
tension, it often prevents the original two people from resolving their conflict. In family
therapy, the PMHNP works to ‘detriangulate’ these relationships to improve individual
functioning.
3. A client expresses a specific threat to harm a named individual during a therapy session.
Which legal principle primarily guides the PMHNP’s next action?
A. Beneficence
B. Autonomy
C. Duty to Warn (Tarasoff)
D. The Baker Act
Answer: C
Rationale: The Duty to Warn, derived from the Tarasoff v. Regents of the University of
California case, requires clinicians to protect identifiable victims from potential harm. This
legal obligation supersedes patient confidentiality when a credible threat of violence is
made. The PMHNP must follow state-specific statutes to notify both the potential victim
and law enforcement.
, 4. During a Cognitive Behavioral Therapy (CBT) session, the PMHNP asks the client to look at
the evidence for and against their belief that ‘everyone hates me.’ This technique is known
as:
A. Flooding
B. Free Association
C. Cognitive Restructuring
D. Paradoxical Intention
Answer: C
Rationale: Cognitive restructuring involves identifying, challenging, and changing
irrational or maladaptive thoughts. By examining the evidence, the client learns to replace
cognitive distortions with more realistic and balanced perspectives. This process is a
cornerstone of the CBT model in treating depression and anxiety.
5. In the context of trauma-informed care, what does the ‘Window of Tolerance’ represent?
A. The optimal zone of arousal where emotions can be processed
B. The degree of medication side effects a patient can handle
C. The time limit for a therapy session
D. The period before a crisis becomes irreversible
Answer: A
