NRNP 6645 PSYCHOTHERAPY MIDTERM EXAM WEEK 6
,SECTION 1: FOUNDATIONS OF PSYCHOTHERAPY & THERAPEUTIC FRAME
(Questions 1–10)
Question 1
A psychiatric mental health nurse practitioner (PMHNP) is seeing a patient for the
first time. The patient states, "I don't know if talking will help." Which response best
demonstrates a therapeutic frame?
A. "Talking always helps, trust me."
B. "Medication might be a better option for you."
C. "Some people feel that way. What concerns you about talking?"
D. "Let's just try it for 15 minutes."
Answer: C. "Some people feel that way. What concerns you about talking?"
Rationale: Validating the patient's concern while inviting exploration respects
autonomy and builds alliance. Option A is dismissive, B changes the subject
prematurely, and D imposes without addressing resistance.
Question 2
Recognizing that many factors may have contributed to a patient's current situation
is an example of which of the following?
A. Biomedical model
B. Psychosocial framework
C. Overdeterminism
D. Resiliency
,Answer: B. Psychosocial framework
Rationale: A psychosocial framework recognizes that multiple factors—including
biological, psychological, social, and cultural influences—contribute to a patient's
current situation. This is foundational to comprehensive psychiatric assessment.
Question 3
A PMHNP notices a patient consistently arrives 10 minutes late to sessions. Which
psychodynamic concept best explains this behavior?
A. Transference
B. Resistance
C. Countertransference
D. Free association
Answer: B. Resistance
Rationale: Resistance in psychodynamic therapy refers to any behavior that
impedes the therapeutic process, including arriving late. It may reflect unconscious
avoidance of painful material. Transference involves feelings displaced from past
figures.
Question 4
The novice advanced practice psychiatric nurse working as a new nurse
psychotherapist is in which stage of the progression of a learner?
A. Unconscious incompetence
B. Conscious incompetence
, C. Conscious competence
D. Unconscious competence
Answer: A. Unconscious incompetence
Rationale: The progression of a learner begins with unconscious incompetence
(not knowing what one doesn't know), progresses to conscious incompetence,
then conscious competence, and finally unconscious competence. A new nurse
psychotherapist is typically in the early stages.
Question 5
During a session, a patient says, "I feel nothing about my father's death." The
PMHNP responds, "And yet your fists are clenched." Which technique is being
used?
A. Confrontation
B. Interpretation
C. Clarification
D. Containment
Answer: A. Confrontation
Rationale: Confrontation gently points out a discrepancy between affect and verbal
content. The patient reports feeling nothing, but the clenched fists suggest
otherwise. Interpretation explains unconscious meaning; clarification seeks more
detail.
,SECTION 1: FOUNDATIONS OF PSYCHOTHERAPY & THERAPEUTIC FRAME
(Questions 1–10)
Question 1
A psychiatric mental health nurse practitioner (PMHNP) is seeing a patient for the
first time. The patient states, "I don't know if talking will help." Which response best
demonstrates a therapeutic frame?
A. "Talking always helps, trust me."
B. "Medication might be a better option for you."
C. "Some people feel that way. What concerns you about talking?"
D. "Let's just try it for 15 minutes."
Answer: C. "Some people feel that way. What concerns you about talking?"
Rationale: Validating the patient's concern while inviting exploration respects
autonomy and builds alliance. Option A is dismissive, B changes the subject
prematurely, and D imposes without addressing resistance.
Question 2
Recognizing that many factors may have contributed to a patient's current situation
is an example of which of the following?
A. Biomedical model
B. Psychosocial framework
C. Overdeterminism
D. Resiliency
,Answer: B. Psychosocial framework
Rationale: A psychosocial framework recognizes that multiple factors—including
biological, psychological, social, and cultural influences—contribute to a patient's
current situation. This is foundational to comprehensive psychiatric assessment.
Question 3
A PMHNP notices a patient consistently arrives 10 minutes late to sessions. Which
psychodynamic concept best explains this behavior?
A. Transference
B. Resistance
C. Countertransference
D. Free association
Answer: B. Resistance
Rationale: Resistance in psychodynamic therapy refers to any behavior that
impedes the therapeutic process, including arriving late. It may reflect unconscious
avoidance of painful material. Transference involves feelings displaced from past
figures.
Question 4
The novice advanced practice psychiatric nurse working as a new nurse
psychotherapist is in which stage of the progression of a learner?
A. Unconscious incompetence
B. Conscious incompetence
, C. Conscious competence
D. Unconscious competence
Answer: A. Unconscious incompetence
Rationale: The progression of a learner begins with unconscious incompetence
(not knowing what one doesn't know), progresses to conscious incompetence,
then conscious competence, and finally unconscious competence. A new nurse
psychotherapist is typically in the early stages.
Question 5
During a session, a patient says, "I feel nothing about my father's death." The
PMHNP responds, "And yet your fists are clenched." Which technique is being
used?
A. Confrontation
B. Interpretation
C. Clarification
D. Containment
Answer: A. Confrontation
Rationale: Confrontation gently points out a discrepancy between affect and verbal
content. The patient reports feeling nothing, but the clenched fists suggest
otherwise. Interpretation explains unconscious meaning; clarification seeks more
detail.
