Wilkes University NSG 526 – Clinical Modalities in
Advanced Psychiatric Mental Health Nursing
Practice | Questions and Correct Verified Answers
with Rationale 2026-2027
Question 1
A 35-year-old patient with Major Depressive Disorder has attended six CBT
sessions but reports minimal improvement. The patient has completed few
homework assignments. What is the PMHNP's best intervention?
A. Terminate CBT and begin psychodynamic therapy immediately.
B. Explore barriers to homework completion, reinforce the rationale for CBT
homework, and collaborate on achievable assignments.
C. Continue therapy without addressing homework adherence.
D. Discontinue psychotherapy and prescribe medication only.
� Correct Answer: B. Explore barriers to homework completion, reinforce
the rationale for CBT homework, and collaborate on achievable assignments.
� Rationale:
Homework is a core component of CBT because it helps patients apply skills
outside therapy sessions. Nonadherence should prompt collaborative problem-
solving rather than criticism or abrupt changes in treatment.
� Question 2
,A patient with Borderline Personality Disorder frequently telephones the
PMHNP between appointments for reassurance. Which intervention best supports
DBT principles?
A. Provide unlimited reassurance whenever requested.
B. Establish consistent boundaries while reinforcing the use of DBT coping skills
before contacting the clinician.
C. Ignore every phone call.
D. Increase therapy sessions indefinitely.
� Correct Answer: B. Establish consistent boundaries while reinforcing the
use of DBT coping skills before contacting the clinician.
� Rationale:
DBT balances validation with accountability. Consistent boundaries encourage
patients to practice emotion regulation and distress tolerance skills while
preventing dependence.
� Question 3
A patient reports persistent conflict with coworkers because they assume others are
criticizing them. Which therapy most directly targets identifying and changing
these automatic interpretations?
A. CBT
B. Psychoanalysis
C. Family Therapy
D. Supportive Therapy
,� Correct Answer: A. CBT
� Rationale:
CBT focuses on identifying automatic thoughts, evaluating evidence, and
modifying maladaptive interpretations that contribute to emotional distress and
interpersonal difficulties.
� Question 4
A PMHNP notices feeling unusually protective toward a patient who reminds them
of a younger sibling. What is the best initial response?
A. Increase personal involvement with the patient.
B. Recognize possible countertransference and seek supervision if needed.
C. Ignore the emotional reaction.
D. Transfer the patient immediately.
� Correct Answer: B. Recognize possible countertransference and seek
supervision if needed.
� Rationale:
Recognizing countertransference helps clinicians maintain objectivity and
therapeutic effectiveness. Consultation or supervision may be appropriate when
these reactions affect clinical judgment.
� Question 5
A patient says,
"My anxiety will never improve."
Which CBT response is most appropriate?
, A. "You're probably right."
B. "Let's examine the evidence supporting and challenging that belief."
C. "Stop thinking negatively."
D. "Don't worry about it."
� Correct Answer: B. "Let's examine the evidence supporting and
challenging that belief."
� Rationale:
CBT uses collaborative empiricism to evaluate automatic thoughts and replace
distorted beliefs with more balanced alternatives.
� Question 6
During a psychotherapy group, one member begins criticizing another member
aggressively. What should the PMHNP do first?
A. Allow the confrontation to continue without intervention.
B. Intervene promptly to maintain psychological safety while encouraging
respectful communication.
C. Remove both members immediately.
D. End the group session.
� Correct Answer: B. Intervene promptly to maintain psychological safety
while encouraging respectful communication.
� Rationale:
The group leader is responsible for maintaining a safe therapeutic environment.
Addressing hostile interactions early helps preserve trust and group cohesion.
Advanced Psychiatric Mental Health Nursing
Practice | Questions and Correct Verified Answers
with Rationale 2026-2027
Question 1
A 35-year-old patient with Major Depressive Disorder has attended six CBT
sessions but reports minimal improvement. The patient has completed few
homework assignments. What is the PMHNP's best intervention?
A. Terminate CBT and begin psychodynamic therapy immediately.
B. Explore barriers to homework completion, reinforce the rationale for CBT
homework, and collaborate on achievable assignments.
C. Continue therapy without addressing homework adherence.
D. Discontinue psychotherapy and prescribe medication only.
� Correct Answer: B. Explore barriers to homework completion, reinforce
the rationale for CBT homework, and collaborate on achievable assignments.
� Rationale:
Homework is a core component of CBT because it helps patients apply skills
outside therapy sessions. Nonadherence should prompt collaborative problem-
solving rather than criticism or abrupt changes in treatment.
� Question 2
,A patient with Borderline Personality Disorder frequently telephones the
PMHNP between appointments for reassurance. Which intervention best supports
DBT principles?
A. Provide unlimited reassurance whenever requested.
B. Establish consistent boundaries while reinforcing the use of DBT coping skills
before contacting the clinician.
C. Ignore every phone call.
D. Increase therapy sessions indefinitely.
� Correct Answer: B. Establish consistent boundaries while reinforcing the
use of DBT coping skills before contacting the clinician.
� Rationale:
DBT balances validation with accountability. Consistent boundaries encourage
patients to practice emotion regulation and distress tolerance skills while
preventing dependence.
� Question 3
A patient reports persistent conflict with coworkers because they assume others are
criticizing them. Which therapy most directly targets identifying and changing
these automatic interpretations?
A. CBT
B. Psychoanalysis
C. Family Therapy
D. Supportive Therapy
,� Correct Answer: A. CBT
� Rationale:
CBT focuses on identifying automatic thoughts, evaluating evidence, and
modifying maladaptive interpretations that contribute to emotional distress and
interpersonal difficulties.
� Question 4
A PMHNP notices feeling unusually protective toward a patient who reminds them
of a younger sibling. What is the best initial response?
A. Increase personal involvement with the patient.
B. Recognize possible countertransference and seek supervision if needed.
C. Ignore the emotional reaction.
D. Transfer the patient immediately.
� Correct Answer: B. Recognize possible countertransference and seek
supervision if needed.
� Rationale:
Recognizing countertransference helps clinicians maintain objectivity and
therapeutic effectiveness. Consultation or supervision may be appropriate when
these reactions affect clinical judgment.
� Question 5
A patient says,
"My anxiety will never improve."
Which CBT response is most appropriate?
, A. "You're probably right."
B. "Let's examine the evidence supporting and challenging that belief."
C. "Stop thinking negatively."
D. "Don't worry about it."
� Correct Answer: B. "Let's examine the evidence supporting and
challenging that belief."
� Rationale:
CBT uses collaborative empiricism to evaluate automatic thoughts and replace
distorted beliefs with more balanced alternatives.
� Question 6
During a psychotherapy group, one member begins criticizing another member
aggressively. What should the PMHNP do first?
A. Allow the confrontation to continue without intervention.
B. Intervene promptly to maintain psychological safety while encouraging
respectful communication.
C. Remove both members immediately.
D. End the group session.
� Correct Answer: B. Intervene promptly to maintain psychological safety
while encouraging respectful communication.
� Rationale:
The group leader is responsible for maintaining a safe therapeutic environment.
Addressing hostile interactions early helps preserve trust and group cohesion.
