Wilkes University NSG 526 Exam 1
Clinical Modalities In Advanced Psychiatric Mental Health
Nursing Practice
Actual Questions & Answers (Verified Answers) | 100%
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1. A PMHNP is seeing a new patient for the first time. Which action best
establishes the therapeutic alliance?
A) Completing a comprehensive biopsychosocial assessment
B) Explaining the limits of confidentiality upfront
C) Demonstrating empathy, genuineness, and unconditional positive regard
D) Obtaining a complete medication history
Correct Answer: C
Rationale: The therapeutic alliance is the foundation of psychiatric mental health
nursing. Carl Rogers' core conditions of empathy, genuineness, and unconditional
positive regard are essential for building trust and rapport. While assessment,
confidentiality, and medication history are important components of the initial visit, they
are tasks-oriented and do not establish the interpersonal connection that defines the
therapeutic alliance. The alliance is built through the quality of the relationship, not
through the completion of clinical tasks.
,2. A patient states, "I'm nothing but a burden to everyone. My family would be
better off without me." What is the PMHNP's BEST response?
A) "Don't say things like that—you have so much to live for."
B) "Your family loves you and needs you."
C) "It sounds like you're feeling hopeless and like a burden to others."
D) "Why do you feel that way?"
Correct Answer: C
Rationale: This response demonstrates therapeutic communication through reflection
and validation of the patient's expressed feelings. It acknowledges the patient's
emotional state without judgment, denial, or false reassurance. Option A dismisses the
patient's feelings, Option B offers false reassurance, and Option D uses a "why" question
that can sound accusatory and may put the patient on the defensive.
3. According to Peplau's Interpersonal Relations Theory, which of the following is
the PRIMARY role of the PMHNP during the orientation phase?
A) Implementing therapeutic interventions
B) Establishing trust and clarifying expectations
C) Terminating the therapeutic relationship
D) Identifying transference issues
Correct Answer: B
Rationale: Peplau's Interpersonal Relations Theory identifies four phases: orientation,
identification, exploitation, and resolution. During the orientation phase, the nurse and
patient establish a trusting relationship, clarify expectations, define problems, and
negotiate roles. Interventions (A) occur in later phases, termination (C) occurs during
,resolution, and transference identification (D) typically emerges during the identification
phase.
4. A patient with chronic depression tells the PMHNP, "I've been taking my
medications every single day, but I still feel terrible. What's the point?" Which
response demonstrates therapeutic use of self?
A) "You need to give the medication more time to work."
B) "Tell me more about what you're experiencing with your symptoms."
C) "I understand your frustration—let's look at adjusting your dose."
D) "Many patients feel that way before achieving remission."
Correct Answer: B
Rationale: The therapeutic use of self involves using one's personality, insights,
perceptions, and judgments to create a healing relationship. Option B opens exploration
and demonstrates genuine curiosity about the patient's experience. Option A dismisses
the patient's concern, Option C jumps to intervention without fully exploring the issue,
and Option D uses platitudes that minimize the patient's unique experience.
5. A PMHNP notices a patient consistently arrives late to sessions and frequently
asks for rescheduling. Which is the MOST therapeutic way to address this pattern?
A) "I've noticed you've been late to our last three appointments. I'm wondering if you'd
like to discuss this pattern."
B) "If you're going to be late again, I'll have to terminate our sessions."
C) "It's really disrespectful when you arrive late—I have other patients waiting."
D) "Late arrivals disrupt my schedule—please arrive on time in the future."
, Correct Answer: A
Rationale: This response uses the therapeutic technique of observation and explores
the pattern in a non-judgmental, curious manner. It invites collaboration and exploration
of possible meanings behind the behavior (e.g., resistance, ambivalence, testing
boundaries). Options B and C are confrontational and punitive, while D is directive
without exploration.
6. In motivational interviewing, which technique is used to resolve ambivalence by
helping the patient articulate arguments for change?
A) Confrontation
B) Advising
C) OARS (Open-ended questions, Affirmations, Reflective listening, Summaries)
D) Elicit-provide-elicit
Correct Answer: D
Rationale: The "elicit-provide-elicit" technique in motivational interviewing is a
structured approach to providing information while respecting the patient's autonomy.
The clinician (1) elicits the patient's current knowledge, (2) provides information, and (3)
elicits the patient's response. This approach helps patients articulate their own
motivations for change rather than receiving advice, which supports intrinsic motivation
and reduces resistance.
7. Which of the following is the PRIMARY goal of crisis intervention?
Clinical Modalities In Advanced Psychiatric Mental Health
Nursing Practice
Actual Questions & Answers (Verified Answers) | 100%
Guaranteed Pass || Complete A+ Guide
1. A PMHNP is seeing a new patient for the first time. Which action best
establishes the therapeutic alliance?
A) Completing a comprehensive biopsychosocial assessment
B) Explaining the limits of confidentiality upfront
C) Demonstrating empathy, genuineness, and unconditional positive regard
D) Obtaining a complete medication history
Correct Answer: C
Rationale: The therapeutic alliance is the foundation of psychiatric mental health
nursing. Carl Rogers' core conditions of empathy, genuineness, and unconditional
positive regard are essential for building trust and rapport. While assessment,
confidentiality, and medication history are important components of the initial visit, they
are tasks-oriented and do not establish the interpersonal connection that defines the
therapeutic alliance. The alliance is built through the quality of the relationship, not
through the completion of clinical tasks.
,2. A patient states, "I'm nothing but a burden to everyone. My family would be
better off without me." What is the PMHNP's BEST response?
A) "Don't say things like that—you have so much to live for."
B) "Your family loves you and needs you."
C) "It sounds like you're feeling hopeless and like a burden to others."
D) "Why do you feel that way?"
Correct Answer: C
Rationale: This response demonstrates therapeutic communication through reflection
and validation of the patient's expressed feelings. It acknowledges the patient's
emotional state without judgment, denial, or false reassurance. Option A dismisses the
patient's feelings, Option B offers false reassurance, and Option D uses a "why" question
that can sound accusatory and may put the patient on the defensive.
3. According to Peplau's Interpersonal Relations Theory, which of the following is
the PRIMARY role of the PMHNP during the orientation phase?
A) Implementing therapeutic interventions
B) Establishing trust and clarifying expectations
C) Terminating the therapeutic relationship
D) Identifying transference issues
Correct Answer: B
Rationale: Peplau's Interpersonal Relations Theory identifies four phases: orientation,
identification, exploitation, and resolution. During the orientation phase, the nurse and
patient establish a trusting relationship, clarify expectations, define problems, and
negotiate roles. Interventions (A) occur in later phases, termination (C) occurs during
,resolution, and transference identification (D) typically emerges during the identification
phase.
4. A patient with chronic depression tells the PMHNP, "I've been taking my
medications every single day, but I still feel terrible. What's the point?" Which
response demonstrates therapeutic use of self?
A) "You need to give the medication more time to work."
B) "Tell me more about what you're experiencing with your symptoms."
C) "I understand your frustration—let's look at adjusting your dose."
D) "Many patients feel that way before achieving remission."
Correct Answer: B
Rationale: The therapeutic use of self involves using one's personality, insights,
perceptions, and judgments to create a healing relationship. Option B opens exploration
and demonstrates genuine curiosity about the patient's experience. Option A dismisses
the patient's concern, Option C jumps to intervention without fully exploring the issue,
and Option D uses platitudes that minimize the patient's unique experience.
5. A PMHNP notices a patient consistently arrives late to sessions and frequently
asks for rescheduling. Which is the MOST therapeutic way to address this pattern?
A) "I've noticed you've been late to our last three appointments. I'm wondering if you'd
like to discuss this pattern."
B) "If you're going to be late again, I'll have to terminate our sessions."
C) "It's really disrespectful when you arrive late—I have other patients waiting."
D) "Late arrivals disrupt my schedule—please arrive on time in the future."
, Correct Answer: A
Rationale: This response uses the therapeutic technique of observation and explores
the pattern in a non-judgmental, curious manner. It invites collaboration and exploration
of possible meanings behind the behavior (e.g., resistance, ambivalence, testing
boundaries). Options B and C are confrontational and punitive, while D is directive
without exploration.
6. In motivational interviewing, which technique is used to resolve ambivalence by
helping the patient articulate arguments for change?
A) Confrontation
B) Advising
C) OARS (Open-ended questions, Affirmations, Reflective listening, Summaries)
D) Elicit-provide-elicit
Correct Answer: D
Rationale: The "elicit-provide-elicit" technique in motivational interviewing is a
structured approach to providing information while respecting the patient's autonomy.
The clinician (1) elicits the patient's current knowledge, (2) provides information, and (3)
elicits the patient's response. This approach helps patients articulate their own
motivations for change rather than receiving advice, which supports intrinsic motivation
and reduces resistance.
7. Which of the following is the PRIMARY goal of crisis intervention?
