Walden University NRNP 6640 Midterm Exam (pdf) | 2026/2027 |
PMHNP Psychotherapy Q&A | Psychotherapy
**1. During a session, the PMHNP asks a patient with a history of sexual
abuse to recall the relationship she had as a child with her parents. The
patient responds by saying she has a headache and her stomach hurts, and
starts talking about her physical ailments. What is the appropriate response
by the PMHNP?**
A) Acknowledge the physical complaints and move on to another topic
B) Explain why it is important for the patient to discuss these memories
openly
C) Recommend a medical evaluation for the physical symptoms
D) Redirect the patient to discuss her current relationships instead
**Correct Answer: B**
**Rationale:** The patient is exhibiting somatic symptoms as a defense
mechanism to avoid discussing painful memories. The PMHNP should gently
explain the importance of exploring these memories while acknowledging
the patient's discomfort. This validates the patient's experience while
keeping the therapeutic focus on the underlying issues.
---
**2. A PMHNP is assessing ego functioning of his 40-year-old patient by
asking what she feels is the cause of her problems. She attributes her
problems to her overprotective parents not letting her have enough freedom
growing up. Based on her answer, the PMHNP is testing:**
A) Reality testing and impulse control
B) Cognitive and affective functioning
,C) Defensive and interpersonal functioning
D) Identity and self-esteem
**Correct Answer: C**
**Rationale:** Ego functioning encompasses defensive and interpersonal
functioning. The patient's attribution of her problems to her parents reflects
how she perceives and relates to others (interpersonal functioning) and how
she defends against internal conflict by externalizing blame (defensive
functioning).
---
**3. A 28-year-old male patient is experiencing distress related to the
workplace. What might the PMHNP ask to assess affective development?**
A) "How do you typically express anger?"
B) "What emotions do you experience when you feel criticized?"
C) "How do you react when you feel stressed at work?"
D) All of the above
**Correct Answer: D**
**Rationale:** Affective development assessment involves exploring how the
patient experiences, expresses, and regulates emotions in various contexts.
Asking about anger expression, emotional responses to criticism, and
reactions to stress all help the PMHNP understand the patient's affective
functioning.
---
,**4. The PMHNP has been treating a 15-year-old patient with a history of
abuse and neglect. Thirty minutes into their therapy session the patient
jumps up and begins to pace around the room. Utilizing Socratic dialogue,
the PMHNP's best action would be to:**
A) Tell the patient to sit down and continue the session
B) End the session early and reschedule
C) Say, "I noticed a change. Can you tell me what happened?"
D) Ask the patient to take several deep breaths
**Correct Answer: C**
**Rationale:** Socratic dialogue involves asking open-ended questions to
explore the patient's experience and promote insight. By noticing the change
and asking the patient to describe what happened, the PMHNP helps the
patient develop awareness of their emotional and behavioral responses.
---
**5. The PMHNP understands that anxiety and depression are two disorders
in which their symptoms may overlap. When discussing this, you explain that
the autonomic nervous system is activated and further helps distinguish
anxiety symptoms by making the following points:**
A) "You may experience fatigue and loss of interest."
B) "You may experience fear, sweating, and muscle tension."
C) "You may experience hopelessness and worthlessness."
D) "You may experience changes in appetite and sleep."
, **Correct Answer: B**
**Rationale:** Anxiety symptoms are associated with autonomic nervous
system activation, including fear, sweating, and muscle tension. These
physiological symptoms help distinguish anxiety from depression, which is
more characterized by affective symptoms like hopelessness and loss of
interest.
---
**6. A PMHNP is taking a history and wants to assess how the patient copes
with adversity. To do so, the therapist asks questions about the patient's
belief system. What would be an appropriate question to ask?**
A) "How does your faith or spirituality influence your coping?"
B) "What gives you strength during difficult times?"
C) "Who or what do you turn to for support?"
D) All of the above
**Correct Answer: D**
**Rationale:** Assessing belief systems and coping mechanisms involves
exploring multiple dimensions of the patient's support network and sources
of strength. Questions about faith, sources of strength, and support systems
all contribute to understanding how the patient copes with adversity.
---
PMHNP Psychotherapy Q&A | Psychotherapy
**1. During a session, the PMHNP asks a patient with a history of sexual
abuse to recall the relationship she had as a child with her parents. The
patient responds by saying she has a headache and her stomach hurts, and
starts talking about her physical ailments. What is the appropriate response
by the PMHNP?**
A) Acknowledge the physical complaints and move on to another topic
B) Explain why it is important for the patient to discuss these memories
openly
C) Recommend a medical evaluation for the physical symptoms
D) Redirect the patient to discuss her current relationships instead
**Correct Answer: B**
**Rationale:** The patient is exhibiting somatic symptoms as a defense
mechanism to avoid discussing painful memories. The PMHNP should gently
explain the importance of exploring these memories while acknowledging
the patient's discomfort. This validates the patient's experience while
keeping the therapeutic focus on the underlying issues.
---
**2. A PMHNP is assessing ego functioning of his 40-year-old patient by
asking what she feels is the cause of her problems. She attributes her
problems to her overprotective parents not letting her have enough freedom
growing up. Based on her answer, the PMHNP is testing:**
A) Reality testing and impulse control
B) Cognitive and affective functioning
,C) Defensive and interpersonal functioning
D) Identity and self-esteem
**Correct Answer: C**
**Rationale:** Ego functioning encompasses defensive and interpersonal
functioning. The patient's attribution of her problems to her parents reflects
how she perceives and relates to others (interpersonal functioning) and how
she defends against internal conflict by externalizing blame (defensive
functioning).
---
**3. A 28-year-old male patient is experiencing distress related to the
workplace. What might the PMHNP ask to assess affective development?**
A) "How do you typically express anger?"
B) "What emotions do you experience when you feel criticized?"
C) "How do you react when you feel stressed at work?"
D) All of the above
**Correct Answer: D**
**Rationale:** Affective development assessment involves exploring how the
patient experiences, expresses, and regulates emotions in various contexts.
Asking about anger expression, emotional responses to criticism, and
reactions to stress all help the PMHNP understand the patient's affective
functioning.
---
,**4. The PMHNP has been treating a 15-year-old patient with a history of
abuse and neglect. Thirty minutes into their therapy session the patient
jumps up and begins to pace around the room. Utilizing Socratic dialogue,
the PMHNP's best action would be to:**
A) Tell the patient to sit down and continue the session
B) End the session early and reschedule
C) Say, "I noticed a change. Can you tell me what happened?"
D) Ask the patient to take several deep breaths
**Correct Answer: C**
**Rationale:** Socratic dialogue involves asking open-ended questions to
explore the patient's experience and promote insight. By noticing the change
and asking the patient to describe what happened, the PMHNP helps the
patient develop awareness of their emotional and behavioral responses.
---
**5. The PMHNP understands that anxiety and depression are two disorders
in which their symptoms may overlap. When discussing this, you explain that
the autonomic nervous system is activated and further helps distinguish
anxiety symptoms by making the following points:**
A) "You may experience fatigue and loss of interest."
B) "You may experience fear, sweating, and muscle tension."
C) "You may experience hopelessness and worthlessness."
D) "You may experience changes in appetite and sleep."
, **Correct Answer: B**
**Rationale:** Anxiety symptoms are associated with autonomic nervous
system activation, including fear, sweating, and muscle tension. These
physiological symptoms help distinguish anxiety from depression, which is
more characterized by affective symptoms like hopelessness and loss of
interest.
---
**6. A PMHNP is taking a history and wants to assess how the patient copes
with adversity. To do so, the therapist asks questions about the patient's
belief system. What would be an appropriate question to ask?**
A) "How does your faith or spirituality influence your coping?"
B) "What gives you strength during difficult times?"
C) "Who or what do you turn to for support?"
D) All of the above
**Correct Answer: D**
**Rationale:** Assessing belief systems and coping mechanisms involves
exploring multiple dimensions of the patient's support network and sources
of strength. Questions about faith, sources of strength, and support systems
all contribute to understanding how the patient copes with adversity.
---
