NURS 753 Study Pack Therapeutic
Modalities Questions and Answers
with Rationales Latest Versions
Question 1
A psychiatric nurse practitioner is caring for a patient with severe major
depressive disorder who has failed multiple antidepressant trials. The
patient reports suicidal ideation with a specific plan. Which therapeutic
modality is most appropriate?
A. Cognitive behavioral therapy (CBT)
B. Electroconvulsive therapy (ECT)
C. Interpersonal therapy
D. Psychoeducation
Correct Answer: B. Electroconvulsive therapy (ECT)
Rationale
ECT is indicated for severe depression with suicidality, psychotic
features, or treatment resistance. It produces the fastest antidepressant
response and is considered lifesaving in emergency situations.
• CBT is effective but requires several weeks.
• Interpersonal therapy is beneficial but slower.
• Psychoeducation alone is insufficient.
,Question 2
Which neurotransmitter changes are primarily associated with the
therapeutic effects of electroconvulsive therapy?
A. Increased dopamine only
B. Increased serotonin, norepinephrine, dopamine, and neuroplasticity
C. Decreased acetylcholine
D. Increased glutamate only
Correct Answer: B
Rationale
ECT increases multiple neurotransmitters and enhances neuroplasticity
through increased brain-derived neurotrophic factor (BDNF).
Question 3
Which patient should NOT receive transcranial magnetic stimulation
(TMS)?
A. Patient with mild depression
B. Patient with treatment-resistant depression
C. Patient with cochlear implant
D. Patient intolerant of antidepressants
Correct Answer: C
Rationale
,Metallic implants in or near the head (excluding dental fillings) are
contraindications because magnetic fields may interfere with implanted
devices.
Question 4
A patient asks how CBT works. The best response is:
A. "It changes unconscious conflicts."
B. "It focuses on changing negative thoughts and behaviors."
C. "It uses hypnosis."
D. "It primarily treats childhood trauma."
Correct Answer: B
Rationale
CBT teaches patients to identify distorted thinking and replace
maladaptive beliefs with healthier cognitive patterns.
Question 5
Which disorder has the strongest evidence supporting exposure and
response prevention (ERP)?
A. Bipolar disorder
B. OCD
C. Schizophrenia
D. Delirium
, Correct Answer: B
Rationale
ERP is considered the gold-standard psychotherapy for obsessive-
compulsive disorder.
Question 6
The nurse practitioner explains that dialectical behavior therapy (DBT)
primarily treats:
A. Dementia
B. Borderline personality disorder
C. ADHD
D. Panic disorder
Correct Answer: B
Rationale
DBT focuses on mindfulness, distress tolerance, emotional regulation,
and interpersonal effectiveness.
Question 7
Which statement best describes motivational interviewing?
A. Therapist directs patient decisions.
B. Focuses on medication compliance only.
Modalities Questions and Answers
with Rationales Latest Versions
Question 1
A psychiatric nurse practitioner is caring for a patient with severe major
depressive disorder who has failed multiple antidepressant trials. The
patient reports suicidal ideation with a specific plan. Which therapeutic
modality is most appropriate?
A. Cognitive behavioral therapy (CBT)
B. Electroconvulsive therapy (ECT)
C. Interpersonal therapy
D. Psychoeducation
Correct Answer: B. Electroconvulsive therapy (ECT)
Rationale
ECT is indicated for severe depression with suicidality, psychotic
features, or treatment resistance. It produces the fastest antidepressant
response and is considered lifesaving in emergency situations.
• CBT is effective but requires several weeks.
• Interpersonal therapy is beneficial but slower.
• Psychoeducation alone is insufficient.
,Question 2
Which neurotransmitter changes are primarily associated with the
therapeutic effects of electroconvulsive therapy?
A. Increased dopamine only
B. Increased serotonin, norepinephrine, dopamine, and neuroplasticity
C. Decreased acetylcholine
D. Increased glutamate only
Correct Answer: B
Rationale
ECT increases multiple neurotransmitters and enhances neuroplasticity
through increased brain-derived neurotrophic factor (BDNF).
Question 3
Which patient should NOT receive transcranial magnetic stimulation
(TMS)?
A. Patient with mild depression
B. Patient with treatment-resistant depression
C. Patient with cochlear implant
D. Patient intolerant of antidepressants
Correct Answer: C
Rationale
,Metallic implants in or near the head (excluding dental fillings) are
contraindications because magnetic fields may interfere with implanted
devices.
Question 4
A patient asks how CBT works. The best response is:
A. "It changes unconscious conflicts."
B. "It focuses on changing negative thoughts and behaviors."
C. "It uses hypnosis."
D. "It primarily treats childhood trauma."
Correct Answer: B
Rationale
CBT teaches patients to identify distorted thinking and replace
maladaptive beliefs with healthier cognitive patterns.
Question 5
Which disorder has the strongest evidence supporting exposure and
response prevention (ERP)?
A. Bipolar disorder
B. OCD
C. Schizophrenia
D. Delirium
, Correct Answer: B
Rationale
ERP is considered the gold-standard psychotherapy for obsessive-
compulsive disorder.
Question 6
The nurse practitioner explains that dialectical behavior therapy (DBT)
primarily treats:
A. Dementia
B. Borderline personality disorder
C. ADHD
D. Panic disorder
Correct Answer: B
Rationale
DBT focuses on mindfulness, distress tolerance, emotional regulation,
and interpersonal effectiveness.
Question 7
Which statement best describes motivational interviewing?
A. Therapist directs patient decisions.
B. Focuses on medication compliance only.
