,NSG426/NSG 526 Exam 1 Clinical Modalities in Advanced
Psychiatric/Mental Health Nursing Practice | Wilkes | 26/27
Updated (PDF)
1. During which stage of Hildegard Peplau's interpersonal relations model does the patient begin to
identify problems and explore feelings within the therapeutic relationship?
A) Preorientation phase
B) Orientation phase
C) Working phase
D) Termination phase
Correct Answer: Working phase
Rationale: In Peplau's model, the working phase is when the patient actively identifies problems,
explores feelings, and uses the nurse-patient relationship to develop new coping strategies. The
orientation phase involves establishing rapport and defining the problem, while the termination
phase focuses on consolidating gains and ending the relationship.
2. A patient consistently attributes their own unacceptable feelings to the nurse practitioner, accusing
the nurse of being angry when the patient is actually angry. This defense mechanism is best described
as:
A) Displacement
B) Projection
C) Rationalization
D) Reaction formation
Correct Answer: Projection
Rationale: Projection involves attributing one's own unacceptable thoughts, feelings, or impulses to
another person. In this scenario, the patient projects their anger onto the nurse. Displacement
redirects emotion to a safer target, rationalization provides logical explanations for irrational
behavior, and reaction formation converts an unacceptable impulse into its opposite.
3. Which therapeutic communication technique involves restating the patient's message in the nurse's
own words to confirm understanding?
A) Clarification
B) Reflection
,C) Paraphrasing
D) Validation
Correct Answer: Paraphrasing
Rationale: Paraphrasing restates the patient's message in the nurse's own words to confirm accurate
understanding. Clarification asks for more information or explanation. Reflection mirrors the patient's
feelings back to them. Validation acknowledges the patient's experience as understandable.
4. In the context of group therapy, Yalom's therapeutic factor of "imparting information" refers to:
A) Members sharing personal experiences of suffering
B) The leader or members providing didactic information about mental health
C) Members learning from observing others' therapeutic work
D) The group creating a sense of belonging
Correct Answer: The leader or members providing didactic information about mental health
Rationale: Imparting information involves the group leader or members providing didactic instruction
about mental health, illness, and coping strategies. Universality involves shared experiences.
Vicarious learning involves observing others. Cohesiveness involves belonging.
5. According to Beck's cognitive triad, depression is maintained by negative views of:
A) The self, the world, and the future
B) The past, the present, and the future
C) The self, others, and the environment
D) Thoughts, feelings, and behaviors
Correct Answer: The self, the world, and the future
Rationale: Beck's cognitive triad proposes that depressed individuals hold negative views of
themselves, the world, and the future, which perpetuate depressive symptoms. These maladaptive
schemas influence information processing and maintain the depressive cycle.
6. A patient with borderline personality disorder rapidly shifts from idealizing the nurse practitioner to
devaluing them. This pattern is characteristic of:
A) Splitting
B) Projective identification
, C) Dissociation
D) Magical thinking
Correct Answer: Splitting
Rationale: Splitting is a defense mechanism common in borderline personality disorder where the
individual views others as all-good or all-bad, leading to rapid shifts between idealization and
devaluation. Projective identification involves unconsciously projecting feelings onto another and
then identifying with them. Dissociation involves detachment from reality, and magical thinking
involves believing thoughts can cause events.
7. In Dialectical Behavior Therapy (DBT), the primary focus of Stage 1 treatment is:
A) Achieving a life worth living
B) Behavioral control and stabilization
C) Reducing post-traumatic stress symptoms
D) Enhancing self-respect and self-esteem
Correct Answer: Behavioral control and stabilization
Rationale: DBT Stage 1 focuses on stabilizing the patient and achieving behavioral control, specifically
addressing life-threatening behaviors, therapy-interfering behaviors, and quality-of-life-interfering
behaviors. Later stages address trauma, self-respect, and achieving a life worth living.
8. A patient tells the nurse practitioner, "You just don't understand what I'm going through." Which
response demonstrates the therapeutic technique of validation?
A) "You're right, I don't understand."
B) "Tell me more about what you're going through."
C) "It sounds like you're feeling frustrated that I don't fully grasp your experience."
D) "I understand exactly how you feel."
Correct Answer: "It sounds like you're feeling frustrated that I don't fully grasp your experience."
Rationale: Validation acknowledges the patient's feelings as understandable without necessarily
agreeing with their perspective. It reflects the emotional content of the patient's message. Dismissing
the concern, requesting more information without acknowledgment, or claiming full understanding
are less therapeutic.
9. Which family therapy approach, developed by Salvador Minuchin, emphasizes the importance of
boundaries and hierarchies within the family system?
Psychiatric/Mental Health Nursing Practice | Wilkes | 26/27
Updated (PDF)
1. During which stage of Hildegard Peplau's interpersonal relations model does the patient begin to
identify problems and explore feelings within the therapeutic relationship?
A) Preorientation phase
B) Orientation phase
C) Working phase
D) Termination phase
Correct Answer: Working phase
Rationale: In Peplau's model, the working phase is when the patient actively identifies problems,
explores feelings, and uses the nurse-patient relationship to develop new coping strategies. The
orientation phase involves establishing rapport and defining the problem, while the termination
phase focuses on consolidating gains and ending the relationship.
2. A patient consistently attributes their own unacceptable feelings to the nurse practitioner, accusing
the nurse of being angry when the patient is actually angry. This defense mechanism is best described
as:
A) Displacement
B) Projection
C) Rationalization
D) Reaction formation
Correct Answer: Projection
Rationale: Projection involves attributing one's own unacceptable thoughts, feelings, or impulses to
another person. In this scenario, the patient projects their anger onto the nurse. Displacement
redirects emotion to a safer target, rationalization provides logical explanations for irrational
behavior, and reaction formation converts an unacceptable impulse into its opposite.
3. Which therapeutic communication technique involves restating the patient's message in the nurse's
own words to confirm understanding?
A) Clarification
B) Reflection
,C) Paraphrasing
D) Validation
Correct Answer: Paraphrasing
Rationale: Paraphrasing restates the patient's message in the nurse's own words to confirm accurate
understanding. Clarification asks for more information or explanation. Reflection mirrors the patient's
feelings back to them. Validation acknowledges the patient's experience as understandable.
4. In the context of group therapy, Yalom's therapeutic factor of "imparting information" refers to:
A) Members sharing personal experiences of suffering
B) The leader or members providing didactic information about mental health
C) Members learning from observing others' therapeutic work
D) The group creating a sense of belonging
Correct Answer: The leader or members providing didactic information about mental health
Rationale: Imparting information involves the group leader or members providing didactic instruction
about mental health, illness, and coping strategies. Universality involves shared experiences.
Vicarious learning involves observing others. Cohesiveness involves belonging.
5. According to Beck's cognitive triad, depression is maintained by negative views of:
A) The self, the world, and the future
B) The past, the present, and the future
C) The self, others, and the environment
D) Thoughts, feelings, and behaviors
Correct Answer: The self, the world, and the future
Rationale: Beck's cognitive triad proposes that depressed individuals hold negative views of
themselves, the world, and the future, which perpetuate depressive symptoms. These maladaptive
schemas influence information processing and maintain the depressive cycle.
6. A patient with borderline personality disorder rapidly shifts from idealizing the nurse practitioner to
devaluing them. This pattern is characteristic of:
A) Splitting
B) Projective identification
, C) Dissociation
D) Magical thinking
Correct Answer: Splitting
Rationale: Splitting is a defense mechanism common in borderline personality disorder where the
individual views others as all-good or all-bad, leading to rapid shifts between idealization and
devaluation. Projective identification involves unconsciously projecting feelings onto another and
then identifying with them. Dissociation involves detachment from reality, and magical thinking
involves believing thoughts can cause events.
7. In Dialectical Behavior Therapy (DBT), the primary focus of Stage 1 treatment is:
A) Achieving a life worth living
B) Behavioral control and stabilization
C) Reducing post-traumatic stress symptoms
D) Enhancing self-respect and self-esteem
Correct Answer: Behavioral control and stabilization
Rationale: DBT Stage 1 focuses on stabilizing the patient and achieving behavioral control, specifically
addressing life-threatening behaviors, therapy-interfering behaviors, and quality-of-life-interfering
behaviors. Later stages address trauma, self-respect, and achieving a life worth living.
8. A patient tells the nurse practitioner, "You just don't understand what I'm going through." Which
response demonstrates the therapeutic technique of validation?
A) "You're right, I don't understand."
B) "Tell me more about what you're going through."
C) "It sounds like you're feeling frustrated that I don't fully grasp your experience."
D) "I understand exactly how you feel."
Correct Answer: "It sounds like you're feeling frustrated that I don't fully grasp your experience."
Rationale: Validation acknowledges the patient's feelings as understandable without necessarily
agreeing with their perspective. It reflects the emotional content of the patient's message. Dismissing
the concern, requesting more information without acknowledgment, or claiming full understanding
are less therapeutic.
9. Which family therapy approach, developed by Salvador Minuchin, emphasizes the importance of
boundaries and hierarchies within the family system?
