NSG 526 Exam 3 Actual Exam V1 | NSG 526 Clinical Modalities Adv.
Psych (NSG526 Exam 3) | Wilkes University
1. A PMHNP is leading a group therapy session for adults with depression. One member
states, “I thought I was the only one who felt so useless, but hearing others talk makes me
feel less alone.” Which of Yalom’s curative factors is being demonstrated?
A. Universality
B. Altruism
C. Imitative Behavior
D. Catharsis
Answer: A
Rationale: Universality is the recognition of shared experiences and feelings among group
members, which helps to decrease isolation. In this scenario, the patient realizes that their
struggles are not unique to them, which fosters a sense of belonging. The PMHNP facilitates
this process by encouraging members to share their stories openly.
2. In a family therapy session, the PMHNP observes a mother and daughter arguing while the
father remains silent and avoids eye contact. The mother frequently looks at the father for
support, but he retreats further. What structural family therapy concept is illustrated here?
A. Enmeshment
B. Disengagement
C. Triangulation
D. Joining
Answer: C
Rationale: Triangulation occurs when a third person is brought into a two-person tension
to stabilize the relationship. In this case, the mother is attempting to pull the father into the
conflict between her and the daughter. The PMHNP must identify these patterns to help the
family establish healthier boundaries.
3. A client in CBT for Social Anxiety Disorder identifies the thought, “If I go to the party,
everyone will see me blushing and think I am a loser.” This is an example of which cognitive
distortion?
A. Magnification
B. Emotional Reasoning
C. Mind Reading
,D. Catastrophizing
Answer: C
Rationale: Mind reading is a cognitive distortion where an individual assumes they know
what others are thinking without evidence. Here, the client is projecting their own
insecurities onto the party guests. The PMHNP uses Socratic questioning to help the client
challenge the validity of this assumption.
4. During a DBT session, a client with Borderline Personality Disorder describes feeling
overwhelmed by intense anger. The PMHNP suggests using a “TIPP” skill. What is the primary
goal of this intervention?
A. Interpersonal Effectiveness
B. Cognitive Restructuring
C. Distress Tolerance
D. Mindfulness
Answer: C
Rationale: TIPP skills (Temperature, Intense exercise, Paced breathing, Paired muscle
relaxation) are part of the distress tolerance module in DBT. These skills are designed to
rapidly reduce physiological arousal during a crisis. By applying these techniques, the
client can manage intense emotions without engaging in self-destructive behaviors.
5. A group in the ‘storming’ stage of development is experiencing conflict and power
struggles. What is the most appropriate action for the PMHNP leader?
A. Intervene immediately to stop all conflict and maintain peace.
B. Allow the conflict to occur while facilitating open communication and setting
boundaries.
C. Dissolve the group and start over with new members.
D. Assign a dominant member to lead the group for a session.
Answer: B
Rationale: The storming stage is a natural part of group development where members test
boundaries and express individuality. The leader’s role is to facilitate the resolution of
conflict through communication rather than suppressing it. Successfully navigating this
stage is crucial for the group to reach the ‘norming’ phase.
6. A family therapist uses a genogram to map out three generations of a family. What is the
primary purpose of this assessment tool in Bowenian Family Therapy?
A. To identify behavioral rewards and punishments.
B. To visualize multigenerational patterns and levels of differentiation.
, C. To establish a hierarchy of family members.
D. To provide a miracle question for the family to solve.
Answer: B
Rationale: Genograms are essential in Bowenian therapy for identifying recurring patterns
of behavior across generations. They help the PMHNP and the family understand how past
dynamics influence current relationships. This tool is instrumental in promoting
differentiation of self among family members.
7. In Interpersonal Psychotherapy (IPT), a client is struggling with a recent promotion that has
caused significant stress and changes in social roles. Which IPT problem area does this
represent?
A. Role Transition
B. Interpersonal Deficits
C. Role Dispute
D. Grief
Answer: A
Rationale: Role transition involves difficulties adapting to changes in life circumstances,
such as a new job, retirement, or moving. IPT focuses on helping the client navigate these
changes and the emotions associated with them. The goal is to improve the client’s social
functioning and reduce depressive symptoms.
8. A PMHNP is using Motivational Interviewing with a client who is ambivalent about quitting
smoking. The client says, “I know smoking is bad for me, but it helps me relax.” What is the
most appropriate response to elicit ‘change talk’?
A. “You should really think about the health risks of smoking.”
B. “I will give you some brochures on how to quit smoking.”
C. “What are some of the ways your life might be better if you did quit?”
D. “If you don’t quit, you will likely develop lung cancer.”
Answer: C
Rationale: Asking about the benefits of change is a technique in Motivational Interviewing
to elicit change talk. This approach focuses on the client’s own motivations rather than
external pressure. The PMHNP aims to strengthen the client’s resolve by having them
articulate their own reasons for change.
9. During a family session, a PMHNP asks the family to rearrange their seating so that the
children are sitting together and the parents are sitting together. This is an example of:
A. Unbalancing
Psych (NSG526 Exam 3) | Wilkes University
1. A PMHNP is leading a group therapy session for adults with depression. One member
states, “I thought I was the only one who felt so useless, but hearing others talk makes me
feel less alone.” Which of Yalom’s curative factors is being demonstrated?
A. Universality
B. Altruism
C. Imitative Behavior
D. Catharsis
Answer: A
Rationale: Universality is the recognition of shared experiences and feelings among group
members, which helps to decrease isolation. In this scenario, the patient realizes that their
struggles are not unique to them, which fosters a sense of belonging. The PMHNP facilitates
this process by encouraging members to share their stories openly.
2. In a family therapy session, the PMHNP observes a mother and daughter arguing while the
father remains silent and avoids eye contact. The mother frequently looks at the father for
support, but he retreats further. What structural family therapy concept is illustrated here?
A. Enmeshment
B. Disengagement
C. Triangulation
D. Joining
Answer: C
Rationale: Triangulation occurs when a third person is brought into a two-person tension
to stabilize the relationship. In this case, the mother is attempting to pull the father into the
conflict between her and the daughter. The PMHNP must identify these patterns to help the
family establish healthier boundaries.
3. A client in CBT for Social Anxiety Disorder identifies the thought, “If I go to the party,
everyone will see me blushing and think I am a loser.” This is an example of which cognitive
distortion?
A. Magnification
B. Emotional Reasoning
C. Mind Reading
,D. Catastrophizing
Answer: C
Rationale: Mind reading is a cognitive distortion where an individual assumes they know
what others are thinking without evidence. Here, the client is projecting their own
insecurities onto the party guests. The PMHNP uses Socratic questioning to help the client
challenge the validity of this assumption.
4. During a DBT session, a client with Borderline Personality Disorder describes feeling
overwhelmed by intense anger. The PMHNP suggests using a “TIPP” skill. What is the primary
goal of this intervention?
A. Interpersonal Effectiveness
B. Cognitive Restructuring
C. Distress Tolerance
D. Mindfulness
Answer: C
Rationale: TIPP skills (Temperature, Intense exercise, Paced breathing, Paired muscle
relaxation) are part of the distress tolerance module in DBT. These skills are designed to
rapidly reduce physiological arousal during a crisis. By applying these techniques, the
client can manage intense emotions without engaging in self-destructive behaviors.
5. A group in the ‘storming’ stage of development is experiencing conflict and power
struggles. What is the most appropriate action for the PMHNP leader?
A. Intervene immediately to stop all conflict and maintain peace.
B. Allow the conflict to occur while facilitating open communication and setting
boundaries.
C. Dissolve the group and start over with new members.
D. Assign a dominant member to lead the group for a session.
Answer: B
Rationale: The storming stage is a natural part of group development where members test
boundaries and express individuality. The leader’s role is to facilitate the resolution of
conflict through communication rather than suppressing it. Successfully navigating this
stage is crucial for the group to reach the ‘norming’ phase.
6. A family therapist uses a genogram to map out three generations of a family. What is the
primary purpose of this assessment tool in Bowenian Family Therapy?
A. To identify behavioral rewards and punishments.
B. To visualize multigenerational patterns and levels of differentiation.
, C. To establish a hierarchy of family members.
D. To provide a miracle question for the family to solve.
Answer: B
Rationale: Genograms are essential in Bowenian therapy for identifying recurring patterns
of behavior across generations. They help the PMHNP and the family understand how past
dynamics influence current relationships. This tool is instrumental in promoting
differentiation of self among family members.
7. In Interpersonal Psychotherapy (IPT), a client is struggling with a recent promotion that has
caused significant stress and changes in social roles. Which IPT problem area does this
represent?
A. Role Transition
B. Interpersonal Deficits
C. Role Dispute
D. Grief
Answer: A
Rationale: Role transition involves difficulties adapting to changes in life circumstances,
such as a new job, retirement, or moving. IPT focuses on helping the client navigate these
changes and the emotions associated with them. The goal is to improve the client’s social
functioning and reduce depressive symptoms.
8. A PMHNP is using Motivational Interviewing with a client who is ambivalent about quitting
smoking. The client says, “I know smoking is bad for me, but it helps me relax.” What is the
most appropriate response to elicit ‘change talk’?
A. “You should really think about the health risks of smoking.”
B. “I will give you some brochures on how to quit smoking.”
C. “What are some of the ways your life might be better if you did quit?”
D. “If you don’t quit, you will likely develop lung cancer.”
Answer: C
Rationale: Asking about the benefits of change is a technique in Motivational Interviewing
to elicit change talk. This approach focuses on the client’s own motivations rather than
external pressure. The PMHNP aims to strengthen the client’s resolve by having them
articulate their own reasons for change.
9. During a family session, a PMHNP asks the family to rearrange their seating so that the
children are sitting together and the parents are sitting together. This is an example of:
A. Unbalancing
