NSG 526 Final Exam Actual Exam V3 | NSG 526 Clinical Modalities
Adv. Psych (NSG526 Final Exam) | Wilkes University
1. During a Cognitive Behavioral Therapy (CBT) session, a patient states, ‘If I don’t get this
promotion, my entire career is a failure.’ Which cognitive distortion is this patient
demonstrating?
A. Personalization
B. Catastrophizing
C. Emotional reasoning
D. Dichotomous thinking
Answer: D
Rationale: Dichotomous thinking, also known as all-or-nothing thinking, involves seeing
things in black-and-white categories without any middle ground. In this case, the patient
views their career as either a total success or a total failure based on a single event. The
PMHNP should address this by helping the patient identify shades of gray in their
professional development.
2. According to Irvin Yalom, which curative factor in group therapy is characterized by the
realization that one is not alone in their suffering or problems?
A. Altruism
B. Catharsis
C. Cohesiveness
D. Universality
Answer: D
Rationale: Universality provides patients with the relief that their experiences and
struggles are shared by others in the group. This factor is particularly powerful in reducing
the stigma and isolation often associated with mental health conditions. By facilitating the
sharing of common experiences, the PMHNP helps build a supportive group therapeutic
environment.
3. In Murray Bowen’s Family Systems Theory, what is the term for the process where a two-
person system draws in a third person to decrease tension?
A. Multigenerational transmission
B. Differentiation of self
C. Emotional cutoff
,D. Triangulation
Answer: D
Rationale: Triangulation occurs when tension between two people leads them to involve a
third party to stabilize the relationship. While it reduces immediate anxiety, it prevents the
original pair from resolving their conflict directly. Clinical intervention often focuses on
detriangulation to foster healthier direct communication.
4. A patient in Dialectical Behavior Therapy (DBT) is learning to tolerate painful emotions
without acting on them. Which module of DBT is being utilized?
A. Interpersonal Effectiveness
B. Emotion Regulation
C. Mindfulness
D. Distress Tolerance
Answer: D
Rationale: Distress Tolerance skills focus on helping a patient survive immediate crises
without making the situation worse by engaging in impulsive behaviors. This module
teaches techniques such as self-soothing and radical acceptance. It is a critical component
for patients with Borderline Personality Disorder who experience intense emotional
dysregulation.
5. When using Motivational Interviewing with a patient who is ambivalent about quitting
smoking, which technique is the PMHNP using by asking, ‘How would your life be different if
you decided to stop?’
A. Generating change talk
B. Expressing empathy
C. Rolling with resistance
D. Developing discrepancy
Answer: A
Rationale: This question is designed to elicit ‘change talk,’ which involves the patient
vocalizing the advantages of making a positive change. By having the patient describe a
healthier future, the PMHNP strengthens the patient’s internal motivation. This approach
shifts the focus from the clinician’s advice to the patient’s own desires and goals.
6. In Solution-Focused Brief Therapy (SFBT), the ‘Miracle Question’ is used primarily to
achieve which goal?
A. Help the patient visualize a future without the problem
B. Identify cognitive distortions
, C. Explore the patient’s past traumas
D. Assess for suicidal ideation
Answer: A
Rationale: The Miracle Question helps patients move beyond their current focus on
problems and toward a vision of success. It allows for the identification of specific,
actionable goals based on what would be different in the patient’s life. This forward-
looking technique is a hallmark of the strengths-based approach in SFBT.
7. Which therapeutic modality emphasizes the importance of ‘unconditional positive regard’
and and the quality of the therapist-client relationship?
A. Psychoanalytic Therapy
B. Gestalt Therapy
C. Person-Centered Therapy
D. Rational Emotive Behavior Therapy (REBT)
Answer: C
Rationale: Person-Centered Therapy, developed by Carl Rogers, posits that change is
facilitated by the therapist’s empathy, genuineness, and unconditional positive regard. This
modality assumes that the client has the inherent capacity for self-actualization. The role of
the PMHNP is to provide the safe, non-judgmental environment necessary for this growth
to occur.
8. A PMHNP is facilitating a group and notices two members frequently whispering and
making side comments. This behavior is most indicative of which group phenomenon?
A. Imitative behavior
B. Altruism
C. Subgrouping
D. Socializing
Answer: C
Rationale: Subgrouping occurs when small clusters of members form within a larger
group, often hindering the group’s overall progress and cohesion. It can create feelings of
exclusion for other members and distract from the group’s therapeutic tasks. The PMHNP
must address this behavior to maintain a healthy group dynamic.
9. Which family therapy model utilizes ‘reframing’ and ‘paradoxical injunctions’ to change
family interactions?
A. Structural Family Therapy
Adv. Psych (NSG526 Final Exam) | Wilkes University
1. During a Cognitive Behavioral Therapy (CBT) session, a patient states, ‘If I don’t get this
promotion, my entire career is a failure.’ Which cognitive distortion is this patient
demonstrating?
A. Personalization
B. Catastrophizing
C. Emotional reasoning
D. Dichotomous thinking
Answer: D
Rationale: Dichotomous thinking, also known as all-or-nothing thinking, involves seeing
things in black-and-white categories without any middle ground. In this case, the patient
views their career as either a total success or a total failure based on a single event. The
PMHNP should address this by helping the patient identify shades of gray in their
professional development.
2. According to Irvin Yalom, which curative factor in group therapy is characterized by the
realization that one is not alone in their suffering or problems?
A. Altruism
B. Catharsis
C. Cohesiveness
D. Universality
Answer: D
Rationale: Universality provides patients with the relief that their experiences and
struggles are shared by others in the group. This factor is particularly powerful in reducing
the stigma and isolation often associated with mental health conditions. By facilitating the
sharing of common experiences, the PMHNP helps build a supportive group therapeutic
environment.
3. In Murray Bowen’s Family Systems Theory, what is the term for the process where a two-
person system draws in a third person to decrease tension?
A. Multigenerational transmission
B. Differentiation of self
C. Emotional cutoff
,D. Triangulation
Answer: D
Rationale: Triangulation occurs when tension between two people leads them to involve a
third party to stabilize the relationship. While it reduces immediate anxiety, it prevents the
original pair from resolving their conflict directly. Clinical intervention often focuses on
detriangulation to foster healthier direct communication.
4. A patient in Dialectical Behavior Therapy (DBT) is learning to tolerate painful emotions
without acting on them. Which module of DBT is being utilized?
A. Interpersonal Effectiveness
B. Emotion Regulation
C. Mindfulness
D. Distress Tolerance
Answer: D
Rationale: Distress Tolerance skills focus on helping a patient survive immediate crises
without making the situation worse by engaging in impulsive behaviors. This module
teaches techniques such as self-soothing and radical acceptance. It is a critical component
for patients with Borderline Personality Disorder who experience intense emotional
dysregulation.
5. When using Motivational Interviewing with a patient who is ambivalent about quitting
smoking, which technique is the PMHNP using by asking, ‘How would your life be different if
you decided to stop?’
A. Generating change talk
B. Expressing empathy
C. Rolling with resistance
D. Developing discrepancy
Answer: A
Rationale: This question is designed to elicit ‘change talk,’ which involves the patient
vocalizing the advantages of making a positive change. By having the patient describe a
healthier future, the PMHNP strengthens the patient’s internal motivation. This approach
shifts the focus from the clinician’s advice to the patient’s own desires and goals.
6. In Solution-Focused Brief Therapy (SFBT), the ‘Miracle Question’ is used primarily to
achieve which goal?
A. Help the patient visualize a future without the problem
B. Identify cognitive distortions
, C. Explore the patient’s past traumas
D. Assess for suicidal ideation
Answer: A
Rationale: The Miracle Question helps patients move beyond their current focus on
problems and toward a vision of success. It allows for the identification of specific,
actionable goals based on what would be different in the patient’s life. This forward-
looking technique is a hallmark of the strengths-based approach in SFBT.
7. Which therapeutic modality emphasizes the importance of ‘unconditional positive regard’
and and the quality of the therapist-client relationship?
A. Psychoanalytic Therapy
B. Gestalt Therapy
C. Person-Centered Therapy
D. Rational Emotive Behavior Therapy (REBT)
Answer: C
Rationale: Person-Centered Therapy, developed by Carl Rogers, posits that change is
facilitated by the therapist’s empathy, genuineness, and unconditional positive regard. This
modality assumes that the client has the inherent capacity for self-actualization. The role of
the PMHNP is to provide the safe, non-judgmental environment necessary for this growth
to occur.
8. A PMHNP is facilitating a group and notices two members frequently whispering and
making side comments. This behavior is most indicative of which group phenomenon?
A. Imitative behavior
B. Altruism
C. Subgrouping
D. Socializing
Answer: C
Rationale: Subgrouping occurs when small clusters of members form within a larger
group, often hindering the group’s overall progress and cohesion. It can create feelings of
exclusion for other members and distract from the group’s therapeutic tasks. The PMHNP
must address this behavior to maintain a healthy group dynamic.
9. Which family therapy model utilizes ‘reframing’ and ‘paradoxical injunctions’ to change
family interactions?
A. Structural Family Therapy
