NSG 526 Exam 2 Actual Exam V1 | NSG 526 Clinical Modalities Adv.
Psych (NSG526 Exam 2) | Wilkes University
1. When using Cognitive Behavioral Therapy (CBT) with a patient suffering from depression,
which intervention is the Psychiatric-Mental Health Nurse Practitioner (PMHNP) most likely
to implement?
A. Analyzing childhood dreams to uncover unconscious conflicts.
B. Identifying and challenging automatic negative thoughts.
C. Using a mirror to practice emotional regulation skills.
D. Conducting a genogram to map out family history.
Answer: B
Rationale: CBT is primarily focused on the connection between thoughts, feelings, and
behaviors. The PMHNP helps the patient identify cognitive distortions or automatic
thoughts that contribute to their depressive state. By challenging these thoughts and
replacing them with more balanced perspectives, the patient is able to improve their
emotional wellbeing.
2. In Dialectical Behavior Therapy (DBT), which module is specifically designed to help
patients manage crises without making them worse?
A. Interpersonal Effectiveness
B. Distress Tolerance
C. Emotion Regulation
D. Mindfulness
Answer: B
Rationale: Distress Tolerance is a core pillar of DBT that provides patients with skills to
survive immediate crises. These techniques are used to accept reality as it is when it cannot
be changed immediately. Implementing these skills prevents the patient from engaging in
impulsive, self-destructive behaviors during high-stress moments.
3. A PMHNP is conducting Interpersonal Psychotherapy (IPT) with a patient. The focus is on a
recent divorce that the patient is struggling to accept. Which IPT problem area does this
represent?
A. Interpersonal Role Dispute
B. Grief and Loss
C. Role Transition
,D. Interpersonal Deficits
Answer: C
Rationale: Role Transition in IPT refers to the psychological and social changes that occur
when an individual moves from one life state to another, such as becoming single after a
divorce. The therapy focuses on helping the patient mourn the loss of the old role and
master the requirements of the new role. This approach is highly effective for patients
experiencing adjustment disorders or depression triggered by life changes.
4. In Family Systems Therapy, the term ‘triangulation’ refers to:
A. The process of three family members working together for a common goal.
B. The legal process of assigning a guardian to a minor in the family.
C. A diagnostic tool used to measure the intensity of a child’s behavior.
D. A strategy where two people bring in a third person to reduce anxiety between the
original two.
Answer: D
Rationale: Triangulation is a key concept in Bowenian Family Systems Theory describing
how a two-person system stabilizes itself by involving a third party. When tension rises
between two people, they often focus on a third person (like a child) to deflect the conflict.
The PMHNP’s role is to identify these triangles and help the individuals focus on their own
self-differentiation.
5. According to Irvin Yalom, which ‘curative factor’ of group therapy involves the realization
that one is not alone in their suffering?
A. Catharsis
B. Universality
C. Altruism
D. Imparting Information
Answer: B
Rationale: Universality is the curative factor that allows group members to see that others
share similar thoughts, feelings, and problems. This realization significantly reduces
feelings of isolation and stigmatization. It provides a sense of relief and promotes group
cohesiveness early in the therapeutic process.
6. Which therapeutic approach emphasizes the ‘Miracle Question’ to help patients envision a
future without their current problems?
A. Narrative Therapy
B. Solution-Focused Brief Therapy (SFBT)
, C. Existential Therapy
D. Gestalt Therapy
Answer: B
Rationale: The Miracle Question is a hallmark technique of Solution-Focused Brief
Therapy. It asks the patient to imagine that a miracle occurred overnight and their problem
is gone, describing what would be different. This technique shifts the focus from the
problem’s origins to the desired future and concrete goals for change.
7. A PMHNP is working with a 6-year-old child who has experienced trauma. Why is play
therapy considered the most appropriate modality for this developmental stage?
A. Children are physically unable to sit still for traditional talk therapy.
B. It is less expensive than other forms of psychiatric treatment for minors.
C. Play is the natural language of children and allows them to express emotions
symbolically.
D. It allows the therapist to determine the child’s IQ through observation.
Answer: C
Rationale: Play therapy provides a developmentally appropriate medium for children to
communicate their internal experiences. Since young children lack the abstract thinking
and vocabulary required for complex verbal therapy, they use toys to represent their
world. This modality allows them to work through trauma in a safe, indirect manner.
8. In Motivational Interviewing, what is the primary goal of the ‘OARS’ acronym?
A. To challenge the patient’s defenses aggressively.
B. To identify the core symptoms of a personality disorder.
C. To organize the patient’s medical records for billing purposes.
D. To facilitate communication using Open-ended questions, Affirmations, Reflections, and
Summaries.
Answer: D
Rationale: OARS is a foundational communication strategy in Motivational Interviewing
used to engage the patient. Open-ended questions, Affirmations, Reflections, and
Summaries help build rapport and elicit change talk. These techniques encourage the
patient to explore their own ambivalence about behavior change.
9. During a group therapy session, the members are experiencing conflict and power struggles
as they determine their roles. According to Tuckman’s stages, which phase are they in?
A. Forming
Psych (NSG526 Exam 2) | Wilkes University
1. When using Cognitive Behavioral Therapy (CBT) with a patient suffering from depression,
which intervention is the Psychiatric-Mental Health Nurse Practitioner (PMHNP) most likely
to implement?
A. Analyzing childhood dreams to uncover unconscious conflicts.
B. Identifying and challenging automatic negative thoughts.
C. Using a mirror to practice emotional regulation skills.
D. Conducting a genogram to map out family history.
Answer: B
Rationale: CBT is primarily focused on the connection between thoughts, feelings, and
behaviors. The PMHNP helps the patient identify cognitive distortions or automatic
thoughts that contribute to their depressive state. By challenging these thoughts and
replacing them with more balanced perspectives, the patient is able to improve their
emotional wellbeing.
2. In Dialectical Behavior Therapy (DBT), which module is specifically designed to help
patients manage crises without making them worse?
A. Interpersonal Effectiveness
B. Distress Tolerance
C. Emotion Regulation
D. Mindfulness
Answer: B
Rationale: Distress Tolerance is a core pillar of DBT that provides patients with skills to
survive immediate crises. These techniques are used to accept reality as it is when it cannot
be changed immediately. Implementing these skills prevents the patient from engaging in
impulsive, self-destructive behaviors during high-stress moments.
3. A PMHNP is conducting Interpersonal Psychotherapy (IPT) with a patient. The focus is on a
recent divorce that the patient is struggling to accept. Which IPT problem area does this
represent?
A. Interpersonal Role Dispute
B. Grief and Loss
C. Role Transition
,D. Interpersonal Deficits
Answer: C
Rationale: Role Transition in IPT refers to the psychological and social changes that occur
when an individual moves from one life state to another, such as becoming single after a
divorce. The therapy focuses on helping the patient mourn the loss of the old role and
master the requirements of the new role. This approach is highly effective for patients
experiencing adjustment disorders or depression triggered by life changes.
4. In Family Systems Therapy, the term ‘triangulation’ refers to:
A. The process of three family members working together for a common goal.
B. The legal process of assigning a guardian to a minor in the family.
C. A diagnostic tool used to measure the intensity of a child’s behavior.
D. A strategy where two people bring in a third person to reduce anxiety between the
original two.
Answer: D
Rationale: Triangulation is a key concept in Bowenian Family Systems Theory describing
how a two-person system stabilizes itself by involving a third party. When tension rises
between two people, they often focus on a third person (like a child) to deflect the conflict.
The PMHNP’s role is to identify these triangles and help the individuals focus on their own
self-differentiation.
5. According to Irvin Yalom, which ‘curative factor’ of group therapy involves the realization
that one is not alone in their suffering?
A. Catharsis
B. Universality
C. Altruism
D. Imparting Information
Answer: B
Rationale: Universality is the curative factor that allows group members to see that others
share similar thoughts, feelings, and problems. This realization significantly reduces
feelings of isolation and stigmatization. It provides a sense of relief and promotes group
cohesiveness early in the therapeutic process.
6. Which therapeutic approach emphasizes the ‘Miracle Question’ to help patients envision a
future without their current problems?
A. Narrative Therapy
B. Solution-Focused Brief Therapy (SFBT)
, C. Existential Therapy
D. Gestalt Therapy
Answer: B
Rationale: The Miracle Question is a hallmark technique of Solution-Focused Brief
Therapy. It asks the patient to imagine that a miracle occurred overnight and their problem
is gone, describing what would be different. This technique shifts the focus from the
problem’s origins to the desired future and concrete goals for change.
7. A PMHNP is working with a 6-year-old child who has experienced trauma. Why is play
therapy considered the most appropriate modality for this developmental stage?
A. Children are physically unable to sit still for traditional talk therapy.
B. It is less expensive than other forms of psychiatric treatment for minors.
C. Play is the natural language of children and allows them to express emotions
symbolically.
D. It allows the therapist to determine the child’s IQ through observation.
Answer: C
Rationale: Play therapy provides a developmentally appropriate medium for children to
communicate their internal experiences. Since young children lack the abstract thinking
and vocabulary required for complex verbal therapy, they use toys to represent their
world. This modality allows them to work through trauma in a safe, indirect manner.
8. In Motivational Interviewing, what is the primary goal of the ‘OARS’ acronym?
A. To challenge the patient’s defenses aggressively.
B. To identify the core symptoms of a personality disorder.
C. To organize the patient’s medical records for billing purposes.
D. To facilitate communication using Open-ended questions, Affirmations, Reflections, and
Summaries.
Answer: D
Rationale: OARS is a foundational communication strategy in Motivational Interviewing
used to engage the patient. Open-ended questions, Affirmations, Reflections, and
Summaries help build rapport and elicit change talk. These techniques encourage the
patient to explore their own ambivalence about behavior change.
9. During a group therapy session, the members are experiencing conflict and power struggles
as they determine their roles. According to Tuckman’s stages, which phase are they in?
A. Forming
