NSG 526 Exam 1 Actual Exam V3 | NSG 526 Clinical Modalities Adv.
Psych (NSG526 Exam 1) | Wilkes University
1. A 45-year-old patient who recently lost their spouse reports feeling ‘lost’ and is struggling
to adjust to living alone. Which focus area of Interpersonal Psychotherapy (IPT) is most
appropriate for this patient?
A. Complicated Grief
B. Interpersonal Deficits
C. Role Transition
D. Role Dispute
Answer: A
Rationale: Complicated grief in IPT focuses on the death of a significant other and the
patient’s subsequent difficulty in mourning. The therapist works with the patient to
explore the relationship and find new ways of relating to the deceased while re-engaging in
life. This distinguish itself from role transitions which focus on changes in life status rather
than bereavement.
2. During a session, a patient begins to treat the PMHNP as if the therapist were their overly
critical father. Which phenomenon is being demonstrated?
A. Countertransference
B. Projective Identification
C. Resistance
D. Transference
Answer: D
Rationale: Transference occurs when a patient unconsciously displaces feelings and
attitudes from a significant person in their past onto the clinician. It is a fundamental
concept in psychodynamic therapy that allows for the exploration of unresolved conflicts.
Identifying and working through these projections is essential for therapeutic progress and
deepening the clinical relationship.
3. According to Irvin Yalom, which therapeutic factor involves the realization among group
members that they are not alone in their suffering or problems?
A. Altruism
B. Cohesiveness
C. Universality
,D. Catharsis
Answer: C
Rationale: Universality is the recognition that one’s experiences and feelings are shared by
others, reducing the sense of isolation. This factor is particularly powerful in the early
stages of group therapy to build trust and rapport. It helps patients decrease their sense of
shame and uniqueness regarding their mental health struggles.
4. A PMHNP is using Cognitive Behavioral Therapy (CBT) with a patient who says, ‘If I don’t
get an A on this exam, my entire career is ruined.’ This is an example of which cognitive
distortion?
A. Catastrophizing
B. Emotional Reasoning
C. Personalization
D. Labeling
Answer: A
Rationale: Catastrophizing, also known as ‘magnification,’ involves imagining the worst
possible outcome and believing it is more likely than it actually is. The patient is jumping to
an extreme negative conclusion about their future based on a single event. CBT aims to help
the patient identify these distortions and replace them with more balanced, realistic
thoughts.
5. In Bowenian Family Systems Theory, when a two-person system experiences tension and
brings in a third person to stabilize the relationship, it is called:
A. Differentiation
B. Enmeshment
C. Triangulation
D. Fusion
Answer: C
Rationale: Triangulation is a reactive process where a third person is drawn into a dyadic
conflict to reduce anxiety. While it provides temporary stability, it prevents the original
two people from resolving their actual conflict. The goal of therapy in this model is often to
‘detriangulate’ and encourage direct communication between the primary pair.
6. Which of the following is the most significant predictor of positive outcomes in psychiatric
treatment?
A. The specific therapeutic modality used
B. The duration of the sessions
, C. The therapeutic alliance
D. The patient’s socioeconomic status
Answer: C
Rationale: The therapeutic alliance, characterized by trust, shared goals, and empathy, is
consistently cited as the strongest predictor of clinical success. It transcends the specific
technique or theoretical framework employed by the clinician. Building a strong bond with
the patient facilitates engagement and adherence to the treatment plan.
7. A patient in the ‘Contemplation’ stage of Change in Motivational Interviewing is likely to
demonstrate which of the following behaviors?
A. Ambivalence about making a change
B. Denial that a problem exists
C. Active participation in new healthy habits
D. Planning the specific steps for change
Answer: A
Rationale: Contemplation is defined by ambivalence, where the patient is aware that a
problem exists but is weighing the pros and cons of changing. They are not yet ready to
commit to action but are no longer in denial. The clinician’s role here is to help tip the
balance in favor of change by exploring values and discrepancies.
8. In Dialectical Behavior Therapy (DBT), the ‘dialectical’ component refers to the balance
between:
A. Thought and Emotion
B. Past and Present
C. Acceptance and Change
D. Medication and Therapy
Answer: C
Rationale: The core dialectic in DBT is the tension between accepting the patient exactly as
they are and the necessity for the patient to change their behavior. This approach is highly
effective for patients with Borderline Personality Disorder who struggle with emotional
dysregulation. By validating current feelings while teaching new skills, the therapist fosters
a path toward a ‘life worth living.’
9. A PMHNP feels an intense, unexplained surge of anger toward a patient who is chronically
late and misses appointments. The PMHNP should first recognize this as:
A. Patient resistance
Psych (NSG526 Exam 1) | Wilkes University
1. A 45-year-old patient who recently lost their spouse reports feeling ‘lost’ and is struggling
to adjust to living alone. Which focus area of Interpersonal Psychotherapy (IPT) is most
appropriate for this patient?
A. Complicated Grief
B. Interpersonal Deficits
C. Role Transition
D. Role Dispute
Answer: A
Rationale: Complicated grief in IPT focuses on the death of a significant other and the
patient’s subsequent difficulty in mourning. The therapist works with the patient to
explore the relationship and find new ways of relating to the deceased while re-engaging in
life. This distinguish itself from role transitions which focus on changes in life status rather
than bereavement.
2. During a session, a patient begins to treat the PMHNP as if the therapist were their overly
critical father. Which phenomenon is being demonstrated?
A. Countertransference
B. Projective Identification
C. Resistance
D. Transference
Answer: D
Rationale: Transference occurs when a patient unconsciously displaces feelings and
attitudes from a significant person in their past onto the clinician. It is a fundamental
concept in psychodynamic therapy that allows for the exploration of unresolved conflicts.
Identifying and working through these projections is essential for therapeutic progress and
deepening the clinical relationship.
3. According to Irvin Yalom, which therapeutic factor involves the realization among group
members that they are not alone in their suffering or problems?
A. Altruism
B. Cohesiveness
C. Universality
,D. Catharsis
Answer: C
Rationale: Universality is the recognition that one’s experiences and feelings are shared by
others, reducing the sense of isolation. This factor is particularly powerful in the early
stages of group therapy to build trust and rapport. It helps patients decrease their sense of
shame and uniqueness regarding their mental health struggles.
4. A PMHNP is using Cognitive Behavioral Therapy (CBT) with a patient who says, ‘If I don’t
get an A on this exam, my entire career is ruined.’ This is an example of which cognitive
distortion?
A. Catastrophizing
B. Emotional Reasoning
C. Personalization
D. Labeling
Answer: A
Rationale: Catastrophizing, also known as ‘magnification,’ involves imagining the worst
possible outcome and believing it is more likely than it actually is. The patient is jumping to
an extreme negative conclusion about their future based on a single event. CBT aims to help
the patient identify these distortions and replace them with more balanced, realistic
thoughts.
5. In Bowenian Family Systems Theory, when a two-person system experiences tension and
brings in a third person to stabilize the relationship, it is called:
A. Differentiation
B. Enmeshment
C. Triangulation
D. Fusion
Answer: C
Rationale: Triangulation is a reactive process where a third person is drawn into a dyadic
conflict to reduce anxiety. While it provides temporary stability, it prevents the original
two people from resolving their actual conflict. The goal of therapy in this model is often to
‘detriangulate’ and encourage direct communication between the primary pair.
6. Which of the following is the most significant predictor of positive outcomes in psychiatric
treatment?
A. The specific therapeutic modality used
B. The duration of the sessions
, C. The therapeutic alliance
D. The patient’s socioeconomic status
Answer: C
Rationale: The therapeutic alliance, characterized by trust, shared goals, and empathy, is
consistently cited as the strongest predictor of clinical success. It transcends the specific
technique or theoretical framework employed by the clinician. Building a strong bond with
the patient facilitates engagement and adherence to the treatment plan.
7. A patient in the ‘Contemplation’ stage of Change in Motivational Interviewing is likely to
demonstrate which of the following behaviors?
A. Ambivalence about making a change
B. Denial that a problem exists
C. Active participation in new healthy habits
D. Planning the specific steps for change
Answer: A
Rationale: Contemplation is defined by ambivalence, where the patient is aware that a
problem exists but is weighing the pros and cons of changing. They are not yet ready to
commit to action but are no longer in denial. The clinician’s role here is to help tip the
balance in favor of change by exploring values and discrepancies.
8. In Dialectical Behavior Therapy (DBT), the ‘dialectical’ component refers to the balance
between:
A. Thought and Emotion
B. Past and Present
C. Acceptance and Change
D. Medication and Therapy
Answer: C
Rationale: The core dialectic in DBT is the tension between accepting the patient exactly as
they are and the necessity for the patient to change their behavior. This approach is highly
effective for patients with Borderline Personality Disorder who struggle with emotional
dysregulation. By validating current feelings while teaching new skills, the therapist fosters
a path toward a ‘life worth living.’
9. A PMHNP feels an intense, unexplained surge of anger toward a patient who is chronically
late and misses appointments. The PMHNP should first recognize this as:
A. Patient resistance
