NRNP 6645 Psychotherapy with Multiple
Modalities – Academic Year 2026/2027 –
Midterm Comprehensive Examination |
Verified Questions
ACTUAL QUESTIONS
Domain 1: Psychodynamic and Cognitive-Behavioral Therapies
Question 1. Which of the following is a core concept in psychodynamic
therapy?
A. Automatic thoughts as the primary focus of change
B. Unconscious processes, defense mechanisms, and the influence of early
relationships on current functioning
C. Exclusive focus on measurable behavioral outcomes without exploration of
meaning
D. Ignoring the therapeutic relationship
Correct Answer: B
Rationale: Psychodynamic approaches emphasize unconscious motivation, defense
mechanisms, transference, and how early relational patterns shape present
difficulties.
Question 2. Transference in psychodynamic therapy refers to:
A. The therapist’s emotional reactions to the patient only
B. The patient’s unconscious redirection of feelings from significant past
relationships onto the therapist
C. A deliberate homework assignment
D. Only conscious liking or disliking of the therapist
Correct Answer: B
Rationale: Transference involves transferring feelings, expectations, and relational
patterns from important past figures onto the therapist, providing material for
therapeutic exploration.
Question 3. Countertransference is best described as:
A. Only the patient’s feelings toward the therapist
,B. The therapist’s emotional responses to the patient, which may stem from the
therapist’s own history or from the patient’s interpersonal pull
C. A technique for assigning homework
D. Exclusive use of medication
Correct Answer: B
Rationale: Countertransference includes the therapist’s reactions to the patient.
When recognized and managed, it can inform understanding of the patient’s
relational patterns.
Question 4. Defense mechanisms are:
A. Always pathological and must be eliminated
B. Unconscious strategies that protect against anxiety; some are adaptive and
others may become maladaptive
C. Only conscious coping skills taught in CBT
D. Irrelevant to psychodynamic formulation
Correct Answer: B
Rationale: Defenses manage internal conflict and anxiety. Mature defenses can be
adaptive; rigid or immature defenses may contribute to symptoms and relational
problems.
Question 5. Cognitive-behavioral therapy (CBT) primarily targets:
A. Unconscious conflicts from childhood
B. The relationship between thoughts, feelings, and behaviors in the present
C. Dream analysis exclusively
D. Free association exclusively
Correct Answer: B
Rationale: CBT is present-focused, structured, and aims to identify and modify
maladaptive thoughts and behaviors that maintain psychological distress.
Question 6. In CBT, "automatic thoughts" are:
A. Deliberate, planned decisions
B. Involuntary, spontaneous cognitions that arise in response to situations and
influence emotions
C. Unconscious drives
D. Genetic predispositions
Correct Answer: B
Rationale: Automatic thoughts are the immediate, often unconscious appraisals
that occur in response to a situation and drive emotional reactions.
,Question 7. Which cognitive distortion involves interpreting situations in
extreme, all-or-nothing terms?
A. Catastrophizing
B. Dichotomous thinking
C. Personalization
D. Emotional reasoning
Correct Answer: B
Rationale: Dichotomous (all-or-nothing) thinking is the tendency to evaluate
experiences in mutually exclusive categories (e.g., perfect or failure), a common
target of cognitive restructuring.
Question 8. A client states, "I'm sure I'll fail the exam, and then my life will be
ruined." This is an example of:
A. Mind reading
B. Catastrophizing
C. Discounting the positive
D. Overgeneralization
Correct Answer: B
Rationale: Catastrophizing involves predicting the worst possible outcome and
magnifying its consequences.
Question 9. In CBT, the technique of "cognitive restructuring" involves:
A. Analyzing childhood trauma
B. Identifying, challenging, and replacing maladaptive thoughts with more
balanced alternatives
C. Using free association to access the unconscious
D. Prescribing medication
Correct Answer: B
Rationale: Cognitive restructuring targets the "cognition" component of the CBT
model, aiming to change how a person thinks to change how they feel and behave.
Question 10. A "thought record" in CBT is used to:
A. Record dreams
B. Track automatic thoughts, emotions, and alternative balanced responses
C. Document medication side effects
D. Evaluate family history
Correct Answer: B
, Rationale: Thought records are a core CBT tool that help clients identify, evaluate,
and modify maladaptive automatic thoughts.
Question 11. Socratic questioning in CBT is intended to:
A. Test the client's memory
B. Help clients examine the validity of their thoughts through guided discovery
C. Confront the client aggressively
D. Provide direct advice
Correct Answer: B
Rationale: Socratic questioning helps clients develop critical thinking skills and
arrive at their own conclusions about the accuracy of their thoughts.
Question 12. Behavioral activation is a CBT technique primarily used to treat:
A. Panic disorder
B. Depression
C. Obsessive-compulsive disorder
D. Schizophrenia
Correct Answer: B
Rationale: Behavioral activation helps depressed clients re-engage in rewarding
activities, breaking the cycle of withdrawal and low mood.
Question 13. Exposure and response prevention (ERP) is the gold-standard
treatment for:
A. Generalized anxiety disorder
B. Obsessive-compulsive disorder
C. Post-traumatic stress disorder
D. Major depressive disorder
Correct Answer: B
Rationale: ERP involves exposing the client to anxiety-provoking stimuli
(obsessions) while preventing the compulsive response, leading to habituation.
Question 14. Systematic desensitization involves:
A. Immediate, intense exposure to a feared stimulus
B. Gradual exposure to a hierarchy of feared stimuli paired with relaxation
C. Analyzing the unconscious roots of fear
D. Prescribing anti-anxiety medication
Correct Answer: B
Rationale: Developed by Joseph Wolpe, systematic desensitization pairs a
Modalities – Academic Year 2026/2027 –
Midterm Comprehensive Examination |
Verified Questions
ACTUAL QUESTIONS
Domain 1: Psychodynamic and Cognitive-Behavioral Therapies
Question 1. Which of the following is a core concept in psychodynamic
therapy?
A. Automatic thoughts as the primary focus of change
B. Unconscious processes, defense mechanisms, and the influence of early
relationships on current functioning
C. Exclusive focus on measurable behavioral outcomes without exploration of
meaning
D. Ignoring the therapeutic relationship
Correct Answer: B
Rationale: Psychodynamic approaches emphasize unconscious motivation, defense
mechanisms, transference, and how early relational patterns shape present
difficulties.
Question 2. Transference in psychodynamic therapy refers to:
A. The therapist’s emotional reactions to the patient only
B. The patient’s unconscious redirection of feelings from significant past
relationships onto the therapist
C. A deliberate homework assignment
D. Only conscious liking or disliking of the therapist
Correct Answer: B
Rationale: Transference involves transferring feelings, expectations, and relational
patterns from important past figures onto the therapist, providing material for
therapeutic exploration.
Question 3. Countertransference is best described as:
A. Only the patient’s feelings toward the therapist
,B. The therapist’s emotional responses to the patient, which may stem from the
therapist’s own history or from the patient’s interpersonal pull
C. A technique for assigning homework
D. Exclusive use of medication
Correct Answer: B
Rationale: Countertransference includes the therapist’s reactions to the patient.
When recognized and managed, it can inform understanding of the patient’s
relational patterns.
Question 4. Defense mechanisms are:
A. Always pathological and must be eliminated
B. Unconscious strategies that protect against anxiety; some are adaptive and
others may become maladaptive
C. Only conscious coping skills taught in CBT
D. Irrelevant to psychodynamic formulation
Correct Answer: B
Rationale: Defenses manage internal conflict and anxiety. Mature defenses can be
adaptive; rigid or immature defenses may contribute to symptoms and relational
problems.
Question 5. Cognitive-behavioral therapy (CBT) primarily targets:
A. Unconscious conflicts from childhood
B. The relationship between thoughts, feelings, and behaviors in the present
C. Dream analysis exclusively
D. Free association exclusively
Correct Answer: B
Rationale: CBT is present-focused, structured, and aims to identify and modify
maladaptive thoughts and behaviors that maintain psychological distress.
Question 6. In CBT, "automatic thoughts" are:
A. Deliberate, planned decisions
B. Involuntary, spontaneous cognitions that arise in response to situations and
influence emotions
C. Unconscious drives
D. Genetic predispositions
Correct Answer: B
Rationale: Automatic thoughts are the immediate, often unconscious appraisals
that occur in response to a situation and drive emotional reactions.
,Question 7. Which cognitive distortion involves interpreting situations in
extreme, all-or-nothing terms?
A. Catastrophizing
B. Dichotomous thinking
C. Personalization
D. Emotional reasoning
Correct Answer: B
Rationale: Dichotomous (all-or-nothing) thinking is the tendency to evaluate
experiences in mutually exclusive categories (e.g., perfect or failure), a common
target of cognitive restructuring.
Question 8. A client states, "I'm sure I'll fail the exam, and then my life will be
ruined." This is an example of:
A. Mind reading
B. Catastrophizing
C. Discounting the positive
D. Overgeneralization
Correct Answer: B
Rationale: Catastrophizing involves predicting the worst possible outcome and
magnifying its consequences.
Question 9. In CBT, the technique of "cognitive restructuring" involves:
A. Analyzing childhood trauma
B. Identifying, challenging, and replacing maladaptive thoughts with more
balanced alternatives
C. Using free association to access the unconscious
D. Prescribing medication
Correct Answer: B
Rationale: Cognitive restructuring targets the "cognition" component of the CBT
model, aiming to change how a person thinks to change how they feel and behave.
Question 10. A "thought record" in CBT is used to:
A. Record dreams
B. Track automatic thoughts, emotions, and alternative balanced responses
C. Document medication side effects
D. Evaluate family history
Correct Answer: B
, Rationale: Thought records are a core CBT tool that help clients identify, evaluate,
and modify maladaptive automatic thoughts.
Question 11. Socratic questioning in CBT is intended to:
A. Test the client's memory
B. Help clients examine the validity of their thoughts through guided discovery
C. Confront the client aggressively
D. Provide direct advice
Correct Answer: B
Rationale: Socratic questioning helps clients develop critical thinking skills and
arrive at their own conclusions about the accuracy of their thoughts.
Question 12. Behavioral activation is a CBT technique primarily used to treat:
A. Panic disorder
B. Depression
C. Obsessive-compulsive disorder
D. Schizophrenia
Correct Answer: B
Rationale: Behavioral activation helps depressed clients re-engage in rewarding
activities, breaking the cycle of withdrawal and low mood.
Question 13. Exposure and response prevention (ERP) is the gold-standard
treatment for:
A. Generalized anxiety disorder
B. Obsessive-compulsive disorder
C. Post-traumatic stress disorder
D. Major depressive disorder
Correct Answer: B
Rationale: ERP involves exposing the client to anxiety-provoking stimuli
(obsessions) while preventing the compulsive response, leading to habituation.
Question 14. Systematic desensitization involves:
A. Immediate, intense exposure to a feared stimulus
B. Gradual exposure to a hierarchy of feared stimuli paired with relaxation
C. Analyzing the unconscious roots of fear
D. Prescribing anti-anxiety medication
Correct Answer: B
Rationale: Developed by Joseph Wolpe, systematic desensitization pairs a
