Exam (elaborations) NUR 6650 Midterm

Exam (elaborations) NUR 6650 Midterm  Question 1 1 out of 1 points The PMHNP is meeting with the parents of a school-aged girl. The mother reports feeling frustrated, because they cannot get their daughter to do her homework. “All she wants to do is play on her phone,” the father reports. The mother tells the PMHNP that they have tried threatening her by telling her that she won’t be able to have her friends over and that she won’t be allowed to watch TV. Which of the following responses made by the PMHNP demonstrates use of the Premack principle? Selected Answer: B. “Have you tried making her phone privileges contingent on finishing her homework?”  Question 2 0 out of 1 points The PMHNP is meeting with a family composed of two parents and their two children. The PMHNP observes that the mother projects her concerns onto one of the children, and that child seems to conform to the parents’ way of thinking. The other child seems to be less involved in the family’s fusion. What action taken by the PMHNP demonstrates the use of the Bowen Family Systems Therapy model? Selected Answer: D. None of the above  Question 3 0 out of 1 points The PMHNP is working with a patient who is sleep deprived and depressed. Which of the following is an appropriate scaling question for the PMHNP to ask? Selected Answer: D. “How many days per week are you able to sleep?”  Question 4 1 out of 1 points The PMHNP is working with the parents of an adolescent daughter. The parents complain that the daughter is misbehaving and having emotional outbursts on a nightly basis. However, the parents cannot agree on ways to discipline and deal with the daughter. This leads to arguments between them. What does the PMHNP do to support the strategic use of rituals? Selected Answer: A. Suggest the mom help the daughter with homework on even days of the week  Question 5 0 out of 1 points NUR 6650 Midterm A family is in therapy because they have been unable to resolve conflicts and are arguing frequently. When using a strategic family therapy approach, which of the following directives might the PMHNP suggest to create a sense of togetherness? Selected Answer: A. Encourage the family to address concerns by writing letters to each other  Question 6 1 out of 1 points The PMHNP is working with a family composed of two parents and their 16-year-old son. The parents report they have been experiencing conflict regarding the son’s defiant behavior in the home. Which action will the PMHNP employ as part of the early phase of the therapy? Selected Answer: D. A and C  Question 7 1 out of 1 points The PMHNP is working with 12-year-old twin sisters. Their parents report that the twins got into a big fight recently, which they haven’t been able to overcome. Which cognitive interaction can the PMHNP use to help the sisters gain a new perspective of the argument to help soften their own opinion of it? Selected Answer: A. Have the sisters play each other’s role in the argument  Question 8 1 out of 1 points The PMHNP is meeting with a married couple. The woman feels very insecure, particularly when it comes to her husband working with women in his office. She reports, “My girlfriends say that it’s not attractive to be insecure like I am, so I’m really making the problem worse by being so insecure.” How can the PMHNP externalize the woman’s problem? Selected Answer: B. Help the woman free herself from the label of “insecure”  Question 9 1 out of 1 points The PMHNP is providing family therapy to two parents and their twin 14-year-old children. The children become defiant around bedtime and are still working on their homework late into the night. How does the PMHNP employ an experiential technique of family sculpting? Selected Answer: A. Asks one of the parents to arrange the family into a typical bedtime scene  Question 10 1 out of 1 points The PMHNP is assessing a married couple who disclosed on the intake form that that they are having intimacy issues. During the assessment, the PMHNP asks the couple what brings them in today. The wife is quick to answer, “My husband doesn’t listen to me anymore.” Using the Mental Research Institute (MRI) assessment technique, how does the PMHNP respond to this? Selected Answer: B. By asking the wife to explain what exactly “not listening” means  Question 11 1 out of 1 points During a family therapy session, a 10-year-old girl says to her father, “You are at work all the time and are never around.” What is the most appropriate response by the PMHNP to improve communication? Selected Answer: B. Ask the father what he heard when his daughter made that comment  Question 12 0 out of 1 points The PMHNP is assessing a 19-year-old patient who reports feeling burdened and constrained by her family. “I feel like I can’t live my own life, and like I need their approval for everything I do,” she says during the assessment. Which response by the PMHNP supports the principles of family therapy? Selected Answer: A. “It’s important for you to feel safe to explore the full range of your feelings.”  Question 13 0 out of 1 points The PMHNP has just completed an intake assessment on a 15-year-old patient and believes the patient would benefit from family therapy. How does the PMHNP describe the goals of the therapy to the patient and the patient’s parents? Selected Answer: D. All of the above  Question 14 0 out of 1 points The PMHNP is working with a married couple who have agreed to seek sex therapy due to the wife’s gradual decrease in interest in sex. The wife explains that she feels as though she cannot feel comfortable naked and enjoying being intimate. The PMHNP recognizes that the couple could possibly benefit from sensate focus. To apply the sensate focus exercise, the PMHNP suggests the couple first do what? Selected Answer: A. Practice desensitizing themselves from sex so that they do not feel any anxiety  Question 15 0 out of 1 points During a family therapy session, the PMHNP identifies a significant amount of emotional fusion between the parents and their young adult son. The son admits that he tries to seek distance from his parents. This is why he moved out of state for college, though he still comes back to visit out of obligation. What does the PMHNP interpret about this scenario? Selected Answer: The parents are trying to create a triangle of emotion with their son.  Question 16 0 out of 1 points The PMHNP is providing narrative therapy to a family. Although each family member assigns a “problem” to another, the PMHNP attempts to separate each person in the family from their problems. The goal is to find something they all have in common so the family can unite. What will the PMHNP do next to help facilitate this goal? Selected Answer: C. Map the influence of the family on the problem  Question 17 0 out of 1 points The PMHNP is providing family therapy to a married couple having an issue with communication. Using the structural family model, what does the PMNHP have the couple do as part of enactment? Selected Answer: A. Have the spouses switch roles and pretend to act like the other person  Question 18 1 out of 1 points The PMHNP is meeting with a woman and her 11-year-old child, who was a victim of sexual abuse. The offender is the child’s stepfather, who is currently in jail. What action does the PMHNP employ with the child and mother during the first session? Selected Answer: D. Giving the child and mother a choice about how much to discuss  Question 19 1 out of 1 points The PMHNP is providing marital therapy to a husband and wife who have been married for 6 years. They are attending therapy sessions, because they both want to get their marriage back on track. They report that lately they have not been communicating well or meeting each other’s needs. What does the PMHNP suggest to the couple when applying a behavior exchange technique? Selected Answer: D. All of the above  Question 20 1 out of 1 points The PMHNP is working with a family that includes two parents and their two children. The PMHNP defined the problem and goal in a previous session. Today, the PMHNP wants to find out whether the family has experienced any attempted solutions. What does the PMHNP identify as an attempted solution that actually perpetuates the family problem? Selected Answer: D. All of the above  Question 21 1 out of 1 points Which of the following is an exception question that the PMHNP can ask when working with a patient who is having trouble managing stress at work? Selected Answer: A. “What’s different about times when the problem doesn’t come up in your office?”  Question 22 1 out of 1 points During the initial assessment of a newly married couple, the PMHNP learns that they decided to come to family therapy in order to address their communication problems. Which of the following actions taken by the PMHNP demonstrates the use of the solutions-focused approach? Selected Answer: D. B and C  Question 23 1 out of 1 points The PMHNP is meeting with a family that consists of a mother and father and their two daughters, ages 8 and 10. During the session, the PMHNP hears one child say, “My sister never gets into trouble because she’s the smart one.” Which family therapy theory is most applicable to this family? Selected Answer: B. Role theory  Question 24 1 out of 1 points The PMHNP is assessing a family that consists of a mother and a father and their daughter Rachel. The family is discussing the issue of time management in the home, particularly involving the daughter’s extracurricular schedule. The mother asks, “Rachel, how many times has your father been late to pick you up from soccer?” What does the PMHNP take away from this interaction? Selected Answer: C. The family is involved in pairing.  Question 25 0 out of 1 points The PMHNP is working with a father and his son, who is 7 years old. According to the father, the son frequently experiences outbursts and poor impulse control. Using the differentiation of self-concept, what advice does the PMHNP offer the child? Selected Answer: D. “Let your father know when something he does triggers you to feel bad.”  Question 26 1 out of 1 points The PMHNP is meeting with a set of parents and their 12-year-old son, who according to the parents is fearful of “nearly everything.” The son admits that he does not like to ride his bike, play with his friends, or participate in activities such as sports, in which he could hurt himself or become dirty. What does the PMHNP say to the son to personify the problem using externalizing conversation techniques? Selected Answer: C. “How often does fear make you do what it wants you to do?”  Question 27 0 out of 1 points The PMHNP is meeting with a married couple who have recently had a baby. The transition of becoming new parents has caused a lot of friction and tension in the household. The wife wishes the husband would help out at least once with the nighttime feedings so she can get more than 3 hours of sleep at night. The husband feels like this is an unfair request, because the wife no longer works, but she still asks the husband to do a lot of errands during the day. What does the PMHNP do to create a quid pro quo contract between the husband and wife? Selected Answer: C. Recommend that the husband and wife spend more quality time together outside of the home and without the baby around  Question 28 0 out of 1 points The PMHNP is working with a family consisting of a father, a mother, and a daughter who is a sophomore in high school. The issue being discussed has to do with the daughter’s emotional outbursts about wanting to spend more time with her friends. Recently, the daughter blew up at the parents over the fact that they wouldn’t let her go to a party, since older kids from the school were throwing it. This outburst led to arguments in the household, which led to the daughter getting grounded for 2 weeks. Which theory does the PMHNP recognize as the most applicable? Selected Answer: C. Social constructionism  Question 29 0 out of 1 points The PMHNP is working with a married couple who are having trouble communicating. The wife wants to ask for things from the husband, but she doesn’t want to be perceived as a nag. The husband wants to tell the wife that he needs alone time, but he doesn’t want to hurt her feelings. Which pretend technique can the PMHNP use with the couple? Selected Answer: C. Tell the husband to call the wife a nag three times a day  Question 30 0 out of 1 points The PMHNP is discussing problem-solving techniques with a married couple. What recommendation will the PMHNP provide to the couple? Selected Answer: D. “Speak on behalf of your partner to show that you understand.”  Question 31 1 out of 1 points The PMHNP is performing an intake assessment on parents who had their son later in life. Since their son left for college 6 months ago, the couple reports arguing a lot and not getting along in general. When applying the theory of the family life cycle, what does the PMHNP say in response to this concern? Selected Answer: A. "These sorts of experiences can be normal. You are going through a major transition period that is forcing you to question or readjust your relationship."  Question 32 0 out of 1 points The PMHNP is meeting with a single father and his adolescent daughter. They have been “butting heads” because of the daughter’s differing opinions about her curfew and social life. They haven’t been able to communicate well. The PMHNP tries an experiential technique of family drawing. What will the PMHNP have the father and daughter do for this technique? Selected Answer: D. All of the above  Question 33 1 out of 1 points The PMHNP is assessing a young husband and wife who just had their first baby. Ever since having the baby, the couple has been arguing more frequently, which the husband believes is the result of sleep deprivation. Also, the husband believes the wife has postpartum depression. Using the Bowen Family Systems Therapy model, what does the PMHNP do as part of the assessment? Select all that apply. Selected Answers: A. Come up with the process question B. Determine the history of the presenting problem C. Create a genogram to show the family members and their relationships  Question 34 0 out of 1 points A PMHNP learns that the family has been experiencing dysfunction because a mother and her teenage son have been getting easily annoyed and yelling at each other. When using a strategic family therapy approach, which directive should the PMHNP suggest to solve the problem? Selected Answer: A. Have the family pretend they are not related for a given period of time  Question 35 1 out of 1 points A PMHNP is using a structural family therapy approach. During a family therapy session, a child says, “Is that what you really mean?” Tracking the phrase, the PMHNP discovers that the family often uses sarcasm when communicating. What is the appropriate next step by the PMHNP? Selected Answer: C. Listen for the use of sarcasm and, when it occurs, help members communicate more directly  Question 36 1 out of 1 points The PMHNP wants to identify the unique outcomes of a married couple who are having arguments about finances. In particular, the wife is concerned about her husband splurging without consulting her. What question will the PMHNP ask to arrive at the unique outcomes? Selected Answer: D. All of the above  Question 37 1 out of 1 points The PMHNP is working with parents who argue about ways to discipline their school-aged son. The PMHNP initiates enactment, telling the parents to discuss the disciplinary choices directly with each other. At what point does the PMHNP determine that the parents are demonstrating enmeshment? Selected Answer: D. All of the above.  Question 38 0 out of 1 points During a family therapy session, the PMHNP hears the father say to the son, “You shouldn’t play video games where you shoot people.” According to the Bion school of thought, what is the content of the message that the father is trying to express? Selected Answer: B. “You should find other things to do with your time.”  Question 39 1 out of 1 points During family therapy, a husband says to his spouse, “When you ignore me, I can’t help but shout.” Using an emotionally focused family therapy approach, the PMHNP comments to the husband, “You feel like you are invisible and need to be heard.” Why does the PMHNP make this comment? Selected Answer: C. To help the client capture an elusive emotional experience  Question 40 0 out of 1 points The PMHNP is working with a father and his teenage daughter. The father has full custody of his daughter as of recently. He reports that the two of them get into arguments all the time over curfew, chores, and the daughter’s lack of responsibility that “she gets from her mother.” The daughter feels like the father never listens to her. Which of the following actions taken by the PMHNP demonstrates unbalancing the relationship? Selected Answer: B. Asking the daughter to describe how she feels about the transition of living with her father full time  Question 41 1 out of 1 points The PMHNP is meeting with a husband and wife and observes that the husband is able to maintain his composure while the wife becomes more teary and emotional throughout the session. Which principle is used to describe this observation? Selected Answer: A. Complementary relationship  Question 42 1 out of 1 points The PMHNP is meeting with a family that consists of a husband, wife, and the wife’s mother and sister. The husband complains to the PMHNP that the way his motherin- law and sister-in-law barge into their home whenever they want, without any warning, is becoming intrusive. He says, “Because, of course, everyone in the family has keys to our home.” Which pattern does the PMHNP identify in this family relationship? Selected Answer: B. The family is enmeshed.  Question 43 1 out of 1 points The PMHNP meets with the parents of a 3-year-old boy, who was adopted at 6 months of age. The parents ask the PMHNP if he will see the child individually for therapy sessions on a weekly basis, based on the fact that the parents are having difficulty getting their son to listen to them. Which statement made by the PMHNP supports the systems theory approach to treatment? Selected Answer: A. “It would be difficult for me to make sense of your child’s behavior without the rest of the family around.”  Question 44 1 out of 1 points The PMHNP is meeting with a mother and her teenage daughter; they are having trouble getting along. The mother complains that the daughter is defiant and never listens or goes out whenever she wants to. The daughter complains that the mother is too strict and won’t let her see her friends. What does the PMHNP do to employ the use of the paradoxical intervention technique? Selected Answer: D. A and B  Question 45 1 out