1
NRNP 6645 Final Exam
2025/2026: Psychotherapy
with Multiple Modalities –
Walden
1. A PMHNP is conducting an initial psychiatric assessment with a
client who reports feeling "empty" and disconnected. Which
therapeutic approach is most aligned with exploring unconscious
conflicts contributing to these feelings?
A. Cognitive-Behavioral Therapy
B. Psychodynamic Therapy
C. Solution-Focused Brief Therapy
D. Dialectical Behavior Therapy
Answer: B
Rationale: Psychodynamic therapy focuses on exploring
unconscious conflicts and past experiences that influence
current emotions, such as feelings of emptiness. CBT addresses
thought patterns, solution-focused therapy targets goal-setting,
and DBT emphasizes emotional regulation, none of which
prioritize unconscious dynamics.
2. A client with borderline personality disorder (BPD) is struggling
with intense emotional dysregulation. Which DBT skill should the
PMHNP prioritize teaching?
A. Cognitive restructuring
B. Distress tolerance
C. Goal-setting strategies
D. Systematic desensitization
Answer: B
Rationale: Distress tolerance skills in DBT help clients with
BPD manage intense emotions without impulsive behaviors.
Cognitive restructuring is a CBT technique, goal-setting aligns
, 2
with solution-focused therapy, and desensitization is used for
phobias.
3. During a group therapy session, a client monopolizes the
discussion, interrupting others. What is the most therapeutic group
facilitator response?
A. Ignore the behavior to avoid conflict
B. Set clear group boundaries and redirect
C. Ask the client to leave the session
D. Allow the client to continue to express themselves
Answer: B
Rationale: Setting boundaries maintains group cohesion and
ensures equitable participation, aligning with group therapy
principles. Ignoring the behavior disrupts the group process,
expulsion is too harsh, and allowing monopolization
undermines group dynamics.
4. A PMHNP is using motivational interviewing with a client
resistant to quitting smoking. Which statement reflects the spirit of
this approach?
A. “You need to quit smoking to avoid health risks.”
B. “What are your thoughts about quitting smoking?”
C. “Here’s a plan to help you stop smoking.”
D. “Smoking is harmful, and you should stop immediately.”
Answer: B
Rationale: Motivational interviewing uses open-ended
questions to explore ambivalence and foster autonomy.
Directive statements (A, C, D) are inconsistent with its
collaborative, client-centered approach.
5. A client with generalized anxiety disorder (GAD) reports persistent
worry. Which CBT technique is most effective for addressing this
symptom?
A. Free association
B. Cognitive restructuring
C. Empty chair technique
D. Mindfulness meditation
Answer: B
Rationale: Cognitive restructuring in CBT helps clients
identify and challenge irrational thoughts causing worry. Free
, 3
association is psychodynamic, empty chair is Gestalt, and
mindfulness is adjunctive but not primary for GAD.
6. A PMHNP is conducting family therapy with a family
experiencing conflict. Which concept from systems theory is most
relevant?
A. Transference
B. Family homeostasis
C. Countertransference
D. Cognitive distortions
Answer: B
Rationale: Family homeostasis refers to the family’s tendency
to maintain balance, a key systems theory concept.
Transference and countertransference are psychodynamic, and
cognitive distortions are CBT-related.
7. A client with major depressive disorder (MDD) expresses
hopelessness. Which humanistic therapy technique fosters a sense
of worth?
A. Behavioral activation
B. Unconditional positive regard
C. Exposure therapy
D. Reality testing
Answer: B
Rationale: Unconditional positive regard, a humanistic
approach, fosters self-worth by accepting the client without
judgment. Behavioral activation and exposure are CBT
techniques, and reality testing is psychodynamic.
8. A PMHNP observes a client with schizophrenia displaying flat
affect during therapy. Which approach is most appropriate?
A. Challenge cognitive distortions
B. Use supportive therapy
C. Implement role-playing
D. Encourage free association
Answer: B
Rationale: Supportive therapy builds trust and rapport for
clients with schizophrenia, addressing symptoms like flat
affect. Cognitive distortions and free association are less
effective, and role-playing may be overwhelming.
NRNP 6645 Final Exam
2025/2026: Psychotherapy
with Multiple Modalities –
Walden
1. A PMHNP is conducting an initial psychiatric assessment with a
client who reports feeling "empty" and disconnected. Which
therapeutic approach is most aligned with exploring unconscious
conflicts contributing to these feelings?
A. Cognitive-Behavioral Therapy
B. Psychodynamic Therapy
C. Solution-Focused Brief Therapy
D. Dialectical Behavior Therapy
Answer: B
Rationale: Psychodynamic therapy focuses on exploring
unconscious conflicts and past experiences that influence
current emotions, such as feelings of emptiness. CBT addresses
thought patterns, solution-focused therapy targets goal-setting,
and DBT emphasizes emotional regulation, none of which
prioritize unconscious dynamics.
2. A client with borderline personality disorder (BPD) is struggling
with intense emotional dysregulation. Which DBT skill should the
PMHNP prioritize teaching?
A. Cognitive restructuring
B. Distress tolerance
C. Goal-setting strategies
D. Systematic desensitization
Answer: B
Rationale: Distress tolerance skills in DBT help clients with
BPD manage intense emotions without impulsive behaviors.
Cognitive restructuring is a CBT technique, goal-setting aligns
, 2
with solution-focused therapy, and desensitization is used for
phobias.
3. During a group therapy session, a client monopolizes the
discussion, interrupting others. What is the most therapeutic group
facilitator response?
A. Ignore the behavior to avoid conflict
B. Set clear group boundaries and redirect
C. Ask the client to leave the session
D. Allow the client to continue to express themselves
Answer: B
Rationale: Setting boundaries maintains group cohesion and
ensures equitable participation, aligning with group therapy
principles. Ignoring the behavior disrupts the group process,
expulsion is too harsh, and allowing monopolization
undermines group dynamics.
4. A PMHNP is using motivational interviewing with a client
resistant to quitting smoking. Which statement reflects the spirit of
this approach?
A. “You need to quit smoking to avoid health risks.”
B. “What are your thoughts about quitting smoking?”
C. “Here’s a plan to help you stop smoking.”
D. “Smoking is harmful, and you should stop immediately.”
Answer: B
Rationale: Motivational interviewing uses open-ended
questions to explore ambivalence and foster autonomy.
Directive statements (A, C, D) are inconsistent with its
collaborative, client-centered approach.
5. A client with generalized anxiety disorder (GAD) reports persistent
worry. Which CBT technique is most effective for addressing this
symptom?
A. Free association
B. Cognitive restructuring
C. Empty chair technique
D. Mindfulness meditation
Answer: B
Rationale: Cognitive restructuring in CBT helps clients
identify and challenge irrational thoughts causing worry. Free
, 3
association is psychodynamic, empty chair is Gestalt, and
mindfulness is adjunctive but not primary for GAD.
6. A PMHNP is conducting family therapy with a family
experiencing conflict. Which concept from systems theory is most
relevant?
A. Transference
B. Family homeostasis
C. Countertransference
D. Cognitive distortions
Answer: B
Rationale: Family homeostasis refers to the family’s tendency
to maintain balance, a key systems theory concept.
Transference and countertransference are psychodynamic, and
cognitive distortions are CBT-related.
7. A client with major depressive disorder (MDD) expresses
hopelessness. Which humanistic therapy technique fosters a sense
of worth?
A. Behavioral activation
B. Unconditional positive regard
C. Exposure therapy
D. Reality testing
Answer: B
Rationale: Unconditional positive regard, a humanistic
approach, fosters self-worth by accepting the client without
judgment. Behavioral activation and exposure are CBT
techniques, and reality testing is psychodynamic.
8. A PMHNP observes a client with schizophrenia displaying flat
affect during therapy. Which approach is most appropriate?
A. Challenge cognitive distortions
B. Use supportive therapy
C. Implement role-playing
D. Encourage free association
Answer: B
Rationale: Supportive therapy builds trust and rapport for
clients with schizophrenia, addressing symptoms like flat
affect. Cognitive distortions and free association are less
effective, and role-playing may be overwhelming.
