1
NR605 MIDTERM EXAM / NR 605 MIDTERM ACTUAL EXAM COMPLETE
REAL QUESTIONS AND WELL ELABORATED ANSWERS (CORRECT
VERIFIED ANSWERS) LATEST UPDATES
1. A PMHNP is meeting with a 35-year-old client for an initial psychiatric
evaluation. The client reports depressed mood, insomnia, loss of interest in
previously enjoyable activities, and increasing difficulty maintaining
employment. The client asks, “Are you going to tell me what is wrong with
me and prescribe something immediately?” Which response best reflects a
holistic psychiatric approach?
A. “Your symptoms are most likely caused by a neurotransmitter imbalance,
so medication will be the primary focus.”
B. “We will first identify the diagnosis and then determine whether
psychotherapy is necessary.”
C. “We will work together to understand your symptoms, biological factors,
psychological experiences, relationships, strengths, and goals before
developing a treatment plan.”
D. “Your symptoms need to be controlled before we explore any social or
environmental factors.”
Answer: C. “We will work together to understand your symptoms, biological
factors, psychological experiences, relationships, strengths, and goals before
developing a treatment plan.”
2. A client with recurrent depressive episodes begins psychotherapy and
states that treatment should focus only on eliminating sadness. The PMHNP
explains that psychotherapy has several broader objectives. Which outcome
is most consistent with a comprehensive goal of psychotherapy?
A. Symptom reduction, improved functioning, relapse prevention,
empowerment, and achievement of collaboratively established goals
B. Elimination of all negative emotions regardless of their adaptive purpose
C. Complete dependence on the therapist for decision-making and
emotional regulation
D. Immediate resolution of every psychosocial stressor contributing to the
,2
client's symptoms
Answer: A. Symptom reduction, improved functioning, relapse prevention,
empowerment, and achievement of collaboratively established goals
3. During a psychotherapy session, a client tells the PMHNP, “You are the only
person who understands me. I want to call you every night when I feel
lonely.” The client begins requesting personal contact outside scheduled
sessions. Which PMHNP response best demonstrates appropriate
therapeutic boundaries?
A. Give the client a personal telephone number because maintaining the
relationship is the highest priority.
B. Explain that therapeutic contact occurs within established professional
boundaries and explore what the client's request represents emotionally.
C. Agree to daily calls but limit each call to five minutes.
D. Tell the client that the request is inappropriate and immediately
terminate treatment.
Answer: B. Explain that therapeutic contact occurs within established
professional boundaries and explore what the client's request represents
emotionally.
4. A PMHNP begins treatment with a client who has significant emotional
distress but remains capable of functioning in the community. The client
needs assistance identifying coping strategies, solving current problems,
and managing overwhelming feelings. Which psychotherapy approach is
particularly appropriate for this situation?
A. Classical psychoanalysis
B. Exposure therapy
C. Supportive psychotherapy
D. Aversion therapy
Answer: C. Supportive psychotherapy
5. A client receiving supportive psychotherapy frequently becomes
overwhelmed when discussing family conflict. The PMHNP uses empathic
listening, encouragement, reassurance, problem-solving, and assistance
,3
with coping. What is the primary purpose of these interventions?
A. To uncover unconscious childhood conflicts exclusively
B. To establish stabilization, strengthen coping resources, and reduce
emotional distress
C. To eliminate the need for all future psychotherapy
D. To confront the client with irrational beliefs during every session
Answer: B. To establish stabilization, strengthen coping resources, and
reduce emotional distress
6. A client says, “I cannot decide whether I want to stop drinking. Part of me
wants to quit, but another part thinks drinking helps me cope.” The PMHNP
recognizes that the client is expressing ambivalence about changing the
behavior. Which stage of the transtheoretical model is most consistent with
this presentation?
A. Preparation
B. Maintenance
C. Action
D. Contemplation
Answer: D. Contemplation
7. A client with nicotine dependence tells the PMHNP, “I have decided to stop
smoking and have already chosen a quit date next month. I have also
purchased nicotine replacement products.” Which stage of the
transtheoretical model best describes this client?
A. Preparation
B. Precontemplation
C. Maintenance
D. Relapse
Answer: A. Preparation
8. A client has successfully stopped using cocaine for eight months and reports
actively using coping strategies to prevent returning to use. Which stage of
behavioral change is most appropriate?
A. Precontemplation
, 4
B. Contemplation
C. Maintenance
D. Preparation
Answer: C. Maintenance
9. A PMHNP is evaluating a client who repeatedly states, “My depression is
completely my fault, and nothing I do will ever change it.” Which cognitive-
behavioral concept should the clinician recognize when developing
treatment?
A. Magical thinking
B. Cognitive distortion
C. Classical conditioning
D. Free association
Answer: B. Cognitive distortion
10. A client with generalized anxiety reports automatically thinking, “If I make
one mistake at work, I will definitely be fired, lose my home, and become
homeless.” Which cognitive distortion is most evident?
A. Catastrophizing
B. Thought blocking
C. Projection
D. Sublimation
Answer: A. Catastrophizing
11. A PMHNP uses CBT with a client who repeatedly interprets a neutral facial
expression from a coworker as evidence that the coworker hates them.
Which intervention is most consistent with CBT?
A. Encourage the client to avoid the coworker permanently.
B. Explore alternative interpretations and examine evidence supporting and
contradicting the automatic thought.
C. Encourage the client to suppress the thought whenever it occurs.
D. Focus exclusively on early childhood experiences without examining
current beliefs.
NR605 MIDTERM EXAM / NR 605 MIDTERM ACTUAL EXAM COMPLETE
REAL QUESTIONS AND WELL ELABORATED ANSWERS (CORRECT
VERIFIED ANSWERS) LATEST UPDATES
1. A PMHNP is meeting with a 35-year-old client for an initial psychiatric
evaluation. The client reports depressed mood, insomnia, loss of interest in
previously enjoyable activities, and increasing difficulty maintaining
employment. The client asks, “Are you going to tell me what is wrong with
me and prescribe something immediately?” Which response best reflects a
holistic psychiatric approach?
A. “Your symptoms are most likely caused by a neurotransmitter imbalance,
so medication will be the primary focus.”
B. “We will first identify the diagnosis and then determine whether
psychotherapy is necessary.”
C. “We will work together to understand your symptoms, biological factors,
psychological experiences, relationships, strengths, and goals before
developing a treatment plan.”
D. “Your symptoms need to be controlled before we explore any social or
environmental factors.”
Answer: C. “We will work together to understand your symptoms, biological
factors, psychological experiences, relationships, strengths, and goals before
developing a treatment plan.”
2. A client with recurrent depressive episodes begins psychotherapy and
states that treatment should focus only on eliminating sadness. The PMHNP
explains that psychotherapy has several broader objectives. Which outcome
is most consistent with a comprehensive goal of psychotherapy?
A. Symptom reduction, improved functioning, relapse prevention,
empowerment, and achievement of collaboratively established goals
B. Elimination of all negative emotions regardless of their adaptive purpose
C. Complete dependence on the therapist for decision-making and
emotional regulation
D. Immediate resolution of every psychosocial stressor contributing to the
,2
client's symptoms
Answer: A. Symptom reduction, improved functioning, relapse prevention,
empowerment, and achievement of collaboratively established goals
3. During a psychotherapy session, a client tells the PMHNP, “You are the only
person who understands me. I want to call you every night when I feel
lonely.” The client begins requesting personal contact outside scheduled
sessions. Which PMHNP response best demonstrates appropriate
therapeutic boundaries?
A. Give the client a personal telephone number because maintaining the
relationship is the highest priority.
B. Explain that therapeutic contact occurs within established professional
boundaries and explore what the client's request represents emotionally.
C. Agree to daily calls but limit each call to five minutes.
D. Tell the client that the request is inappropriate and immediately
terminate treatment.
Answer: B. Explain that therapeutic contact occurs within established
professional boundaries and explore what the client's request represents
emotionally.
4. A PMHNP begins treatment with a client who has significant emotional
distress but remains capable of functioning in the community. The client
needs assistance identifying coping strategies, solving current problems,
and managing overwhelming feelings. Which psychotherapy approach is
particularly appropriate for this situation?
A. Classical psychoanalysis
B. Exposure therapy
C. Supportive psychotherapy
D. Aversion therapy
Answer: C. Supportive psychotherapy
5. A client receiving supportive psychotherapy frequently becomes
overwhelmed when discussing family conflict. The PMHNP uses empathic
listening, encouragement, reassurance, problem-solving, and assistance
,3
with coping. What is the primary purpose of these interventions?
A. To uncover unconscious childhood conflicts exclusively
B. To establish stabilization, strengthen coping resources, and reduce
emotional distress
C. To eliminate the need for all future psychotherapy
D. To confront the client with irrational beliefs during every session
Answer: B. To establish stabilization, strengthen coping resources, and
reduce emotional distress
6. A client says, “I cannot decide whether I want to stop drinking. Part of me
wants to quit, but another part thinks drinking helps me cope.” The PMHNP
recognizes that the client is expressing ambivalence about changing the
behavior. Which stage of the transtheoretical model is most consistent with
this presentation?
A. Preparation
B. Maintenance
C. Action
D. Contemplation
Answer: D. Contemplation
7. A client with nicotine dependence tells the PMHNP, “I have decided to stop
smoking and have already chosen a quit date next month. I have also
purchased nicotine replacement products.” Which stage of the
transtheoretical model best describes this client?
A. Preparation
B. Precontemplation
C. Maintenance
D. Relapse
Answer: A. Preparation
8. A client has successfully stopped using cocaine for eight months and reports
actively using coping strategies to prevent returning to use. Which stage of
behavioral change is most appropriate?
A. Precontemplation
, 4
B. Contemplation
C. Maintenance
D. Preparation
Answer: C. Maintenance
9. A PMHNP is evaluating a client who repeatedly states, “My depression is
completely my fault, and nothing I do will ever change it.” Which cognitive-
behavioral concept should the clinician recognize when developing
treatment?
A. Magical thinking
B. Cognitive distortion
C. Classical conditioning
D. Free association
Answer: B. Cognitive distortion
10. A client with generalized anxiety reports automatically thinking, “If I make
one mistake at work, I will definitely be fired, lose my home, and become
homeless.” Which cognitive distortion is most evident?
A. Catastrophizing
B. Thought blocking
C. Projection
D. Sublimation
Answer: A. Catastrophizing
11. A PMHNP uses CBT with a client who repeatedly interprets a neutral facial
expression from a coworker as evidence that the coworker hates them.
Which intervention is most consistent with CBT?
A. Encourage the client to avoid the coworker permanently.
B. Explore alternative interpretations and examine evidence supporting and
contradicting the automatic thought.
C. Encourage the client to suppress the thought whenever it occurs.
D. Focus exclusively on early childhood experiences without examining
current beliefs.
