PSYCHOTHERAPY FOR THE ADVANCED
PRACTICE PSYCHIATRIC NURSE
A HOW-TO GUIDE FOR EVIDENCE-BASED
PRACTICE
3RD EDITION
• AUTHOR(S)KATHLEEN WHEELER
TEST BANK
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Q1
Stem: A 38-year-old woman with chronic depression attends an
intake. She describes feeling unheard by prior clinicians and
asks for “something that helps me get through daily life.” As the
PMHNP beginning treatment, which initial therapist stance best
reflects the nursing framework Wheeler recommends?
A. Rapid symptom-reduction plan focusing mainly on
medication adjustments.
,B. Establishing a patient-centered, relationship-focused stance
with collaborative goal setting.
C. Immediate directive teaching of behavioral activation tasks
without eliciting patient priorities.
D. Early exploration of unconscious transference dynamics in
lengthy interpretive sessions.
Correct answer: B
Rationale — Correct (3–4 sentences): Choosing a patient-
centered, relationship-focused stance aligns with the
framework’s emphasis on relationship, resilience, and patient-
centered care. Initial sessions should prioritize alliance and
collaborative goal setting to respect the patient’s perspective
and promote engagement. This stance integrates nursing
strengths (holism, collaboration) while allowing later phased
interventions.
Rationale — Incorrect:
A. Prematurely prioritizes medication without building alliance;
effective care integrates relationship and, when indicated,
pharmacotherapy.
C. Directive behavioral tasks are useful but premature without
collaboration; may undermine empowerment.
D. Deep interpretive work early risks breaching readiness and is
not aligned with initial patient-centered stabilization.
Teaching point (≤20 words): Build alliance and co-create goals
first; therapeutic relationship is the treatment platform.
,Citation (APA): Wheeler, K. (2022). Psychotherapy for the
Advanced Practice Psychiatric Nurse (3rd ed.). Ch. 1.
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Q2
Stem: A newly hired PMHNP is developing a psychotherapy
program in an outpatient clinic constrained to 20-minute
follow-ups. According to Wheeler’s discussion of nursing
practice and psychotherapy, which programmatic adaptation
best preserves patient-centered psychotherapy principles?
A. Replace psychotherapy with medication visits to maximize
throughput.
B. Use brief, structured relational interventions while arranging
periodic longer therapy slots.
C. Standardize a single evidence-based manual and require all
patients to follow it.
D. Focus exclusively on psychoeducation handouts to
compensate for short visits.
Correct answer: B
Rationale — Correct (3–4 sentences): Wheeler emphasizes
adapting practice pragmatically while preserving relationship
and patient-centered care. Brief relational interventions
combined with scheduled longer sessions maintain alliance and
allow deeper work when needed. This balances system
, constraints with the therapeutic framework rather than
abandoning psychotherapy.
Rationale — Incorrect:
A. Abandoning psychotherapy ignores the relational foundation
and the nurse psychotherapist role.
C. One manual for all patients ignores individualized, culturally
informed care central to the framework.
D. Handouts are useful adjuncts but cannot substitute for
relational therapeutic engagement.
Teaching point: Adapt interventions to system limits but protect
relational, individualized care.
Citation (APA): Wheeler, K. (2022). Psychotherapy for the
Advanced Practice Psychiatric Nurse (3rd ed.). Ch. 1.
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Q3
Stem: A PMHNP supervises an early-career therapist who feels
pressured to “fix” safety concerns immediately. Using Wheeler’s
nursing-based psychotherapist requisites, what supervisory
emphasis best fosters competent psychotherapeutic practice?
A. Encourage immediate, directive problem-solving to ensure
perceived quick results.
B. Reinforce reflective practice, mindfulness, and staged
interventions consistent with nursing strengths.
PRACTICE PSYCHIATRIC NURSE
A HOW-TO GUIDE FOR EVIDENCE-BASED
PRACTICE
3RD EDITION
• AUTHOR(S)KATHLEEN WHEELER
TEST BANK
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Q1
Stem: A 38-year-old woman with chronic depression attends an
intake. She describes feeling unheard by prior clinicians and
asks for “something that helps me get through daily life.” As the
PMHNP beginning treatment, which initial therapist stance best
reflects the nursing framework Wheeler recommends?
A. Rapid symptom-reduction plan focusing mainly on
medication adjustments.
,B. Establishing a patient-centered, relationship-focused stance
with collaborative goal setting.
C. Immediate directive teaching of behavioral activation tasks
without eliciting patient priorities.
D. Early exploration of unconscious transference dynamics in
lengthy interpretive sessions.
Correct answer: B
Rationale — Correct (3–4 sentences): Choosing a patient-
centered, relationship-focused stance aligns with the
framework’s emphasis on relationship, resilience, and patient-
centered care. Initial sessions should prioritize alliance and
collaborative goal setting to respect the patient’s perspective
and promote engagement. This stance integrates nursing
strengths (holism, collaboration) while allowing later phased
interventions.
Rationale — Incorrect:
A. Prematurely prioritizes medication without building alliance;
effective care integrates relationship and, when indicated,
pharmacotherapy.
C. Directive behavioral tasks are useful but premature without
collaboration; may undermine empowerment.
D. Deep interpretive work early risks breaching readiness and is
not aligned with initial patient-centered stabilization.
Teaching point (≤20 words): Build alliance and co-create goals
first; therapeutic relationship is the treatment platform.
,Citation (APA): Wheeler, K. (2022). Psychotherapy for the
Advanced Practice Psychiatric Nurse (3rd ed.). Ch. 1.
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Q2
Stem: A newly hired PMHNP is developing a psychotherapy
program in an outpatient clinic constrained to 20-minute
follow-ups. According to Wheeler’s discussion of nursing
practice and psychotherapy, which programmatic adaptation
best preserves patient-centered psychotherapy principles?
A. Replace psychotherapy with medication visits to maximize
throughput.
B. Use brief, structured relational interventions while arranging
periodic longer therapy slots.
C. Standardize a single evidence-based manual and require all
patients to follow it.
D. Focus exclusively on psychoeducation handouts to
compensate for short visits.
Correct answer: B
Rationale — Correct (3–4 sentences): Wheeler emphasizes
adapting practice pragmatically while preserving relationship
and patient-centered care. Brief relational interventions
combined with scheduled longer sessions maintain alliance and
allow deeper work when needed. This balances system
, constraints with the therapeutic framework rather than
abandoning psychotherapy.
Rationale — Incorrect:
A. Abandoning psychotherapy ignores the relational foundation
and the nurse psychotherapist role.
C. One manual for all patients ignores individualized, culturally
informed care central to the framework.
D. Handouts are useful adjuncts but cannot substitute for
relational therapeutic engagement.
Teaching point: Adapt interventions to system limits but protect
relational, individualized care.
Citation (APA): Wheeler, K. (2022). Psychotherapy for the
Advanced Practice Psychiatric Nurse (3rd ed.). Ch. 1.
Ch. 1 — The Nurse Psychotherapist and a Framework for
Practice
Q3
Stem: A PMHNP supervises an early-career therapist who feels
pressured to “fix” safety concerns immediately. Using Wheeler’s
nursing-based psychotherapist requisites, what supervisory
emphasis best fosters competent psychotherapeutic practice?
A. Encourage immediate, directive problem-solving to ensure
perceived quick results.
B. Reinforce reflective practice, mindfulness, and staged
interventions consistent with nursing strengths.
