NSG526 Exam 4 V2 | NSG 526 Clinical
Modalities Adv. Psych | Wilkes University
1. A family therapist is working with a family where the parents are highly anxious and
constantly involve their teenage daughter in their conflicts to reduce their own tension.
According to Bowen, this is an example of which concept?
A. Differentiation of self
B. Emotional cutoff
C. Enmeshment
D. Triangulation
Answer: D
Rationale: Triangulation occurs when a third person is brought into a two-person
relationship to stabilize the system and reduce anxiety. In Bowenian theory, this process
prevents the two primary individuals from resolving their actual conflict directly. The
daughter in this scenario serves as a stabilizer for the parents’ relational instability.
2. When implementing the Assertive Community Treatment (ACT) model for a patient with
schizophrenia, which characteristic is a hallmark of this intervention?
A. Multidisciplinary team providing 24/7 coverage in the community
B. Referral-based services to outside agencies
C. Traditional office-based therapy sessions
,D. Time-limited treatment focused on symptom stabilization
Answer: A
Rationale: The ACT model provides comprehensive, community-based psychiatric
treatment, rehabilitation, and support to persons with serious and persistent mental
illness. Unlike traditional models, services are provided where the patient lives and works
rather than in a clinic. The multidisciplinary team shares responsibility for a small caseload
and remains available to the client 24 hours a day.
3. In Yalom’s framework of group therapy, a member realizes that they are not alone in their
suffering and that others share similar problems. This curative factor is known as:
A. Catharsis
B. Universality
C. Altruism
D. Imitative behavior
Answer: B
Rationale: Universality is the recognition that one’s experiences and feelings are shared by
others, which reduces the sense of isolation. It helps members feel more ‘human’ and less
stigmatized by their mental health challenges. This realization often provides significant
relief early in the group therapy process.
, 4. A PMHNP is treating a couple using the Gottman Method. The husband frequently uses
sarcasm and eye-rolling when the wife speaks. Which of the ‘Four Horsemen’ does this
represent?
A. Criticism
B. Defensiveness
C. Contempt
D. Stonewalling
Answer: C
Rationale: Contempt is characterized by a position of moral superiority over the partner
and often involves sarcasm, name-calling, or mocking. It is considered the single greatest
predictor of divorce in Gottman’s research. Addressing contempt is a priority in couples
therapy as it erodes the foundation of respect in a relationship.
5. Which ethical principle is most directly involved when a PMHNP must decide whether to
breach confidentiality because a patient has made a specific threat to harm a named
individual?
A. Autonomy
B. Fidelity
C. Non-maleficence
D. Beneficence
Modalities Adv. Psych | Wilkes University
1. A family therapist is working with a family where the parents are highly anxious and
constantly involve their teenage daughter in their conflicts to reduce their own tension.
According to Bowen, this is an example of which concept?
A. Differentiation of self
B. Emotional cutoff
C. Enmeshment
D. Triangulation
Answer: D
Rationale: Triangulation occurs when a third person is brought into a two-person
relationship to stabilize the system and reduce anxiety. In Bowenian theory, this process
prevents the two primary individuals from resolving their actual conflict directly. The
daughter in this scenario serves as a stabilizer for the parents’ relational instability.
2. When implementing the Assertive Community Treatment (ACT) model for a patient with
schizophrenia, which characteristic is a hallmark of this intervention?
A. Multidisciplinary team providing 24/7 coverage in the community
B. Referral-based services to outside agencies
C. Traditional office-based therapy sessions
,D. Time-limited treatment focused on symptom stabilization
Answer: A
Rationale: The ACT model provides comprehensive, community-based psychiatric
treatment, rehabilitation, and support to persons with serious and persistent mental
illness. Unlike traditional models, services are provided where the patient lives and works
rather than in a clinic. The multidisciplinary team shares responsibility for a small caseload
and remains available to the client 24 hours a day.
3. In Yalom’s framework of group therapy, a member realizes that they are not alone in their
suffering and that others share similar problems. This curative factor is known as:
A. Catharsis
B. Universality
C. Altruism
D. Imitative behavior
Answer: B
Rationale: Universality is the recognition that one’s experiences and feelings are shared by
others, which reduces the sense of isolation. It helps members feel more ‘human’ and less
stigmatized by their mental health challenges. This realization often provides significant
relief early in the group therapy process.
, 4. A PMHNP is treating a couple using the Gottman Method. The husband frequently uses
sarcasm and eye-rolling when the wife speaks. Which of the ‘Four Horsemen’ does this
represent?
A. Criticism
B. Defensiveness
C. Contempt
D. Stonewalling
Answer: C
Rationale: Contempt is characterized by a position of moral superiority over the partner
and often involves sarcasm, name-calling, or mocking. It is considered the single greatest
predictor of divorce in Gottman’s research. Addressing contempt is a priority in couples
therapy as it erodes the foundation of respect in a relationship.
5. Which ethical principle is most directly involved when a PMHNP must decide whether to
breach confidentiality because a patient has made a specific threat to harm a named
individual?
A. Autonomy
B. Fidelity
C. Non-maleficence
D. Beneficence
