NRNP 6645 PSYCHOTHERAPY EXAM 200 ACTUAL
QUESTIONS AND CORRECT ANSWERS WITH RATIONALE
LATEST 2026 ALREADY GRADED A+ ASSURED PASS
200 questions covering the core content of the NRNP 6645 Psychotherapy
Exam. The questions span psychodynamic therapy (transference,
countertransference, resistance, dream interpretation), cognitive-behavioral
therapy (cognitive restructuring, behavioral activation, exposure, thought
records), dialectical behavior therapy (mindfulness, distress tolerance,
emotion regulation, interpersonal effectiveness), family therapy (structural,
Bowenian, strategic, narrative), group therapy dynamics, and
humanistic/existential approaches. Each question includes a correct answer
and detailed rationale explaining the therapeutic concept, technique, or
intervention. The questions reflect the exam's depth across theoretical
orientations, with no duplication of modalities, theorists, techniques, or
clinical applications.
1. A patient in psychodynamic therapy states, "You remind me of my critical
father." The therapist recognizes this as which phenomenon?
A. Countertransference
B. Projective identification
C. Transference
D. Resistance
Answer: C
Rationale: Transference is the unconscious redirection of feelings from a
significant figure in the patient's past onto the therapist. This is a central concept in
psychodynamic therapy.
2. A therapist finds herself feeling overly protective of a patient and wanting to
rescue them. This is most consistent with:
A. Transference
B. Countertransference
C. Empathy
D. Therapeutic alliance
Answer: B
,Rationale: Countertransference refers to the therapist's emotional reactions to the
patient, often based on the therapist's own unresolved issues. It requires self-
awareness and supervision.
3. In cognitive-behavioral therapy, the therapist helps the patient identify automatic
thoughts. What is the primary goal of this intervention?
A. Uncover unconscious conflicts
B. Identify maladaptive thought patterns that influence behavior
C. Explore family dynamics
D. Increase insight into childhood trauma
Answer: B
Rationale: CBT focuses on the connection between thoughts, feelings, and
behaviors. Identifying automatic thoughts allows the patient to challenge and
restructure cognitive distortions.
4. A patient with depression reports, "I'm a failure at everything I try." The
therapist asks the patient to examine the evidence for this belief. This technique is
called:
A. Cognitive restructuring
B. Behavioral activation
C. Exposure therapy
D. Free association
Answer: A
Rationale: Cognitive restructuring involves identifying, challenging, and
modifying maladaptive thoughts. Examining evidence is a core technique used to
test the accuracy of negative beliefs.
5. A patient with social anxiety avoids all social gatherings. The therapist creates a
hierarchy of feared situations and gradually exposes the patient to them. This is an
example of:
A. Systematic desensitization
B. Flooding
C. Aversion therapy
D. Behavioral activation
Answer: A
Rationale: Systematic desensitization combines relaxation techniques with gradual
exposure to a hierarchy of anxiety-provoking stimuli, reducing avoidance behavior.
6. A therapist working with a family uses a genogram. What is the primary purpose
of this tool?
,A. Diagnose mental illness
B. Map family relationships and patterns across generations
C. Assign roles to family members
D. Determine medication needs
Answer: B
Rationale: A genogram is a visual representation of family relationships, including
patterns of illness, conflict, and emotional bonds, used to understand
multigenerational dynamics.
7. A family therapist notices that the identified patient's behavior serves to
maintain family stability by deflecting attention from marital conflict. This is an
example of:
A. Homeostasis
B. Triangulation
C. Enmeshment
D. Differentiation
Answer: A
Rationale: Homeostasis is the tendency of a family system to maintain stability and
balance. The identified patient's symptoms can serve a homeostatic function by
reducing conflict elsewhere.
8. A therapist working with a couple observes a pattern where one partner
criticizes and the other becomes defensive. This pattern is most consistent with
which theory?
A. Structural family therapy
B. Emotion-focused therapy
C. Gottman method
D. Strategic family therapy
Answer: C
Rationale: The Gottman method identifies the "Four Horsemen" (criticism,
defensiveness, contempt, stonewalling) as predictors of relationship dissolution.
9. In group therapy, a member remains silent and avoids participation. The
therapist's most appropriate initial intervention is:
A. Confront the member about their resistance
B. Ask the member directly why they are silent
C. Allow the silence and wait for the member to engage naturally
D. Explore the member's feelings about participation in a supportive manner
Answer: D
, Rationale: Silencing in group therapy should be addressed with curiosity and
support, not confrontation. Exploring feelings helps the member feel safe and
encourages participation.
10. A patient in group therapy takes on the role of the "helper" and offers advice to
others while avoiding their own issues. This role is known as:
A. Monopolist
B. Scapegoat
C. Social worker
D. Gatekeeper
Answer: C
Rationale: The "social worker" or "helper" role is a common group dynamic where
a member provides support to others to avoid addressing their own vulnerabilities.
11. A patient is diagnosed with borderline personality disorder. Which
psychotherapy has the strongest evidence base for this condition?
A. Psychodynamic therapy
B. Dialectical behavior therapy (DBT)
C. Cognitive-behavioral therapy (CBT)
D. Interpersonal therapy
Answer: B
Rationale: DBT, developed by Marsha Linehan, is a modified form of CBT that
focuses on mindfulness, distress tolerance, emotion regulation, and interpersonal
effectiveness for BPD.
12. A therapist using DBT teaches a patient the "STOP" skill. This skill is
primarily used for:
A. Distress tolerance
B. Emotion regulation
C. Interpersonal effectiveness
D. Mindfulness
Answer: A
Rationale: The STOP skill (Stop, Take a step back, Observe, Proceed mindfully) is
a distress tolerance technique used to prevent impulsive reactions in crisis
situations.
13. A therapist uses the "ABC" model in CBT. What does the "B" stand for?
A. Behavior
B. Belief
C. Brain
QUESTIONS AND CORRECT ANSWERS WITH RATIONALE
LATEST 2026 ALREADY GRADED A+ ASSURED PASS
200 questions covering the core content of the NRNP 6645 Psychotherapy
Exam. The questions span psychodynamic therapy (transference,
countertransference, resistance, dream interpretation), cognitive-behavioral
therapy (cognitive restructuring, behavioral activation, exposure, thought
records), dialectical behavior therapy (mindfulness, distress tolerance,
emotion regulation, interpersonal effectiveness), family therapy (structural,
Bowenian, strategic, narrative), group therapy dynamics, and
humanistic/existential approaches. Each question includes a correct answer
and detailed rationale explaining the therapeutic concept, technique, or
intervention. The questions reflect the exam's depth across theoretical
orientations, with no duplication of modalities, theorists, techniques, or
clinical applications.
1. A patient in psychodynamic therapy states, "You remind me of my critical
father." The therapist recognizes this as which phenomenon?
A. Countertransference
B. Projective identification
C. Transference
D. Resistance
Answer: C
Rationale: Transference is the unconscious redirection of feelings from a
significant figure in the patient's past onto the therapist. This is a central concept in
psychodynamic therapy.
2. A therapist finds herself feeling overly protective of a patient and wanting to
rescue them. This is most consistent with:
A. Transference
B. Countertransference
C. Empathy
D. Therapeutic alliance
Answer: B
,Rationale: Countertransference refers to the therapist's emotional reactions to the
patient, often based on the therapist's own unresolved issues. It requires self-
awareness and supervision.
3. In cognitive-behavioral therapy, the therapist helps the patient identify automatic
thoughts. What is the primary goal of this intervention?
A. Uncover unconscious conflicts
B. Identify maladaptive thought patterns that influence behavior
C. Explore family dynamics
D. Increase insight into childhood trauma
Answer: B
Rationale: CBT focuses on the connection between thoughts, feelings, and
behaviors. Identifying automatic thoughts allows the patient to challenge and
restructure cognitive distortions.
4. A patient with depression reports, "I'm a failure at everything I try." The
therapist asks the patient to examine the evidence for this belief. This technique is
called:
A. Cognitive restructuring
B. Behavioral activation
C. Exposure therapy
D. Free association
Answer: A
Rationale: Cognitive restructuring involves identifying, challenging, and
modifying maladaptive thoughts. Examining evidence is a core technique used to
test the accuracy of negative beliefs.
5. A patient with social anxiety avoids all social gatherings. The therapist creates a
hierarchy of feared situations and gradually exposes the patient to them. This is an
example of:
A. Systematic desensitization
B. Flooding
C. Aversion therapy
D. Behavioral activation
Answer: A
Rationale: Systematic desensitization combines relaxation techniques with gradual
exposure to a hierarchy of anxiety-provoking stimuli, reducing avoidance behavior.
6. A therapist working with a family uses a genogram. What is the primary purpose
of this tool?
,A. Diagnose mental illness
B. Map family relationships and patterns across generations
C. Assign roles to family members
D. Determine medication needs
Answer: B
Rationale: A genogram is a visual representation of family relationships, including
patterns of illness, conflict, and emotional bonds, used to understand
multigenerational dynamics.
7. A family therapist notices that the identified patient's behavior serves to
maintain family stability by deflecting attention from marital conflict. This is an
example of:
A. Homeostasis
B. Triangulation
C. Enmeshment
D. Differentiation
Answer: A
Rationale: Homeostasis is the tendency of a family system to maintain stability and
balance. The identified patient's symptoms can serve a homeostatic function by
reducing conflict elsewhere.
8. A therapist working with a couple observes a pattern where one partner
criticizes and the other becomes defensive. This pattern is most consistent with
which theory?
A. Structural family therapy
B. Emotion-focused therapy
C. Gottman method
D. Strategic family therapy
Answer: C
Rationale: The Gottman method identifies the "Four Horsemen" (criticism,
defensiveness, contempt, stonewalling) as predictors of relationship dissolution.
9. In group therapy, a member remains silent and avoids participation. The
therapist's most appropriate initial intervention is:
A. Confront the member about their resistance
B. Ask the member directly why they are silent
C. Allow the silence and wait for the member to engage naturally
D. Explore the member's feelings about participation in a supportive manner
Answer: D
, Rationale: Silencing in group therapy should be addressed with curiosity and
support, not confrontation. Exploring feelings helps the member feel safe and
encourages participation.
10. A patient in group therapy takes on the role of the "helper" and offers advice to
others while avoiding their own issues. This role is known as:
A. Monopolist
B. Scapegoat
C. Social worker
D. Gatekeeper
Answer: C
Rationale: The "social worker" or "helper" role is a common group dynamic where
a member provides support to others to avoid addressing their own vulnerabilities.
11. A patient is diagnosed with borderline personality disorder. Which
psychotherapy has the strongest evidence base for this condition?
A. Psychodynamic therapy
B. Dialectical behavior therapy (DBT)
C. Cognitive-behavioral therapy (CBT)
D. Interpersonal therapy
Answer: B
Rationale: DBT, developed by Marsha Linehan, is a modified form of CBT that
focuses on mindfulness, distress tolerance, emotion regulation, and interpersonal
effectiveness for BPD.
12. A therapist using DBT teaches a patient the "STOP" skill. This skill is
primarily used for:
A. Distress tolerance
B. Emotion regulation
C. Interpersonal effectiveness
D. Mindfulness
Answer: A
Rationale: The STOP skill (Stop, Take a step back, Observe, Proceed mindfully) is
a distress tolerance technique used to prevent impulsive reactions in crisis
situations.
13. A therapist uses the "ABC" model in CBT. What does the "B" stand for?
A. Behavior
B. Belief
C. Brain
