NRNP 6645 PSYCHOTHERAPY MIDTERM EXAM
QUESTIONS AND 100% VERIFIED ANSWERS
WITH RATIONALES GRADED A+ LATEST
WALDEN UNIVERSITY
1. A 35-year-old patient presents with persistent negative thoughts about self-
worth and experiences difficulty managing anxiety. Which approach would be
most appropriate to address maladaptive thinking patterns?
A. Psychodynamic therapy
B. Cognitive Behavioral Therapy (CBT)
C. Solution-focused brief therapy
D. Supportive therapy
Answer: B. Cognitive Behavioral Therapy (CBT)
Rationale: CBT is evidence-based for identifying and restructuring maladaptive
thought patterns. Psychodynamic therapy focuses more on unconscious conflicts,
and solution-focused therapy emphasizes future-oriented problem-solving rather
than cognitive restructuring.
2. A therapist observes a client frequently avoiding discussing feelings of
anger toward a parent. According to psychodynamic theory, this is an
example of:
A. Transference
B. Countertransference
C. Resistance
D. Repression
Answer: C. Resistance
Rationale: Resistance occurs when a client unconsciously avoids discussing
emotionally charged topics. Transference involves projecting feelings onto the
therapist; countertransference is the therapist’s emotional response; repression is an
unconscious defense mechanism.
,3. In a group therapy session, a patient consistently interrupts others and
seeks attention. The therapist's best approach is to:
A. Confront the patient harshly to maintain control
B. Ignore the behavior entirely to avoid conflict
C. Explore the underlying purpose of the behavior and set boundaries
D. Remove the patient from the group immediately
Answer: C. Explore the underlying purpose of the behavior and set boundaries
Rationale: Effective group therapy requires addressing disruptive behavior while
maintaining therapeutic alliance. Understanding motivations helps the therapist
guide behavioral change without alienating the patient.
4. A patient expresses hope that therapy will solve all problems immediately.
The nurse should:
A. Agree and provide immediate solutions
B. Set realistic expectations and collaboratively identify achievable goals
C. Critique the patient for unrealistic thinking
D. Refer to another clinician without explanation
Answer: B. Set realistic expectations and collaboratively identify achievable goals
Rationale: Establishing realistic goals is essential for therapy adherence. Solution-
focused approaches often emphasize goal-setting and incremental change.
5. Which ethical principle is most relevant when a therapist shares clinical
notes with a patient without consent?
A. Autonomy
B. Beneficence
C. Nonmaleficence
D. Fidelity
Answer: D. Fidelity
,Rationale: Fidelity involves maintaining trust and confidentiality in the
therapeutic relationship. Sharing notes without consent violates professional trust,
even if intended to benefit the patient.
6. In CBT, a patient is asked to record instances of negative self-talk and
challenge them with evidence. This is an example of:
A. Exposure therapy
B. Behavioral activation
C. Cognitive restructuring
D. Psychodynamic interpretation
Answer: C. Cognitive restructuring
Rationale: Cognitive restructuring involves identifying distorted thoughts and
replacing them with evidence-based alternatives, a core CBT technique.
7. A family therapy session focuses on the dynamics between a parent and
adolescent. The therapist notes repeated cycles of blame and withdrawal.
Which modality is most relevant?
A. Solution-focused therapy
B. Structural family therapy
C. Gestalt therapy
D. Supportive therapy
Answer: B. Structural family therapy
Rationale: Structural family therapy examines family hierarchies, interaction
patterns, and roles to address relational dysfunctions. Solution-focused therapy
emphasizes goal achievement rather than structural patterns.
, 8. Which is the most appropriate use of a treatment manual in
psychotherapy?
A. Limiting therapist creativity
B. Ensuring fidelity to evidence-based protocols
C. Replacing clinical judgment entirely
D. Avoiding individualized care
Answer: B. Ensuring fidelity to evidence-based protocols
Rationale: Treatment manuals guide standardized interventions while allowing
therapists to adapt to individual needs. They support evidence-based practice, not
rigid application.
9. A therapist notices feeling unusually frustrated when a client frequently
cancels appointments. This is an example of:
A. Countertransference
B. Transference
C. Projection
D. Resistance
Answer: A. Countertransference
Rationale: Countertransference occurs when the therapist’s emotional response is
influenced by the client’s behavior. Awareness is crucial for maintaining
professional boundaries.
10. A 28-year-old client has difficulty expressing emotions due to cultural
norms emphasizing emotional restraint. The therapist should:
A. Encourage expression without consideration of culture
B. Adapt interventions to respect cultural values while fostering insight
C. Dismiss cultural factors as irrelevant
D. Use a standardized approach regardless of client background
Answer: B. Adapt interventions to respect cultural values while fostering insight
QUESTIONS AND 100% VERIFIED ANSWERS
WITH RATIONALES GRADED A+ LATEST
WALDEN UNIVERSITY
1. A 35-year-old patient presents with persistent negative thoughts about self-
worth and experiences difficulty managing anxiety. Which approach would be
most appropriate to address maladaptive thinking patterns?
A. Psychodynamic therapy
B. Cognitive Behavioral Therapy (CBT)
C. Solution-focused brief therapy
D. Supportive therapy
Answer: B. Cognitive Behavioral Therapy (CBT)
Rationale: CBT is evidence-based for identifying and restructuring maladaptive
thought patterns. Psychodynamic therapy focuses more on unconscious conflicts,
and solution-focused therapy emphasizes future-oriented problem-solving rather
than cognitive restructuring.
2. A therapist observes a client frequently avoiding discussing feelings of
anger toward a parent. According to psychodynamic theory, this is an
example of:
A. Transference
B. Countertransference
C. Resistance
D. Repression
Answer: C. Resistance
Rationale: Resistance occurs when a client unconsciously avoids discussing
emotionally charged topics. Transference involves projecting feelings onto the
therapist; countertransference is the therapist’s emotional response; repression is an
unconscious defense mechanism.
,3. In a group therapy session, a patient consistently interrupts others and
seeks attention. The therapist's best approach is to:
A. Confront the patient harshly to maintain control
B. Ignore the behavior entirely to avoid conflict
C. Explore the underlying purpose of the behavior and set boundaries
D. Remove the patient from the group immediately
Answer: C. Explore the underlying purpose of the behavior and set boundaries
Rationale: Effective group therapy requires addressing disruptive behavior while
maintaining therapeutic alliance. Understanding motivations helps the therapist
guide behavioral change without alienating the patient.
4. A patient expresses hope that therapy will solve all problems immediately.
The nurse should:
A. Agree and provide immediate solutions
B. Set realistic expectations and collaboratively identify achievable goals
C. Critique the patient for unrealistic thinking
D. Refer to another clinician without explanation
Answer: B. Set realistic expectations and collaboratively identify achievable goals
Rationale: Establishing realistic goals is essential for therapy adherence. Solution-
focused approaches often emphasize goal-setting and incremental change.
5. Which ethical principle is most relevant when a therapist shares clinical
notes with a patient without consent?
A. Autonomy
B. Beneficence
C. Nonmaleficence
D. Fidelity
Answer: D. Fidelity
,Rationale: Fidelity involves maintaining trust and confidentiality in the
therapeutic relationship. Sharing notes without consent violates professional trust,
even if intended to benefit the patient.
6. In CBT, a patient is asked to record instances of negative self-talk and
challenge them with evidence. This is an example of:
A. Exposure therapy
B. Behavioral activation
C. Cognitive restructuring
D. Psychodynamic interpretation
Answer: C. Cognitive restructuring
Rationale: Cognitive restructuring involves identifying distorted thoughts and
replacing them with evidence-based alternatives, a core CBT technique.
7. A family therapy session focuses on the dynamics between a parent and
adolescent. The therapist notes repeated cycles of blame and withdrawal.
Which modality is most relevant?
A. Solution-focused therapy
B. Structural family therapy
C. Gestalt therapy
D. Supportive therapy
Answer: B. Structural family therapy
Rationale: Structural family therapy examines family hierarchies, interaction
patterns, and roles to address relational dysfunctions. Solution-focused therapy
emphasizes goal achievement rather than structural patterns.
, 8. Which is the most appropriate use of a treatment manual in
psychotherapy?
A. Limiting therapist creativity
B. Ensuring fidelity to evidence-based protocols
C. Replacing clinical judgment entirely
D. Avoiding individualized care
Answer: B. Ensuring fidelity to evidence-based protocols
Rationale: Treatment manuals guide standardized interventions while allowing
therapists to adapt to individual needs. They support evidence-based practice, not
rigid application.
9. A therapist notices feeling unusually frustrated when a client frequently
cancels appointments. This is an example of:
A. Countertransference
B. Transference
C. Projection
D. Resistance
Answer: A. Countertransference
Rationale: Countertransference occurs when the therapist’s emotional response is
influenced by the client’s behavior. Awareness is crucial for maintaining
professional boundaries.
10. A 28-year-old client has difficulty expressing emotions due to cultural
norms emphasizing emotional restraint. The therapist should:
A. Encourage expression without consideration of culture
B. Adapt interventions to respect cultural values while fostering insight
C. Dismiss cultural factors as irrelevant
D. Use a standardized approach regardless of client background
Answer: B. Adapt interventions to respect cultural values while fostering insight
