150 Comprehensive Questions with Detailed Rationales |
Wilkes University
Course: NSG 526 – Clinical Modalities in Advanced Psychiatric-Mental Health Nurse
Practitioner Practice
Institution: Wilkes University (Passan School of Nursing)
Exam: Exam 3
Academic Year: 2026/2027
Total Questions: 150
Format: Multiple Choice
Content Areas: Cognitive Behavioral Therapy, Dialectical Behavior Therapy,
Interpersonal Therapy, Group Therapy, Family Therapy, Psychopharmacology
Integration, Crisis Intervention, Motivational Interviewing
1. Cognitive Behavioral Therapy (CBT) is based on the premise that:
a) Unconscious conflicts drive all behavior
b) Thoughts, feelings, and behaviors are interconnected
c) Only medication can change behavior
d) Family relationships are irrelevant to mental health
,Rationale: CBT is founded on the cognitive model, which posits that thoughts, feelings, and
behaviors are interconnected. Changing maladaptive thoughts can change emotions and
behaviors .
2. In CBT, a patient's belief that "I must be perfect in everything I do" is an
example of:
a) Cognitive distortion
b) Core belief
c) Automatic thought
d) Intermediate belief
Rationale: Core beliefs are deeply held, global beliefs about oneself, others, or the world.
The belief "I must be perfect" is a core belief that shapes automatic thoughts and
behaviors. Core beliefs are the most fundamental level of cognition .
3. A patient states, "I failed my exam; I'm a complete failure in everything." The
PMHNP identifies this as which cognitive distortion?
a) Magnification
b) All-or-nothing thinking
c) Overgeneralization
d) Personalization
Rationale: Overgeneralization involves drawing a sweeping conclusion based on a single
event. The patient is generalizing from one failed exam to "a complete failure in
everything." This is a common cognitive distortion in depression .
4. Which of the following is an example of the cognitive distortion of
catastrophizing?
a) "I made a mistake, so I'm a failure."
b) "If I don't get this job, my life will be ruined."
c) "Everyone is looking at me and judging me."
d) "I should have known better."
,Rationale: Catastrophizing involves anticipating the worst possible outcome. "If I don't get
this job, my life will be ruined" exaggerates the consequences of a specific event. This
distortion fuels anxiety and avoidance .
5. A patient with social anxiety says, "Everyone at the party will notice how
nervous I am and think I'm weird." This is an example of:
a) Mind reading
b) Fortune telling
c) All-or-nothing thinking
d) Personalization
Rationale: Mind reading involves assuming you know what others are thinking without
evidence. The patient is assuming others will think they are weird, which is a common
cognitive distortion in social anxiety .
6. The first step in cognitive restructuring is:
a) Testing the validity of the thought
b) Identifying and labeling the automatic thought
c) Generating alternative thoughts
d) Changing the behavior
Rationale: The first step in cognitive restructuring is to identify and label automatic
thoughts. Patients must first recognize their automatic thoughts before they can evaluate
and modify them .
7. A PMHNP is using the Socratic questioning technique with a patient. Which
question is an example of this technique?
a) "What is the evidence for and against your thought?"
b) "How did you feel when that happened?"
c) "What would you like to achieve in therapy?"
d) "Can you describe your symptoms?"
, Rationale: Socratic questioning is a guided discovery technique where the therapist asks
questions to help the patient examine the evidence for their thoughts. "What is the
evidence for and against your thought?" is a classic Socratic question .
8. In CBT, a cognitive-behavioral formulation (case conceptualization) includes:
a) Only the patient's diagnosis
b) The patient's core beliefs, automatic thoughts, and behaviors
c) Only the patient's medication history
d) The patient's family history only
Rationale: A cognitive-behavioral formulation includes core beliefs, automatic thoughts,
and behaviors, as well as the triggers and maintaining factors for the patient's problems. It
provides a comprehensive framework for treatment .
9. A patient with depression engages in "positive thought journaling" as part of
CBT. The purpose of this intervention is to:
a) Avoid negative emotions
b) Increase awareness of positive experiences and challenge negative bias
c) Suppress negative thoughts
d) Distract from underlying problems
Rationale: Positive thought journaling helps patients increase awareness of positive
experiences, which challenges the negative cognitive bias common in depression. This is a
behavioral activation technique that also addresses cognitive patterns .
10. Which of the following statements best describes the concept of "cognitive
vulnerability" in CBT?
a) The tendency to develop physical illness due to stress
b) The predisposition to interpret ambiguous situations negatively
c) The inability to form relationships
d) The tendency to avoid all social situations
Wilkes University
Course: NSG 526 – Clinical Modalities in Advanced Psychiatric-Mental Health Nurse
Practitioner Practice
Institution: Wilkes University (Passan School of Nursing)
Exam: Exam 3
Academic Year: 2026/2027
Total Questions: 150
Format: Multiple Choice
Content Areas: Cognitive Behavioral Therapy, Dialectical Behavior Therapy,
Interpersonal Therapy, Group Therapy, Family Therapy, Psychopharmacology
Integration, Crisis Intervention, Motivational Interviewing
1. Cognitive Behavioral Therapy (CBT) is based on the premise that:
a) Unconscious conflicts drive all behavior
b) Thoughts, feelings, and behaviors are interconnected
c) Only medication can change behavior
d) Family relationships are irrelevant to mental health
,Rationale: CBT is founded on the cognitive model, which posits that thoughts, feelings, and
behaviors are interconnected. Changing maladaptive thoughts can change emotions and
behaviors .
2. In CBT, a patient's belief that "I must be perfect in everything I do" is an
example of:
a) Cognitive distortion
b) Core belief
c) Automatic thought
d) Intermediate belief
Rationale: Core beliefs are deeply held, global beliefs about oneself, others, or the world.
The belief "I must be perfect" is a core belief that shapes automatic thoughts and
behaviors. Core beliefs are the most fundamental level of cognition .
3. A patient states, "I failed my exam; I'm a complete failure in everything." The
PMHNP identifies this as which cognitive distortion?
a) Magnification
b) All-or-nothing thinking
c) Overgeneralization
d) Personalization
Rationale: Overgeneralization involves drawing a sweeping conclusion based on a single
event. The patient is generalizing from one failed exam to "a complete failure in
everything." This is a common cognitive distortion in depression .
4. Which of the following is an example of the cognitive distortion of
catastrophizing?
a) "I made a mistake, so I'm a failure."
b) "If I don't get this job, my life will be ruined."
c) "Everyone is looking at me and judging me."
d) "I should have known better."
,Rationale: Catastrophizing involves anticipating the worst possible outcome. "If I don't get
this job, my life will be ruined" exaggerates the consequences of a specific event. This
distortion fuels anxiety and avoidance .
5. A patient with social anxiety says, "Everyone at the party will notice how
nervous I am and think I'm weird." This is an example of:
a) Mind reading
b) Fortune telling
c) All-or-nothing thinking
d) Personalization
Rationale: Mind reading involves assuming you know what others are thinking without
evidence. The patient is assuming others will think they are weird, which is a common
cognitive distortion in social anxiety .
6. The first step in cognitive restructuring is:
a) Testing the validity of the thought
b) Identifying and labeling the automatic thought
c) Generating alternative thoughts
d) Changing the behavior
Rationale: The first step in cognitive restructuring is to identify and label automatic
thoughts. Patients must first recognize their automatic thoughts before they can evaluate
and modify them .
7. A PMHNP is using the Socratic questioning technique with a patient. Which
question is an example of this technique?
a) "What is the evidence for and against your thought?"
b) "How did you feel when that happened?"
c) "What would you like to achieve in therapy?"
d) "Can you describe your symptoms?"
, Rationale: Socratic questioning is a guided discovery technique where the therapist asks
questions to help the patient examine the evidence for their thoughts. "What is the
evidence for and against your thought?" is a classic Socratic question .
8. In CBT, a cognitive-behavioral formulation (case conceptualization) includes:
a) Only the patient's diagnosis
b) The patient's core beliefs, automatic thoughts, and behaviors
c) Only the patient's medication history
d) The patient's family history only
Rationale: A cognitive-behavioral formulation includes core beliefs, automatic thoughts,
and behaviors, as well as the triggers and maintaining factors for the patient's problems. It
provides a comprehensive framework for treatment .
9. A patient with depression engages in "positive thought journaling" as part of
CBT. The purpose of this intervention is to:
a) Avoid negative emotions
b) Increase awareness of positive experiences and challenge negative bias
c) Suppress negative thoughts
d) Distract from underlying problems
Rationale: Positive thought journaling helps patients increase awareness of positive
experiences, which challenges the negative cognitive bias common in depression. This is a
behavioral activation technique that also addresses cognitive patterns .
10. Which of the following statements best describes the concept of "cognitive
vulnerability" in CBT?
a) The tendency to develop physical illness due to stress
b) The predisposition to interpret ambiguous situations negatively
c) The inability to form relationships
d) The tendency to avoid all social situations
