Practice Psychiatric Nurse: A How-To Guide
for Evidence-Based Practice, 3rd Edition by
Kathleen Wheeler | Chapters 1–24 | Latest &
Verified A+ Guide
Your definitive PMHNP exam companion. This comprehensive test bank delivers 250
graduate-level multiple-choice and multiple-response questions with detailed rationales
covering every chapter of Wheeler's gold-standard text — from therapeutic frameworks
and neurophysiology through CBT, DBT, EMDR, IPT, group and family therapy, trauma
stabilization, psychopharmacotherapy integration, addictions, and psychotherapy with
children and older adults.
SECTION A: CHAPTERS 1–5 — FOUNDATIONS OF NURSE
PSYCHOTHERAPY
Chapter 1: The Nurse Psychotherapist and a Framework for
Practice
1. A nurse beginning a new role in generalist psychiatric-mental health nursing
reviews their job description, which aligns with the definition of psychiatric-
mental health nursing. In which areas would it be appropriate for the nurse to plan
interventions and programs? Select all that apply.
1. Techniques for managing stress
2. Early identification of mental health conditions
3. Educational classes for new parents
, 4. Conducting psychotherapy in family and group settings
5. Teaching about anti-anxiety medications
Answer: 1, 3, 4, 5
Rationale: Developing stress management skills promotes mental health and falls
within the scope of generalist-level psychiatric nursing. Diagnosing psychiatric
conditions is typically beyond the generalist nurse's scope and is not a standard
responsibility. Offering parenting education supports mental health prevention and is
aligned with generalist practice. While psychotherapy is typically performed by
advanced practice nurses, group and family sessions may be supported or co-facilitated
by generalists depending on the setting. Educating patients on medications like
anxiolytics enhances treatment adherence and quality care—appropriate for generalist
nurses.
2. A 34-year-old patient with chronic depressive symptoms asks during the second
therapy session whether the nurse can prescribe medication in addition to
providing psychotherapy. The nurse psychotherapist must decide how to respond
to preserve the therapeutic alliance while clarifying role and scope. Which
response best balances transparency, scope of practice, and collaborative care?
A. "Yes — I can prescribe medication and manage it entirely here; we'll combine both
treatments."
B. "I don't prescribe; I can refer you to a prescriber and continue psychotherapy
independently."
C. "I can prescribe if you want, but will not discuss medication during therapy sessions."
D. "I can prescribe and, if we agree it's appropriate, coordinate your medication with
other providers and integrate that into the treatment plan."
Answer: D
Rationale: Correct D transparently states prescribing capability while emphasizing
coordination and integration of care — reflecting the nurse psychotherapist role that
,bridges psychotherapy and psychiatric nursing responsibilities when within scope and
competence. It preserves alliance, supports shared decision-making, and aligns with a
collaborative framework. Incorrect A is risky because it assumes sole management
without clarifying competence, collaborative planning, or informed consent. B
inappropriately limits the therapeutic role. C dismisses the patient's question and harms
the alliance.
3. A client from a cultural background different than the therapist's reports that
"therapy feels like it's not for people like me." What is the nurse psychotherapist's
most culturally responsive action?
A. Reassure the client that therapy is effective for everyone.
B. Explore the client's cultural beliefs about mental health, help-seeking, and healing.
C. Refer the client to a therapist from the same cultural background.
D. Focus on symptom reduction rather than cultural concerns.
Answer: B
Rationale: Culturally responsive psychotherapy requires exploring the client's cultural
context, beliefs about mental health, and preferred healing practices before adapting
the treatment approach. Referral may sometimes be appropriate, but exploration should
come first to preserve alliance and avoid premature termination.
4. The nurse psychotherapist is serving on a committee charged with reviewing the
roles and responsibilities of nurses on the psychiatric unit. Which reference should
the nurse bring to guide the discussion?
1. Diagnostic and Statistical Manual of Mental Disorders
2. Certification criteria from the American Nurses Credentialing Center
3. American Nurses Association Code of Ethics
4. Psychiatric-Mental Health Nursing Standards of Practice
Answer: 4
, Rationale: The Psychiatric-Mental Health Nursing Standards of Practice outlines the
roles and responsibilities specific to psychiatric-mental health nurses and provides
benchmarks for high-quality care. The DSM is used mainly by physicians for diagnosis.
The Code of Ethics addresses ethical behavior but not roles. Certification guidelines
focus on achieving recognition but don't define practice expectations.
5. A psychiatric-mental health nurse is reviewing their professional responsibilities
and seeks guidance on performance standards. Which organization should the
nurse consult?
1. North American Nursing Diagnosis Association (NANDA)
2. American Nurses Credentialing Center (ANCC)
3. National League for Nursing (NLN)
4. American Nurses Association (ANA)
Answer: 4
Rationale: The ANA outlines professional performance expectations in its Psychiatric-
Mental Health Nursing Standards of Practice. The NLN focuses on education. ANCC
deals with certification. NANDA provides standardized nursing diagnoses.
6. While mentoring a new graduate nurse on a psychiatric unit, which statement
suggests the new nurse may misunderstand their role at the generalist level?
1. "Could you double-check my notes on the patient's treatment progress?"
2. "I plan to review how well the therapeutic environment is working."
3. "I'm a bit anxious about starting psychotherapy with patients."
4. "I'm learning how to include complementary therapies in care plans."
Answer: 3
Rationale: Providing psychotherapy is a responsibility for advanced practice psychiatric
nurses, not generalist-level nurses. The other statements reflect appropriate generalist