Psychotherapy for the Advanced Practice
Psychiatric Nurse (4th Edition) by Kathleen
Wheeler latest update 2026/2027
Chapter 1: The Nurse Psychotherapist and a Framework for Practice
1. A psychiatric-mental health nurse at the generalist level is planning interventions consistent
with the ANA, APNA, and ISPN Psychiatric-Mental Health Nursing Standards of Practice.
Which of the following activities are appropriate for this level of practice? Select all that apply.
Stress management strategies
Early diagnosis of psychiatric disorders
Parenting classes for new parents
Family and group psychotherapy
Medication teaching for anti-anxiety medications
Correct Answer: 1, 3, 5
,Rationale: Stress management, parenting classes, and medication teaching are consistent with the
generalist level of psychiatric-mental health nursing practice, which focuses on health
promotion, prevention, and direct care. Early diagnosis and family/group psychotherapy are
advanced practice competencies requiring graduate-level preparation and prescriptive authority
or specialized psychotherapy training.
2. A nurse psychotherapist is explaining the core philosophy of the holistic model of care to a
new patient. Which statement best reflects this framework?
A. "The focus is exclusively on symptom reduction and medication compliance."
B. "We prioritize biological interventions over psychosocial ones."
C. "Healing integrates biological, psychological, social, and spiritual dimensions of the person."
D. "The therapist's role is to provide expert advice and solutions."
Correct Answer: C
Rationale: The holistic model of care embraced by psychiatric-mental health advanced practice
nurses integrates biopsychosocial-spiritual elements, focusing on healing the whole person rather
than just treating symptoms. This person-centered approach is a foundational principle of the
nurse psychotherapist's framework.
Chapter 2: The Neurophysiology of Trauma and Psychotherapy
3. According to Wheeler's framework, which theoretical model is central to understanding the
neurophysiological responses to trauma?
A. Cognitive-behavioral theory
,B. Polyvagal theory
C. Social learning theory
D. Psychodynamic theory
Correct Answer: B
Rationale: Polyvagal theory is a central framework in Wheeler's work for understanding how the
autonomic nervous system responds to trauma, particularly the role of the vagus nerve in
mediating social engagement, fight/flight, and freeze responses. The Adaptive Information
Processing (AIP) model is also used as an overall framework for practice.
4. A patient with a history of complex trauma presents with emotional dysregulation and
difficulty engaging in relationships. The nurse psychotherapist understands that trauma has
primarily affected which neural process?
A. It enhances connection between the prefrontal cortex and limbic system.
B. It disconnects the person from self and impairs integration of neural networks.
C. It strengthens the ability to modulate arousal.
D. It promotes adaptive information processing.
Correct Answer: B
Rationale: Trauma disconnects the person from self and leads to maladaptive linkage of neural
networks, impairing the integration needed for adaptive functioning. Psychotherapy aims to
mediate the reintegration and connection of these neural networks.
Chapter 3: Assessment and Diagnosis
, 5. A comprehensive psychiatric assessment for psychotherapy should include which of the
following components? Select all that apply.
Presenting problem and history of present illness
Past psychiatric and medical history
Family history and genogram
Functional status and social supports
Only the patient's self-reported symptoms
Correct Answer: 1, 2, 3, 4
Rationale: A comprehensive assessment includes the presenting problem, psychiatric and
medical history, family history/genogram, functional status, and social supports. Relying solely
on self-reported symptoms would miss critical diagnostic and contextual information.
6. During an assessment, a patient reports difficulty with memory and concentration after a
traumatic event. The nurse psychotherapist recognizes this as a potential indicator of:
A. Major depressive disorder
B. Dissociative experiences
C. Generalized anxiety disorder
D. Bipolar disorder
Psychiatric Nurse (4th Edition) by Kathleen
Wheeler latest update 2026/2027
Chapter 1: The Nurse Psychotherapist and a Framework for Practice
1. A psychiatric-mental health nurse at the generalist level is planning interventions consistent
with the ANA, APNA, and ISPN Psychiatric-Mental Health Nursing Standards of Practice.
Which of the following activities are appropriate for this level of practice? Select all that apply.
Stress management strategies
Early diagnosis of psychiatric disorders
Parenting classes for new parents
Family and group psychotherapy
Medication teaching for anti-anxiety medications
Correct Answer: 1, 3, 5
,Rationale: Stress management, parenting classes, and medication teaching are consistent with the
generalist level of psychiatric-mental health nursing practice, which focuses on health
promotion, prevention, and direct care. Early diagnosis and family/group psychotherapy are
advanced practice competencies requiring graduate-level preparation and prescriptive authority
or specialized psychotherapy training.
2. A nurse psychotherapist is explaining the core philosophy of the holistic model of care to a
new patient. Which statement best reflects this framework?
A. "The focus is exclusively on symptom reduction and medication compliance."
B. "We prioritize biological interventions over psychosocial ones."
C. "Healing integrates biological, psychological, social, and spiritual dimensions of the person."
D. "The therapist's role is to provide expert advice and solutions."
Correct Answer: C
Rationale: The holistic model of care embraced by psychiatric-mental health advanced practice
nurses integrates biopsychosocial-spiritual elements, focusing on healing the whole person rather
than just treating symptoms. This person-centered approach is a foundational principle of the
nurse psychotherapist's framework.
Chapter 2: The Neurophysiology of Trauma and Psychotherapy
3. According to Wheeler's framework, which theoretical model is central to understanding the
neurophysiological responses to trauma?
A. Cognitive-behavioral theory
,B. Polyvagal theory
C. Social learning theory
D. Psychodynamic theory
Correct Answer: B
Rationale: Polyvagal theory is a central framework in Wheeler's work for understanding how the
autonomic nervous system responds to trauma, particularly the role of the vagus nerve in
mediating social engagement, fight/flight, and freeze responses. The Adaptive Information
Processing (AIP) model is also used as an overall framework for practice.
4. A patient with a history of complex trauma presents with emotional dysregulation and
difficulty engaging in relationships. The nurse psychotherapist understands that trauma has
primarily affected which neural process?
A. It enhances connection between the prefrontal cortex and limbic system.
B. It disconnects the person from self and impairs integration of neural networks.
C. It strengthens the ability to modulate arousal.
D. It promotes adaptive information processing.
Correct Answer: B
Rationale: Trauma disconnects the person from self and leads to maladaptive linkage of neural
networks, impairing the integration needed for adaptive functioning. Psychotherapy aims to
mediate the reintegration and connection of these neural networks.
Chapter 3: Assessment and Diagnosis
, 5. A comprehensive psychiatric assessment for psychotherapy should include which of the
following components? Select all that apply.
Presenting problem and history of present illness
Past psychiatric and medical history
Family history and genogram
Functional status and social supports
Only the patient's self-reported symptoms
Correct Answer: 1, 2, 3, 4
Rationale: A comprehensive assessment includes the presenting problem, psychiatric and
medical history, family history/genogram, functional status, and social supports. Relying solely
on self-reported symptoms would miss critical diagnostic and contextual information.
6. During an assessment, a patient reports difficulty with memory and concentration after a
traumatic event. The nurse psychotherapist recognizes this as a potential indicator of:
A. Major depressive disorder
B. Dissociative experiences
C. Generalized anxiety disorder
D. Bipolar disorder
