NURS 6640 Midterm Exam Questions With Answers (Psychotherapy With Individuals) 2023/2024 (VERIFIED)

The PMHNP is treating a 35-year-old male officer in the military. He discloses that both of his parents are deceased and that he loved them. However, he says that he had feelings of inadequacy because his parents held him to a standard that he could never achieve. He went on to say that nothing he did ever felt good enough. The PMHNP assesses that this patient has perfect creases in his uniform with no strings or tags out of place; she also notices that he has perfect posture and questions him about ritualistic behaviors. She suspects that this patient has maladaptive responses to the expectations placed on him as a teenager and young adult. Which statements made by the patient would verify the PMHNP‟s suspicion? A. “I typically don‟t listen to anyone. I take care of my own wants and needs so I feel like no one can judge me or criticize me, period.” B. “I don‟t mean to hurt other people‟s feelings. When people cry or say that I have made them upset in some way, that‟s not my fault; some people are just sensitive.” C. “I like to listen to the beat of my own drum; I don‟t mind spending most of my days alone. I don‟t need recognition or praise; I would just like to be left alone.” D. “I believe in systems; I have to have order and rules in my everyday life. If a task must be completed, I will often complete it myself versus depending on someone else.” 1 points QUESTION 13 1. During a therapy session with an 18-year-old female the PMHNP learns that she has lived in six different foster homes in the last 24 months. She states that her mother is in a correctional facility for drug abuse and prostitution. During the assessment, the PMHNP notices multiple superficial cuts to each wrist. The patient appears tearful, withdrawn, and never makes direct eye contact. The PMHNP believes that this patient may have feelings of insecurities as well as abandonment issues and is aware that which diagnosis is likely possible? A. Narcissistic personality disorder B. Obsessive-compulsive personality disorder C. Borderline personality disorder D. Paranoid personality disorder 1 points QUESTION 14 5 1. In your office, you see a 58-year-old patient with PTSD who reports having nightmares, making it impossible for her to sleep. What recommendations based on principles of sleep hygiene will the PMHNP make? A. Eat a heavy meal before bedtime to induce sleepiness B. Maintain a warm bedroom temperature C. Avoid watching television or reading in bed D. Try going to sleep at different times throughout the week to avoid monotony 1 points QUESTION 15 1. The PMHNP is working with a patient who experiences anxiety around her parents that later leads to poor impulse control. What will the PMHNP do to employ psychodynamic psychotherapy properly for this patient? A. Emphasize the past B. Focus on expressions of emotion C. Identify patterns in relationships D. All of the above 1 points QUESTION 16 1. The PMHNP is working with a patient who seems dissatisfied with the therapeutic relationship. The PMHNP invites the patient to discuss her feelings regarding the PMHNP openly and honestly. It becomes clear to the PMHNP that they are experiencing an alliance rupture. How does the PMHNP repair the therapeutic alliance? A. Responding to the patient in a nondefensive manner and accepting responsibility for the PMHNP‟s part in the tension B. Emphasizing with the patient‟s experiences and validating the patient for bringing it up C. Considering changing the goals of the patient‟s treatment D. All of the above 1 points QUESTION 17 1. The PMHNP is caring for a patient with borderline personality disorder. Using a psychoanalytic psychotherapy approach, the PMHNP attempts to intensify the patient‟s transference to enhance emotional processing by: A. Developing increased boundaries B. Decreasing supportive psychotherapy C. Scaling back contact with the patient D. Increasing the number of sessions per week 1 points QUESTION 18 6 1. The PMHNP is working with a patient who has dissociative disorder and requests pharmacological interventions for dealing with her trauma. What education does the PMHNP provide to the patient regarding medication therapy? A. “The medication will help you forget the things that trigger your flashbacks.” B. “The medication takes a while to build up in your system and cure you.” C. “The medication may provide symptom relief, but you still need psychotherapy.” D. All of the above. 1 points QUESTION 19 1. The patient is a 56-year-old female patient diagnosed with panic disorder and reports symptoms that include heart palpitations, frequent trembling, and feelings of choking in stressful situations. What special consideration does the PMHNP make? A. Using a special focus on transference as the agent promoting change B. Confronting the emotional significance of the patient‟s symptoms C. Employing psychodynamic therapy combined with pharmacotherapy D. A and B 1 points QUESTION 20 1. A 65-year-old patient has suffered the loss of his wife. He is in a state of hyperarousal with increased sympathetic nervous system arousal. One or more interventions may help the patient to deal with this arousal. To decrease sympathetic nervous system arousal, the PMHNP‟s treatment strategy is ___________. A. mindfulness techniques B. deep breathing exercises C. self-regulation strategies D. all of the above 1 points QUESTION 21 1. The PMHNP is caring for a patient who the PMHNP believes would benefit from a relational psychodynamic approach to therapy. Which action made by the PMHNP demonstrates appropriate use and understanding of the relationship psychodynamic model? A. Focusing the exploration on making the unconscious conscious B. Focusing the exploration on the genetic roots of the patient‟s problem C. Focusing the exploration on here and now D. None of the above 1 points QUESTION 22 7 1. The PMHNP is working with a 43-year-old male patient who develops idiosyncratic transference over weeks of therapy. The best way for the PMHNP to respond to this patient is to ___________: A. employ cognitive behavioral therapy B. use empathy C. utilize intersubjectivity D. none of the above 1 points QUESTION 23 1. The PMHNP has a session with a patient who was injured and traumatized from an explosion at the industrial plant where he used to work. During the session, an outside noise startles the patient and he experiences a flashback of the loud boom from the explosion. The PMHNP witnesses the patient present with anxiety and belabored breathing. What is the appropriate action of the PMHNP? A. Telling the patient there is no reason to be startled B. Avoiding interrupting the flashback as it occurs C. Asking the patient to describe the flashbacks D. Have the patient use the relaxation response (take a deep breath, exhale long, and slow down) 1 points QUESTION 24 1. The PMHNP is working with a veteran who has posttraumatic stress disorder (PTSD). The PMHNP believes that dual awareness will be beneficial in allowing the patient to focus on the here and now. What strategies can the PMHNP use to develop dual awareness in the patient? A. Asking the patient to recall a recent and mildly disturbing event B. Having the patient focus on details of the room, such as how hot or cold it is C. Telling the patient to rate the level of disturbance he feels from a mildly disturbing event D. All of the above 1 points QUESTION 25 1. The PMHNP is working with a patient who experiences abreactions when discussing repressed feelings of his sexual abuse as a child. What can the PMHNP do to manage the patient‟s intense emotional reactions? A. Sit closer to the patient so the patient does not feel isolated B. Embrace the patient to provide physical comfort C. Suggest a relaxation technique, such as yoga or meditation D. All of the above 1 points 8 QUESTION 26 1. A 35-year-old patient has been seeking treatment for depression for several months. The PMHNP does an assessment to see if processing has led to adaptive change. The patient‟s self-references are positive in relation to past events, work is productive, relationships are adaptive, and there is congruence between behavior, thoughts, and affect. Based on this information, the PMHNP decides the patient ____________. A. will require more processing strategies B. would benefit from the stabilization stage C. is ready to move to Stage III, future visioning D. no longer needs to continue with therapy 1 points QUESTION 27 1. When a PMHNP is seeing a patient for the first time, what is an important step to assure that the patient and provider understand the limits of their discussion? A. Assure the patient that she is safe to discuss her secrets B. Talk about the importance of being truthful and open C. Have a discussion about the confidentiality and its limits D. Mention the possible need for selective self-disclosure 1 points QUESTION 28 1. An 11-year-old patient has been exhibiting low self-esteem at school and acting out. According to Maslow‟s hierarchy of needs, which of the following questions would best be addressed first by the PMHNP? A. “Are Joel‟s peers including him at recess?” B. “Does Joel feel safe and secure at school?” C. “Is Joel getting enough sleep at home?” D. “How can Joel feel that he is loved?” 1 points QUESTION 29 1. A patient who has borderline personality disorder is meeting with the PMHNP. When asked about future goals, the patient responds, “I‟d like to go back to school to do what you do. You know, talk to people all day about their problems. It seems pretty easy.” How does the PHMNP respond to the client in a way that is free from any stigmatizing beliefs or judgments? A. “It is dangerous to fantasize about the future.” B. “I think that‟s an excellent idea! I can help you review the prerequisites!” C. “You may want to explore the requirements for becoming a PMNHP.” D. None of the above. 9 1 points QUESTION 30 1. The PMHNP meets with a 47-year-old male patient who is fearful of leaving the house after having witnessed his neighbor getting run over by a car. When the PMHNP asks why he is afraid to leave his house, the patient replies, “Because another accident might occur.” Which cognitive behavioral therapy (CBT) strategy does the PMHNP employ? A. Pharmacological therapy B. Stress inoculation therapy C. Dialectical behavior therapy D. All of the above 1 points QUESTION 31 1. Your patient is a 65-year-old male who has a strained relationship with his son and daughter. His children refuse to participate in a family session. The PMHNP asks the patient to draw his family genogram as a next step to _______________. A. assess the patient‟s mental health status and functioning B. explore the interpersonal styles of each family member C. provide background information for the patient‟s family structure D. measure the patient‟s quality of well-being and productivity 1 points QUESTION 32 1. The PMHNP has been treating a 15-year-old patient with a history of abuse and neglect. Thirty minutes into their therapy session the patient jumps up and begins to pace around the room. Utilizing Socratic dialogue (SD) the PMHNP‟s best action would be to: A. Allow the patient time to process before speaking. B. Ask, “Why don‟t you come have a seat beside me?” while tapping the table. C. Say, “I noticed a change. Can you tell me what happened?” D. Say, “We can continue this session later if you prefer.” 1 points QUESTION 33 1. The PMHNP employs psychodynamic psychotherapy with a patient who experiences anxiety and depression. As the process enters the psychoanalytic end of the psychodynamic continuum, the PMNHP will focus on: A. Interpreting unconscious conflict in the patient B. Restoring the patient‟s functioning and stabilization C. Reducing the patient‟s anxiety D. Strengthening the patient‟s defenses 10 1 points QUESTION 34 1. A 28-year-old male patient is experiencing distress related to the workplace. What might the PMHNP ask to assess affective development? A. “How do you think your colleagues feel about you?” B. “How do you calm yourself when you are upset at the office?” C. “How do you think your colleague felt when you blamed her?” D. All of the above. 1 points QUESTION 35 1. A PMHNP is taking a history and wants to assess how the patient copes with adversity. To do so, the therapist asks questions about the patient‟s belief system. What would be an appropriate question to ask? A. “What are your beliefs about therapy and seeking help?” B. “To what extent do your religious beliefs give you comfort?” C. “What gives you a sense of meaning and purpose in life?” D. All of the above. 1 points QUESTION 36 1. A new patient has been informed of the limits of confidentiality, and has signed informed consent forms. No consent, however, has been obtained for voluntary “Release of Information.” The patient is 20 years old and still lives at home with his parents. He is being treated for depression, which he attributes to the trouble he‟s had finding employment. True or false: If the patient‟s mother calls the PMHNP to check up on her son to see how he is doing, the therapist is required to protect patient confidentiality and not disclose information. True False 1 points QUESTION 37 1. The PMHNP is caring for a patient with dissociated self-state that the PMHNP identifies as being associated with traumatic experiences in the patient‟s past. What approach does the PMHNP use with the patient that is crucial to the psychodynamic therapy process? A. Assisting the patient to experience and accept the various dimensions of the self through enhanced awareness of the traumatic states B. Becoming a co-participant in the co-construction of the relationship with the patient, rather than an outside observer C. Making associations between an event or situation and the patient‟s feelings 11 D. Providing empathy, understanding, and soothing to help the patient identify the other self-states 1 points QUESTION 38 1. The PMHNP is mentoring a student. After working with a patient during a session, the student laments about all the things she should have, or could have, said to the patient. “I feel guilty that I didn’t speak up more about the patient’s concern toward her son,” says the student. The PMHNP understands that the student is exhibiting signs of which therapeutic concept? A. Countertransference B. Therapeutic communication C. Empathy D. Boundaries 1 points QUESTION 39 1. A PMHNP has been working with a young female patient who suffers from depression to change self-defeating behaviors. By creating a presence of acceptance and using good listening skills, the PMHNP‟s overall goal is to __________. A. deepen the patient‟s understanding of herself in order to cultivate empowerment B. slowly transfer authority to the patient when the PMHNP feels that she is ready C. remain caring, y