Midterm Exam: NR605/ NR 605 (Latest Update 2025/ 2026)
Diagnosis & Management in Psychiatri
Psychotherapy - ✔✔ANSWER✔✔>>-nonpharmacological intervention
-used to tx mental health diagnoses or distress
-help clients improve functioning and well-being
-talk therapy
-provided by psychiatrists, psychologists, social workers, marriage and family therapists,
counselors, and PMHNPs
-may include individual, couple, family, or group sessions
-Goals: symptom reduction, improvement in functioning, relapse prevention,
empowerment, achievement of collaborative goals set by the client & therapist.
Methods of Collaboration - ✔✔ANSWER✔✔>>Intraprofessional Collaboration
-the interaction and efforts between two disciplines with the same profession
• Potential barriers: tension, large team size, high turnover, lack of familiarity and
common goals, role ambiguity, generational differences, and lack of undergraduate
nursing education on intraprofessional practice.
Transprofessional Collaboration
-includes communication with various disciplines: physicians, physical/occupational
therapy, and social services, along with others to ensure care is delivered safely
• Potential barrier: lack of training
Role of PMHNPs in Psychotherapy - ✔✔ANSWER✔✔>>-unique, full-spectrum
approach
-may provide psychotherapy in addition to prescribing medications
-providing client and family education
-coordinating care and referrals as a part of the treatment plan
-provide psychotherapy in a variety of ambulatory, emergency department, inpatient,
and outpatient settings
Holistic Paradigm of Healing - ✔✔ANSWER✔✔>>-holistic model of care with a focus on
healing
-Holistic therapy respects the complexity of each unique individual
• appreciating the relationship between the client's mind, body, and spirit
• recognizing the interdependence of all parts of the human system
,-Foundational to healing is the relationship between the client and therapist
• Emotional connection in the relationship is critical to the success of psychotherapy
• PMHNP approaches the nurse-client relationship with acceptance, empathy, patience,
and kindness to create a space for healing
-psychotherapy can help the individual accept dysregulation and disharmony in the
present moment
• achieves acceptance of the present, they may be able to let go of resistance, relax,
and release fears
Theoretical Models in Psychotherapy - ✔✔ANSWER✔✔>>Maslow's Hierarchy of Needs
Health Belief Model
Transtheoretical Model of Change
Maslow's Hierarchy of Needs - ✔✔ANSWER✔✔>>framework for understanding client
motivation
-first four levels of need in the hierarchy (physiological needs, safety, love and
belonging, and esteem) are sometimes referred to as deficiency needs (D-needs)
• Motivation decreases once D-needs are met
-highest level of need, self-actualization, is considered a growth or being need (B-need)
• Once D-needs are met, clients can focus on self-actualization and personal growth
• As the B-need is met, motivation for further growth increases
self-actualized person - ✔✔ANSWER✔✔>>is self-fulfilled
-Qualities exhibited by the self-actualized person include independence, autonomy,
creativity, and maturity
therapeutic communication - ✔✔ANSWER✔✔>>-Translating emotions
• Sharing observations
• Sharing empathy
• Sharing hope
• Sharing humor
• Sharing feelings
-Non-verbal communication
• Active Listening
• Using touch
• Using silence
-Information verification/dissemination
• Providing information
• Clarifying
• Focusing
• Paraphrasing
• Validation
• Asking relevant questions
nontherapeutic techniques - ✔✔ANSWER✔✔>>Asking for Explanations
,-Why are you so anxious?
Asking Personal Questions
-Why don't you and John get married?
Giving Advice
-If I was you, I'd take a break from school.
Disapproval
-You shouldn't even think about assisted suicide; it's not right.
Defensive Responses
-No one here would intentionally lie to you.
False Reassurance
-Don't worry, everything will be all right.
Therapeutic techniques - ✔✔ANSWER✔✔>>Broad Openings
-What would you like to talk about today?
Reflecting
-What do you think you should do about it?
Presenting Reality
-I don't see anyone else in the room.
Sympathy
-I'm so sorry about your mastectomy; it must be terrible to lose a breast.
Summarizing
-Today we have talked about a plan for you to manage feelings of anger.
Making an Observation
-You seem upset about something.
Which theory would the psychiatric mental health nurse practitioner (PMHNP) most
need to consider when conducting a psychiatric interview in the following situations?
A 35-year-old homeless client is in the emergency department with suicidal ideations.
Hierarchy of Needs Theory
Psychosocial Development Theory
Cognitive Development Theory - ✔✔ANSWER✔✔>>Hierarchy of Needs Theory
Rationale: To attend to higher-level needs, a client must first meet foundational needs.
A homeless client may be struggling to meet physiological and safety needs.
, Which theory would the PMHNP most need to consider when conducting a psychiatric
interview in the following situations?
A 14-year-old foster child struggling to develop trusting relationships with his foster
parents.
Hierarchy of Needs Theory
Psychosocial Development Theory
Cognitive Development Theory - ✔✔ANSWER✔✔>>Psychosocial Development Theory
Rationale: According to Erickson's theory, a developmental crisis in infancy trust vs.
mistrust. When basic trust in caregivers is not developed in early life, it can impact the
creation of trusting relationships later.
Which theory would the PMHNP most need to consider when conducting a psychiatric
interview in the following situations?
A 4-year-old is struggling to understand what she has seen on television about civil
protests.
Hierarchy of Needs Theory
Psychosocial Development Theory
Cognitive Development Theory - ✔✔ANSWER✔✔>>Cognitive Development Theory
Rationale: According to Piaget, children in early childhood do not have the cognitive
ability to understand abstract concepts, such as justice.
Erikson's psychosocial stages: - ✔✔ANSWER✔✔>>-Infancy: Trust vs. Mistrust (birth-18
months)
-Early Childhood: Autonomy vs. Shame and Doubt (ages 18 months-2 to 3 years)
-Preschool: Initiative vs. Guilt (ages 3-5)
-School Age: Industry vs. Inferiority (ages 6-11)
-Adolescence: Identity vs. Role Confusion (ages 12-18)
-Young Adulthood: Intimacy vs. Isolation (ages 19-40)
-Middle Adulthood: Generativity vs. Stagnation (ages 40-65)
-Maturity: Integrity vs. Despair (ages 65-death)
Psychoanalytic theory - ✔✔ANSWER✔✔>>Freuds theory of personality
-childhood experiences & unconscious desires influence behavior
-libido, fixation stuck at psychosexual development stages
• predicts adult personality
Diagnosis & Management in Psychiatri
Psychotherapy - ✔✔ANSWER✔✔>>-nonpharmacological intervention
-used to tx mental health diagnoses or distress
-help clients improve functioning and well-being
-talk therapy
-provided by psychiatrists, psychologists, social workers, marriage and family therapists,
counselors, and PMHNPs
-may include individual, couple, family, or group sessions
-Goals: symptom reduction, improvement in functioning, relapse prevention,
empowerment, achievement of collaborative goals set by the client & therapist.
Methods of Collaboration - ✔✔ANSWER✔✔>>Intraprofessional Collaboration
-the interaction and efforts between two disciplines with the same profession
• Potential barriers: tension, large team size, high turnover, lack of familiarity and
common goals, role ambiguity, generational differences, and lack of undergraduate
nursing education on intraprofessional practice.
Transprofessional Collaboration
-includes communication with various disciplines: physicians, physical/occupational
therapy, and social services, along with others to ensure care is delivered safely
• Potential barrier: lack of training
Role of PMHNPs in Psychotherapy - ✔✔ANSWER✔✔>>-unique, full-spectrum
approach
-may provide psychotherapy in addition to prescribing medications
-providing client and family education
-coordinating care and referrals as a part of the treatment plan
-provide psychotherapy in a variety of ambulatory, emergency department, inpatient,
and outpatient settings
Holistic Paradigm of Healing - ✔✔ANSWER✔✔>>-holistic model of care with a focus on
healing
-Holistic therapy respects the complexity of each unique individual
• appreciating the relationship between the client's mind, body, and spirit
• recognizing the interdependence of all parts of the human system
,-Foundational to healing is the relationship between the client and therapist
• Emotional connection in the relationship is critical to the success of psychotherapy
• PMHNP approaches the nurse-client relationship with acceptance, empathy, patience,
and kindness to create a space for healing
-psychotherapy can help the individual accept dysregulation and disharmony in the
present moment
• achieves acceptance of the present, they may be able to let go of resistance, relax,
and release fears
Theoretical Models in Psychotherapy - ✔✔ANSWER✔✔>>Maslow's Hierarchy of Needs
Health Belief Model
Transtheoretical Model of Change
Maslow's Hierarchy of Needs - ✔✔ANSWER✔✔>>framework for understanding client
motivation
-first four levels of need in the hierarchy (physiological needs, safety, love and
belonging, and esteem) are sometimes referred to as deficiency needs (D-needs)
• Motivation decreases once D-needs are met
-highest level of need, self-actualization, is considered a growth or being need (B-need)
• Once D-needs are met, clients can focus on self-actualization and personal growth
• As the B-need is met, motivation for further growth increases
self-actualized person - ✔✔ANSWER✔✔>>is self-fulfilled
-Qualities exhibited by the self-actualized person include independence, autonomy,
creativity, and maturity
therapeutic communication - ✔✔ANSWER✔✔>>-Translating emotions
• Sharing observations
• Sharing empathy
• Sharing hope
• Sharing humor
• Sharing feelings
-Non-verbal communication
• Active Listening
• Using touch
• Using silence
-Information verification/dissemination
• Providing information
• Clarifying
• Focusing
• Paraphrasing
• Validation
• Asking relevant questions
nontherapeutic techniques - ✔✔ANSWER✔✔>>Asking for Explanations
,-Why are you so anxious?
Asking Personal Questions
-Why don't you and John get married?
Giving Advice
-If I was you, I'd take a break from school.
Disapproval
-You shouldn't even think about assisted suicide; it's not right.
Defensive Responses
-No one here would intentionally lie to you.
False Reassurance
-Don't worry, everything will be all right.
Therapeutic techniques - ✔✔ANSWER✔✔>>Broad Openings
-What would you like to talk about today?
Reflecting
-What do you think you should do about it?
Presenting Reality
-I don't see anyone else in the room.
Sympathy
-I'm so sorry about your mastectomy; it must be terrible to lose a breast.
Summarizing
-Today we have talked about a plan for you to manage feelings of anger.
Making an Observation
-You seem upset about something.
Which theory would the psychiatric mental health nurse practitioner (PMHNP) most
need to consider when conducting a psychiatric interview in the following situations?
A 35-year-old homeless client is in the emergency department with suicidal ideations.
Hierarchy of Needs Theory
Psychosocial Development Theory
Cognitive Development Theory - ✔✔ANSWER✔✔>>Hierarchy of Needs Theory
Rationale: To attend to higher-level needs, a client must first meet foundational needs.
A homeless client may be struggling to meet physiological and safety needs.
, Which theory would the PMHNP most need to consider when conducting a psychiatric
interview in the following situations?
A 14-year-old foster child struggling to develop trusting relationships with his foster
parents.
Hierarchy of Needs Theory
Psychosocial Development Theory
Cognitive Development Theory - ✔✔ANSWER✔✔>>Psychosocial Development Theory
Rationale: According to Erickson's theory, a developmental crisis in infancy trust vs.
mistrust. When basic trust in caregivers is not developed in early life, it can impact the
creation of trusting relationships later.
Which theory would the PMHNP most need to consider when conducting a psychiatric
interview in the following situations?
A 4-year-old is struggling to understand what she has seen on television about civil
protests.
Hierarchy of Needs Theory
Psychosocial Development Theory
Cognitive Development Theory - ✔✔ANSWER✔✔>>Cognitive Development Theory
Rationale: According to Piaget, children in early childhood do not have the cognitive
ability to understand abstract concepts, such as justice.
Erikson's psychosocial stages: - ✔✔ANSWER✔✔>>-Infancy: Trust vs. Mistrust (birth-18
months)
-Early Childhood: Autonomy vs. Shame and Doubt (ages 18 months-2 to 3 years)
-Preschool: Initiative vs. Guilt (ages 3-5)
-School Age: Industry vs. Inferiority (ages 6-11)
-Adolescence: Identity vs. Role Confusion (ages 12-18)
-Young Adulthood: Intimacy vs. Isolation (ages 19-40)
-Middle Adulthood: Generativity vs. Stagnation (ages 40-65)
-Maturity: Integrity vs. Despair (ages 65-death)
Psychoanalytic theory - ✔✔ANSWER✔✔>>Freuds theory of personality
-childhood experiences & unconscious desires influence behavior
-libido, fixation stuck at psychosexual development stages
• predicts adult personality
