NSG 527 STUDY QUESTIONS
1. Case: Delusional Content in Context
A 34-year-old male reports that the government implanted a chip in his head to control his
thoughts. He has poor insight and a history of paranoid schizophrenia.
Which of the following statements are TRUE?
A) This belief qualifies as a non-bizarre delusion.
B) Dopamine dysregulation is a core neurochemical feature of this presentation.
C) Antipsychotic medication is indicated as first-line.
D) Cognitive Behavioral Therapy alone can replace pharmacotherapy.
E) His impaired insight is a typical feature of psychosis.
Correct: B, C, E
A is false: This is a bizarre delusion.
D is false: CBT can supplement but not replace medication in schizophrenia.
2. Case: Trauma and Attachment
A 7-year-old foster child exhibits emotional numbing, frequent outbursts, and difficulty
trusting adults. History reveals prolonged neglect and inconsistent caregiving.
Which statements reflect best-practice understanding?
A) The child’s behavior is likely rooted in disrupted attachment patterns.
B) These symptoms are more consistent with ADHD than trauma.
C) Dyadic Developmental Psychotherapy (DDP) is an appropriate intervention.
D) The child is likely operating outside their window of tolerance.
E) Behavior modification with strict discipline will promote security.
Correct: A, C, D
B is incorrect: ADHD may overlap, but trauma is more consistent with relational
patterns here.
E is incorrect: Strict discipline may reinforce fear and mistrust.
3. Case: Mood and Cultural Framing
A 42-year-old Haitian woman presents with fatigue, sadness, and GI upset after losing her
mother. She denies being “depressed” but says she is “spiritually sick.”
, NSG 527 STUDY QUESTIONS
What considerations should the PMHNP make?
A) Her expression of distress may reflect cultural idioms rather than psychopathology.
B) Grief-related depression should be assessed within a cultural context.
C) An emic (insider) perspective supports culturally safe care.
D) Her beliefs suggest poor insight and denial of depression.
E) Somatic complaints in this context are uncommon.
Correct: A, B, C
D is incorrect: It reflects a cultural model of suffering, not denial.
E is incorrect: Somatization is common in many global contexts.
4. Case: OCD or PTSD?
A 25-year-old ER nurse reports repeated thoughts about dying patients. She checks door
locks compulsively and avoids anything related to work.
Which statements apply?
A) These are flashbacks and meet PTSD diagnostic criteria.
B) Repetitive checking may indicate OCD if driven by obsessional fear.
C) PTSD and OCD may coexist and require differential diagnosis.
D) Her behavior is likely malingering due to occupational stress.
E) Detailed history is critical to distinguish between trauma response and intrusive
obsessions.
Correct: B, C, E
A is incorrect: Recurrent thoughts aren't necessarily flashbacks.
D is inappropriate: There’s no evidence of secondary gain.
5. Case: Gestalt in Action
A patient repeatedly says, “I just want to disappear,” but smiles and jokes throughout the
session. The therapist senses incongruence.
What Gestalt-informed approaches are appropriate?
A) Draw attention to the emotional disconnect in the here-and-now.
B) Assign a thought record to challenge the statement.
C) Invite the client to “become” the feeling of disappearance.
, NSG 527 STUDY QUESTIONS
D) Explore the contradiction as a figure-ground phenomenon.
E) Redirect to past childhood memories.
Correct: A, C, D
B is CBT, not Gestalt.
E may be useful later, but not core to Gestalt's present-focus.
6. Case: Bipolar Disorder or Borderline Personality?
A 29-year-old woman reports unstable relationships, impulsive spending, and chronic
feelings of emptiness. Her mood shifts rapidly within hours, often triggered by
interpersonal events.
Which are TRUE regarding this presentation?
A) Affective instability that is reactive to interpersonal stressors is typical of BPD.
B) Bipolar disorder is more likely due to rapid cycling moods.
C) DBT is considered first-line therapy for BPD.
D) Splitting and identity disturbance are common features of BPD.
E) BPD can be ruled out if the patient does not engage in self-harm.
Correct: A, C, D
B is incorrect: Bipolar shifts usually last days to weeks.
E is false: Self-harm is common but not required for BPD diagnosis.
7. Case: Existential Crisis
A 58-year-old man facing retirement expresses, “I don't know who I am anymore. Work
was my life.” He denies suicidal ideation but reports feeling empty.
Which of the following are most aligned with Existential Therapy?
A) Explore themes of meaning, freedom, and responsibility.
B) Facilitate reflection on identity beyond occupational roles.
C) Identify and restructure distorted automatic thoughts.
D) Normalize existential anxiety as part of the human condition.
E) Recommend long-term psychodynamic analysis.
Correct: A, B, D
C is CBT, not Existential.
E may help, but isn’t central to Existential's active approach to meaning.
1. Case: Delusional Content in Context
A 34-year-old male reports that the government implanted a chip in his head to control his
thoughts. He has poor insight and a history of paranoid schizophrenia.
Which of the following statements are TRUE?
A) This belief qualifies as a non-bizarre delusion.
B) Dopamine dysregulation is a core neurochemical feature of this presentation.
C) Antipsychotic medication is indicated as first-line.
D) Cognitive Behavioral Therapy alone can replace pharmacotherapy.
E) His impaired insight is a typical feature of psychosis.
Correct: B, C, E
A is false: This is a bizarre delusion.
D is false: CBT can supplement but not replace medication in schizophrenia.
2. Case: Trauma and Attachment
A 7-year-old foster child exhibits emotional numbing, frequent outbursts, and difficulty
trusting adults. History reveals prolonged neglect and inconsistent caregiving.
Which statements reflect best-practice understanding?
A) The child’s behavior is likely rooted in disrupted attachment patterns.
B) These symptoms are more consistent with ADHD than trauma.
C) Dyadic Developmental Psychotherapy (DDP) is an appropriate intervention.
D) The child is likely operating outside their window of tolerance.
E) Behavior modification with strict discipline will promote security.
Correct: A, C, D
B is incorrect: ADHD may overlap, but trauma is more consistent with relational
patterns here.
E is incorrect: Strict discipline may reinforce fear and mistrust.
3. Case: Mood and Cultural Framing
A 42-year-old Haitian woman presents with fatigue, sadness, and GI upset after losing her
mother. She denies being “depressed” but says she is “spiritually sick.”
, NSG 527 STUDY QUESTIONS
What considerations should the PMHNP make?
A) Her expression of distress may reflect cultural idioms rather than psychopathology.
B) Grief-related depression should be assessed within a cultural context.
C) An emic (insider) perspective supports culturally safe care.
D) Her beliefs suggest poor insight and denial of depression.
E) Somatic complaints in this context are uncommon.
Correct: A, B, C
D is incorrect: It reflects a cultural model of suffering, not denial.
E is incorrect: Somatization is common in many global contexts.
4. Case: OCD or PTSD?
A 25-year-old ER nurse reports repeated thoughts about dying patients. She checks door
locks compulsively and avoids anything related to work.
Which statements apply?
A) These are flashbacks and meet PTSD diagnostic criteria.
B) Repetitive checking may indicate OCD if driven by obsessional fear.
C) PTSD and OCD may coexist and require differential diagnosis.
D) Her behavior is likely malingering due to occupational stress.
E) Detailed history is critical to distinguish between trauma response and intrusive
obsessions.
Correct: B, C, E
A is incorrect: Recurrent thoughts aren't necessarily flashbacks.
D is inappropriate: There’s no evidence of secondary gain.
5. Case: Gestalt in Action
A patient repeatedly says, “I just want to disappear,” but smiles and jokes throughout the
session. The therapist senses incongruence.
What Gestalt-informed approaches are appropriate?
A) Draw attention to the emotional disconnect in the here-and-now.
B) Assign a thought record to challenge the statement.
C) Invite the client to “become” the feeling of disappearance.
, NSG 527 STUDY QUESTIONS
D) Explore the contradiction as a figure-ground phenomenon.
E) Redirect to past childhood memories.
Correct: A, C, D
B is CBT, not Gestalt.
E may be useful later, but not core to Gestalt's present-focus.
6. Case: Bipolar Disorder or Borderline Personality?
A 29-year-old woman reports unstable relationships, impulsive spending, and chronic
feelings of emptiness. Her mood shifts rapidly within hours, often triggered by
interpersonal events.
Which are TRUE regarding this presentation?
A) Affective instability that is reactive to interpersonal stressors is typical of BPD.
B) Bipolar disorder is more likely due to rapid cycling moods.
C) DBT is considered first-line therapy for BPD.
D) Splitting and identity disturbance are common features of BPD.
E) BPD can be ruled out if the patient does not engage in self-harm.
Correct: A, C, D
B is incorrect: Bipolar shifts usually last days to weeks.
E is false: Self-harm is common but not required for BPD diagnosis.
7. Case: Existential Crisis
A 58-year-old man facing retirement expresses, “I don't know who I am anymore. Work
was my life.” He denies suicidal ideation but reports feeling empty.
Which of the following are most aligned with Existential Therapy?
A) Explore themes of meaning, freedom, and responsibility.
B) Facilitate reflection on identity beyond occupational roles.
C) Identify and restructure distorted automatic thoughts.
D) Normalize existential anxiety as part of the human condition.
E) Recommend long-term psychodynamic analysis.
Correct: A, B, D
C is CBT, not Existential.
E may help, but isn’t central to Existential's active approach to meaning.
