NURS 631 Exam Questions and Answers Latest Update 2025-2026
low differentation - Answers differentiation might feel guilty or anxious saying "no" to family,
even if it's the right choice for them
high differntation - Answers can say "no" kindly and confidently, without cutting off or feeling
overwhelmed.
Strategic - Answers o focuses on solving problems by changing patterns of behavior, not by
exploring deep psychological causes. It uses direct interventions and planned strategies to shift
dysfunctional dynamics quickly and effectively.
▪ Ex: Clingy patient who has good insight. To counteract these feelings, the therapist may ask to
schedule times for neediness or interrupt their pattern
Cognitive triad - Answers o Negative thoughts about self, others and future
Behavioral action - Answers o therapeutic approach, primarily used in treating depression, that
focuses on increasing engagement in positive, meaningful activities to improve mood and
reduce avoidance (short walks, hobbies)
Corrective Recapitulation of the Primary Family Group - Answers o Re-experiencing and working
through family dynamics within the group.
catharsis - Answers Expressing and releasing pent-up emotions.
Existential Factors (Yalom) - Answers o Confronting realities such as responsibility, mortality,
and freedom.
Group developmental stages - Answers forming, storming, norming, performing, adjourning
conflict person centered therapy - Answers o conflict is an internal tension related to self-
concept discrepancies. The therapist's role is to provide a supportive, empathic environment
that helps clients explore and resolve these conflicts authentically. (unconditional positive
regard, congruence, empathy)
congruence - Answers genuineness and authenticity—being real and transparent with the client
rather than putting on a professional facade
Bottom-Up vs. Top-Down Processing - Answers o Wheeler emphasizes the need to address
both bottom-up (body/brainstem) and top-down (cognitive/cortical) pathways in trauma
treatment. o Bottom-up approaches: grounding, sensory work, somatic therapy
o Top-down approaches: CBT, narrative therapy, insight-based work
, Polyvagal Theory Integration - Answers o Wheeler draws on Stephen Porges' polyvagal theory,
explaining trauma responses through the autonomic nervous system:
EMDR - Answers Eye-movement Desensitization & Reprocessing. New treatment for PTSD,
client imagines the traumatic event and processes it in a non-threatening manner.
Lamotrigine - Answers 6 week therapeutic dose (start low and slow)
-no interaction with atomoxetine and escitalopram
mirtazapine - Answers therapeutic dose 15 - 45
-adequate trial = 3 months
zoloft - Answers good for depression with melancholic features
venlafaxine - Answers for tx resistant depression (SNRI)
-For more severe depression with melancholic features ▪ Initial: 37.5-75 mg PO once daily ▪
Target: 150-225 mg PO once daily ▪ Monitor for blood pressure increases
SSRI for OCD - Answers • Depression: Sertraline 50-100 mg o OCD: Sertraline 150-200 mg or
higher
-• Continue 1-2 years after remission before considering taper
• High relapse risk with shorter duration
Temazepam (Restoril) - Answers -Medium acting
-Benzodiazepine - binds to GABA-A
-contraindicated with copd = respiratory depression
-While effective for short-term management of insomnia, long-term use is associated with
tolerance (which she is experiencing), dependence, and adverse effects
zolpidem - Answers 5mg for women (slower metabolism) and 10mg for men
-Selective for BZ1 receptors, causing fewer muscle relaxant and cognitive effects than
benzodiazepines. Selectively bind to the alpha-1 subunit of GABA-A receptors (BZ1 receptors)
-generic available (costs less)
Fluoxetine for bulemia - Answers 60mg vs 20mg for depression
bupropion - Answers increases seizure threshold for eating disorders (electrolyte imbalance)
-NDRI
low differentation - Answers differentiation might feel guilty or anxious saying "no" to family,
even if it's the right choice for them
high differntation - Answers can say "no" kindly and confidently, without cutting off or feeling
overwhelmed.
Strategic - Answers o focuses on solving problems by changing patterns of behavior, not by
exploring deep psychological causes. It uses direct interventions and planned strategies to shift
dysfunctional dynamics quickly and effectively.
▪ Ex: Clingy patient who has good insight. To counteract these feelings, the therapist may ask to
schedule times for neediness or interrupt their pattern
Cognitive triad - Answers o Negative thoughts about self, others and future
Behavioral action - Answers o therapeutic approach, primarily used in treating depression, that
focuses on increasing engagement in positive, meaningful activities to improve mood and
reduce avoidance (short walks, hobbies)
Corrective Recapitulation of the Primary Family Group - Answers o Re-experiencing and working
through family dynamics within the group.
catharsis - Answers Expressing and releasing pent-up emotions.
Existential Factors (Yalom) - Answers o Confronting realities such as responsibility, mortality,
and freedom.
Group developmental stages - Answers forming, storming, norming, performing, adjourning
conflict person centered therapy - Answers o conflict is an internal tension related to self-
concept discrepancies. The therapist's role is to provide a supportive, empathic environment
that helps clients explore and resolve these conflicts authentically. (unconditional positive
regard, congruence, empathy)
congruence - Answers genuineness and authenticity—being real and transparent with the client
rather than putting on a professional facade
Bottom-Up vs. Top-Down Processing - Answers o Wheeler emphasizes the need to address
both bottom-up (body/brainstem) and top-down (cognitive/cortical) pathways in trauma
treatment. o Bottom-up approaches: grounding, sensory work, somatic therapy
o Top-down approaches: CBT, narrative therapy, insight-based work
, Polyvagal Theory Integration - Answers o Wheeler draws on Stephen Porges' polyvagal theory,
explaining trauma responses through the autonomic nervous system:
EMDR - Answers Eye-movement Desensitization & Reprocessing. New treatment for PTSD,
client imagines the traumatic event and processes it in a non-threatening manner.
Lamotrigine - Answers 6 week therapeutic dose (start low and slow)
-no interaction with atomoxetine and escitalopram
mirtazapine - Answers therapeutic dose 15 - 45
-adequate trial = 3 months
zoloft - Answers good for depression with melancholic features
venlafaxine - Answers for tx resistant depression (SNRI)
-For more severe depression with melancholic features ▪ Initial: 37.5-75 mg PO once daily ▪
Target: 150-225 mg PO once daily ▪ Monitor for blood pressure increases
SSRI for OCD - Answers • Depression: Sertraline 50-100 mg o OCD: Sertraline 150-200 mg or
higher
-• Continue 1-2 years after remission before considering taper
• High relapse risk with shorter duration
Temazepam (Restoril) - Answers -Medium acting
-Benzodiazepine - binds to GABA-A
-contraindicated with copd = respiratory depression
-While effective for short-term management of insomnia, long-term use is associated with
tolerance (which she is experiencing), dependence, and adverse effects
zolpidem - Answers 5mg for women (slower metabolism) and 10mg for men
-Selective for BZ1 receptors, causing fewer muscle relaxant and cognitive effects than
benzodiazepines. Selectively bind to the alpha-1 subunit of GABA-A receptors (BZ1 receptors)
-generic available (costs less)
Fluoxetine for bulemia - Answers 60mg vs 20mg for depression
bupropion - Answers increases seizure threshold for eating disorders (electrolyte imbalance)
-NDRI
