NRNP 6645 Final Exam 2022
(Answers and Rationales at the End)
1. The therapeutic frame supports the clinician in which of the following ways? Select all
thatapply.
A . Maintaining a therapeutic stance of neutrality.
B . Maintaining a therapeutic stance of anonymity.
C . Maintaining a therapeutic stance of non-intrusiveness.
D . A and C
2. The advanced practice psychiatric nurse is working with a patient with who is
chronicallysuicidal. The advanced practice psychiatric nurse using a Dialectical Behavior
Therapy (DBT) approach realizes which of the following?
A . Every time the patient has suicidal ideations hospitalization is recommended.
B . To the chronically suicidal patient, hospitalization reinforces the status quo and abdicating
the hard work of change.
C . To the chronically suicidal patient hospitalization frequent hospitalizations allow a safe place
to learn new coping behaviors and promote change.
D . The Advanced practice psychiatric nurse should not be using DBT with a chronically suicidal
patient.
3. The concept of resiliency in child therapies is in direct contrast to which
traditionalapproach for treating children?
A . Family inclusion
B . The concept of recovery
C . Problem-based therapy
D . Interacting systems consideration
4. Stigma of mental illness in the elderly:
A . Has contributed to psychiatric symptoms being expressed with physical
symptoms.
B . Is much more severe in baby boomers than in other elderly cohorts.
C . Is much less an issue in baby boomers than in other elderly cohorts
D . Leads to more discussion of emotions in primary care settings.
5. Which of the following is not consistent with the Psychoanalyst's perspective when
treatingand individual with a personality disorder?
A . It is important to identify and then modify "core" problems when treating individuals with
personality disorders.
B . Personality structures are unconscious and thus mostly unavailable to the individual.
,C . Personality products and processes are within the realm of awareness, accessible to the
individual.
D . Psychoanalytic therapy is an effective treatment for Borderline personality disorder
6. Which of the following statements would not be consistent with the humanistic-
existentialconcept of "holism" ?
A People are unique.
B . The whole is greater than the sum of its parts.
C . Mind, body, spirit work in a unified synergistic fashion.
D . Dysfunctions such as a chemical imbalance must be identified.
7. Which of the following is true about dream work from a Gestalt
perspective?
A . The individual tells the dream in past tense
B . Elements of the dream are viewed using standardized dream symbol
meaning.
C . A dream diary is required to capture all elements of the team.
D . The characters and objects in the dream are projections of the individual whose dream it is.
8. When the advanced practice psychiatric nurse builds a formulation when working
with achild in therapy the advanced practice psychiatric nurse is doing which of the
following?
A . Formulation is a type of play therapy.
B . Formulation is the child's diagnosis.
C . The formulation explains the contexts of the child and family situation, the child's unique
presentation, responses and narratives of the events that shaped the interpretation.
D . The formulation is the treatment plan.
9. In providing psychoeducation to patients in recovery, the advanced practice
psychiatricnurse would not include which of the following?
A . Recovery is a lifelong process of change
B . A patient is considered recovered after 5 years free of substance use.
C . Recovery encompasses dimensions of health, home, purpose and community.
D . Recovery applies to recovery from mental disorder, substance use disorders and behavioral
addictions.
10. Which best describes gerotranscendence?
A Erik Erikson's ninth stage of development .
B . Emphasizes ongoing growth over decrements
C . Focuses on the transition to old-old (80 years and older).
D . Focuses on letting go and coming to terms with end of one's life
11. The advanced practice psychiatric nurse is working with a group of patients in an
outpatientsubstance abuse treatment program. One patient comes to the advanced practice
psychiatric nurse after the group session and asks if the advanced practice psychiatric nurse
would meet at anearby Starbucks to clarify a couple of questions that came up at the end of the
session and fearsrelapse. Which of the following would be consistent with the traditional
therapeutic frame?
A . Given concerns about relapse it would be important to meet with the patient just this one time
and just for 10 minutes but meet in your office.
,B . Remind the patient that one of the rules is not having contact outside of therapy sessions.
C . Agree to meet with patient alone in the group room to resolve any outstanding concerns
fromthe group.
D . Agree to meet with the patient at Starbucks briefly to discuss the unresolved issues, but only
this once and only for 10 minutes.
12. The situation in which increasing amounts of a substance is needed to achieve the
samedesired effect is known as which of the following?
A . Addiction
B . Tolerance
C . Withdrawal
D . Dependence
13. Which of the following describes the basic neurobiological pathways of the reward system
in the brain?
A . Projections from the ventral tegmental area, through the median forebrain and terminate
in the nucleus accumbens where there is a proliferation of dopamine neurons.
B . Projections through the median forebrain, to the ventral tegmental area where there is
aproliferation of dopamine neurons, to the nucleus accumbens.
C . Projections from the nucleus accumbens to the median forebrains where there is
aproliferation of dopamine neurons to the ventral tegmental area.
D . Projections from the median forebrain through the ventral tegmental area to the
nucleusaccumbens where there is a proliferation of dopamine neurons.
14. Evidence supports use of Dialectical Behavior Therapy patients with which of the
followingdiagnoses?
A . Schizophrenia
B . New onset depression
C . Bipolar Affective Disorder
D . Borderline Personality Disorder
15. The existential concept of an openness, readiness, and flexibility to grow and change, which
necessitates a capacity to choose alternatives, and shape one's own destiny as authors of creating
their own world is which of the following?
A . Freedom
B . Responsibility
C . Authenticity
D . Meaning
16. Using a psychodynamic psychotherapy stage oriented model for the treatment of trauma,
theadvanced practice psychiatric nurse would do which of the following in Stage 1?
A . Address safety issues
B . Promote symptoms stabilization
C . Process painful memories
D . A and C
17. The advanced practice psychiatric nurse is working with a patient who states she believes
her boss hates her. After some discussion, it is clear the patient has strong negative feelings
towards her boss. The advanced practice psychiatric nurse working within a Gestalt
framework,recognizes this as an interruption consistent with which of the following?
, A Projection .
B . Retroflection
C . Confluence
D . Deflection
18. The patient in Dialectical Behavior Therapy (DBT) expresses frustration that the skills
taught don't work, the process is taking too long, and is struggling to complete homework.
Theadvanced practice psychiatric nurse using a DBT model would do which of the
following?
A . Validate the patient’s frustration while encouraging and reinforcing use of
skills.
B . Analyze the behaviors and consequences of the behaviors with the patient.
C . Focus on behavioral control and management with emotions as a contextual element.
D . All of the above
19. An organized, consistent set of perceptions about the self, continually influenced by
experience and its interpretation which includes self-worth, self-image and ideal self, is
whichkey concept of person-centered therapy?
A . Belief of human nature
B . Self-concept
C . Actualizing tendency
D . Fully functioning person
20. The advanced practice psychiatric nurse using a Dialectical Behavior Therapy approach
witha patient with Borderline Personality Disorder explains the four essential elements which
includes all but which of the following?
A . Bi-weekly individual therapy sessions for the patient of about 1 hour
each.
B . Weekly group skills training sessions for the patient of 2.5 hours each.
C . Skills coaching via telephone or other electronic means as needed by the patient to manage
Ivivo situations
D . Team consultation to the therapist to maintain treatment fidelity and adherence
Answer & Explanation
Solved by verified expert
1. The therapeutic frame supports the clinician in which of the following ways? Select all
thatapply.
D . A and C
Rationale: B is wrong because it should not be anonymous. Information should be disclosed.
2. The advanced practice psychiatric nurse is working with a patient with who is
chronicallysuicidal. The advanced practice psychiatric nurse using a Dialectical Behavior
Therapy (DBT) approach realizes which of the following?
B . To the chronically suicidal patient, hospitalization reinforces the status quo andabdicating
the hard work of change.
Rationale: Dialectical behavior therapy (DBT) is a type of cognitive behavioral therapy thatcombines
strategies like mindfulness, acceptance, and emotion regulation.
3. The concept of resiliency in child therapies is in direct contrast to which
traditionalapproach for treating children?
(Answers and Rationales at the End)
1. The therapeutic frame supports the clinician in which of the following ways? Select all
thatapply.
A . Maintaining a therapeutic stance of neutrality.
B . Maintaining a therapeutic stance of anonymity.
C . Maintaining a therapeutic stance of non-intrusiveness.
D . A and C
2. The advanced practice psychiatric nurse is working with a patient with who is
chronicallysuicidal. The advanced practice psychiatric nurse using a Dialectical Behavior
Therapy (DBT) approach realizes which of the following?
A . Every time the patient has suicidal ideations hospitalization is recommended.
B . To the chronically suicidal patient, hospitalization reinforces the status quo and abdicating
the hard work of change.
C . To the chronically suicidal patient hospitalization frequent hospitalizations allow a safe place
to learn new coping behaviors and promote change.
D . The Advanced practice psychiatric nurse should not be using DBT with a chronically suicidal
patient.
3. The concept of resiliency in child therapies is in direct contrast to which
traditionalapproach for treating children?
A . Family inclusion
B . The concept of recovery
C . Problem-based therapy
D . Interacting systems consideration
4. Stigma of mental illness in the elderly:
A . Has contributed to psychiatric symptoms being expressed with physical
symptoms.
B . Is much more severe in baby boomers than in other elderly cohorts.
C . Is much less an issue in baby boomers than in other elderly cohorts
D . Leads to more discussion of emotions in primary care settings.
5. Which of the following is not consistent with the Psychoanalyst's perspective when
treatingand individual with a personality disorder?
A . It is important to identify and then modify "core" problems when treating individuals with
personality disorders.
B . Personality structures are unconscious and thus mostly unavailable to the individual.
,C . Personality products and processes are within the realm of awareness, accessible to the
individual.
D . Psychoanalytic therapy is an effective treatment for Borderline personality disorder
6. Which of the following statements would not be consistent with the humanistic-
existentialconcept of "holism" ?
A People are unique.
B . The whole is greater than the sum of its parts.
C . Mind, body, spirit work in a unified synergistic fashion.
D . Dysfunctions such as a chemical imbalance must be identified.
7. Which of the following is true about dream work from a Gestalt
perspective?
A . The individual tells the dream in past tense
B . Elements of the dream are viewed using standardized dream symbol
meaning.
C . A dream diary is required to capture all elements of the team.
D . The characters and objects in the dream are projections of the individual whose dream it is.
8. When the advanced practice psychiatric nurse builds a formulation when working
with achild in therapy the advanced practice psychiatric nurse is doing which of the
following?
A . Formulation is a type of play therapy.
B . Formulation is the child's diagnosis.
C . The formulation explains the contexts of the child and family situation, the child's unique
presentation, responses and narratives of the events that shaped the interpretation.
D . The formulation is the treatment plan.
9. In providing psychoeducation to patients in recovery, the advanced practice
psychiatricnurse would not include which of the following?
A . Recovery is a lifelong process of change
B . A patient is considered recovered after 5 years free of substance use.
C . Recovery encompasses dimensions of health, home, purpose and community.
D . Recovery applies to recovery from mental disorder, substance use disorders and behavioral
addictions.
10. Which best describes gerotranscendence?
A Erik Erikson's ninth stage of development .
B . Emphasizes ongoing growth over decrements
C . Focuses on the transition to old-old (80 years and older).
D . Focuses on letting go and coming to terms with end of one's life
11. The advanced practice psychiatric nurse is working with a group of patients in an
outpatientsubstance abuse treatment program. One patient comes to the advanced practice
psychiatric nurse after the group session and asks if the advanced practice psychiatric nurse
would meet at anearby Starbucks to clarify a couple of questions that came up at the end of the
session and fearsrelapse. Which of the following would be consistent with the traditional
therapeutic frame?
A . Given concerns about relapse it would be important to meet with the patient just this one time
and just for 10 minutes but meet in your office.
,B . Remind the patient that one of the rules is not having contact outside of therapy sessions.
C . Agree to meet with patient alone in the group room to resolve any outstanding concerns
fromthe group.
D . Agree to meet with the patient at Starbucks briefly to discuss the unresolved issues, but only
this once and only for 10 minutes.
12. The situation in which increasing amounts of a substance is needed to achieve the
samedesired effect is known as which of the following?
A . Addiction
B . Tolerance
C . Withdrawal
D . Dependence
13. Which of the following describes the basic neurobiological pathways of the reward system
in the brain?
A . Projections from the ventral tegmental area, through the median forebrain and terminate
in the nucleus accumbens where there is a proliferation of dopamine neurons.
B . Projections through the median forebrain, to the ventral tegmental area where there is
aproliferation of dopamine neurons, to the nucleus accumbens.
C . Projections from the nucleus accumbens to the median forebrains where there is
aproliferation of dopamine neurons to the ventral tegmental area.
D . Projections from the median forebrain through the ventral tegmental area to the
nucleusaccumbens where there is a proliferation of dopamine neurons.
14. Evidence supports use of Dialectical Behavior Therapy patients with which of the
followingdiagnoses?
A . Schizophrenia
B . New onset depression
C . Bipolar Affective Disorder
D . Borderline Personality Disorder
15. The existential concept of an openness, readiness, and flexibility to grow and change, which
necessitates a capacity to choose alternatives, and shape one's own destiny as authors of creating
their own world is which of the following?
A . Freedom
B . Responsibility
C . Authenticity
D . Meaning
16. Using a psychodynamic psychotherapy stage oriented model for the treatment of trauma,
theadvanced practice psychiatric nurse would do which of the following in Stage 1?
A . Address safety issues
B . Promote symptoms stabilization
C . Process painful memories
D . A and C
17. The advanced practice psychiatric nurse is working with a patient who states she believes
her boss hates her. After some discussion, it is clear the patient has strong negative feelings
towards her boss. The advanced practice psychiatric nurse working within a Gestalt
framework,recognizes this as an interruption consistent with which of the following?
, A Projection .
B . Retroflection
C . Confluence
D . Deflection
18. The patient in Dialectical Behavior Therapy (DBT) expresses frustration that the skills
taught don't work, the process is taking too long, and is struggling to complete homework.
Theadvanced practice psychiatric nurse using a DBT model would do which of the
following?
A . Validate the patient’s frustration while encouraging and reinforcing use of
skills.
B . Analyze the behaviors and consequences of the behaviors with the patient.
C . Focus on behavioral control and management with emotions as a contextual element.
D . All of the above
19. An organized, consistent set of perceptions about the self, continually influenced by
experience and its interpretation which includes self-worth, self-image and ideal self, is
whichkey concept of person-centered therapy?
A . Belief of human nature
B . Self-concept
C . Actualizing tendency
D . Fully functioning person
20. The advanced practice psychiatric nurse using a Dialectical Behavior Therapy approach
witha patient with Borderline Personality Disorder explains the four essential elements which
includes all but which of the following?
A . Bi-weekly individual therapy sessions for the patient of about 1 hour
each.
B . Weekly group skills training sessions for the patient of 2.5 hours each.
C . Skills coaching via telephone or other electronic means as needed by the patient to manage
Ivivo situations
D . Team consultation to the therapist to maintain treatment fidelity and adherence
Answer & Explanation
Solved by verified expert
1. The therapeutic frame supports the clinician in which of the following ways? Select all
thatapply.
D . A and C
Rationale: B is wrong because it should not be anonymous. Information should be disclosed.
2. The advanced practice psychiatric nurse is working with a patient with who is
chronicallysuicidal. The advanced practice psychiatric nurse using a Dialectical Behavior
Therapy (DBT) approach realizes which of the following?
B . To the chronically suicidal patient, hospitalization reinforces the status quo andabdicating
the hard work of change.
Rationale: Dialectical behavior therapy (DBT) is a type of cognitive behavioral therapy thatcombines
strategies like mindfulness, acceptance, and emotion regulation.
3. The concept of resiliency in child therapies is in direct contrast to which
traditionalapproach for treating children?
