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A study guide for the nur6640 final exam focusing on the therapeutic approaches and interventions used by a psychiatric-mental health nurse practitioner (pmhnp). It includes various scenarios and questions related to different therapeutic modalities such as interpersonal psychotherapy, supportive psychodynamic psychotherapy, gestalt therapy, motivational interviewing, cognitive behavioral therapy, and emotion-focused therapy. The guide also covers topics like termination, substance abuse treatment, and therapeutic communication skills.
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Question 1
1 out of 1 points
A PMHNP is using interpersonal psychotherapy with a 40-year-old patient having relationship problems with his extended family. The patient shares that he has been using the strategies they identified to reduce his distress, but they have not been helping. He is frustrated and is considering stopping treatment. What would be an appropriate step by the PMHNP?
Selected Answer: A.
Encourage the patient to continue treatment by using alternative strategies
Question 2
0 out of 1 points
The PMHNP has been providing supportive psychodynamic psychotherapy to a patient and is nearing the termination stage. The PMHNP will use which criteria for determining that the patient is ready for termination?
Selected Answer: D.
Self-analytic capacity has been developed.
Question 3
1 out of 1 points
A PMHNP is using Gestalt therapy to communicate with a 42-year-old patient who is upset with her mother. She says, “I want to tell her how hurt I feel when she doesn’t call me, but I don’t want to upset her.” What technique can the PMHNP use to help Sasha express herself?
Selected Answer: B.
Empty-chair dialogue
Question 4
1 out of 1 points
The PMHNP is caring for an older patient with major depressive disorder, seasonal pattern. The patient has been resolute about not taking medication to manage the depression brought on by his illness, stating that it is against his yogic lifestyle. In addition to psychotherapy, what can the PMHNP suggest to this patient?
Selected Answer:
Question 5
0 out of 1 points
“You may want to look into therapeutic oils and aromatherapy as an alternative to medication.”
A PMHNP is assessing a 60-year-old patient named Carlos. He has severe PTSD and mild substance abuse issues. The most appropriate setting to treat Carlos would be a.
Selected Answer: A.
primary health care setting with some specialized care
Question 6
1 out of 1 points
The PMHNP is caring for a patient who is histrionic. Using the supportive psychodynamic therapy model, what is the best statement made by the PMHNP?
Selected B. Answer:
A 25-year-old female states, “I really need to lose weight. I know I’m the cause of our problems, if I could just lose weight he might be more attracted to me. Then we could start a family and we would be happy. I’m sure of it, right, we would definitely be happy!” Which statement shows the PMHNP’s ability to apply “summarizing”?
Selected Answer: A.
“You believe that your weight is a cause of your marital problems.”
Question 11
1 out of 1 points
An 8-year-old has been having trouble making friends at school. His parents initiated treatment when he also started acting out at home. Which is the most appropriate step that the PMHNP takes during the assessment process when using an integrated approach?
Selected Answer: D.
All of the above
Question 12
1 out of 1 points
A 21-year-old patient is worried about starting a new job. She talks about her fears of failure and not making friends at the office. Using a person-centered approach, an appropriate response by the PMHNP is to.
Selected Answer: C.
ask the patient to reflect on and explore what she is experiencing
Question 13
0 out of 1 points
A PMHNP is using emotion-focused therapy to help a 38-year-old patient who says, “I’ve been feeling angry lately, but I’m not sure why.” The first attempt by the PMHNP is to say:
Selected Answer: C.
“Please tell me in detail about your anger and confusion.”
Question 14
1 out of 1 points
A PMHNP is using motivational interviewing (MI) with a 50-year-old patient named Dave to commit to a healthy drug-free lifestyle. By using “change talk,” the PMHNP hopes to help the patient build self-esteem and hope. True or false: If Dave is resisting change, the PMHNP should challenge his resistance in order for MI to be successful.
Selected Answer: False
Question 15
1 out of 1 points
The PMHNP is treating an older adult patient who reports experiencing nightmares associated with an automobile accident he was in 20 years ago. As the PMHNP formulates the case using the dynamic supportive therapy model, what questions will the PMHNP use during the session?
Selected Answer: C.
“Let’s talk about what kinds of things are triggering you now.”
Question 16
1 out of 1 points
The PMHNP is caring for an older adult patient who is in the acute phase of schizophrenia. Which therapeutic model will the PMHNP employ with this patient?
Selected Answer: D.
None of the above
Question 17
0 out of 1 points
A 43-year-old single mother is seeing the PMHNP at the request of her sister. “My sister thinks I need
Selected Answer:
A statement that both challenges the patient’s resistance and offers an opportunity to discuss the issues allows the patient to argue with him/herself to help produce a desired change.
Question 21
1 out of 1 points
The PMHNP is meeting with an older, female adult patient and her daughter. The patient has early onset dementia. The daughter expresses concern, saying, “I don’t want you to just stick my mother in a home and give her medicine. I’m worried that’s what people are going to want to do.” What is the best response by the PMHNP to the daughter?
Selected Answer:
Question 22
0 out of 1 points
“The type of treatment depends on the stage of dementia and safety considerations.”
The PMHNP is assessing a patient who requires cognitive behavioral therapy (CBT). Which of the following statements made by the PMHNP approach the termination phase for this patient?
Selected Answer:
Question 23
1 out of 1 points
“Now that you are feeling more stable, let’s talk about terminating these sessions.”
The PMHNP assesses a 27-year-old patient named Jeff, who was a victim of child abuse and neglect. Jeff says that he remembers a traumatic situation that he wants to share, but is having trouble talking about it. Which statement made by the PMHNP demonstrates the use of emotion-focused therapy?
Selected A. Answer:
“Let’s see if we can come up with some ideas for you to feel safe telling your story.”
Question 24
1 out of 1 points
The PMHNP is caring for a geriatric patient who expresses symptoms of gastrointestinal problems, aches and pains, and loss of appetite. The patient reports feeling lonely, as more of his friends have been passing away over the recent months and years. The PMHNP focuses on which therapeutic approach for this patient?
Selected Answer: D.
All of the above
Question 25
1 out of 1 points
The PMHNP is assessing a patient who has been receiving months of outpatient psychotherapy. According to the PMHNP’s assessment, the patient is nearing the termination phase of their therapeutic relationship because the patient’s symptoms have improved, and the patient shows progress managing behaviors and decision-making abilities according to the diagnosis. How does the PMHNP approach termination with this patient?
Selected Answer: B.
Manage termination issues as part of the treatment
Question 26
1 out of 1 points
A 12-year-old girl was referred for treatment after witnessing the physical abuse of her sibling by their mother. The patient has been anxious and irritable since the experience. What evidence-based treatment would be most appropriate for the PMHNP to use?
Selected Answer: A.
Trauma-focused CBT
Question 27
Employ cognitive behavioral therapy
Question 31
1 out of 1 points
While assessing a patient using a humanistic-existential approach, a patient tells the PMHNP, “For the past few weeks, I’ve felt anxious almost every single day.” What would be an appropriate next step by the PMHNP?
Selected Answer: D.
Encourage the patient to clarify by asking, “You constantly feel anxious?”
Question 32
1 out of 1 points
The PMHNP is caring for a young adult patient with whom the PMHNP decides to use a dynamic supportive therapy approach in addition to pharmacological intervention. Which therapeutic action will the PMHNP take to employ the strategy of holding and containing the patient?
Selected Answer: B.
Asking the patient how the patient feels
Question 33
1 out of 1 points
The PMHNP has been providing interpersonal psychotherapy (IPT) for a patient who the PMHNP observes implementing new ways of being, such as interacting more with peers and being less isolated in social scenarios. The PMHNP understands that the patient is approaching termination. How does the PMHNP address termination with this patient?
Selected Answer: C.
Embed the termination into the work of the therapeutic phase
Question 34
0 out of 1 points
The PMHNP is actively listening to Ms. Thomas who is detoxing from alcohol. Ms. Thomas is currently discussing with the PMHNP the reasons why she feels guilty about her drinking. Ms. Thomas tearfully states, “I have driven my family and friends away with this terrible habit. I have no one left. I had more than enough chances and now my children won’t even talk to me.” Which of the following statements demonstrate a simple reflection?
Selected Answer: C.
“You feel that your use of alcohol is a terrible habit.”
Question 35
1 out of 1 points
A 55-year-old patient recovering from substance abuse tells the PMHNP, “It’s impossible to meet new people. I really hate being single.” Using existential psychotherapy, what might the PMHNP say next?
Selected Answer: D.
“What might help you to live a more meaningful life?”
Question 36
1 out of 1 points
The PMHNP is caring for a patient who experiences depression caused by the traumatic experience of her dog passing away. She reports not being able to eat or sleep, and sometimes doesn’t want to leave the house at all. Which statement is most appropriate for the PMHNP to maximize the patient’s adaptive coping mechanisms?
Selected Answer:
Question 37
1 out of 1 points
“It’s important to be mindful of how you feel and then to determine what causes those feelings.”
The PMHNP is interviewing a patient who is in the process of successfully completing a substance abuse program. During the interview, the patient states, “I wish I was strong enough to keep the
the PMHNP apply a mindfulness approach to this case?
Selected Answer:
Question 41
1 out of 1 points
Help Linda develop an awareness of triggers in order to have greater control over physical and emotional responses
The PMHNP is assessing a 30-year-old client who reports feeling stressed out due to his current employment situation. When asked about how he manages this work-related stress, the patient says that exercise helps him feel less anxious, so he often spends 2 or more hours at the gym each night. After completing the patient assessment, the PMHNP has determined that an existential psychotherapy approach may best benefit this client. What is the PMHNP’s goal in employing this treatment approach?
Selected Answer: B.
Help the patient be aware of his anxiety and embrace it
Question 42
1 out of 1 points
The PMHNP uses the cognitive behavioral therapy model with Gerald, an older adult patient who is being treated for depression and mood disorder. What will the PMHNP do with the patient during the first three sessions?
Selected Answer: A.
Build a therapeutic alliance
Question 43
1 out of 1 points
A PMHNP is treating a 10-year-old boy who is exhibiting signs of aggression and attention problems. What type of intervention will the PMHNP consider using a common elements approach?
Selected Answer: D.
All of the above
Question 44
1 out of 1 points
The PMHNP is assessing a new geriatric patient who reports symptoms of depression. The PMHNP wants to identify the patient’s symptom severity over time. Which assessment tool will the PMHNP use to collect this data on the patient?
Selected Answer: B.
Montgomery-Asberg Depression Rating Scale
Question 45
0 out of 1 points
A 38-year-old patient tells the PMHNP that her father went to jail for selling drugs when she was a child. The patient is visibly upset when discussing what happened. Using a humanistic-existential approach to psychotherapy, which of the following is the most appropriate response by the PMHNP?
Selected Answer: D.
“Are able to let go of the painful emotions you felt as a child?”
Question 46
1 out of 1 points
The PMHNP meets with a 31-year-old woman who reports feeling as though she is “at her breaking point” with work. The PMHNP learns that the woman works 12-hour days, including one day on the weekend, because she is nervous about company layoffs. “I feel like I need to work myself to death in order to prove that I am valuable to the organization,” the woman says. Using the supportive psychodynamic therapy approach, how does the PMHNP respond?
Selected Answer:
“That must be a very tiring work schedule. How do you feel about working so much?”
When recalling the phases of change, the PMHNP demonstrates “open questioning” in the “engagement” phase by making which statement?
Selected Answer: B.
“What occurred to cause you to seek treatment?”
Question 51
0 out of 1 points
A PMHNP has been working with a 50-year-old patient who has a stressful job and goes to the casino on weekends to play poker with his friends, which he says relieves his stress. Tim admits that he sometimes misses work on Monday when he stays out too late at the casino on Sunday nights. In addition, he once was an avid runner, and has given up running to spend more time gambling. True or false: According to the PMHNP, the desired goal after treatment is not complete abstinence from gambling, but reaching a healthy level of the behavior.
Selected Answer: False
The correct answer was true
Question 52
1 out of 1 points
The PMHNP uses the Adult Attachment Interview (AAI) with a male patient who reports having had a difficult time being separated from his parents during his childhood. He explains that going to school or visiting his relatives without his parents was troublesome. The PMHNP characterizes the patient as unresolved/disorganized, according to his outcomes on the AAI. What does the PMHNP anticipate from the patient?
Selected Answer: A.
He will have lapses in his memory of his childhood.
Question 53
0 out of 1 points
How does the PMHNP approach termination with the patient who has been receiving intermittent therapy?
Selected Answer: A.
Uses the word “interrupt” instead of “terminate” with the patient
Question 54
1 out of 1 points
The PMHNP is working with a patient who describes having a painful and traumatic childhood experience, which causes her to have anxiety as an adult. When asked how she manages her anxiety, the patient dismisses it and denies that it is a problem. Using the supportive psychotherapy approach, the PMHNP will do which of the following when assessing the patient’s ego strength?
Selected Answer: A.
Identify the primary defenses the patient uses to ward off anxiety
Question 55
1 out of 1 points
A 35-year-old male patient is being treated for alcohol addiction. He asks for the PMHNP’s cell phone number to use in case of an emergency. When the PMHNP responds that giving her number would be against therapeutic rules, the patient threatens an act of violence to the therapist. What would be the most appropriate response by the PMHNP?
Selected Answer: A.
Immediately report the threat to the local police department
Question 56
1 out of 1 points
A PMHNP has been treating a 9-year-old patient who was referred by her school. Students are asked to raise their hands before speaking during group discussion, but the patient seems to blurt out what she wants to say without being called on. She also interrupts other children while they are talking instead of waiting her turn. When the patient gets frustrated, she has trouble controlling her emotions and cries often. Based on the initial information provided, the first focus by PMHNP is the child’s.
Selected Answer: B.
In the planning phase of change, a 42-year-old male client who struggles with gambling discusses how he plans to abstain from gambling. He tells the PMHNP, “I am no longer going to carry cash to the casino because you can’t spend what you don’t have.” The PMHNP uses an affirming communication skill when she states:
Selected Answer:
Question 61
1 out of 1 points
“Why don’t we try to deal with your addiction to gambling before you go into a casino to decrease your temptation?”
The PMHNP who practices motivational interviewing understands its relationship to patient behaviors and/or outcomes to mean which of the following?
Selected Answer:
Question 62
There is a lower incidence of inconsistent behaviors with motivational interviewing. This is related to client engagement and better outcomes.
1 out of 1 points
A 21-year-old patient has been having trouble adjusting to college life. She tells the PMHNP that she had five alcoholic drinks at a party this past weekend. She also acknowledges that she drank the same amount of alcohol at a party the previous month. Based on this information, what would the PMHNP most likely recommend?
Selected Answer: D.
None of the above
Question 63
1 out of 1 points
The PMHNP has been treating a patient who is now being transferred to another provider. What is the appropriate action made by the PMHNP?
Selected Answer: D.
A and C
Question 64
1 out of 1 points
The PMHNP is terminating treatment with a patient who is aggressive and has a history of anger. What does the PMHNP do when terminating treatment with this patient?
Selected Answer: C.
Emphasizes and validates the patient’s feelings of anger that may emerge
Question 65
1 out of 1 points
When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?
Selected Answers: Yes
Question 66
1 out of 1 points
The PMHNP is caring for an older adult patient who presents with mixed dysphoric states and whose daughter reports “is becoming more irritable more easily.” When talking with the patient, the PMHNP also recognizes displays of cognitive dysfunction. Which treatment options will the PMHNP most likely suggest?
Selected Answer: D.
Combination of CBT and medication
Question 67
1 out of 1 points
The PMHNP is assessing an older adult male patient with depression and comorbidities. According to the medical chart, the patient takes medication to manage joint and bone pain. The patient reports