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NURS 6640 MIDTERM EXAM 1,2,3 AND FINAL EXAM 1,2,3,4 / NURS6640 MIDTERM EXAM 1,2,3 AND FINAL EXAM 1,2,3,4 (LATEST)| -WALDEN UNIVERSITY
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NURS 6640 FINAL EXAM 1 / NURS6640 FINAL EXAM 1(LATEST)| -WALDEN UNIVERSITY
NURS 6640 FINAL EXAM 1 / NURS6640 FINAL EXAM 1(LATEST)| -WALDEN UNIVERSITY o Question 1 The PMHNP is actively listening to Ms. Thomas who is detoxi... [Show More] ng 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? o Question 2 The PMHNP continues to meet with Gerald, who is the patient with depression and mood disorder. The PMHNP uses the CBT approach. Gerald is now meeting with the PMHNP for his fifth session and feels comfortable with how the therapy works. What does the PMHNP plan to do with Gerald over the course of the next several sessions? o Question 3 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? o Question 4 A cocaine-addicted female patient is entering residential treatment for substance abuse. Using the 10 guiding principles of recovery, an appropriate step by the PMHNP is to ______________. o Question 5 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? o Question 6 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? o Question 7 Following an attempted suicide, Mr. Durham was admitted to an acute psychiatric facility. After 4 weeks in treatment, he is preparing for discharge. He is beginning to miss individual and group therapy sessions and has refused medications twice in the past 2 days. The PMHNP demonstrates understanding in this phase by saying which of the following statements? o Question 8 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? o Question 9 A patient’s depression is affecting her relationship with her spouse. What might the PMHNP ask during the initial sessions of interpersonal psychotherapy treatment? o Question 10 How does the PMHNP approach termination with the patient who has been receiving intermittent therapy? o Question 11 The PMHNP who practices motivational interviewing understands its relationship to patient behaviors and/or outcomes to mean which of the following? o Question 12 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? o Question 13 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? o Question 14 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. o Question 15 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 same friends I had before I came here for treatment. I’m really afraid of being discharged because I’ll probably run into my old friends again.” The PMHNP offers a complex reflection when she states the following: o Question 16 The PMHNP is in the process of terminating treatment with a patient who witnessed the death of her parent who used to sexually abuse her. What does the PMHNP understand about terminating this patient? o Question 17 A 13-year-old patient and his parents are meeting with a PMHNP. When the PMHNP says hello, the boy just nods. His parents tell the PMHNP that he didn’t want to come to the session, but they insisted. They explain that their son has been moody and depressed at home, but is still getting good grades at school. Which of the following would be the best response by the PMHNP? o Question 18 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: o Question 19 The PMHNP is communicating with a middle-aged male patient who has a history of addiction to Percocet (acetaminophen/oxycodone). The patient suddenly yells, “I do not have a problem with pain pills! I’ve never had an overdose and no one even knows that I take them unless I tell them.” The PMHNP understands that there are phases of change and can best demonstrate “focusing” by responding with: o Question 20 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 ______________. o Question 21 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? o Question 22 The PMHNP is caring for an adult male patient whose wife left him several months ago. He recently learned that his ex-wife is dating someone much younger. The man feels belittled, sad, and lonely. He talks about trying to meet other women, but says, “I can’t compete with the younger guys these days, with the cool clothes and the vegan diets. I’m bald and overweight, and what woman is going to want to be with me?” How does the PMHNP help raise the man’s self-esteem? o Question 23 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? o Question 24 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? o Question 25 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? o Question 26 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 ____________. o Question 27 A PMHNP is using Gestalt therapy to communicate with a 50-year-old patient who is going through a divorce. As he is calmly sharing the details of his divorce, the PMHNP notices that Dave is tapping his fingers on his legs. What is an appropriate response by the PMHNP using the technique of focusing? o Question 28 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 feeling “forgetful” and complains that he has a hard time remembering where he puts things. What is the primary action by the PMHNP? o Question 29 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: o Question 30 A PMHNP is assessing a 40-year-old patient named Sarah who has a severe cocaine addiction and mild depression. Using the four-quadrant model, what would be the most appropriate setting to help the patient? o Question 31 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? o Question 32 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? o Question 33 When recalling the phases of change, the PMHNP demonstrates “open questioning” in the “engagement” phase by making which statement? o Question 34 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? o Question 35 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? o Question 36 When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? o Question 37 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? o Question 38 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? o Question 39 A PMHNP is treating a 12-year-old girl who witnessed the physical abuse of her sibling. She has been anxious and irritable since the experience. After speaking with the PMHNP, the patient says she keeps having anxiety-causing thoughts about the experience. Using the PRACTICE technique, which skill will best help the patient interrupt these negative thoughts? o Question 40 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? o Question 41 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? o Question 42 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? o Question 43 The PMHNP is terminating treatment for a patient who has been receiving eye movement desensitization and reprocessing (EMDR) therapy. What action does the PMHNP take at the final session to terminate treatment? o Question 44 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? o Question 45 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? o Question 46 A 19-year-old female patient named Anna, who was the victim of child abuse and neglect, is also in treatment for substance abuse. At her most recent appointment, Anna confesses to the PMHNP that she is having romantic fantasies about him, and explains the he is one of the few people she trusts. She believes that he is interested in her as well. What is the most appropriate response by the PMHNP in this situation? o Question 47 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? o Question 48 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? o Question 49 The PMHNP is initiating a plan of care for a patient who requires comprehensive psychotherapy to manage his depression and mood disorder. Throughout the initial sessions, the patient reports feeling as though he cannot be helped. The PMHNP is concerned about premature termination initiated by the patient. What strategy can the PMHNP employ to prevent or reduce premature termination? o Question 50 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”? o Question 51 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? o Question 52 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? o Question 53 The PMHNP is treating an older adult patient who reports symptoms of late-life anxiety. What type of treatment(s) will the PMHNP consider? o Question 54 When preparing to terminate a patient, what does the PMHNP do to organize thoughts about the patient’s progress made during treatment? o Question 55 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? o Question 56 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? o Question 57 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. o Question 58 The PMHNP is initiating a plan of care for Holly, a 73-year-old female patient who has late-life bipolar disorder and reports consuming alcoholic beverages four times per week. What is the focus of Holly’s therapy going to be? o Question 59 A patient is finishing the active treatment phase of interpersonal psychotherapy (IPT). After the PMHNP reminds the patient that she has three sessions left, the patient says nothing, but looks distressed. What would be the best reply by the PMHNP following IPT protocol? o Question 60 The PMHNP uses therapeutic communication skills while ensuring that the patient understands that he has choices. The PMHNP comprehends and practices motivational interviewing. This is best understood as which of the following? o Question 61 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? o Question 62 The PMHNP is interviewing a patient with a history of substance abuse. He has attempted to stop abusing drugs three times before. He states to the PMHNP, “I just cannot change. How can you help me?!” As it applies to change, the PMHNP understands the principle of evocation to mean: o Question 63 A 43-year-old single mother is seeing the PMHNP at the request of her sister. “My sister thinks I need to come here to talk about my feelings,” the patient reports. The PMHNP learns that the patient has three children from three different men, but is unable to collect appropriate child support payments from any of the biological fathers. Additionally, the woman is barely able to afford her apartment or utilities payments. What is the appropriate response from the PMHNP when using the psychodynamic psychotherapy technique? o Question 64 Linda is a 65-year-old patient who has completed initial treatment for alcohol addiction and anxiety problems. She is motivated to continue her treatment gains and have a healthy lifestyle. How would the PMHNP apply a mindfulness approach to this case? o Question 65 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 _________. o Question 66 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? o Question 67 The PMHNP initiates feeling-state therapy to help a 25-year-old patient named Monique who has a compulsive urge to exercise. Using the Feeling-State Addiction Protocol, what is an appropriate next step the PMHNP should take after identifying the specific positive feeling linked with the addictive behavior and its Positive Feeling Score level? o Question 68 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? o Question 69 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? o Question 70 A PMHNP is treating a 25-year-old patient who has a compulsive urge to exercise to excess. When asked to describe why she does so much exercise, she says, “I like the compliments I receive from others on my new level of fitness, and the excitement of getting more attention.” The PMHNP can use feeling-state therapy to help Monique ___________. o Question 71 The PMHNP has been treating a patient who is now being transferred to another provider. What is the appropriate action made by the PMHNP? o Question 72 Mia is a 75-year-old patient who has completed initial treatment for depression. What might a PMHNP ask Mia when using a solution-focused therapy approach? o Question 73 A PMHNP has been treating a 14-year-old patient using interpersonal psychotherapy. The patient has been depressed since the death of his grandmother. To help the patient recover, the PMHNP has told the parents: o Question 74 The PMHNP is meeting with a patient who has been diagnosed with depression. The patient is having trouble adjusting to her new job and hasn’t made any new friends there. What would an appropriate response be by the PMHNP using the interpersonal psychotherapy approach? o Question 75 As part of the PMHNP’s role in the clinic, the PMHNP oversees students that gain clinical experience at the agency. The student is instructed to use the supportive psychodynamic therapy approach with the patient. Which action made by the student causes the PMHNP to intervene, after observing the student interacting with the patient? o Question 76 A 38-year-old patient has been having trouble communicating with his teenage daughter. Using a solution-focused therapy approach, the PMHNP responds by saying, “When was a time that a communication problem could have occurred, but did not?” In this case, what type of question is the PMHNP asking? [Show Less]
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NURS 6640 FINAL EXAM 2 / NURS6640 FINAL EXAM 2(LATEST)| -WALDEN UNIVERSITY
NURS 6640 FINAL EXAM 2 / NURS6640 FINAL EXAM 2(LATEST)| -WALDEN UNIVERSITY NURS 6640 FINAL EXAM 2 • Question 1 A PMHNP is using Gestalt therapy ... [Show More] to communicate with a 50-year-old patient who is going through a divorce. As he is calmly sharing the details of his divorce, the PMHNP notices that Dave is tapping his fingers on his legs. What is an appropriate response by the PMHNP using the technique of focusing? • Question 2 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”? • Question 3 As part of the PMHNP’s role in the clinic, the PMHNP oversees students that gain clinical experience at the agency. The student is instructed to use the supportive psychodynamic therapy approach with the patient. Which action made by the student causes the PMHNP to intervene, after observing the student interacting with the patient? • Question 4 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. • Question 5 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? • Question 6 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? • Question 7 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? • Question 8 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? • Question 9 When preparing to terminate a patient, what does the PMHNP do to organize thoughts about the patient’s progress made during treatment? • Question 10 Linda is a 65-year-old patient who has completed initial treatment for alcohol addiction and anxiety problems. She is motivated to continue her treatment gains and have a healthy lifestyle. How would the PMHNP apply a mindfulness approach to this case? • Question 11 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? • Question 12 The PMHNP is caring for an adult male patient whose wife left him several months ago. He recently learned that his ex-wife is dating someone much younger. The man feels belittled, sad, and lonely. He talks about trying to meet other women, but says, “I can’t compete with the younger guys these days, with the cool clothes and the vegan diets. I’m bald and overweight, and what woman is going to want to be with me?” How does the PMHNP help raise the man’s self-esteem? • Question 13 A 43-year-old single mother is seeing the PMHNP at the request of her sister. “My sister thinks I need to come here to talk about my feelings,” the patient reports. The PMHNP learns that the patient has three children from three different men, but is unable to collect appropriate child support payments from any of the biological fathers. Additionally, the woman is barely able to afford her apartment or utilities payments. What is the appropriate response from the PMHNP when using the psychodynamic psychotherapy technique? • Question 14 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? • Question 15 A PMHNP has been treating a 14-year-old patient using interpersonal psychotherapy. The patient has been depressed since the death of his grandmother. To help the patient recover, the PMHNP has told the parents: • Question 16 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: • Question 17 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? • Question 18 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? • Question 19 A cocaine-addicted female patient is entering residential treatment for substance abuse. Using the 10 guiding principles of recovery, an appropriate step by the PMHNP is to ______________. • Question 20 A PMHNP is assessing a 40-year-old patient named Sarah who has a severe cocaine addiction and mild depression. Using the four-quadrant model, what would be the most appropriate setting to help the patient? • Question 21 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? • Question 22 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: • Question 23 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? • Question 24 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 same friends I had before I came here for treatment. I’m really afraid of being discharged because I’ll probably run into my old friends again.” The PMHNP offers a complex reflection when she states the following: • Question 25 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? • Question 26 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? • Question 27 The PMHNP is treating an older adult patient who reports symptoms of late-life anxiety. What type of treatment(s) will the PMHNP consider? Selected Answer: • Question 28 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? • Question 29 A patient’s depression is affecting her relationship with her spouse. What might the PMHNP ask during the initial sessions of interpersonal psychotherapy treatment? • Question 30 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? • Question 31 The PMHNP who practices motivational interviewing understands its relationship to patient behaviors and/or outcomes to mean which of the following? • Question 32 A PMHNP is treating a 12-year-old girl who witnessed the physical abuse of her sibling. She has been anxious and irritable since the experience. After speaking with the PMHNP, the patient says she keeps having anxiety-causing thoughts about the experience. Using the PRACTICE technique, which skill will best help the patient interrupt these negative thoughts? • Question 33 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? • Question 34 The PMHNP uses therapeutic communication skills while ensuring that the patient understands that he has choices. The PMHNP comprehends and practices motivational interviewing. This is best understood as which of the following? • Question 35 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? • Question 36 The PMHNP is meeting with a patient who has been diagnosed with depression. The patient is having trouble adjusting to her new job and hasn’t made any new friends there. What would an appropriate response be by the PMHNP using the interpersonal psychotherapy approach? • Question 37 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? • Question 38 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 feeling “forgetful” and complains that he has a hard time remembering where he puts things. What is the primary action by the PMHNP? • Question 39 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? • Question 40 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? • Question 41 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? • Question 42 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? • Question 43 The PMHNP is initiating a plan of care for a patient who requires comprehensive psychotherapy to manage his depression and mood disorder. Throughout the initial sessions, the patient reports feeling as though he cannot be helped. The PMHNP is concerned about premature termination initiated by the patient. What strategy can the PMHNP employ to prevent or reduce premature termination? • Question 44 How does the PMHNP approach termination with the patient who has been receiving intermittent therapy? • Question 45 A PMHNP is treating a 25-year-old patient who has a compulsive urge to exercise to excess. When asked to describe why she does so much exercise, she says, “I like the compliments I receive from others on my new level of fitness, and the excitement of getting more attention.” The PMHNP can use feeling-state therapy to help Monique ___________. • Question 46 A 19-year-old female patient named Anna, who was the victim of child abuse and neglect, is also in treatment for substance abuse. At her most recent appointment, Anna confesses to the PMHNP that she is having romantic fantasies about him, and explains the he is one of the few people she trusts. She believes that he is interested in her as well. What is the most appropriate response by the PMHNP in this situation? • Question 47 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 ______________. • Question 48 The PMHNP initiates feeling-state therapy to help a 25-year-old patient named Monique who has a compulsive urge to exercise. Using the Feeling-State Addiction Protocol, what is an appropriate next step the PMHNP should take after identifying the specific positive feeling linked with the addictive behavior and its Positive Feeling Score level? • Question 49 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? • Question 50 Following an attempted suicide, Mr. Durham was admitted to an acute psychiatric facility. After 4 weeks in treatment, he is preparing for discharge. He is beginning to miss individual and group therapy sessions and has refused medications twice in the past 2 days. The PMHNP demonstrates understanding in this phase by saying which of the following statements? • Question 51 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? • Question 52 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? • Question 53 The PMHNP has been treating a patient who is now being transferred to another provider. What is the appropriate action made by the PMHNP? • Question 54 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 ____________. • Question 55 When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? • Question 56 A 38-year-old patient has been having trouble communicating with his teenage daughter. Using a solution-focused therapy approach, the PMHNP responds by saying, “When was a time that a communication problem could have occurred, but did not?” In this case, what type of question is the PMHNP asking? • Question 57 A patient is finishing the active treatment phase of interpersonal psychotherapy (IPT). After the PMHNP reminds the patient that she has three sessions left, the patient says nothing, but looks distressed. What would be the best reply by the PMHNP following IPT protocol? • Question 58 The PMHNP is in the process of terminating treatment with a patient who witnessed the death of her parent who used to sexually abuse her. What does the PMHNP understand about terminating this patient? • Question 59 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? • Question 60 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? • Question 61 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 _________. • Question 62 The PMHNP is terminating treatment for a patient who has been receiving eye movement desensitization and reprocessing (EMDR) therapy. What action does the PMHNP take at the final session to terminate treatment? • Question 63 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? • Question 64 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? • Question 65 When recalling the phases of change, the PMHNP demonstrates “open questioning” in the “engagement” phase by making which statement? • Question 66 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? • Question 67 The PMHNP is communicating with a middle-aged male patient who has a history of addiction to Percocet (acetaminophen/oxycodone). The patient suddenly yells, “I do not have a problem with pain pills! I’ve never had an overdose and no one even knows that I take them unless I tell them.” The PMHNP understands that there are phases of change and can best demonstrate “focusing” by responding with: • Question 68 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? • Question 69 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? • Question 70 The PMHNP is interviewing a patient with a history of substance abuse. He has attempted to stop abusing drugs three times before. He states to the PMHNP, “I just cannot change. How can you help me?!” As it applies to change, the PMHNP understands the principle of evocation to mean: • Question 71 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. • Question 72 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? • Question 73 A 13-year-old patient and his parents are meeting with a PMHNP. When the PMHNP says hello, the boy just nods. His parents tell the PMHNP that he didn’t want to come to the session, but they insisted. They explain that their son has been moody and depressed at home, but is still getting good grades at school. Which of the following would be the best response by the PMHNP? • Question 74 The PMHNP is initiating a plan of care for Holly, a 73-year-old female patient who has late-life bipolar disorder and reports consuming alcoholic beverages four times per week. What is the focus of Holly’s therapy going to be? • Question 75 The PMHNP continues to meet with Gerald, who is the patient with depression and mood disorder. The PMHNP uses the CBT approach. Gerald is now meeting with the PMHNP for his fifth session and feels comfortable with how the therapy works. What does the PMHNP plan to do with Gerald over the course of the next several sessions? • Question 76 Mia is a 75-year-old patient who has completed initial treatment for depression. What might a PMHNP ask Mia when using a solution-focused therapy approach? [Show Less]
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NURS 6640 FINAL EXAM 3 / NURS6640 FINAL EXAM 3(LATEST)| -WALDEN UNIVERSITY
NURS 6640 FINAL EXAM 3 / NURS6640 FINAL EXAM 3(LATEST)| -WALDEN UNIVERSITYNURS 6640 FINAL EXAM 3 Question 1 A PMHNP has been treating a 9-year-old pa... [Show More] tient 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 ____________. Question 2 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? Question 3 A PMHNP is using Gestalt therapy to communicate with a 50-year-old patient who is going through a divorce. As he is calmly sharing the details of his divorce, the PMHNP notices that Dave is tapping his fingers on his legs. What is an appropriate response by the PMHNP using the technique of focusing? Question 4 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? Question 5 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? Question 6 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? Question 7 The PMHNP is caring for an adult male patient whose wife left him several months ago. He recently learned that his ex-wife is dating someone much younger. The man feels belittled, sad, and lonely. He talks about trying to meet other women, but says, “I can’t compete with the younger guys these days, with the cool clothes and the vegan diets. I’m bald and overweight, and what woman is going to want to be with me?” How does the PMHNP help raise the man’s self-esteem? Question 8 The PMHNP uses therapeutic communication skills while ensuring that the patient understands that he has choices. The PMHNP comprehends and practices motivational interviewing. This is best understood as which of the following? Question 9 The PMHNP is terminating treatment for a patient who has been receiving eye movement desensitization and reprocessing (EMDR) therapy. What action does the PMHNP take at the final session to terminate treatment? Question 10 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 feeling “forgetful” and complains that he has a hard time remembering where he puts things. What is the primary action by the PMHNP? Question 11 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? Question 12 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? Question 13 How does the PMHNP approach termination with the patient who has been receiving intermittent therapy? Question 14 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: Question 15 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? Question 16 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? Question 17 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? Question 18 1 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: Question 19 1 out of 1 points Following an attempted suicide, Mr. Durham was admitted to an acute psychiatric facility. After 4 weeks in treatment, he is preparing for discharge. He is beginning to miss individual and group therapy sessions and has refused medications twice in the past 2 days. The PMHNP demonstrates understanding in this phase by saying which of the following statements? Question 20 1 out of 1 points The PMHNP is communicating with a middle-aged male patient who has a history of addiction to Percocet (acetaminophen/oxycodone). The patient suddenly yells, “I do not have a problem with pain pills! I’ve never had an overdose and no one even knows that I take them unless I tell them.” The PMHNP understands that there are phases of change and can best demonstrate “focusing” by responding with: Question 21 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? Question 22 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? Question 23 1 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? Question 24 1 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. Question 25 1 out of 1 points The PMHNP is interviewing a patient with a history of substance abuse. He has attempted to stop abusing drugs three times before. He states to the PMHNP, “I just cannot change. How can you help me?!” As it applies to change, the PMHNP understands the principle of evocation to mean: Question 26 The PMHNP is in the process of terminating treatment with a patient who witnessed the death of her parent who used to sexually abuse her. What does the PMHNP understand about terminating this patient? Question 27 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? Question 28 1 out of 1 points A 19-year-old female patient named Anna, who was the victim of child abuse and neglect, is also in treatment for substance abuse. At her most recent appointment, Anna confesses to the PMHNP that she is having romantic fantasies about him, and explains the he is one of the few people she trusts. She believes that he is interested in her as well. What is the most appropriate response by the PMHNP in this situation? Question 29 1 out of 1 points A 38-year-old patient has been having trouble communicating with his teenage daughter. Using a solution-focused therapy approach, the PMHNP responds by saying, “When was a time that a communication problem could have occurred, but did not?” In this case, what type of question is the PMHNP asking? Question 30 1 out of 1 points The PMHNP is treating an older adult patient who reports symptoms of late-life anxiety. What type of treatment(s) will the PMHNP consider? Question 31 1 out of 1 points A cocaine-addicted female patient is entering residential treatment for substance abuse. Using the 10 guiding principles of recovery, an appropriate step by the PMHNP is to ______________. Question 32 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. Question 33 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 ______________. Question 34 1 out of 1 points The PMHNP is initiating a plan of care for a patient who requires comprehensive psychotherapy to manage his depression and mood disorder. Throughout the initial sessions, the patient reports feeling as though he cannot be helped. The PMHNP is concerned about premature termination initiated by the patient. What strategy can the PMHNP employ to prevent or reduce premature termination? Question 35 1 out of 1 points A PMHNP has been treating a 14-year-old patient using interpersonal psychotherapy. The patient has been depressed since the death of his grandmother. To help the patient recover, the PMHNP has told the parents: Question 36 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? Question 37 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: Question 38 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? Question 39 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? Question 40 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? Question 41 1 out of 1 points When recalling the phases of change, the PMHNP demonstrates “open questioning” in the “engagement” phase by making which statement? B. “What occurred to cause you to seek treatment?” Question 42 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? Question 43 1 out of 1 points Linda is a 65-year-old patient who has completed initial treatment for alcohol addiction and anxiety problems. She is motivated to continue her treatment gains and have a healthy lifestyle. How would the PMHNP apply a mindfulness approach to this case? Question 44 1 out of 1 points 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? Question 45 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? Question 46 1 out of 1 points The PMHNP initiates feeling-state therapy to help a 25-year-old patient named Monique who has a compulsive urge to exercise. Using the Feeling-State Addiction Protocol, what is an appropriate next step the PMHNP should take after identifying the specific positive feeling linked with the addictive behavior and its Positive Feeling Score level? Question 47 1 out of 1 points A patient’s depression is affecting her relationship with her spouse. What might the PMHNP ask during the initial sessions of interpersonal psychotherapy treatment? Question 48 1 out of 1 points 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 _________. Question 49 1 out of 1 points The PMHNP continues to meet with Gerald, who is the patient with depression and mood disorder. The PMHNP uses the CBT approach. Gerald is now meeting with the PMHNP for his fifth session and feels comfortable with how the therapy works. What does the PMHNP plan to do with Gerald over the course of the next several sessions? Question 50 A PMHNP is treating a 25-year-old patient who has a compulsive urge to exercise to excess. When asked to describe why she does so much exercise, she says, “I like the compliments I receive from others on my new level of fitness, and the excitement of getting more attention.” The PMHNP can use feeling-state therapy to help Monique ___________. Question 51 A 43-year-old single mother is seeing the PMHNP at the request of her sister. “My sister thinks I need to come here to talk about my feelings,” the patient reports. The PMHNP learns that the patient has three children from three different men, but is unable to collect appropriate child support payments from any of the biological fathers. Additionally, the woman is barely able to afford her apartment or utilities payments. What is the appropriate response from the PMHNP when using the psychodynamic psychotherapy technique? Question 52 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? Question 53 A 13-year-old patient and his parents are meeting with a PMHNP. When the PMHNP says hello, the boy just nods. His parents tell the PMHNP that he didn’t want to come to the session, but they insisted. They explain that their son has been moody and depressed at home, but is still getting good grades at school. Which of the following would be the best response by the PMHNP? Question 54 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? Question 55 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? Question 56 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? Question 58 A patient is finishing the active treatment phase of interpersonal psychotherapy (IPT). After the PMHNP reminds the patient that she has three sessions left, the patient says nothing, but looks distressed. What would be the best reply by the PMHNP following IPT protocol? Question 59 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: Question 60 The PMHNP who practices motivational interviewing understands its relationship to patient behaviors and/or outcomes to mean which of the following? Question 61 A PMHNP is treating a 12-year-old girl who witnessed the physical abuse of her sibling. She has been anxious and irritable since the experience. After speaking with the PMHNP, the patient says she keeps having anxiety-causing thoughts about the experience. Using the PRACTICE technique, which skill will best help the patient interrupt these negative thoughts? Question 62 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? Question 63 The PMHNP is meeting with a patient who has been diagnosed with depression. The patient is having trouble adjusting to her new job and hasn’t made any new friends there. What would an appropriate response be by the PMHNP using the interpersonal psychotherapy approach? Question 64 The PMHNP is initiating a plan of care for Holly, a 73-year-old female patient who has late-life bipolar disorder and reports consuming alcoholic beverages four times per week. What is the focus of Holly’s therapy going to be? Question 65 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 same friends I had before I came here for treatment. I’m really afraid of being discharged because I’ll probably run into my old friends again.” The PMHNP offers a complex reflection when she states the following: Question 66 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: Question 67 A PMHNP is assessing a 40-year-old patient named Sarah who has a severe cocaine addiction and mild depression. Using the four-quadrant model, what would be the most appropriate setting to help the patient? Question 68 Mia is a 75-year-old patient who has completed initial treatment for depression. What might a PMHNP ask Mia when using a solution-focused therapy approach? Selected Answer: Question 69 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? Question 70 As part of the PMHNP’s role in the clinic, the PMHNP oversees students that gain clinical experience at the agency. The student is instructed to use the supportive psychodynamic therapy approach with the patient. Which action made by the student causes the PMHNP to intervene, after observing the student interacting with the patient? Question 71 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? Question 72 When preparing to terminate a patient, what does the PMHNP do to organize thoughts about the patient’s progress made during treatment? Question 73 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? Question 74 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? Question 75 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? Question 76 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: [Show Less]
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NURS 6640 FINAL EXAM 4 / NURS6640 FINAL EXAM 4(LATEST)| -WALDEN UNIVERSITY
NURS 6640 FINAL EXAM 4 / NURS6640 FINAL EXAM 4(LATEST)| -WALDEN UNIVERSITYNURS 6640 FINAL EXAM 4 Question 1 A PMHNP is using interpersonal psychot... [Show More] herapy 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? Question 2 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? Question 3 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? Question 4 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? Question 5 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 _________. Question 6 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? Question 7 The PMHNP is meeting with a patient who has been diagnosed with depression. The patient is having trouble adjusting to her new job and hasn’t made any new friends there. What would an appropriate response be by the PMHNP using the interpersonal psychotherapy approach? Question 8 The PMHNP is initiating a plan of care for a patient who requires comprehensive psychotherapy to manage his depression and mood disorder. Throughout the initial sessions, the patient reports feeling as though he cannot be helped. The PMHNP is concerned about premature termination initiated by the patient. What strategy can the PMHNP employ to prevent or reduce premature termination? Question 9 A PMHNP is assessing a 40-year-old patient named Sarah who has a severe cocaine addiction and mild depression. Using the four-quadrant model, what would be the most appropriate setting to help the patient? Question 10 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”? Question 11 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? Question 12 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 ______________. Question 13 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: Question 14 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. Question 15 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? Question 16 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? Question 17 A 43-year-old single mother is seeing the PMHNP at the request of her sister. “My sister thinks I need to come here to talk about my feelings,” the patient reports. The PMHNP learns that the patient has three children from three different men, but is unable to collect appropriate child support payments from any of the biological fathers. Additionally, the woman is barely able to afford her apartment or utilities payments. What is the appropriate response from the PMHNP when using the psychodynamic psychotherapy technique? Question 18 Following an attempted suicide, Mr. Durham was admitted to an acute psychiatric facility. After 4 weeks in treatment, he is preparing for discharge. He is beginning to miss individual and group therapy sessions and has refused medications twice in the past 2 days. The PMHNP demonstrates understanding in this phase by saying which of the following statements? Question 19 When preparing to terminate a patient, what does the PMHNP do to organize thoughts about the patient’s progress made during treatment? Question 20 The PMHNP uses therapeutic communication skills while ensuring that the patient understands that he has choices. The PMHNP comprehends and practices motivational interviewing. This is best understood as which of the following? Question 21 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? Question 22 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? Question 23 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? Question 24 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? Question 25 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? Question 26 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? Question 27 A patient is finishing the active treatment phase of interpersonal psychotherapy (IPT). After the PMHNP reminds the patient that she has three sessions left, the patient says nothing, but looks distressed. What would be the best reply by the PMHNP following IPT protocol? Question 28 The PMHNP is initiating a plan of care for Holly, a 73-year-old female patient who has late-life bipolar disorder and reports consuming alcoholic beverages four times per week. What is the focus of Holly’s therapy going to be? Question 29 The PMHNP is in the process of terminating treatment with a patient who witnessed the death of her parent who used to sexually abuse her. What does the PMHNP understand about terminating this patient? Question 30 The PMHNP is treating an older adult patient who reports symptoms of late-life anxiety. What type of treatment(s) will the PMHNP consider? Question 31 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? Question 32 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? Question 33 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? Question 34 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? Question 35 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? Question 36 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? Question 37 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 same friends I had before I came here for treatment. I’m really afraid of being discharged because I’ll probably run into my old friends again.” The PMHNP offers a complex reflection when she states the following: Question 38 The PMHNP is communicating with a middle-aged male patient who has a history of addiction to Percocet (acetaminophen/oxycodone). The patient suddenly yells, “I do not have a problem with pain pills! I’ve never had an overdose and no one even knows that I take them unless I tell them.” The PMHNP understands that there are phases of change and can best demonstrate “focusing” by responding with: Question 39 The PMHNP initiates feeling-state therapy to help a 25-year-old patient named Monique who has a compulsive urge to exercise. Using the Feeling-State Addiction Protocol, what is an appropriate next step the PMHNP should take after identifying the specific positive feeling linked with the addictive behavior and its Positive Feeling Score level? Question 40 Linda is a 65-year-old patient who has completed initial treatment for alcohol addiction and anxiety problems. She is motivated to continue her treatment gains and have a healthy lifestyle. How would the PMHNP apply a mindfulness approach to this case? Question 41 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? Question 42 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? Question 43 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? Question 44 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? Question 45 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? Question 46 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? Question 47 A PMHNP is treating a 12-year-old girl who witnessed the physical abuse of her sibling. She has been anxious and irritable since the experience. After speaking with the PMHNP, the patient says she keeps having anxiety-causing thoughts about the experience. Using the PRACTICE technique, which skill will best help the patient interrupt these negative thoughts? Question 48 The PMHNP is terminating treatment for a patient who has been receiving eye movement desensitization and reprocessing (EMDR) therapy. What action does the PMHNP take at the final session to terminate treatment? Question 49 A PMHNP is treating a 25-year-old patient who has a compulsive urge to exercise to excess. When asked to describe why she does so much exercise, she says, “I like the compliments I receive from others on my new level of fitness, and the excitement of getting more attention.” The PMHNP can use feeling-state therapy to help Monique ___________. Question 50 When recalling the phases of change, the PMHNP demonstrates “open questioning” in the “engagement” phase by making which statement? Question 51 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. Question 52 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? Question 53 How does the PMHNP approach termination with the patient who has been receiving intermittent therapy? Question 54 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? Question 55 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? 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 ____________. Question 57 The PMHNP is caring for an adult male patient whose wife left him several months ago. He recently learned that his ex-wife is dating someone much younger. The man feels belittled, sad, and lonely. He talks about trying to meet other women, but says, “I can’t compete with the younger guys these days, with the cool clothes and the vegan diets. I’m bald and overweight, and what woman is going to want to be with me?” How does the PMHNP help raise the man’s self-esteem? Question 58 A PMHNP has been treating a 14-year-old patient using interpersonal psychotherapy. The patient has been depressed since the death of his grandmother. To help the patient recover, the PMHNP has told the parents: Question 59 A 38-year-old patient has been having trouble communicating with his teenage daughter. Using a solution-focused therapy approach, the PMHNP responds by saying, “When was a time that a communication problem could have occurred, but did not?” In this case, what type of question is the PMHNP asking? Question 60 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: Question 61 The PMHNP who practices motivational interviewing understands its relationship to patient behaviors and/or outcomes to mean which of the following? Question 62 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? Question 63 The PMHNP has been treating a patient who is now being transferred to another provider. What is the appropriate action made by the PMHNP? Question 64 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? Question 65 When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Question 66 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? Question 67 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 feeling “forgetful” and complains that he has a hard time remembering where he puts things. What is the primary action by the PMHNP? Question 68 A patient’s depression is affecting her relationship with her spouse. What might the PMHNP ask during the initial sessions of interpersonal psychotherapy treatment? Question 69 A 19-year-old female patient named Anna, who was the victim of child abuse and neglect, is also in treatment for substance abuse. At her most recent appointment, Anna confesses to the PMHNP that she is having romantic fantasies about him, and explains the he is one of the few people she trusts. She believes that he is interested in her as well. What is the most appropriate response by the PMHNP in this situation? Question 70 Mia is a 75-year-old patient who has completed initial treatment for depression. What might a PMHNP ask Mia when using a solution-focused therapy approach? Question 71 As part of the PMHNP’s role in the clinic, the PMHNP oversees students that gain clinical experience at the agency. The student is instructed to use the supportive psychodynamic therapy approach with the patient. Which action made by the student causes the PMHNP to intervene, after observing the student interacting with the patient? Question 72 The PMHNP continues to meet with Gerald, who is the patient with depression and mood disorder. The PMHNP uses the CBT approach. Gerald is now meeting with the PMHNP for his fifth session and feels comfortable with how the therapy works. What does the PMHNP plan to do with Gerald over the course of the next several sessions? Question 73 A 13-year-old patient and his parents are meeting with a PMHNP. When the PMHNP says hello, the boy just nods. His parents tell the PMHNP that he didn’t want to come to the session, but they insisted. They explain that their son has been moody and depressed at home, but is still getting good grades at school. Which of the following would be the best response by the PMHNP? Question 74 A PMHNP is using Gestalt therapy to communicate with a 50-year-old patient who is going through a divorce. As he is calmly sharing the details of his divorce, the PMHNP notices that Dave is tapping his fingers on his legs. What is an appropriate response by the PMHNP using the technique of focusing? Question 75 A cocaine-addicted female patient is entering residential treatment for substance abuse. Using the 10 guiding principles of recovery, an appropriate step by the PMHNP is to ______________. Question 76 The PMHNP is interviewing a patient with a history of substance abuse. He has attempted to stop abusing drugs three times before. He states to the PMHNP, “I just cannot change. How can you help me?!” As it applies to change, the PMHNP understands the principle of evocation to mean: [Show Less]
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NURS 6640 MIDTERM EXAM 1 / NURS6640 MIDTERM EXAM 1(LATEST)| -WALDEN UNIVERSITY
NURS 6640 MIDTERM EXAM 1 / NURS6640 MIDTERM EXAM 1(LATEST)| -WALDEN UNIVERSITY Question 1 The PMHNP is caring for a patient who the PMHNP believes would ... [Show More] benefit from a relational psychodynamic approach to therapy. Which action made by the PMHNP demonstrates appropriate use and understanding of the relationship psychodynamic model? Question 2 After informing a prospective patient about limits of confidentiality, the patient consents to the “conditions” of confidentiality and signs an informed consent form. Several weeks later, a lawyer representing the patient’s spouse for a court case, asks the PMHNP for the disclosure of information about the patient. The PMHNP should: Question 3 An initial evaluation reveals that an 11-year-old patient has moved to a new school after her parents’ recent divorce, and is having trouble making friends. The patient has normal mental status and exhibits appropriate behavior. What is the most appropriate scale for the PMHNP to use to get more information? Question 4 The PMHNP has been treating a 15-year-old patient with a history of abuse and neglect. Thirty minutes into their therapy session the patient jumps up and begins to pace around the room. Utilizing Socratic dialogue (SD) the PMHNP’s best action would be to: Question 5 A PMHNP is treating a 50-year-old patient who suffers from depression. When he was growing up, he was often responsible for taking care of his three younger siblings. Since then, the patient puts other people’s needs before his own. Based on this information, the PMHNP would conclude that his interpersonal style is __________. Question 6 At the initial interview with a patient, the PMHNP reviews the condition of receiving services, including limits that will be imposed on confidentiality. During the discussion, the patient shares information that the PMHNP is legally required to report. True or false: If the PMHNP does not report information that s/he is legally required to report, state laws govern the consequences which include penalties for not reporting, especially child and elder abuse. Question 7 The PMHNP is meeting with a new patient who is a young veteran back from serving two tours overseas. When reviewing the patient’s health history file that was sent from the VA, the PMHNP learns that several months ago, the patient was diagnosed with PTSD, but never followed up with treatment for it. After a comprehensive mental health assessment, the PMHNP confirms the PTSD diagnosis and understands that which therapeutic approach will be the most effective as a first-line treatment modality? Question 8 True or false: A PMHNP may ask his patient to describe her relationship with her father, both as a child and now, in order to assess interpersonal style. Question 9 When conducting an initial assessment, a PMHNP has finished conducting a mental status examination with 10 minutes left in the session. The patient is distressed and would like to continue sharing her personal history. True or false: An appropriate response that the PMHNP might tell the patient is, “I understand that you are upset. [Summarizes diagnosis, treatment recommendations, and follow-up plan.] We can continue the conversation next week. How does this time next Monday work for you?” Question 10 The PMHNP is caring for a patient with borderline personality disorder. Using a psychoanalytic psychotherapy approach, the PMHNP attempts to intensify the patient’s transference to enhance emotional processing by: Question 11 During a therapy session with an 18-year-old female the PMHNP learns that she has lived in six different foster homes in the last 24 months. She states that her mother is in a correctional facility for drug abuse and prostitution. During the assessment, the PMHNP notices multiple superficial cuts to each wrist. The patient appears tearful, withdrawn, and never makes direct eye contact. The PMHNP believes that this patient may have feelings of insecurities as well as abandonment issues and is aware that which diagnosis is likely possible? Question 12 A 35-year-old patient seeks treatment for depression and anxiety after an abusive relationship. To help empower the patient, the PMHNP wants to teach the safe-place exercise to create a feeling of calm. In order to walk the patient through the exercise, the PMHNP first says: Question 13 The PMHNP is caring for a patient who seems to seek affection and attention from the PMHNP and others in the clinic, as well as displays heightened emotional responses to feelings of being excluded. What therapeutic approach does the PMHNP use to decrease autonomic arousal in the patient? Question 14 A 28-year-old male patient is experiencing distress related to the workplace. What might the PMHNP ask to assess affective development? Question 15 During cognitive behavioral therapy (CBT), a 64-year-old male patient, states, “My wife hates me! She’s just waiting for me to die.” Using Socratic dialogue (SD) the PMHNP demonstrates understanding of analysis when she responds: Question 16 The PMHNP is meeting with a 38-year-old divorced, single mother who has been seeing the PMHNP for anxiety and anger management. During one of the sessions, the patient tells the PMHNP that she is having a problem getting her child support payments from her ex-husband, which is triggering increased anxiety and anger, which she admittedly takes out on her children. How does the PMHNP respond in a way that upholds the supportive psychodynamic psychotherapy approach? Question 17 The PMHNP is working with an adult patient who has somatic complaints caused by a history of childhood abuse. As part of the therapeutic process, what does the PMHNP do to assess and organize a trauma history? Question 18 A 16-year-old female patient has had a stable therapeutic relationship with the PMHNP for several months. The PMHNP notices what appears to be fresh cigarette burns on the patient’s arm. When asked, the patient admits to this self-injurious behavior. Although the patient is still depressed, her mood seems to be somewhat better this week. True or false: The PMHNP would most likely consider this patient stabilized and ready to move to Stage II. Question 19 A PMHNP has been working with a young female patient who suffers from depression to change self-defeating behaviors. By creating a presence of acceptance and using good listening skills, the PMHNP’s overall goal is to __________. Question 20 The PMHNP meets with a 47-year-old male patient who is fearful of leaving the house after having witnessed his neighbor getting run over by a car. When the PMHNP asks why he is afraid to leave his house, the patient replies, “Because another accident might occur.” Which cognitive behavioral therapy (CBT) strategy does the PMHNP employ? Question 21 The PMHNP is working with a patient who experiences anxiety around her parents that later leads to poor impulse control. What will the PMHNP do to employ psychodynamic psychotherapy properly for this patient? Question 22 A PMHNP is taking a history and wants to assess how the patient copes with adversity. To do so, the therapist asks questions about the patient’s belief system. What would be an appropriate question to ask? Question 23 A middle-aged man who works over 50 hours a week is being seen for depression and anger management. He states, “I am even more frustrated when I come home and my wife wants to argue about stupid stuff. All I want to do is come home, take a shower, and eat. Is that too much to ask?” The PMHNP explains that people can be assertive, aggressive, and passive. She encourages the patient to be more assertive and begins role-play with assertive training. The PMHNP determines that the patient is beginning to understand when he states: Question 24 The PMHNP is working with a 43-year-old male patient who develops idiosyncratic transference over weeks of therapy. The best way for the PMHNP to respond to this patient is to ___________: Question 25 In your office, you see a 58-year-old patient with PTSD who reports having nightmares, making it impossible for her to sleep. What recommendations based on principles of sleep hygiene will the PMHNP make? Question 26 The PMHNP is working with a patient who has dissociative disorder and requests pharmacological interventions for dealing with her trauma. What education does the PMHNP provide to the patient regarding medication therapy? Question 27 A PMHNP is treating a 45-year-old female patient who is upset that her brother has not been calling since his divorce. When asked to describe her brother and what prompts him not to call as frequently, she says, “Everything is about him, not me. I think he’s jealous that I have a good marriage and he wants me to be unhappy, too. So he doesn’t call to upset me and ruin my relationships.” Based on this information, the PMHNP can conclude that the patient _________. Question 28 The PMHNP is working with a school-aged child who has been diagnosed with depression. The child has attended several sessions with the PMNHP, but recently presents with avoidant behavior by showing increased distress and being late to sessions. What approach does the PMHNP need to employ with the child to continue making therapeutic progress? Question 29 A PMHNP is assessing ego functioning of his 40-year-old patient by asking what she feels is the cause of her problems. She attributes her problems to her overprotective parents not letting her have enough freedom growing up. Based on her answer, the PMHNP is testing _____________. Question 30 The PMHNP meets with an adolescent patient who has depression and often presents with resistance when discussing his parent’s divorce. For the past couple of sessions, the patient has been quiet, sometimes refusing to speak. To further support the therapeutic relationship, the PMNHP: Question 31 When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Question 32 The PMHNP understands that anxiety and depression are two disorders in which their symptoms may overlap. When discussing this, you explain that the autonomic nervous system is activated and further helps distinguish anxiety symptoms by making the following points: Question 33 Your patient is a 65-year-old male who has a strained relationship with his son and daughter. His children refuse to participate in a family session. The PMHNP asks the patient to draw his family genogram as a next step to _______________. Question 34 A patient who has borderline personality disorder is meeting with the PMHNP. When asked about future goals, the patient responds, “I’d like to go back to school to do what you do. You know, talk to people all day about their problems. It seems pretty easy.” How does the PHMNP respond to the client in a way that is free from any stigmatizing beliefs or judgments? Question 35 A 35-year-old patient has been seeking treatment for depression for several months. The PMHNP does an assessment to see if processing has led to adaptive change. The patient’s self-references are positive in relation to past events, work is productive, relationships are adaptive, and there is congruence between behavior, thoughts, and affect. Based on this information, the PMHNP decides the patient ____________. Question 36 A 24-year-old female patient presents for her initial appointment with the PMHNP. Which action will the PMHNP take to establish therapeutic alliance? Question 37 The PMHNP is assessing a patient who grew up in a foster home because she was neglected and abused by her birth parents at a young age. The patient admits to having difficulty forming and maintaining relationships throughout her life. Understanding maladaptive schemas, which statement does the PMHNP predict that the patient is likely to make? Question 38 The PMHNP is caring for a patient with dissociated self-state that the PMHNP identifies as being associated with traumatic experiences in the patient’s past. What approach does the PMHNP use with the patient that is crucial to the psychodynamic therapy process? Question 39 The patient is a 56-year-old female patient diagnosed with panic disorder and reports symptoms that include heart palpitations, frequent trembling, and feelings of choking in stressful situations. What special consideration does the PMHNP make? Question 40 The PMHNP is working with a patient who is living in poverty and abusing substances. According to the treatment hierarchy framework, what needs does the PMHNP need to attend to first? Question 41 When a PMHNP is seeing a patient for the first time, what is an important step to assure that the patient and provider understand the limits of their discussion? Question 42 During cognitive behavioral therapy (CBT), a 64-year-old male patient states, “I get so frustrated sometimes and I just blow up at everybody!” Which response by the PMHNP demonstrates translation of Socratic dialogue (SD)? Question 43 The PMHNP has been assisting a shy and timid 23-year-old male patient struggling with esteem and self-concept issues. Over the weekend, this patient was given the task of completing an exercise that would usually cause him distress and shame, also called a shame-attacking exercise. The PMHNP determines that this task has successfully been achieved when the patient states: Question 44 The PMHNP is working with a patient who experiences abreactions when discussing repressed feelings of his sexual abuse as a child. What can the PMHNP do to manage the patient’s intense emotional reactions? Question 45 The PMHNP is meeting with a 42-year-old man with depression brought on by the recent passing of his wife. As he describes the circumstances surrounding his late wife’s death, the PMHNP begins to feel sad. The sadness lingers for several hours, and the PMHNP finds it difficult to focus on other patients for the rest of the day. What is the most appropriate explanation for the reaction that the PMHNP is experiencing? Question 46 During a session, the PMHNP asks a patient with a history of sexual abuse to recall the relationship she had as a child with her parents. The patient responds by saying she has a headache and her stomach hurts, and starts talking about her physical ailments. What is the appropriate response by the PMHNP? Question 47 A PMHNP’s patients have already signed confidentiality agreements, including limits that will be imposed on confidentiality. Months later, the state’s laws have changed that affect confidentiality promises the PMHNP has already made. What is an appropriate step for the PMHNP to take after finding out this information? Question 48 The PMHNP is working with a patient who has insomnia and battles going to sleep. The patient reports consistent self-defeating behaviors, and hates trying to go to sleep. Which action made by the PMHNP demonstrates the use of a paradoxical intervention? Question 49 When the patient comes into the office, she says, “I just saw a friend of mine out in the waiting room. What’s wrong with him?” The PMHNP says, “He’ll be fine. He has mild depression.” Which of the following statement is correct related to confidentiality rights? Question 50 The PMHNP is mentoring a student. After working with a patient during a session, the student laments about all the things she should have, or could have, said to the patient. “I feel guilty that I didn’t speak up more about the patient’s concern toward her son,” says the student. The PMHNP understands that the student is exhibiting signs of which therapeutic concept? Question 51 The PMHNP is having a therapy session with Charlotte, a 20-year-old victim of date rape. The patient states, “I shouldn’t have been there; I should have just gone home. This was all my fault; how could I have been so stupid?” Using the Socratic method, what is the PMHNP’s best response? Question 52 An 11-year-old patient has been exhibiting low self-esteem at school and acting out. According to Maslow’s hierarchy of needs, which of the following questions would best be addressed first by the PMHNP? Question 53 The PMHNP is treating a 35-year-old male officer in the military. He discloses that both of his parents are deceased and that he loved them. However, he says that he had feelings of inadequacy because his parents held him to a standard that he could never achieve. He went on to say that nothing he did ever felt good enough. The PMHNP assesses that this patient has perfect creases in his uniform with no strings or tags out of place; she also notices that he has perfect posture and questions him about ritualistic behaviors. She suspects that this patient has maladaptive responses to the expectations placed on him as a teenager and young adult. Which statements made by the patient would verify the PMHNP’s suspicion? Question 54 The PMHNP is caring for a patient who has acute stress disorder after experiencing a traumatic event 1 week prior. The PMHNP wants to begin with a therapeutic framework that follows the adaptive information processing (AIP) model. What is the priority action for the PMHNP to take? Question 55 A patient named Steve is seeking therapy to get help with his home situation, stating that he has been stressed since his mother-in-law moved into the house. What can the PMHNP do to assist the patient in constructing a narrative? Question 56 One of the strategies the PMHNP wants to try includes sleep restriction. What will the PMHNP suggest to follow sleep restriction therapy? Question 57 The PMHNP is conducting a peer review of another PMHNP’s medical charts. Upon review, the PMHNP notes that the peer often begins patient sessions late, as well as ends them later than scheduled. The PMHNP also found a comment in the chart regarding the patient sending text messages while in the middle of the session. Based on these findings, the feedback that the PMHNP will provide to the peer involves which therapeutic principle? 32.The PMHNP is mentoring a student. After working with a patient during a session, the student laments about all the things she should have, or could have, said to the patient. “I feel guilty that I didn’t speak up more about the patient’s concern toward her son,” says the student. The PMHNP understands that the student is exhibiting signs of which therapeutic concept? Question 58 A PMHNP is caring for a 21-year-old woman who is suffering from anxiety and is having difficulty managing stress. Which of the following would be an appropriate step by the PMHNP? Question 59 The PMHNP has a session with a patient who was injured and traumatized from an explosion at the industrial plant where he used to work. During the session, an outside noise startles the patient and he experiences a flashback of the loud boom from the explosion. The PMHNP witnesses the patient present with anxiety and belabored breathing. What is the appropriate action of the PMHNP? Question 60 The patient attempts the PMHNP’s sleep hygiene recommendations for 2 weeks, but does not make any progress mitigating nightmares and hyperarousal. Which behavioral strategy does the PMHNP suggest next? Question 61 The PMHNP is treating a patient with a substantial fear of feeling closed in (claustrophobia). Thus, the patient will not get into an elevator. The office where he works is on the 10th floor and this requires that he walk up and down the stairs in the morning and evening to get to his office. With permission from the patient, the PMHNP is beginning systematic desensitization to address the patient’s need to use the elevator. What is the PMHNP’s best plan of action? Question 62 The PMHNP is working with a veteran who has posttraumatic stress disorder (PTSD). The PMHNP believes that dual awareness will be beneficial in allowing the patient to focus on the here and now. What strategies can the PMHNP use to develop dual awareness in the patient? Question 63 The PMHNP is working with a patient who witnessed her father pass away after suffering for several months from terminal cancer. The PMHNP sees this as a traumatic event. The patient reports sometimes feeling out of touch with surroundings; almost as if things feel like a dream. “Sometimes that sensation lingers for a while,” the patient says, “and other times I snap out of it quickly.” What does the PMHNP infer about the condition based on psychotherapy concepts for trauma? Question 64 The PMHNP is working with a patient who seems dissatisfied with the therapeutic relationship. The PMHNP invites the patient to discuss her feelings regarding the PMHNP openly and honestly. It becomes clear to the PMHNP that they are experiencing an alliance rupture. How does the PMHNP repair the therapeutic alliance? Question 65 A new patient has been informed of the limits of confidentiality, and has signed informed consent forms. No consent, however, has been obtained for voluntary “Release of Information.” The patient is 20 years old and still lives at home with his parents. He is being treated for depression, which he attributes to the trouble he’s had finding employment. True or false: If the patient’s mother calls the PMHNP to check up on her son to see how he is doing, the therapist is required to protect patient confidentiality and not disclose information. Question 66 True or false: If after a third round of processing followed by stabilization, a patient has increased anxiety that requires further interventions aimed at stabilization, the therapeutic relationship can no longer successfully provide therapeutic change. Question 67 You are seeing a 29-year-old widow whose husband recently died overseas while serving his country in the military. She has been mourning the loss of her husband for several months, and continues to grieve. She refuses to go to group grieving sessions, but reports that she is still able to go to work and her fitness classes sometimes, and even makes attempts to stay social. She says, “Sometimes it’s like he’s not even gone. Other times it feels like it’s been an eternity since I’ve seen him. It’s hard to talk about this type of stuff with my girlfriends, especially since all of their husbands are still alive.” The PMHNP understands that it is appropriate to employ which therapeutic principle? Question 68 A 41-year-old male patient is meeting with the PMHNP and reveals that he is homosexual. He begins telling the PMHNP about his feelings as a homosexual, middle-aged man. The PMHNP nods understandingly. Before long, the patient asks, “Are you gay? Are you married? Do you have kids?” What is the best response by the PMHNP? Question 69 A PMHNP is preparing confidentiality forms for his patients. What is the most appropriate first step he should take? Question 70 During a clinical assessment of a 15-year-old patient, the PMHNP asks, “How can I help you?” The patient answers by saying, “Honestly, I don’t really think I need any help.” Which of the following is the most appropriate response by the PMHNP? Question 71 An elderly patient in a nursing home has been losing interest in activities and now refuses to leave his room. After a physical exam, he is referred to a PMHNP for an initial assessment. True or false: After speaking with the patient, an appropriate screening tool for the PMHNP to use would be the Geriatric Depression Scale. Question 72 A 62-year-old patient has been diagnosed with borderline personality disorder. Upon assessment, the PMHNP learns that he participates in spending sprees and occasional binge eating, accompanied by rapid changes in self-image. Which evidence-based psychotherapeutic model does the PMHNP identify as effective and beneficial? Question 73 During a therapy session the patient is asked how she currently deals with stress, and she says, “Well, I don’t. I just let it build and build.” The PMHNP responds by asking how well this has been working out for her. The patient states, “Well, to be honest, it just feels like I’m drowning, you know what I mean.” Illustrating idiosyncratic meaning, the PMHNP responds with: Question 74 A 65-year-old patient has suffered the loss of his wife. He is in a state of hyperarousal with increased sympathetic nervous system arousal. One or more interventions may help the patient to deal with this arousal. To decrease sympathetic nervous system arousal, the PMHNP’s treatment strategy is ___________. Question 75 The PMHNP employs psychodynamic psychotherapy with a patient who experiences anxiety and depression. As the process enters the psychoanalytic end of the psychodynamic continuum, the PMNHP will focus on: Question 76 The PMHNP is working with a 56-year-old man who is being seen because of his anxiety and depression. During the therapy sessions, the PMHNP assists the patient in discussing his experiences and expanding on his thoughts and feelings. He tells the PMHNP stories about how he used to be teased by his coworkers at the office for becoming too anxious in large conference rooms. The PMHNP listens to the patient and helps focus on his strengths to promote self-understanding. Which principle best accounts for the PMHNP’s interactions with the patient? Selected Answer: A. Therapeutic communication Tuesday, October 2, 2018 10:30:32 PM EDT [Show Less]
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NURS 6640 MIDTERM EXAM 3 / NURS6640 MIDTERM EXAM 3(LATEST)| -WALDEN UNIVERSITY
NURS 6640 MIDTERM EXAM 3 / NURS6640 MIDTERM EXAM 3(LATEST)| -WALDEN UNIVERSITY
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