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
... [Show More] would be a .
Selected Answer:
D.
mental health system of care
The PMHNP uses the cognitive behavioral therapy model with Gerald, an older adult patient who is being treated for depression and mood disorder. What will the PMHNP do with the patient during the first three sessions?
Selected Answer:
A.
Build a therapeutic alliance
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?
Selected Answer:
C.
“Tell me more about why you’re having trouble making new friends at work.”
A PMHNP is using motivational interviewing (MI) with a 50-year-old patient named Dave to commit to a healthy drug-free lifestyle. By using “change talk,” the PMHNP hopes to help the patient build self-esteem and hope.
True or false: If Dave is resisting change, the PMHNP should challenge his resistance in order for MI to be successful.
Selected Answer:
Fals e
The PMHNP uses the Adult Attachment Interview (AAI) with a male patient who reports having had a difficult time being separated from his parents during his childhood. He explains that going to school or visiting his relatives without his parents was troublesome. The PMHNP characterizes the patient as unresolved/disorganized, according to his outcomes on the AAI. What does the PMHNP anticipate from the patient?
Selected Answer:
A.
He will have lapses in his memory of his childhood.
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:
Selected Answer:
D.
“I am wondering if your use of pain medication has ever prompted you to seek medical attention.”
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?
Selected Answer:
B.
Affect modulation
The PMHNP assesses a 27-year-old patient named Jeff, who was a victim of child abuse and neglect. Jeff says that he remembers a traumatic situation that he wants to share, but is having trouble talking about it. Which statement made by the PMHNP demonstrates the use of emotion-focused therapy?
Selected Answer:
A.
“Let’s see if we can come up with some ideas for you to feel safe telling your story.”
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 .
Selected Answer:
D.
all of the above
The PMHNP is caring for a young adult patient with whom the PMHNP decides to use a dynamic supportive therapy approach in addition to pharmacological intervention. Which therapeutic action will the PMHNP take to employ the strategy of holding and containing the patient?
Selected Answer:
B.
Asking the patient how the patient feels
A PMHNP is using emotion-focused therapy to help a 38-year-old patient who says, “I’ve been feeling angry lately, but I’m not sure why.” The first attempt by the PMHNP
is to say:
Selected Answer:
A.
“Focus on your anger, take a deep breath, and allow an image to emerge.”
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:
Selected Answer:
B.
“Modify your expectations at home and school until the depression lifts.”
The PMHNP is assessing a patient who has been receiving months of outpatient psychotherapy. According to the PMHNP’s assessment, the patient is nearing the termination phase of their therapeutic relationship because the patient’s symptoms have improved, and the patient shows progress managing behaviors and decision- making abilities according to the diagnosis. How does the PMHNP approach termination with this patient?
Selected Answer:
B.
Manage termination issues as part of the treatment
A 35-year-old male patient is being treated for alcohol addiction. He asks for the PMHNP’s cell phone number to use in case of an emergency. When the PMHNP responds that giving her number would be against therapeutic rules, the patient threatens an act of violence to the therapist. What would be the most appropriate response by the PMHNP?
Selected Answer:
A.
Immediately report the threat to the local police department
The PMHNP is assessing a patient who requires cognitive behavioral therapy (CBT). Which of the following statements made by the PMHNP approach the termination phase for this patient?
Selected Answer:
A.
“Although it’s your first session, we will discuss how termination of your treatment will go.”
A 38-year-old patient tells the PMHNP that her father went to jail for selling drugs when she was a child. The patient is visibly upset when discussing what happened. Using a humanistic-existential approach to psychotherapy, which of the following is the most appropriate response by the PMHNP?
Selected Answer:
B.
“What are you experiencing now as you share this story?”
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 .
Selected Answer:
B.
integrate services that encompass mind, body, spirit, and community
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?
Selected Answer:
C.
Suggesting that the patient seek professional legal help
The PMHNP has been providing supportive psychodynamic psychotherapy to a patient and is nearing the termination stage. The PMHNP will use which criteria for determining that the patient is ready for termination?
Selected Answer:
B.
Symptoms have improved.
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 D.
Answer: “What might help you to live a more meaningful life?”
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?
Selected Answer:
A.
Help Linda develop an awareness of triggers in order to have greater control over physical and emotional responses
The PMHNP is actively listening to Ms. Thomas who is detoxing from alcohol. Ms. Thomas is currently discussing with the PMHNP the reasons why she feels guilty about her drinking. Ms. Thomas tearfully states, “I have driven my family and friends away with this terrible habit. I have no one left. I had more than enough chances and now my children won’t even talk to me.” Which of the following statements demonstrate a simple reflection?
Selected Answer:
D.
All the above.
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?
Selected Answer:
C.
Substance abuse treatment system
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?
Selected Answer:
D.
The patient may need to have follow-up sessions every few months.
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 A.
Answer: Employ cognitive behavioral therapy
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?
Selected Answer:
C.
Locate and identify any physical sensations created by the positive feelings
The PMHNP is assessing a 30-year-old client who reports feeling stressed out due to his current employment situation. When asked about how he manages this work- related stress, the patient says that exercise helps him feel less anxious, so he often spends 2 or more hours at the gym each night. After completing the patient assessment, the PMHNP has determined that an existential psychotherapy approach may best benefit this client. What is the PMHNP’s goal in employing this treatment approach?
Selected Answer:
B.
Help the patient be aware of his anxiety and embrace it
The PMHNP is caring for a patient who is histrionic. Using the supportive psychodynamic therapy model, what is the best statement made by the PMHNP?
Selected Answer:
B.
“Let’s not think too much about emotion right now. Let’s focus on what got you upset in the first place.”
A PMHNP is treating a 10-year-old boy who is exhibiting signs of aggression and attention problems. What type of intervention will the PMHNP consider using a common elements approach?
Selected Answer:
D.
All of the above
A patient’s depression is affecting her relationship with her spouse. What might the
PMHNP ask during the initial sessions of interpersonal psychotherapy treatment?
Selected Answer:
D.
All of the above.
The PMHNP who practices motivational interviewing understands its relationship to patient behaviors and/or outcomes to mean which of the following?
Selected Answer:
D.
There is a lower incidence of inconsistent behaviors with motivational interviewing. This is related to client engagement and better outcomes.
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:
D.
All of the above.
A PMHNP is using Gestalt therapy to communicate with a 42-year-old patient who is upset with her mother. She says, “I want to tell her how hurt I feel when she doesn’t call me, but I don’t want to upset her.” What technique can the PMHNP use to help Sasha express herself?
Selected Answer:
B.
Empty-chair dialogue
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?
Selected Answer:
B.
“Have you thought of how you will continue your treatment plans?”
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?
Selected Answer:
D.
“You seem upset. Tell me what seems to be bothering you.”
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?
Selected Answer:
C.
Determining if the patient’s medications can be causing memory problems
The PMHNP is caring for an older patient with major depressive disorder, seasonal pattern. The patient has been resolute about not taking medication to manage the depression brought on by his illness, stating that it is against his yogic lifestyle. In addition to psychotherapy, what can the PMHNP suggest to this patient?
Selected Answer:
A.
“You may want to look into therapeutic oils and aromatherapy as an alternative to medication.”
The PMHNP is working with a patient who describes having a painful and traumatic childhood experience, which causes her to have anxiety as an adult. When asked how she manages her anxiety, the patient dismisses it and denies that it is a problem. Using the supportive psychotherapy approach, the PMHNP will do which of the following when assessing the patient’s ego strength?
Selected Answer:
A.
Identify the primary defenses the patient uses to ward off anxiety
The PMHNP has been treating a patient who is now being transferred to another provider. What is the appropriate action made by the PMHNP?
Selected Answer:
D.
A and C
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?
Selected Answer:
B.
A statement that both challenges the patient’s resistance and offers an opportunity to discuss the issues allows the patient to argue with him/herself to help produce a desired change.
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?
Selected Answer:
D.
All of the above
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?
Selected Answer:
D.
All of the above
A 12-year-old girl was referred for treatment after witnessing the physical abuse of her sibling by their mother. The patient has been anxious and irritable since the experience. What evidence-based treatment would be most appropriate for the PMHNP to use?
Selected Answer:
A.
Trauma-focused CBT
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?
Selected Answer:
C.
Compliment the patient on his academic achievement
How does the PMHNP approach termination with the patient who has been receiving intermittent therapy?
Selected Answer:
D.
A and C
The PMHNP has been providing interpersonal psychotherapy (IPT) for a patient who the PMHNP observes implementing new ways of being, such as interacting more with peers and being less isolated in social scenarios. The PMHNP understands that the patient is approaching termination. How does the PMHNP address termination with this patient?
Selected Answer:
C.
Embed the termination into the work of the therapeutic phase
When preparing to terminate a patient, what does the PMHNP do to organize thoughts about the patient’s progress made during treatment?
Selected Answer:
B.
Reviews the patient’s file to identify issues and important themes that were highlighted throughout treatment
The PMHNP is caring for a patient who experiences depression caused by the traumatic experience of her dog passing away. She reports not being able to eat or sleep, and sometimes doesn’t want to leave the house at all. Which statement is most appropriate for the PMHNP to maximize the patient’s adaptive coping mechanisms?
Selected Answer:
C.
“It’s important to be mindful of how you feel and then to determine what causes those feelings.” [Show Less]