Exam (elaborations) NUR 6640 Final Exam 1
Week 11 Final Exam
Test Week 11 Final Exam
Started 8/12/20 11:39 AM
Submitted 8/12/20 1:02 PM
Due Date
... [Show More] 8/17/20 1:59 AM
Status Completed
Attempt Score 74 out of 75 points
Time Elapsed 1 hour, 22 minutes out of
2 hours
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Question 1
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?
Selected
Answer:
A.
Help Linda develop an awareness of triggers in order to have greater
control over physical and emotional responses
Question 2
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
_________.
Selected
Answer:
D.
mental health system of care
Question 3
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:
Selected
Answer:
B.
The patient already has everything needed and the PMHNP would like
to help him facilitate his own inner coping.
Question 4
1 out of 1 points
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 workrelated
stress, the patient says that exercise helps him feel less anxious, so he often
spends 2 or more hours at the gym each night. After completing the patient
assessment, the PMHNP has determined that an existential psychotherapy approach
may best benefit this client. What is the PMHNP’s goal in employing this treatment
approach?
Selected
Answer:
B.
Help the patient be aware of his anxiety and embrace
it
Question 5
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?
Selected
Answer:
C.
Locate and identify any physical sensations created by the positive
feelings
Question 6
1 out of 1 points
The PMHNP uses the Adult Attachment Interview (AAI) with a male patient who
reports having had a difficult time being separated from his parents during his
childhood. He explains that going to school or visiting his relatives without his parents
was troublesome. The PMHNP characterizes the patient as unresolved/disorganized,
according to his outcomes on the AAI. What does the PMHNP anticipate from the
patient?
Selected
Answer:
A.
He will have lapses in his memory of his childhood.
Question 7
0 out of 1 points
A PMHNP is using motivational interviewing (MI) with a 50-year-old patient named
Dave to commit to a healthy drug-free lifestyle. By using “change talk,” the PMHNP
hopes to help the patient build self-esteem and hope.
True or false: If Dave is resisting change, the PMHNP should challenge his resistance
in order for MI to be successful.
Selected
Answer:
Tru
e
Question 8
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:
Selected
Answer:
A.
“Focus on your anger, take a deep breath, and allow an image to
emerge.”
Question 9
1 out of 1 points
The PMHNP is actively listening to Ms. Thomas who is detoxing from alcohol. Ms.
Thomas is currently discussing with the PMHNP the reasons why she feels guilty
about her drinking. Ms. Thomas tearfully states, “I have driven my family and friends
away with this terrible habit. I have no one left. I had more than enough chances and
now my children won’t even talk to me.” Which of the following statements
demonstrate a simple reflection?
Selected
Answer:
D.
All the above.
Question 10
1 out of 1 points
The PMHNP is caring for a geriatric patient who expresses symptoms of
gastrointestinal problems, aches and pains, and loss of appetite. The patient reports
feeling lonely, as more of his friends have been passing away over the recent months
and years. The PMHNP focuses on which therapeutic approach for this patient?
Selected
Answer:
D.
All of the above
Question 11
1 out of 1 points
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?
Selected
Answer:
D.
All of the above
Question 12
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?
Selected
Answer:
D.
All of the above
Question 13
1 out of 1 points
The PMHNP is caring for an older adult patient who is in the acute phase of
schizophrenia. Which therapeutic model will the PMHNP employ with this patient?
Selected
Answer:
D.
None of the above
Question 14
1 out of 1 points
The PMHNP uses the cognitive behavioral therapy model with Gerald, an older adult
patient who is being treated for depression and mood disorder. What will the PMHNP
do with the patient during the first three sessions?
Selected
Answer:
A.
Build a therapeutic alliance
Question 15
1 out of 1 points
A PMHNP has been treating a 9-year-old patient who was referred by her school. Students
are asked to raise their hands before speaking during group discussion, but the patient
seems to blurt out what she wants to say without being called on. She also interrupts other
children while they are talking instead of waiting her turn. When the patient gets
frustrated, she has trouble controlling her emotions and cries often. Based on the initial
information provided, the first focus by PMHNP is the child’s ____________.
Selected
Answer:
B.
selfregulation
Question 16
1 out of 1 points
The PMHNP is working with a patient who describes having a painful and traumatic
childhood experience, which causes her to have anxiety as an adult. When asked how
she manages her anxiety, the patient dismisses it and denies that it is a problem.
Using the supportive psychotherapy approach, the PMHNP will do which of the
following when assessing the patient’s ego strength?
Selected
Answer:
A.
Identify the primary defenses the patient uses to ward off anxiety
Question 17
1 out of 1 points
When recalling the phases of change, the PMHNP demonstrates “open questioning” in
the “engagement” phase by making which statement?
Selected
Answer:
B.
“What occurred to cause you to seek
treatment?”
Question 18
1 out of 1 points
A PMHNP is using Gestalt therapy to communicate with a 42-year-old patient who is
upset with her mother. She says, “I want to tell her how hurt I feel when she doesn’t
call me, but I don’t want to upset her.” What technique can the PMHNP use to help
Sasha express herself?
Selected
Answer:
B.
Empty-chair dialogue
Question 19
1 out of 1 points
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?
Selected
Answer:
B.
Discusses all issues that have been addressed
Question 20
1 out of 1 points
The PMHNP is assessing an older adult male patient with depression and
comorbidities. According to the medical chart, the patient takes medication to manage
joint and bone pain. The patient reports 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
Question 21
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?
Selected
Answer:
A.
“Let’s see if we can come up with some ideas for you to feel safe
telling your story.”
Question 22
1 out of 1 points
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:
Selected
Answer:
C.
“You’d like to keep your old friends but know being around them may
lead you to abuse substances again.”
Question 23
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?
Selected
Answer:
C.
Develop cognitive skills to challenge Gerald’s negative thinking
Question 24
0 out of 0 points
When completing this exam, did you comply with Walden University’s Code of
Conduct including the expectations for academic integrity?
Selected
Answers:
Ye
s
Question 25
1 out of 1 points
The PMHNP is terminating treatment with a patient who is aggressive and has a
history of anger. What does the PMHNP do when terminating treatment with this
patient?
Selected
Answer:
C.
Emphasizes and validates the patient’s feelings of anger that may
emerge
Question 26
1 out of 1 points
The PMHNP is meeting with an older, female adult patient and her daughter. The
patient has early onset dementia. The daughter expresses concern, saying, “I don’t
want you to just stick my mother in a home and give her medicine. I’m worried that’s
what people are going to want to do.” What is the best response by the PMHNP to the
daughter?
Selected
Answer:
B.
“The type of treatment depends on the stage of dementia and safety
considerations.”
Question 27
1 out of 1 points
The PMHNP meets with a 31-year-old woman who reports feeling as though she is “at
her breaking point” with work. The PMHNP learns that the woman works 12-hour
days, including one day on the weekend, because she is nervous about company
layoffs. “I feel like I need to work myself to death in order to prove that I am valuable to
the organization,” the woman says. Using the supportive psychodynamic therapy
approach, how does the PMHNP respond?
Selected
Answer:
D.
“That must be a very tiring work schedule. How do you feel about
working so much?”
Question 28
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?
Selected
Answer:
B.
“What are you experiencing now as you share this story?”
Question 29
1 out of 1 points
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.
Question 30
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:
Selected
Answer:
B.
“Modify your expectations at home and school until the depression
lifts.”
Question 31
1 out of 1 points
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
Question 32
1 out of 1 points
A PMHNP is using interpersonal psychotherapy with a 40-year-old patient having
relationship problems with his extended family. The patient shares that he has been
using the strategies they identified to reduce his distress, but they have not been
helping. He is frustrated and is considering stopping treatment. What would be an
appropriate step by the PMHNP?
Selected A.
Answer: Encourage the patient to continue treatment by using alternative
strategies
Question 33
1 out of 1 points
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
Question 34
1 out of 1 points
The PMHNP has been treating a patient who is now being transferred to another
provider. What is the appropriate action made by the PMHNP?
Selected
Answer:
D.
A and C
Question 35
1 out of 1 points
The PMHNP has been providing interpersonal psychotherapy (IPT) for a patient who
the PMHNP observes implementing new ways of being, such as interacting more with
peers and being less isolated in social scenarios. The PMHNP understands that the
patient is approaching termination. How does the PMHNP address termination with
this patient?
Selected
Answer:
C.
Embed the termination into the work of the therapeutic phase
Question 36
1 out of 1 points
A 21-year-old patient has been having trouble adjusting to college life. She tells the
PMHNP that she had five alcoholic drinks at a party this past weekend. She also
acknowledges that she drank the same amount of alcohol at a party the previous
month. Based on this information, what would the PMHNP most likely recommend?
Selected
Answer:
D.
None of the above
Question 37
1 out of 1 points
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.”
Question 38
1 out of 1 points
A 55-year-old patient recovering from substance abuse tells the PMHNP, “It’s
impossible to meet new people. I really hate being single.” Using existential
psychotherapy, what might the PMHNP say next?
Selected
Answer:
D.
“What might help you to live a more meaningful
life?”
Question 39
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.
True or false: According to the PMHNP, the desired goal after treatment is not
complete abstinence from gambling, but reaching a healthy level of the behavior.
Selected
Answer:
Tru
e
Question 40
1 out of 1 points
A 35-year-old male patient is being treated for alcohol addiction. He asks for the
PMHNP’s cell phone number to use in case of an emergency. When the PMHNP
responds that giving her number would be against therapeutic rules, the patient
threatens an act of violence to the therapist. What would be the most appropriate
response by the PMHNP?
Selected
Answer:
A.
Immediately report the threat to the local police department
Question 41
1 out of 1 points
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?
Selected
Answer:
A.
Focusing too heavily on defenses
Question 42
1 out of 1 points
The PMHNP is caring for a patient who is histrionic. Using the supportive
psychodynamic therapy model, what is the best statement made by the PMHNP?
Selected
Answer:
B.
“Let’s not think too much about emotion right now. Let’s focus on what
got you upset in the first place.”
Question 43
1 out of 1 points
In the planning phase of change, a 42-year-old male client who struggles with
gambling discusses how he plans to abstain from gambling. He tells the PMHNP, “I
am no longer going to carry cash to the casino because you can’t spend what you
don’t have.” The PMHNP uses an affirming communication skill when she states:
Selected
Answer:
A.
“Not gambling is a tough habit to break; not carrying cash is a big step
in the right direction.”
Question 44
1 out of 1 points [Show Less]