NURS 6501N Review Test Submission
Review Test Submission: Week 6 Midterm exam
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NURS-6640 Psychotherapy Individ
Week 6 Midterm
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Submitted Answers Question 1 0 out of 1 points
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 _________.
Selected Answer:
B. has an insistent emphasis on the feelings of others
Question 2 1 out of 1 points
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?
Selected Answer:
C. Have a discussion about the confidentiality and its limits
Question 3 1 out of 1 points
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?Selected
Answer:
A.
Encouraging catharsis
Question 4
1 out of 1 points
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?
Selected
Answer:
D.
“I believe in systems; I have to have order and rules in my everyday life.
If a task must be completed, I will often complete it myself versus
depending on someone else.”
Question 5
0 out of 1 points
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?
Selected
Answer:
B.
Focus on expressions of emotion
Question 6
1 out of 1 points
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:
Selected
Answer:
C.
Say, “I noticed a change. Can you tell me what happened?”
Question 7
1 out of 1 points
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)?
Selected
Answer:
B.
“When you say blow up, what exactly does blow up mean and howdoes it feel to you?”
Question 8
1 out of 1 points
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:
Selected
Answer:
B.
“You may experience fear, sweating, and muscle tension.”
Question 9
1 out of 1 points
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:
Selected
Answer:
A.
Observes and points out the behavior
Question 10
1 out of 1 points
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?
Selected
Answer:
C.
Suggest a relaxation technique, such as yoga or meditation
Question 11
0 out of 1 points
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:
Selected
Answer:
D.
“Picture a beautiful beach and describe to me what you see.”
Question 12
1 out of 1 points
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.
Selected
Answer:
Fals
e
Question 131 out of 1 points
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?
Selected
Answer:
D.
Impact of Event Scale
Question 14
1 out of 1 points
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?
Selected
Answer:
C.
Dialectical behavior
therapy
Question 15
0 out of 1 points
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?
Selected
Answer:
D.
Debrief with the patient
Question 16
1 out of 1 points
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?
Selected
Answer:
D.
All of the above
Question 17
1 out of 1 points
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 __________.
Selected
Answer:
A.
overly
nurturing
Question 18
1 out of 1 points
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?
Selected
Answer:
A.
Provide safety through case management strategies
Question 19
0 out of 1 points
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?
Selected
Answer:
C.
Tell the patient that she may not get better if she does not face her
fears
Question 20
1 out of 1 points
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?
Selected
Answer:
A.
Countertransfer
ence
Question 21
1 out of 1 points
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?
Selected
Answer:
B.
The patient is reporting signs of dissociation.
Question 22
1 out of 1 points
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 moreinterventions may help the patient to deal with this arousal. To decrease sympathetic
nervous system arousal, the PMHNP’s treatment strategy is ___________.
Selected
Answer:
D.
all of the above
Question 23
1 out of 1 points
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:
Selected
Answer:
A.
“I was able to eat in public yesterday despite how loudly I chew.”
Question 24
1 out of 1 points
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.
Selected
Answer:
Fals
e
Question 25
1 out of 1 points
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?
Selected
Answer:
C.
Concordant identification
Question 26
1 out of 1 points
A PMHNP is preparing confidentiality forms for his patients. What is the most
appropriate first step he should take?
Selected
Answer:
B.
Research his profession’s ethics code and state/federal laws
Question 271 out of 1 points
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:
Selected
Answer:
A.
Interpreting unconscious conflict in the patient
Question 28
1 out of 1 points
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:
Selected
Answer:
B.
“No, I am not sure what you are saying. Can you please explain?”
Question 29
1 out of 1 points
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
____________.
Selected
Answer:
C.
is ready to move to Stage III, future visioning
Question 30
1 out of 1 points
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:
Selected
Answer:
D.
“What has your wife done to make you believe this?”
Question 31
1 out of 1 points
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?
Selected
A.Answer:
The PMHNP was not protecting patient confidentially rights.
Question 32
1 out of 1 points
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.
Selected
Answer:
Fals
e
Question 33
1 out of 1 points
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?
Selected
Answer:
A.
Begin by having the patient stand in front of the elevator and write
down his feelings
Question 34
1 out of 1 points
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
__________.
Selected
Answer:
A.
deepen the patient’s understanding of herself in order to cultivate
empowerment
Question 35
1 out of 1 points
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?
Selected
Answer:
B.
Mention that the patient seems quite curious, and ask him to discuss
more about himself
Question 36
0 out of 0 pointsWhen completing this exam, did you comply with Walden University’s Code of
Conduct including the expectations for academic integrity?
Selected
Answer:
Ye
s
Question 37
1 out of 1 points
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?
Selected
Answer:
D.
A and B
Question 38
1 out of 1 points
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.
Selected
Answer:
Tru
e
Question 39
1 out of 1 points
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?
Selected
Answer:
A.
“If this had happened to someone else with the exact same
circumstances, would you say this was her fault?”
Question 40
1 out of 1 points
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:Selected Answer:
D. “I feel frustrated when I come home and we argue.”
Question 41 1 out of 1 points
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
Question 42 0 out of 1 points
A 24-year-old female patient presents for her initial appointment with the PMHNP. Which action will the PMHNP take to establish therapeutic alliance?
Selected Answer:
C. Establishing a therapy process
Question 43 0 out of 1 points
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?
Selected Answer:
A. Asking the patient what she does to relieve anxiety Question 44 1 out of 1 points
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?
Selected Answer:
D. Have the patient use the relaxation response (take a deep breath, exhale long, and slow down)
Question 45 [Show Less]