Study guide

Walden University NURS6640 Mid-Term Exam 2. Questions and Answers (

Walden University NURS6640 Mid-Term Exam 2. Questions and Answers Walden University NURS6640 Mid-Term Exam 2. NURS 6640 Walden University NURS6640... [Show More] Mid-Term Exam 2. Questions and Answers (Graded A) Question 1 1 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 _________. Answer: C. has an intrusive interpersonal relationship 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? 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? 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? 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? 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: 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)? Answer: B. “When you say blow up, what exactly does blow up mean and how does 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: 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: 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? 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: 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. Answer: False Question 13 1 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? 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? 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? 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? 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 __________. 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? 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? 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? Answer: A. Countertransference 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? 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 more interventions may help the patient to deal with this arousal. To decrease sympathetic nervous system arousal, the PMHNP’s treatment strategy is ___________. 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: 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. Answer: False 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? 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? Answer: B. Research his profession’s ethics code and state/federal laws Question 27 1 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: 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: 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 ____________. 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: 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? Answer: A. 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. Answer: False 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? 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 __________. 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? Answer: B. Mention that the patient seems quite curious, and ask him to discuss more about himself Question 36 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? Answer: Yes 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? 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. Answer: True 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? 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: 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? 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? Answer: C. Establishing a therapy process Question 43 0 out of 1 points [Show Less]

Preview 4 out of 37 pages