Question 21

1. 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?

	A.	He will have lapses in his memory of his childhood.
	B.
	C.
	D.	None of the above.

1 points

Question 22

1. 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?

	A.	“Think of something funny every time you feel sad.”
	B.	“My cat passed away last year, and it’s been hard to adjust to her being gone.”
	C.	“It’s important to be mindful of how you feel and then to determine what causes those feelings.”
	D.	B and C

1 points

“A” is the correct answer. According to the therapeutic frame, counseling is terminated if “threats are made or acts of violence are committed against the counselor,” but the immediate threat calls for notification of the police. The safety of the PMHNP is essential. “B,” “C,” and “D,” are incorrect—the patient has made threats to the PMHNP, so the most appropriate response would be reporting the threat to the local police. See Wheeler, K., Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice, Chapter 16 pages 587-588 for further information.

The correct answer is “B.” For patients who are histrionic or overly emotional, the PMHNP contains the emotion rather than allowing it to be expressed freely. For histrionic patients, affect regulation strategies may need to be employed.  See Wheeler, K., Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice, Chapter 5 page 242 for further information

“A” is the correct answer. “Focusing” is a Gestalt therapy technique used to deepen contact with alienated aspects of self. “B” is incorrect—exaggerating body movements is part of the “body awareness” technique. “C” is incorrect—asking Dave what his is experiencing in his body is also part of body awareness. “D” is incorrect because “A” is the correct answer.  See Wheeler, K., Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice, Chapter 10 page 382 for further information.

Question 23

1. 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”?

	A.	“You believe that your weight is a cause of your marital problems.”
	B.
	C.	“You have identified your weight as a problem in your marriage and but believe that losing weight will gain happiness.”
	D.

1 points

Question 24

1. 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?

	A.
	B.	Maintaining meaningful relationships
	C.
	D.	All of the above

1 points

Question 25

1. 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?

	A.	Encourage the patient to continue treatment by using alternative strategies
	B.
	C.	Explain how the originally identified strategies will address the focus problem
	D.	None of the above

1 points

 

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Question 26

1. 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?

	A.	Build a therapeutic alliance
	B.	Build behavioral skills to increase pleasant activities
	C.	Build cognitive skills to challenge negative thinking
	D.	Build social skills to improve problem solving

1 points

Question 27

1. When preparing to terminate a patient, what does the PMHNP do to organize thoughts about the patient’s progress made during treatment?

	A.	Interviews the patient’s family, caregiver, or friends regarding the patient’s progress outside of the sessions
	B.
	C.	Requests a peer to review the patient’s file to double check that the PMHNP has not overlooked anything
	D.	All of the above

1 points

Question 28

1. 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?

	A.	“Where are you experiencing unhappiness in your body?
	B.
	C.	“Are you willing to say, ‘I’m having a hard time meeting people’?”
	D.

1 points

Question 29

1. 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?

	A.
	B.	Help the patient be aware of his anxiety and embrace it
	C.
	D.	None of the above

1 points

Question 30

1. 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?

	A.	Incorporate patient preferences as to the type of therapy used
	B.
	C.
	D.	All of the above

1 points

Question 31

1. 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?

	A.	Makes a list of all the positive things the patient gained from treatment
	B.	Does not recognize the patient’s emotions so as to not encourage the onset of anger
	C.	Emphasizes and validates the patient’s feelings of anger that may emerge
	D.	Avoids upsetting the patient by keeping an open door policy

1 points

Question 32

1. 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? Psychiatric Nursing Questions and Answers

	A.	Ask the patient to leave the room to speak with his parents
	B.
	C.	Compliment the patient on his academic achievement
	D.	All of the above

1 points

Question 33

1. 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?

	A.	“For homework, please write a list of qualities you’d find in a good friend.”
	B.
	C.	“Tell me more about why you’re having trouble making new friends at work.”
	D.	All of the above.

1 points

Question 34

1. 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?

	A.	Evaluate the patient for having the coping skills to manage feelings
	B.
	C.
	D.	Have the patient visualize performing the addictive behavior

1 points

Question 35

1. 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.

True

False

1 points

Question 36

1. When recalling the phases of change, the PMHNP demonstrates “open questioning” in the “engagement” phase by making which statement?

	A.
	B.
	C.	“What concerns you the most about these subjects?”
	D.	“What do you want do you want be different?”

1 points

Question 37

1. 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:

	A.	“Focus on your anger, take a deep breath, and allow an image to emerge.”
	B.
	C.
	D.	“Your experience of anger and confusion is normal.”

1 points

Question 38

1. 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?

	A.	Coping question
	B.
	C.	Exception question
	D.

1 points

Question 39

1. 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?

	A.	Transference neurosis has been resolved.
	B.
	C.	Core conflicts have been reduced.
	D.

1 points

Question 40

1. 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?

	A.	Collaborating with the patient’s caregiver to discuss a treatment approach
	B.
	C.
	D.	All of the above

1 points