NRNP 6645 Final Exam / NRNP6645 Final Exam (200+ Questions & Answers)(Latest, 2025):Walden, Exams of Nursing

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NRNP 6645 Final Exam / NRNP6645 Final Exam

(200+ Q & A)(2024-2025):Walden university

NRNP 6645 Final Exam

(Answers and Rationales at the End)

1. The therapeutic frame supports the clinician in which of the following ways? Select all that apply. A. Maintaining a therapeutic stance of neutrality. B. Maintaining a therapeutic stance of anonymity. C. Maintaining a therapeutic stance of nonintrusiveness. D. A and C
2. The advanced practice psychiatric nurse is working with a patient with who is chronically suicidal. The advanced practice psychiatric nurse using a Dialectical Behavior Therapy (DBT) approach realizes which of the following? A. Every time the patient has suicidal ideations hospitalization is recommended. B. To the chronically suicidal patient, hospitalization reinforces the status quo and abdicating the hard work of change. C. To the chronically suicidal patient hospitalization frequent hospitalizations allow a safe place to learn new coping behaviors and promote change. D. The Advanced practice psychiatric nurse should not be using DBT with a chronically suicidal patient.
3. The concept of resiliency in child therapies is in direct contrast to which traditional approach for treating children? A. Family inclusion B. The concept of recovery C. Problem-based therapy D. Interacting systems consideration
4. Stigma of mental illness in the elderly: A. Has contributed to psychiatric symptoms being expressed with physical symptoms. B. Is much more severe in baby boomers than in other elderly cohorts. C. Is much less an issue in baby boomers than in other elderly cohorts D. Leads to more discussion of emotions in primary care settings.
5. Which of the following is not consistent with the Psychoanalyst's perspective when treating and individual with a personality disorder? A. It is important to identify and then modify "core" problems when treating individuals with personality disorders. B. Personality structures are unconscious and thus mostly unavailable to the individual.

A. Addiction B. Tolerance C. Withdraw al D. Dependen ce

13. Which of the following describes the basic neurobiological pathways of the reward system in the brain? A. Projections from the ventral tegmental area, through the median forebrain and terminate in the nucleus accumbens where there is a proliferation of dopamine neurons. B. Projections through the median forebrain, to the ventral tegmental area where there is a proliferation of dopamine neurons, to the nucleus accumbens. C. Projections from the nucleus accumbens to the median forebrains where there is a proliferation of dopamine neurons to the ventral tegmental area. D. Projections from the median forebrain through the ventral tegmental area to the nucleus accumbens where there is a proliferation of dopamine neurons.
14. Evidence supports use of Dialectical Behavior Therapy patients with which of the following diagnoses? A. Schizophrenia B. New onset depression C. Bipolar Affective Disorder D. Borderline Personality Disorder
15. The existential concept of an openness, readiness, and flexibility to grow and change, which necessitates a capacity to choose alternatives, and shape one's own destiny as authors of creating their own world is which of the following? A. Freedom B. Responsibili ty C. Authenticity D. Meaning
16. Using a psychodynamic psychotherapy stage oriented model for the treatment of trauma, the advanced practice psychiatric nurse would do which of the following in Stage 1? A. Address safety issues B. Promote symptoms stabilization C. Process painful memories D. A and C
17. The advanced practice psychiatric nurse is working with a patient who states she believes her boss hates her. After some discussion, it is clear the patient has strong negative feelings towards her boss. The advanced practice psychiatric nurse working within a Gestalt framework, recognizes this as an interruption consistent with which of the following? A Projection. B. Retroflecti on C. Confluenc e D. Deflection
18. The patient in Dialectical Behavior Therapy (DBT) expresses frustration that the skills taught don't work, the process is taking too long, and is struggling to complete homework. The advanced practice psychiatric nurse using a DBT model would do which of the following? A. Validate the patient 's frustration while encouraging and reinforcing use of skills. B. Analyze the behaviors and consequences of the behaviors with the patient. C. Focus on behavioral control and management with emotions as a contextual element. D. All of the above

19. An organized, consistent set of perceptions about the self, continually influenced by experience and its interpretation which includes self-worth, self-image and ideal self, is which key concept of person-centered therapy? A. Belief of human nature B. Self-concept C. Actualizing tendency D. Fully functioning person
20. The advanced practice psychiatric nurse using a Dialectical Behavior Therapy approach with a patient with Borderline Personality Disorder explains the four essential elements which includes all but which of the following? A. Bi-weekly individual therapy sessions for the patient of about 1 hour each. B. Weekly group skills training sessions for the patient of 2.5 hours each. C. Skills coaching via telephone or other electronic means as needed by the patient to manage I vivo situations D. Team consultation to the therapist to maintain treatment fidelity and adherence Share Question Answer & Explanation Solved by verified expert
21. The therapeutic frame supports the clinician in which of the following ways? Select all that apply. D. A and C Rationale: B is wrong because it should not be anonymous. Information should be disclosed.
22. The advanced practice psychiatric nurse is working with a patient with who is chronically suicidal. The advanced practice psychiatric nurse using a Dialectical Behavior Therapy (DBT) approach realizes which of the following? B. To the chronically suicidal patient, hospitalization reinforces the status quo and abdicating the hard work of change. Rationale: Dialectical behavior therapy (DBT) is a type of cognitive behavioral therapy that combines strategies like mindfulness, acceptance, and emotion regulation.
23. The concept of resiliency in child therapies is in direct contrast to which traditional approach for treating children? C. Problem-based therapy Rationale: Compared with the traditional study of child development, which has tended to portray 'normal' and 'abnormal' patterns, a resilience approach offers a more differentiated account. In professional practice, resilience means looking for strengths and opportunities to build on, rather than (or alongside) problems, deficits or psychopathology to be remedied or treated
24. Stigma of mental illness in the elderly: A. Has contributed to psychiatric symptoms being expressed with physical symptoms. Rationale: According to Sartorius, stigma leads to discrimination in the provision of services for physical health problems in older people with mental disorders.

fears relapse. Which of the following would be consistent with the traditional therapeutic frame? C. Agree to meet with patient alone in the group room to resolve any outstanding concerns from the group.

Rationale: This will prevent harm for the nurse and allows help from other patient from the group

12. The situation in which increasing amounts of a substance is needed to achieve the same desired effect is known as which of the following? B. Tolerance Rationale: A person may develop tolerance to a drug when the drug is used repeatedly.
13. Which of the following describes the basic neurobiological pathways of the reward system in the brain? A. Projections from the ventral tegmental area, through the median forebrain and terminate in the nucleus accumbens where there is a proliferation of dopamine neurons. Rationale: The reward pathway of the brain is connected to areas of the brain that control behavior and memory. It begins in the ventral tegmental area, where neurons release dopamine to make you feel pleasure. The brain begins to make connections between the activity and the pleasure, ensuring that we will repeat the behavior.
14. Evidence supports use of Dialectical Behavior Therapy patients with which of the following diagnoses? D. Borderline Personality Disorder Rationale: DBT may be used to treat suicidal and other self-destructive behaviors.
15. The existential concept of an openness, readiness, and flexibility to grow and change, which necessitates a capacity to choose alternatives, and shape one's own destiny as authors of creating their own world is which of the following? A. Freedom Rationale: Freedom allows person to choose alternatives.
16. Using a psychodynamic psychotherapy stage oriented model for the treatment of trauma, the advanced practice psychiatric nurse would do which of the following in Stage 1? C. Process painful memories Rationale: The first few sessions of psychotherapy typically focus on understanding and taking a good relationship history, from childhood up to adulthood.
17. The advanced practice psychiatric nurse is working with a patient who states she believes her boss hates her. After some discussion, it is clear the patient has strong negative feelings towards her boss. The advanced practice psychiatric nurse working within a Gestalt framework, recognizes this as an interruption consistent with which of the following? D. Deflection Rationale: Deflection is attempting to draw attention away from oneself and put that attention onto another person. All ages may engage in deflection. Children try to deflect blame when they are in trouble for negative actions by pointing out a different negative action that a sibling did.

C The existential therapist presents broad existential themes but avoids in-depth . questioning. D The existential psychotherapist is free to draw on techniques from other . psychotherapeutic models. A Shame drives a person to engage in treatment while guilt drives a person to avoid . treatment. B Shame causes a person to perceive self as a failure and guilt causes avoidance of . treatment. C Guilt causes a person to perceive himself as a loser and shame drives a person to . avoid treatment. D Shame drives avoidance from treatment, Guilt often motivates a person to seek . treatment. A Relapse indicates treatment failure. . B Relapse is a persistent risk in addiction. . C Relapse is a characteristic of all chronic medical diseases. . D Relapse is the return to substance use or addictive behaviors after periods . of abstinence. A IPT is not an appropriate model for treating depression in older adults. . B This is a common IPT issue with older adults during the initial sessions. . C The advanced practice psychiatric nurse should consider using a standardized scale . to quantify the depression and use this to educate the patient and the family. D B and C . According to Dearing, Stuewig, and Tangney (2005), understanding the difference between guilt and shame and its impact on an individual’s motivation is critical to hope and the recovery process. Which of the following is true regarding guilt and shame? Which of the following is not consistent with what is known about relapse? The advanced practice psychiatric nurse proficient in Interpersonal Psychotherapy (IPT) is working with an older adult who does not realize she has depression. Which of the following is true? The patient in Dialectical Behavior Therapy (DBT) complains the skills being taught in DBT

don’t work, struggles with keeping diary cards, and doing assigned homework. This is consistent with which stage of treatment within the DBT model?

D Empty-chair dialogue . A Given concerns about relapse it would be important to meet with the patient just this

. one time and just for 10 minutes but meet in your office. B Remind the patient that one of the rules is not having contact outside of therapy . sessions. C Agree to meet with patient alone in the group room to resolve any outstanding . concerns from the group. D Agree to meet with the patient at Starbucks briefly to discuss the unresolved issues, . but only this once and only for 10 minutes. A People are unique. . B The whole is greater than the sum of its parts. . C Mind, body, spirit work in a unified synergistic . fashion. D Dysfunctions such as a chemical imbalance . must be A People are unique. . B The whole is greater than the sum of its parts. . C Mind, body, spirit work in a unified synergistic . fashion. The advanced practice psychiatric nurse is working with a group of patients in an outpatient substance abuse treatment program. One patient comes to the advanced practice psychiatric nurse after the group session and asks if the advanced practice psychiatric nurse would meet at a nearby Starbucks to clarify a couple of questions that came up at the end of the session and fears relapse. Which of the following would be consistent with the traditional therapeutic frame? Which of the following statements would not be consistent with the humanistic-existential concept of “holism”? Which of the following statements would not be consistent with the humanistic-existential concept of “holism”?

A Multidimensional addressing medical, psychosocial and mental . health issues B Trauma-informed care. . C 12-Step Peer Support Groups D Dysfunctions such as a chemical imbalance must be . identified. A Life Review Therapy (LRT) . B Reminiscence Therapy (RT) . C A Mindfulness Strategy . D Interpersonal Psychotherapy . (IPT) A Projection . B Retroflecti . on C Confluenc . e D Deflection . Stigma of mental illness in the elderly: A Has contributed to psychiatric symptoms being expressed with . physical symptoms. B Is much more severe in baby boomers than in other elderly cohorts. . C Is much less an issue in baby boomers than in other elderly cohorts . D Leads to more discussion of emotions in primary care settings. . The advanced practice psychiatric nurse encourages the older adult to recall long forgotten experiences, events which are memorable to the person. This is known as The advanced practice psychiatric nurse is working with a patient who states she believes her boss hates her. After some discussion, it is clear the patient has strong negative feelings towards her boss. The advanced practice psychiatric nurse working within a Gestalt framework, recognizes this as an interruption consistent with which of the following? The most effective treatment for SUD with or without co-morbid psychiatric disorders is:

A Somatic approaches .

B Talk therapies focused on cognitive . understanding C EMDR . D A and C . A Conduct Disorders . B Anxiety and Depression . C Depression and Psychosis . D Attention Deficit-Hyperactivity . Disorders

- (^) Question 20 of 101

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Question 20

In following the rules for the Dialectical Behavior Therapy (DBT) therapist, the therapist would not do which of the following? A Recognize the therapist is human and fallible. . B Make every reasonable effort to provide competent treatment for the patient. . C Share the rules for the DBT therapist with the patient during orientation to the . therapy. D The therapist agrees to use consultation and allow the patient to view this . directly if desired. Research suggests that psychodynamic therapeutic approaches are effective for some children, particularly those with which of the following disorders? When using a Dialectical Behavior Therapy (DBT) approach with a patient with Borderline

C Patients need to do better, try harder and be more motived to change. . D Patients may not have caused all their problems, but they need to solve . them anyway. A The patient is ready to focus on self-fulfillment . B The patient is ready to focus on self-efficacy . C The patient is ready to begin exposure . therapy. D The patient is ready to begin termination from . therapy. A The advanced practice psychiatric nurse needs to develop a checklist to determine . goals have been made and it is time to terminate. The advanced practice psychiatric nurse determines therapy goals attained, B terminate the therapeutic relationship, and schedule to meet the patient for coffee to

. ease^ the^ transition^ out^ of^ therapy. C The advanced practice psychiatric nurse should set clear therapy goals, commend . patient on goal attainment and terminate the therapy. D Termination should occur by mutual decision between advanced practice psychiatric . nurse and patient based on the therapy goals attained. A The advanced practice psychiatric nurse needs to develop a checklist to determine . goals have been made and it is time to terminate. The advanced practice psychiatric nurse determines therapy goals attained, B terminate the therapeutic relationship, and schedule to meet the patient for coffee to . ease^ the^ transition^ out^ of^ therapy. C The advanced practice psychiatric nurse should set clear therapy goals, commend . patient on goal attainment and terminate the therapy. The patient in Dialectical Behavior Therapy with a history of self-harming through cutting, has shown progress in effectively using skills to manage urges integrating skills to manage emotions and behaviors with increased awareness of self. The advanced practice psychiatric nurse recognizes the patient is ready for which of the following? Strategies for terminating a therapy relationship with an older adult includes: Strategies for terminating a therapy relationship with an older adult includes:

D Termination should occur by mutual decision between advanced practice psychiatric . nurse and patient based on the therapy goals attained. A Congruence . B Unconditional positive . regard C Accurate empathic . understanding D All of the above . A Stage . 1 B Stage . 2 C Stage . 3 D Stage . 4 The advanced practice psychiatric nurse using a Dialectical Behavior Therapy approach with a patient with Borderl during treatment. . A Treatment needs to be readily accessible. . B Psychotropic medication should be stopped prior to treatment. . C Treatment does not need to be voluntary to be effective. . D Drug use during treatment must be monitored continuously as lapses may occur The person-centered therapist is expected to exhibit which of the following characteristics? The patient demonstrates the ability to regulate his emotions in such a way he can think through them. The advanced practice psychiatric nurse using a Dialectical Behavior Therapy approach recognizes this ability is consistent with which stage of treatment? Which of the following is not consistent with the Principles of Effective Treatment for Addiction according to the NIH? A Bi-weekly individual therapy sessions for the patient of about 1 hour each.