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NURS 6640 FINAL EXAM 7 – QUESTION AND
ANSWERS
Question 1
1 out of 1 points Following an attempted suicide, Mr. Durham was admitted to an acute psychiatric facility. After 4 weeks in treatment, he is preparing for discharge. He is beginning to miss individual and group therapy sessions and has refused medications twice in the past 2 days. The PMHNP demonstrates understanding in this phase by saying which of the following statements? Selected Answer:
B.
“Have you thought of how you will continue your treatment plans?”
Question 2
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 3
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 4
1 out of 1 points A patient’s depression is affecting her relationship with her spouse. What might the PMHNP ask during the initial sessions of interpersonal psychotherapy treatment? Selected D.
Answer: All of the above.
Question 5
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 6
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 7
1 out of 1 points A 21-year-old patient is worried about starting a new job. She talks about her fears of failure and not making friends at the office. Using a person-centered approach, an appropriate response by the PMHNP is to ______________. Selected Answer:
C.
ask the patient to reflect on and explore what she is experiencing
Question 8
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 ____________.
Mia is a 75-year-old patient who has completed initial treatment for depression. What might a PMHNP ask Mia when using a solution-focused therapy approach? Selected Answer:
D.
All of the above.
Question 14
1 out of 1 points A PMHNP is treating a 12-year-old girl who witnessed the physical abuse of her sibling. She has been anxious and irritable since the experience. After speaking with the PMHNP, the patient says she keeps having anxiety-causing thoughts about the experience. Using the PRACTICE technique, which skill will best help the patient interrupt these negative thoughts? Selected Answer:
B.
Affect modulation
Question 15
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 16
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 17
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 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? Selected B.
Answer: Help the patient be aware of his anxiety and embrace it
Question 18
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 19
0 out of 1 points The PMHNP is assessing a patient who requires cognitive behavioral therapy (CBT). Which of the following statements made by the PMHNP approach the termination phase for this patient? Selected Answer:
B.
“Now that you are feeling more stable, let’s talk about terminating these sessions.”
Question 20
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 21
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 22
Answer: Substance abuse treatment system
Question 27
1 out of 1 points A 19-year-old female patient named Anna, who was the victim of child abuse and neglect, is also in treatment for substance abuse. At her most recent appointment, Anna confesses to the PMHNP that she is having romantic fantasies about him, and explains the he is one of the few people she trusts. She believes that he is interested in her as well. What is the most appropriate response by the PMHNP in this situation? Selected Answer:
C.
Guide the patient to examine her feelings and explore the underlying meaning
Question 28
1 out of 1 points The PMHNP is caring for an older adult patient who presents with mixed dysphoric states and whose daughter reports “is becoming more irritable more easily.” When talking with the patient, the PMHNP also recognizes displays of cognitive dysfunction. Which treatment options will the PMHNP most likely suggest? Selected Answer:
D.
Combination of CBT and medication
Question 29
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 30
1 out of 1 points A PMHNP is treating a 10-year-old boy who is exhibiting signs of aggression and attention problems. What type of intervention will the PMHNP consider using a common elements approach? Selected Answer:
D.
All of the above
Question 31
0 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:
C.
Both A and B
Question 32
1 out of 1 points The PMHNP is in the process of terminating treatment with a patient who witnessed the death of her parent who used to sexually abuse her. What does the PMHNP understand about terminating this patient? Selected Answer:
D.
The patient may need to have follow-up sessions every few months.
Question 33
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 34
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 35
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 36
1 out of 1 points
Question 41
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 42
1 out of 1 points A 12-year-old girl was referred for treatment after witnessing the physical abuse of her sibling by their mother. The patient has been anxious and irritable since the experience. What evidence-based treatment would be most appropriate for the PMHNP to use? Selected Answer:
A.
Trauma-focused CBT
Question 43
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 44
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 45
1 out of 1 points 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?
Selected Answer:
C.
“It’s important to be mindful of how you feel and then to determine what causes those feelings.”
Question 46
1 out of 1 points While assessing a patient using a humanistic-existential approach, a patient tells the PMHNP, “For the past few weeks, I’ve felt anxious almost every single day.” What would be an appropriate next step by the PMHNP? Selected Answer:
D.
Encourage the patient to clarify by asking, “You constantly feel anxious?”
Question 47
1 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: Fals e
Question 48
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 49
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
response by the PMHNP? Selected Answer:
A.
Immediately report the threat to the local police department
Question 55
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 56
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 57
1 out of 1 points A patient is finishing the active treatment phase of interpersonal psychotherapy (IPT). After the PMHNP reminds the patient that she has three sessions left, the patient says nothing, but looks distressed. What would be the best reply by the PMHNP following IPT protocol? Selected Answer:
D.
“You seem upset. Tell me what seems to be bothering you.”
Question 58
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 C.
Answer: “You’d like to keep your old friends but know being around them may lead you to abuse substances again.”
Question 59
1 out of 1 points The PMHNP is assessing a patient who has been receiving months of outpatient psychotherapy. According to the PMHNP’s assessment, the patient is nearing the termination phase of their therapeutic relationship because the patient’s symptoms have improved, and the patient shows progress managing behaviors and decision- making abilities according to the diagnosis. How does the PMHNP approach termination with this patient? Selected Answer:
B.
Manage termination issues as part of the treatment
Question 60
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 61
1 out of 1 points 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? Selected Answer:
B.
Symptoms have improved.
Question 62
1 out of 1 points A cocaine-addicted female patient is entering residential treatment for substance abuse. Using the 10 guiding principles of recovery, an appropriate step by the PMHNP is to ______________.
The PMHNP uses therapeutic communication skills while ensuring that the patient understands that he has choices. The PMHNP comprehends and practices motivational interviewing. This is best understood as which of the following? Selected Answer:
B.
A statement that both challenges the patient’s resistance and offers an opportunity to discuss the issues allows the patient to argue with him/herself to help produce a desired change.
Question 68
1 out of 1 points A PMHNP is using Gestalt therapy to communicate with a 50-year-old patient who is going through a divorce. As he is calmly sharing the details of his divorce, the PMHNP notices that Dave is tapping his fingers on his legs. What is an appropriate response by the PMHNP using the technique of focusing? Selected Answer:
A.
“I noticed that your fingers were tapping. Can you give a voice to your fingers?”
Question 69
1 out of 1 points 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”? Selected Answer:
C.
“You have identified your weight as a problem in your marriage and but believe that losing weight will gain happiness.”
Question 70
1 out of 1 points How does the PMHNP approach termination with the patient who has been receiving intermittent therapy? Selected Answer:
D.
A and C
Question 71
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 72
1 out of 1 points The PMHNP is treating an older adult patient who reports symptoms of late-life anxiety. What type of treatment(s) will the PMHNP consider? Selected Answer:
A.
Employ cognitive behavioral therapy
Question 73
1 out of 1 points A 43-year-old single mother is seeing the PMHNP at the request of her sister. “My sister thinks I need to come here to talk about my feelings,” the patient reports. The PMHNP learns that the patient has three children from three different men, but is unable to collect appropriate child support payments from any of the biological fathers. Additionally, the woman is barely able to afford her apartment or utilities payments. What is the appropriate response from the PMHNP when using the psychodynamic psychotherapy technique? Selected Answer:
C.
Suggesting that the patient seek professional legal help
Question 74
1 out of 1 points 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? Selected Answer:
C.
Exception question
Question 75
1 out of 1 points The PMHNP is assessing a new geriatric patient who reports symptoms of depression. The PMHNP wants to identify the patient’s symptom severity over time. Which assessment tool will the PMHNP use to collect this data on the patient? Selected Answer:
B.
Montgomery-Asberg Depression Rating Scale
Question 76
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?
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 6
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 7
1 out of 1 points A 21-year-old patient is worried about starting a new job. She talks about her fears of failure and not making friends at the office. Using a person-centered approach, an appropriate response by the PMHNP is to ______________. Selected Answer:
C.
ask the patient to reflect on and explore what she is experiencing
Question 8
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.
self- regulation
Question 9
1 out of 1 points
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? Selected Answer:
D.
All of the above
Question 10
1 out of 1 points The PMHNP is communicating with a middle-aged male patient who has a history of addiction to Percocet (acetaminophen/oxycodone). The patient suddenly yells, “I do not have a problem with pain pills! I’ve never had an overdose and no one even knows that I take them unless I tell them.” The PMHNP understands that there are phases of change and can best demonstrate “focusing” by responding with: Selected Answer:
D.
“I am wondering if your use of pain medication has ever prompted you to seek medical attention.”
Question 11
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 12
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 13
1 out of 1 points Mia is a 75-year-old patient who has completed initial treatment for depression. What might a PMHNP ask Mia when using a solution-focused therapy approach? Selected Answer:
D.
All of the above.
Question 14
