Psychiatric Nursing Quiz: Final Exam

                                                 Quiz: Final Exam

This exam will cover the following topics from the Wheeler textbook, which relate to psychotherapy of individuals:

• Supportive and Psychodynamic Psychotherapy
• Interpersonal Psychotherapy
• Humanistic-Existential and Solution-Focused Approaches to Psychotherapy
• Psychotherapy With Children
• Psychotherapy With Older Adults
• Termination and Outcome Evaluation

Learning Resources

Required Readings

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

1. 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 ___________.

1 points  

Question 2

1. 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?

1 points  

Question 3

1. A 35-year-old male patient is being treated for alcohol addiction. He asks for the PMHNP’s cell phone number to use in case of an emergency. When the PMHNP responds that giving her number would be against therapeutic rules, the patient threatens an act of violence to the therapist. What would be the most appropriate response by the PMHNP?

1 points  

Question 4

1. The PMHNP is caring for a patient who is histrionic. Using the supportive psychodynamic therapy model, what is the best statement made by the PMHNP?

1 points  

Question 5

1. 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?

1 points  

Question 6

1. 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?

1 points  

Question 7

1. The PMHNP who practices motivational interviewing understands its relationship to patient behaviors and/or outcomes to mean which of the following?

1 points  

Question 8

1. 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?

1 points  

Question 9

1. 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 _________.

1 points  

Question 10

1. 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 ______________.

1 points  

Question 11

1. 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?

1 points  

Question 12

1. 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:

1 points  

Question 13

1. 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?

1 points  

Question 14

1. 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?

1 points  

Question 15

1. 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?

1 points  

Question 16

1. The PMHNP is caring for an older patient with major depressive disorder, seasonal pattern. The patient has been resolute about not taking medication to manage the depression brought on by his illness, stating that it is against his yogic lifestyle. In addition to psychotherapy, what can the PMHNP suggest to this patient?

1 points  

Question 17

1. 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?

1 points  

Question 18

1. 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?

1 points  

Question 19

1. The PMHNP is treating an older adult patient who reports symptoms of late-life anxiety. What type of treatment(s) will the PMHNP consider?

1 points  

Question 20

1. 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?

1 points  

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?

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?

1 points  

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”?

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?

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?

1 points  

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?

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?

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?

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?

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?

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?

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?

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?

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?

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?

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:

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?

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?

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?

1 points  

Question 41

1. The PMHNP is caring for a young adult patient with whom the PMHNP decides to use a dynamic supportive therapy approach in addition to pharmacological intervention. Which therapeutic action will the PMHNP take to employ the strategy of holding and containing the patient?

1 points  

Question 42

1. 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.

True

False

1 points  

Question 43

1. 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?

1 points  

Question 44

1. 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?

1 points  

Question 45

1. A PMHNP has been treating a 14-year-old patient using interpersonal psychotherapy. The patient has been depressed since the death of his grandmother. To help the patient recover, the PMHNP has told the parents:

1 points  

Question 46

1. 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 ______________.

1 points  

Question 47

1. 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?

1 points  

Question 48

1. The PMHNP is treating an older adult patient who reports experiencing nightmares associated with an automobile accident he was in 20 years ago. As the PMHNP formulates the case using the dynamic supportive therapy model, what questions will the PMHNP use during the session?

1 points  

Question 49

1. 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?

1 points  

Question 50

1. 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?

1 points  

Question 51

1. 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?

1 points  

Question 52

1. The PMHNP is interviewing a patient with a history of substance abuse. He has attempted to stop abusing drugs three times before. He states to the PMHNP, “I just cannot change. How can you help me?!” As it applies to change, the PMHNP understands the principle of evocation to mean:

1 points  

Question 53

1. A patient’s depression is affecting her relationship with her spouse. What might the PMHNP ask during the initial sessions of interpersonal psychotherapy treatment?

1 points  

Question 54

1. 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?

1 points  

Question 55

1. 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:

1points  

Question 56

1. 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?

1 points  

Question 57

1. 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?

1 points  

Question 58

1. How does the PMHNP approach termination with the patient who has been receiving intermittent therapy?

1 points  

Question 59

1. 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?

1 points  

Question 60

1. 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?

1 points  

Question 61

1. 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?

1 points  

Question 62

1. 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?

1 points  

Question 63

1. As part of the PMHNP’s role in the clinic, the PMHNP oversees students that gain clinical experience at the agency. The student is instructed to use the supportive psychodynamic therapy approach with the patient. Which action made by the student causes the PMHNP to intervene, after observing the student interacting with the patient?

1 points  

Question 64

1. 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 ____________.

1 points  

Question 65

1. 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?

1 points  

Question 66

1. 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?

1 points  

Question 67

1. The PMHNP has been treating a patient who is now being transferred to another provider. What is the appropriate action made by the PMHNP?

1 points  

Question 68

1. 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?

1 points  

Question 69

1. In the planning phase of change, a 42-year-old male client who struggles with gambling discusses how he plans to abstain from gambling. He tells the PMHNP, “I am no longer going to carry cash to the casino because you can’t spend what you don’t have.” The PMHNP uses an affirming communication skill when she states:

1 points  

Question 70

1. 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?

1 points