All posts by : freelance

NURS6640 Psychotherapy With Individuals
Week 1 Discussion
Does
Psychotherapy Have a Biological Basis?
Many
studies have found that psychotherapy is as effective as psychopharmacology in
terms of influencing changes in behaviors, symptoms of anxiety, and changes in
mental state. Changes influenced by psychopharmacology can be explained by the
biological basis of treatments. But how does psychotherapy achieve these
changes? Does psychotherapy share common neuronal pathways with
psychopharmacology? For this Discussion, consider whether psychotherapy also
has a biological basis.
NURS6640 Psychotherapy With Individuals
Week 2 Discussion
Assessment
Tools
Assessment
tools have two primary purposes: 1) to measure illness and diagnose clients,
and 2) to measure a client’s response to treatment. Often, you will find that
multiple assessment tools are designed to measure the same condition or
response. Not all tools, however, are appropriate for use in all clinical
situations. You must consider the strengths and weaknesses of each tool to
select the appropriate assessment tool for your client. For this Discussion, as
you examine the assessment tool assigned to you by the Course Instructor,
consider its use in psychotherapy.
NURS6640 Psychotherapy With Individuals
Week 5 Discussion
Posttraumatic
Stress Disorder
It is
estimated that more than 6% of the U.S. population will experience
posttraumatic stress disorder (PTSD) in their lifetime (National Center for
PTSD, 2010). This debilitating disorder often interferes with an individual’s
ability to function in daily life. Common symptoms of anxiousness and
depression frequently lead to substance abuse issues and even physical
ailments. For this Discussion, as you examine the Thompson Family Case Study in
this week’s Learning Resources, consider how you might assess and treat clients
presenting with PTSD.
NURS6640 Psychotherapy With Individuals
Week 8 Discussion
Clinical
Supervision
Clinical
Supervision is an essential component of your development as a psychiatric mental
health nurse practitioner. It provides an opportunity for professional
collaboration as you share experiences with and gain insights from colleagues.
For this Clinical Supervision, consider a client whom you do not think is
adequately progressing according to expected clinical outcomes.
NURS6640 Psychotherapy With Individuals
Week 9 Discussion
Counseling
Adolescents
The
adolescent population is often referred to as “young adults,” but in some ways,
this is a misrepresentation. Adolescents are not children, but they are not yet
adults either. This transition from childhood to adulthood often poses many
unique challenges to working with adolescent clients, particularly in terms of
disruptive behavior. In your role, you must overcome these behaviors to
effectively counsel clients. For this Discussion, as you examine the Disruptive
Behaviors media in this week’s Learning Resources, consider how you might
assess and treat adolescent clients presenting with disruptive behavior.
NURS6640 Psychotherapy With Individuals
Week 10 Discussion
Clinical
Supervision
Personal
reflection and discussion with colleagues is essential to your development as a
psychiatric mental health nurse practitioner. In Week 8, you collaborated with
colleagues as you participated in your first Clinical Supervision. This week,
you have the opportunity to continue your collaboration as you reflect on and
discuss your experiences with counseling older adults. Keep in mind that
although there may be challenges to counseling this population, these clients
offer unique learning opportunities. For this Clinical Supervision, consider an
older client you are counseling whom you do not think is adequately progressing
according to expected clinical outcomes.
NURS6640 Psychotherapy With Individuals
Week 11 Discussion
Therapy for
Clients With Personality Disorders
Clients
with personality disorders often find it difficult to overcome their problems
and function in daily life. Even when these clients are aware that they have a
dysfunction with their personality and are open to counseling, treatment can be
challenging for both the client and the therapist. For this Discussion, as you
examine personality disorders, consider therapeutic approaches you might use
with clients.

NURS6640_Week_11_Discussion.docx (91.99 KB)

Walden NURS6640 Week 11 Discussion Latest 2019 March NURS6640 Psychotherapy With Individuals Week 11 Discussion Therapy for Clients With Personality Disorders
Clients with personality disorders often find it difficult to overcome their problems
and function in daily life. Even when these clients are aware that they have a
dysfunction with their personality and are open to counseling, treatment can be
challenging for both the client and the therapist. For this Discussion, as you
examine personality disorders, consider therapeutic approaches you might use
with clients.

Week_4_Assignment_1.docx (19.83 KB)

Walden NURS6640 Week 4 Assignment 1 Latest 2019 March NURS6640 Psychotherapy With Individuals Week 4 Assignment 1 Cognitive Behavioral Theory Versus Rational Emotive Behavioral Theory
While cognitive behavioral therapy (CBT) and rational emotive behavioral therapy
(REBT) have many similarities, they are distinctly different therapeutic
approaches. When assessing clients and selecting one of these therapies, you
must recognize the importance of not only selecting the one that is best for
the client, but also the approach that most aligns to your own skill set. For
this Assignment, as you examine the similarities and differences between CBT
and REBT, consider which therapeutic approach you might use with your clients.
Learning
Objectives
Students
will:
Compare
cognitive behavioral therapy and rational emotive behavioral therapy
Recommend
cognitive behavioral therapies for clients
To prepare:
Review the
media in this week’s Learning Resources.
Reflect on
the various forms of cognitive behavioral therapy.
The
Assignment
In a 1- to
2-page paper, address the following:
Briefly
describe how cognitive behavioral therapy (CBT) and rational emotive behavioral
therapy (REBT) are similar.
Explain at
least three differences between CBT and REBT. Include how these differences
might impact your practice as a mental health counselor.
Explain
which version of cognitive behavioral therapy you might use with clients and
why. Support your approach with evidence-based literature.
Note: The
School of Nursing requires that all papers submitted include a title page,
introduction, summary, and references. The Sample Paper provided at the Walden
Writing Center provides an example of those required elements (available at
http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this
formatting.
By Day 7
Submit your
Assignment.
Submission
and Grading Information
To submit
your completed Assignment for review and grading, do the following:
Please save
your Assignment using the naming convention “WK4Assgn1+last name+first
initial.(extension)” as the name.
Click the
Week 4 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
Click the
Week 4 Assignment 1 link. You will also be able to “View Rubric” for grading
criteria from this area.
Next, from
the Attach File area, click on the Browse My Computer button. Find the document
you saved as “WK4Assgn1+last name+first initial.(extension)” and click Open.
If
applicable: From the Plagiarism Tools area, click the checkbox for I agree to
submit my paper(s) to the Global Reference Database.
Click on
the Submit button to complete your submission.

NURS6640_Week_8_Discussion.docx (61.32 KB)

Walden NURS6640 Week 8 Discussion Latest 2019 March NURS6640 Psychotherapy With Individuals Week 8 Discussion Clinical Supervision
Clinical Supervision is an essential component of your development as a psychiatric mental
health nurse practitioner. It provides an opportunity for professional
collaboration as you share experiences with and gain insights from colleagues.
For this Clinical Supervision, consider a client whom you do not think is
adequately progressing according to expected clinical outcomes.

NURS6640 Psychotherapy With Individuals
Week 10 Discussion
Clinical
Supervision
Personal
reflection and discussion with colleagues is essential to your development as a
psychiatric mental health nurse practitioner. In Week 8, you collaborated with
colleagues as you participated in your first Clinical Supervision. This week,
you have the opportunity to continue your collaboration as you reflect on and
discuss your experiences with counseling older adults. Keep in mind that
although there may be challenges to counseling this population, these clients
offer unique learning opportunities. For this Clinical Supervision, consider an
older client you are counseling whom you do not think is adequately progressing
according to expected clinical outcomes.

NURS6640_Week_9_Discussion.docx (95.95 KB)

Walden NURS6640 Week 9 Discussion Latest 2019 March NURS6640 Psychotherapy With Individuals Week 9 Discussion Counseling Adolescents
The adolescent population is often referred to as “young adults,” but in some ways,
this is a misrepresentation. Adolescents are not children, but they are not yet
adults either. This transition from childhood to adulthood often poses many
unique challenges to working with adolescent clients, particularly in terms of
disruptive behavior. In your role, you must overcome these behaviors to
effectively counsel clients. For this Discussion, as you examine the Disruptive
Behaviors media in this week’s Learning Resources, consider how you might
assess and treat adolescent clients presenting with disruptive behavior.

Week_7_Assignment_3.docx (39.74 KB)

Walden NURS6640 Week 7 Assignment 3 Latest 2019 March NURS6640 Psychotherapy With Individuals Week 7 Assignment 3 Practicum – Week 5 and Week 6
Practicum – Week 5 and Week 6 Journal Submission
Learning Objectives
Students will:
Develop
diagnoses for clients receiving psychotherapy*
Evaluate
the efficacy of therapeutic approaches for clients*
Analyze
legal and ethical implications of counseling clients with psychiatric
disorders*
By Day 7
Submit your
Journal Entries for Week 5 and Week 6. Refer to Week 5 and Week 6 for additional
guidance.
Submission
To submit
your completed Assignment for review and grading, do the following:
Please save
your Assignments using the following naming convention: WK7Journal1+lastname+first
initial,” and “WK7Journal2+lastname+firstinitial.”
Click the
Week 7 Assignment 3 link.
Next, from
the Attach File area, click on the Browse My Computer button. Find the document
you saved as “WK7Assgn3+last name+first initial.(extension)” and click Open.
Repeat for each of the Practicum Journal submissions. If you are submitting
multiple files, repeat until all files are attached.
Click on
the Submit button to complete your submission.

Week_7_Assignment_2.docx (41.24 KB)

Walden NURS6640 Week 7 Assignment 2 Latest 2019 March NURS6640 Psychotherapy With Individuals Week 7 Assignment 2
Practicum – Assessing Client Progress
Learning
Objectives
Students
will:
Assess
progress for clients receiving psychotherapy
Differentiate
progress notes from privileged notes
Analyze
preceptor’s use of privileged notes
To prepare:
Reflect on
the client you selected for the Week 3 Practicum Assignment.
Review the
Cameron and Turtle-Song (2002) article in this week’s Learning Resources for
guidance on writing case notes using the SOAP format.
The
Assignment
Part 1:
Progress Note
Using the
client from your Week 3 Assignment, address the following in a progress note
(without violating HIPAA regulations):
Treatment
modality used and efficacy of approach
Progress
and/or lack of progress toward the mutually agreed-upon client goals (reference
the Treatment plan—progress toward goals)
Modification(s)
of the treatment plan that were made based on progress/lack of progress
Clinical
impressions regarding diagnosis and/or symptoms
Relevant
psychosocial information or changes from original assessment (i.e., marriage,
separation/divorce, new relationships, move to a new house/apartment, change of
job, etc.)
Safety
issues
Clinical
emergencies/actions taken
Medications
used by the patient (even if the nurse psychotherapist was not the one
prescribing them)
Treatment
compliance/lack of compliance
Clinical
consultations
Collaboration
with other professionals (i.e., phone consultations with physicians,
psychiatrists, marriage/family therapists, etc.)
Therapist’s
recommendations, including whether the client agreed to the recommendations
Referrals
made/reasons for making referrals
Termination/issues
that are relevant to the termination process (i.e., client informed of loss of
insurance or refusal of insurance company to pay for continued sessions)
Issues
related to consent and/or informed consent for treatment
Information
concerning child abuse, and/or elder or dependent adult abuse, including
documentation as to where the abuse was reported
Information
reflecting the therapist’s exercise of clinical judgment
Note: Be
sure to exclude any information that should not be found in a discoverable
progress note.
Part 2: Privileged
Note
Based on
this week’s readings, prepare a privileged psychotherapy note that you would
use to document your impressions of therapeutic progress/therapy sessions for
your client from the Week 3 Practicum Assignment.
The
privileged note should include items that you would not typically include in a
note as part of the clinical record.
Explain why
the items you included in the privileged note would not be included in the
client’s progress note.
Explain
whether your preceptor uses privileged notes, and if so, describe the type of
information he or she might include. If not, explain why.
By Day 7
Submit your
Assignment.
Submission
To submit
your completed Assignment for review and grading, do the following:
Please save
your Assignment using the following naming convention:
“WK7Assgn2+lastname+first initial”.
Click the
Week 7 Assignment 2 link.
Next, from
the Attach File area, click on the Browse My Computer button. Find the document
you saved as “WK7Assgn2+last name+first initial.(extension)” and click Open. If
you are submitting multiple files, repeat until all files are attached.
Click on
the Submit button to complete your submission.

Final_Exam.docx (66.9 KB)

Walden NURS6640 Final Exam Latest 2019 March NURS6640 Psychotherapy With Individuals Final Exam
• Question 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?
• Question 2 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?
• Question 3 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?
• Question 4 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 ____________.
• Question 5 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:
• Question 6 The PMHNP has been
treating a patient who is now being transferred to another provider. What is
the appropriate action made by the PMHNP?
• Question 7 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?
• Question 8 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?
• Question 9 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?
• Walden NURS6640 Final Exam Latest 2019 March NURS6640 Psychotherapy With Individuals Final Exam Question 10 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
______________.
• Question 11 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?
• Question 12 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?
• Question 13 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?
• Walden NURS6640 Final Exam Latest 2019 March NURS6640 Psychotherapy With Individuals Final Exam Question 14 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:
• Question 15 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?
• Question 16 A PMHNP is assessing a
40-year-old patient named Sarah who has a severe cocaine addiction and mild
depression. Using the four-quadrant model, what would be the most appropriate
setting to help the patient?
• Question 17 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:
• Question 18 An 8-year-old has been
having trouble making friends at school. His parents initiated treatment when
he also started acting out at home. Which is the most appropriate step that the
PMHNP takes during the assessment process when using an integrated approach?
• Question 19 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?
• Walden NURS6640 Final Exam Latest 2019 March NURS6640 Psychotherapy With Individuals Final Exam Question 20 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?
• Question 21 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?
• Question 22 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?
• Question 23 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?
• Walden NURS6640 Final Exam Latest 2019 March NURS6640 Psychotherapy With Individuals Final Exam Question 24 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?
• Question 25 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?
• Question 26 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?
• Question 27 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?
• Question 28 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”?
• Walden NURS6640 Final Exam Latest 2019 March NURS6640 Psychotherapy With Individuals Final Exam Question 29 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
___________.
• Question 30 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?
• Question 31 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?
• Question 32 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?
•  Walden NURS6640 Final Exam Latest 2019 March NURS6640 Psychotherapy With Individuals Final Exam Question 33 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?
• Question 34 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?
• Question 35 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?
• Question 36 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?
• Question 37 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?
• Question 38 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?
• Question 39 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?
• Walden NURS6640 Final Exam Latest 2019 March NURS6640 Psychotherapy With Individuals Final Exam Question 40 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?
• Question 41 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?
• Question 42 When preparing to
terminate a patient, what does the PMHNP do to organize thoughts about the
patient’s progress made during treatment?
• Question 43 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:
• Walden NURS6640 Final Exam Latest 2019 March NURS6640 Psychotherapy With Individuals Final Exam Question 44 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?
• Question 45 The PMHNP who practices
motivational interviewing understands its relationship to patient behaviors
and/or outcomes to mean which of the following?
• Question 46 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
• Question 47 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?
• Walden NURS6640 Final Exam Latest 2019 March NURS6640 Psychotherapy With Individuals Final Exam Question 48 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?
• Question 49 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 ______________.
• Question 50 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:
• Question 51 When completing this
exam, did you comply with Walden University’s Code of Conduct including the
expectations for academic integrity?
• Question 52 How does the PMHNP
approach termination with the patient who has been receiving intermittent
therapy?
• Question 53 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?
• Question 54 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?
• Question 55 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?
• Question 56 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?
• Question 57 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?
• Question 58 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?
• Question 59 When recalling the
phases of change, the PMHNP demonstrates “open questioning” in the “engagement”
phase by making which statement?
• Question 60 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 _________.
• Question 61 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?
• Question 62 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?
• Walden NURS6640 Final Exam Latest 2019 March NURS6640 Psychotherapy With Individuals Final Exam Question 63 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:
• Question 64 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?
• Question 65 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
• Question 66 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?
• Question 67 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?
• Question 68 A patient’s depression
is affecting her relationship with her spouse. What might the PMHNP ask during
the initial sessions of interpersonal psychotherapy treatment?
• Question 69 The PMHNP is treating
an older adult patient who reports symptoms of late-life anxiety. What type of
treatment(s) will the PMHNP consider?
• Question 70 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
• Question 71 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?
• Walden NURS6640 Final Exam Latest 2019 March NURS6640 Psychotherapy With Individuals Final Exam Question 72 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.
• Question 73 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?
• Question 74 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?
• Question 75 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?
• Question 76 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?

Midterm_exam.docx (66.59 KB)

Walden NURS6640 Midterm Exam Latest 2019 March NURS6640 Psychotherapy With Individuals Midterm Exam
Question 1The
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?
Question 2 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?
Question 3 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:
Question 4 The
PMHNP is working with a 43-year-old male patient who develops idiosyncratic
transference over weeks of therapy. The best way for the PMHNP to respond to
this patient is to ___________ :
Question 5 The
PMHNP is working with a patient who has insomnia and battles going to sleep.
The patient reports consistent self-defeating behaviors, and hates trying to go
to sleep. Which action made by the PMHNP demonstrates the use of a paradoxical
intervention?
Question 6
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:
Question 7
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. Selected Answer:
Walden NURS6640 Midterm Exam Latest 2019 March NURS6640 Psychotherapy With Individuals Midterm Exam Question 8
A PMHNP is
taking a history and wants to assess how the patient copes with adversity. To
do so, the therapist asks questions about the patient’s belief system. What
would be an appropriate question to ask?
Question 9
In your
office, you see a 58-year-old patient with PTSD who reports having nightmares,
making it impossible for her to sleep. What recommendations based on principles
of sleep hygiene will the PMHNP make?
Question 10
A patient
who has borderline personality disorder is meeting with the PMHNP. When asked
about future goals, the patient responds, “I’d like to go back to school to do
what you
do. You
know, talk to people all day about their problems. It seems pretty easy.” How
does the PHMNP respond to the client in a way that is free from any
stigmatizing beliefs or judgments?
Question 11
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?
Walden NURS6640 Midterm Exam Latest 2019 March NURS6640 Psychotherapy With Individuals Midterm Exam Question 12
An elderly
patient in a nursing home has been losing interest in activities and now
refuses to leave his room. After a physical exam, he is referred to a PMHNP for
an initial assessment.
True or
false: After speaking with the patient, an appropriate screening tool for the
PMHNP to use would be the Geriatric
Depression Scale.
Question 13
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 __________.
Question 14
The PMHNP
is working with a school-aged child who has been diagnosed with depression. The
child has attended several sessions with the PMNHP, but recently presents with
avoidant behavior by showing increased distress and being late to sessions.
What approach does the PMHNP need to employ with the child to continue making
therapeutic progress?
Question 15
A PMHNP’s
patients have already signed confidentiality agreements, including limits that
will be imposed on confidentiality. Months later, the state’s laws have changed
that affect confidentiality promises the PMHNP has already made. What is an
appropriate step for the PMHNP to take after finding out this information?
Walden NURS6640 Midterm Exam Latest 2019 March NURS6640 Psychotherapy With Individuals Midterm Exam Question 16
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?
Question 17
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:
Question 18
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?
Question 19
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?
Walden NURS6640 Midterm Exam Latest 2019 March NURS6640 Psychotherapy With Individuals Midterm Exam Question 20
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?
Question 21
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?
Question 22
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:
Question 23
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.
Question 24
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 ____________.
Question 25
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
___________.
Walden NURS6640 Midterm Exam Latest 2019 March NURS6640 Psychotherapy With Individuals Midterm Exam Question 26
During a
clinical assessment of a 15-year-old patient, the PMHNP asks, “How can I help
you?” The patient answers by saying, “Honestly, I don’t really think I need any
help.” Which of the following is the most appropriate response by the PMHNP?
Question 27
Your
patient is a 65-year-old male who has a strained relationship with his son and
daughter. His children refuse to participate in a family session. The PMHNP
asks the patient to draw his family genogram as a next step to _______________.
Question 28
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?
Question 29
A
24-year-old female patient presents for her initial appointment with the PMHNP.
Which action will the PMHNP take to establish therapeutic alliance?
Question 30
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.
Walden NURS6640 Midterm Exam Latest 2019 March NURS6640 Psychotherapy With Individuals Midterm Exam Question 31
The PMHNP
meets with a 47-year-old male patient who is fearful of leaving the house after
having witnessed his neighbor getting run over by a car. When the PMHNP asks
why he is afraid to leave his house, the patient replies, “Because another
accident might occur.” Which cognitive behavioral therapy (CBT) strategy does
the PMHNP employ?
Question 32
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 _________.
Question 33
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)?
Question 34
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.
Question 35
A PMHNP is
caring for a 21-year-old woman who is suffering from anxiety and is having
difficulty managing stress. Which of the following would be an appropriate step
by the PMHNP?
Question 36
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:
Question 37
The patient
attempts the PMHNP’s sleep hygiene recommendations for 2 weeks, but does not
make any progress mitigating nightmares and hyperarousal. Which behavioral
strategy does the PMHNP suggest next?
Question 38
The PMHNP
is caring for a patient who seems to seek affection and attention from the
PMHNP and others in the clinic, as well as displays heightened emotional
responses to feelings of being excluded. What therapeutic approach does the
PMHNP use to decrease autonomic arousal in the patient?
Question 39
The PMHNP
is meeting with a 38-year-old divorced, single mother who has been seeing the
PMHNP for anxiety and anger management. During one of the sessions, the patient
tells the PMHNP that she is having a problem getting her child support payments
from her ex-husband, which is triggering increased anxiety and anger, which she
admittedly takes out on her children. How does the PMHNP respond in a way that
upholds the supportive psychodynamic psychotherapy approach?
Question 40
During a
therapy session with an 18-year-old female the PMHNP learns that she has lived
in six different foster homes in the last 24 months. She states that her mother
is in a correctional facility for drug abuse and prostitution. During the
assessment, the PMHNP notices multiple superficial cuts to each wrist. The
patient appears tearful, withdrawn, and never makes direct eye contact. The
PMHNP believes that this patient may have feelings of insecurities as well as
abandonment issues and is aware that which diagnosis is likely possible?
Question 41
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?
Question 42
The PMHNP
is conducting a peer review of another PMHNP’s medical charts. Upon review, the
PMHNP notes that the peer often begins patient sessions late, as well as ends
them later than scheduled. The PMHNP also found a comment in the chart
regarding the patient sending text messages while in the middle of the session.
Based on these findings, the feedback that the PMHNP will provide to the peer
involves which therapeutic principle?
Question 43
When
conducting an initial assessment, a PMHNP has finished conducting a mental
status examination with 10 minutes left in the session. The patient is
distressed and would like to continue sharing her personal history.
True or
false: An appropriate response that the PMHNP might tell the patient is, “I
understand that you are upset. [Summarizes diagnosis, treatment
recommendations, and follow-up plan.] We can continue the conversation next
week. How does this time next Monday work for you?”
Question 44
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?
Question 45
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
__________.
Question 46
The PMHNP
is caring for a patient with borderline personality disorder. Using a
psychoanalytic psychotherapy approach, the PMHNP attempts to intensify the
patient’s transference to enhance emotional processing by:
Question 47
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:
Question 48
The PMHNP
is caring for a patient who the PMHNP believes would benefit from a relational
psychodynamic approach to therapy. Which action made by the PMHNP demonstrates
appropriate use and understanding of the relationship psychodynamic model?
Question 49
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:
Question 50
After
informing a prospective patient about limits of confidentiality, the patient
consents to the “conditions” of confidentiality and signs an informed consent
form. Several weeks later, a lawyer representing the patient’s spouse for a
court case, asks the PMHNP for the disclosure of information about the patient.
The PMHNP should:
Question 51
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?
Question 52
A
28-year-old male patient is experiencing distress related to the workplace.
What might the PMHNP ask to assess affective development?
Question 53
An
11-year-old patient has been exhibiting low self-esteem at school and acting
out. According to Maslow’s hierarchy of needs, which of the following questions
would best be addressed first by the PMHNP?
Question 54
A PMHNP is
assessing ego functioning of his 40-year-old patient by asking what she feels
is the cause of her problems. She attributes her problems to her overprotective
parents not letting her have enough freedom growing up. Based on her answer,
the PMHNP is testing _____________.
Question 55
The PMHNP
is working with a patient who seems dissatisfied with the therapeutic
relationship. The PMHNP invites the patient to discuss her feelings regarding
the PMHNP openly and honestly. It becomes clear to the PMHNP that they are
experiencing an alliance rupture. How does the PMHNP repair the therapeutic
alliance?
Question 56
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?
Question 57
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:
Question 58
At the
initial interview with a patient, the PMHNP reviews the condition of receiving
services, including limits that will be imposed on confidentiality. During the
discussion, the patient shares information that the PMHNP is legally required
to report.
True or
false: If the PMHNP does not report information that s/he is legally required
to report, state laws govern the consequences which include penalties for not
reporting, especially child and elder abuse.
Question 59
The PMHNP
is working with a patient who has dissociative disorder and requests
pharmacological interventions for dealing with her trauma. What education does
the PMHNP provide to the patient regarding medication therapy?
Question 60
The PMHNP
is caring for a patient who has acute stress disorder after experiencing a
traumatic event 1 week prior. The PMHNP wants to begin with a therapeutic
framework that follows the adaptive information processing (AIP) model. What is
the priority action for the PMHNP to take?
Question 61
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?
Question 62
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?
Question 63
One of the
strategies the PMHNP wants to try includes sleep restriction. What will the
PMHNP suggest to follow sleep restriction therapy?
Question 64
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?
Question 65
The PMHNP
has a session with a patient who was injured and traumatized from an explosion
at the industrial plant where he used to work. During the session, an outside
noise startles the patient and he experiences a flashback of the loud boom from
the explosion. The PMHNP witnesses the patient present with anxiety and
belabored breathing. What is the appropriate action of the PMHNP?
Question 66
The PMHNP
is assessing a patient who grew up in a foster home because she was neglected and
abused by her birth parents at a young age. The patient admits to having
difficulty forming and maintaining relationships throughout her life.
Understanding maladaptive schemas, which statement does the PMHNP predict that
the patient is likely to make?
Question 67
The PMHNP
is caring for a patient with dissociated self-state that the PMHNP identifies
as being associated with traumatic experiences in the patient’s past. What
approach does the PMHNP use with the patient that is crucial to the
psychodynamic therapy process?
Question 68
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:
Question 69
The PMHNP
is meeting with a new patient who is a young veteran back from serving two
tours overseas. When reviewing the patient’s health history file that was sent
from the VA, the PMHNP learns that several months ago, the patient was
diagnosed with PTSD, but never followed up with treatment for it. After a
comprehensive mental health assessment, the PMHNP confirms the PTSD diagnosis
and understands that which therapeutic approach will be the most effective as a
first-line treatment modality?
Question 70
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?
Question 71
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?
Question 72
When
completing this exam, did you comply with Walden University’s Code of Conduct
including the expectations for academic integrity?
Question 73
A PMHNP is
preparing confidentiality forms for his patients. What is the most appropriate
first step he should take?
Question 74
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?
Question 75
A patient
named Steve is seeking therapy to get help with his home situation, stating
that he has been stressed since his mother-in-law moved into the house. What
can the PMHNP do to assist the patient in constructing a narrative?
Question 76
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?