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?

Psychiatric_Mental_Health_Nurse_Practitioner_Role_II_(1).docx (47.55 KB)

Walden NURS6670 Week 1 Discussion Latest 2019 MAY NURS6670 Psychiatric Mental Health Nurse Practitioner Role II Week 1 Discussion
Interview Format
Despite what you may believe (or may have been told), there is no such thing as one
“right” way to do an interview. In fact, there are numerous books written about
the various ways of conducting the clinical interview. In actual clinical
practice, you will find the format that “works” best for you and addresses your
unique strengths and the needs of the client.
In this
Discussion, you will practice finding the interview format that works for you
and share those ideas with your colleagues for feedback.
Learning
Objectives
Students
will:
• Develop
formats for initial interviews of mental health clients
Note: For
this Discussion, you are required to complete your initial post before you will
be able to view and respond to your colleagues’ postings. Begin by clicking on
the “Post to Discussion Question” link and then select “Create Thread” to
complete your initial post. Remember, once you click submit, you cannot delete
or edit your own posts and cannot post anonymously. Please check your post
carefully before clicking Submit!
To prepare
for this Discussion:
• Review
the Learning Resources.
• Develop
an interview format you would use for an initial interview of a client.
• Attach
the interview format document you would use for an initial interview of a
client.
• Describe
what interview format your preceptor uses for the initial interview of a
client.
• Describe
which element of your interview format is most helpful in your practice.
By Day 6
Respond to
at least two of your colleagues by constructively critiquing their interview
format and providing feedback.

FINAL_EXAM.docx (43.97 KB)

• Question 1 In a group therapy session for adolescents, a 15-year-old patient says he has trouble making
conversation with people he does not know well. Based on the principle of
development of socializing techniques, what explicit approach might the PMHNP
take?
• Question 2 One group member is identified by the PMHNP as the
monopolist of the group. Which behavior does the PMHNP believe this member is
most likely to display?
• Question 3 During a first group therapy session, a member is outgoing
and participates actively. Based on this information, what is an appropriate
prediction about this group member by the PMHNP?
• Question 4 A 21-year-old client with narcissistic traits is noted to
continuously disrupt the group by speaking while others are speaking. It
becomes evident that the client is purposely disrupting the group and
decreasing the group’s productivity. What does the PMHNP identify as a cause of
the client’s behavior?
• Question 5 Harold Wyman is a 74-year-old man who is trying to mend a
relationship with his adult daughter. Based on his intake assessment, the PMHNP
believes that the father has depression. The daughter and Harold meet with the
PMNHP, and the daughter explains that her father always appears mopey and
withdrawn and refuses to do anything about it. When asked, the father reports
feeling sad all the time. Which action will the PMNHP employ with Harold using
the interpersonal psychotherapy approach throughout the various sessions?
• Question 6 A PMHNP is leading a group therapy session for patients
with substance abuse problems. After a productive session in which all members
participated, the following week was not as productive. In order to help the
group members assume responsibility for evaluating the meeting, what is an
appropriate comment for the PMHNP to make?
• Question 7 During the “mid-group debrief” the clinical supervisor
focused on the following areas with the two counselors except:
• Question 8 The social microcosm theory is a theory that relates to
group composition. In accordance with this theory, the PMHNP is aware that the
group must consist of which of the following?
• Question 9 Peter, a successful businessman, is introduced to the group
during the twelfth week. Following Peter’s introduction, Joseph, a long-term
member in the group, begins to lead the group and discuss all of the things
that he has personally accomplished. In what way does the PMHNP correctly
interpret Joseph’s behavior?
• Question 10 The PMHNP conducts a specialized individual interview with a
patient named Sandy. During this interview, Sandy expresses her want of the
other members to like her, and she has a deep dread for the first group
meeting. How does the PMHNP correctly interpret Sandy’s interpersonal
circumplex?
• Question 11 When discussing the role of the consultant in the parenting
group session, Dr. Carlson explains that the consultant should use several
skills in order to help keep the group going and should enable group members to
become very engaged with one another. The consultant should use all of the
following skills to achieve this, except:
• Question 12 A PMHNP is meeting with parents and their 10-year-old child.
The child is having trouble paying attention at school and has been getting
easily frustrated at home when doing homework, which often results in everyone
arguing. What step might the PMHNP take as part of a family-centered,
solution-oriented approach?
• Question 13 The PMHNP is meeting with an adult woman and her father, who
is 85 years old. The father stays quiet most of the session. The daughter
explains he is mad at her for “bringing him to a see a shrink.” The daughter
reports that things have been tense in the house since her father moved in. The
father has a history of depression, though he does not take any medication for
it. In addition, lately the father seems to never sleep. “I hear him rummaging
around in the kitchen, the garage, the living room, at all hours of the night.
Sometimes he’ll nap during the day, but not much. This is putting a strain on
my marriage, because my husband can’t sleep with all of this going on.” Which
therapeutic approach does the PMHNP identify as most appropriate for the
85-year-old father?
• Question 14 During an initial meeting, a PMHNP spends time speaking with
a patient who suffers from social anxiety. The therapist finds the patient
extremely loud and overbearing. The PMHNP’s negative feelings continue no
matter how hard he or she tries to feel differently toward the patient. What is
the most appropriate next step by the PMHNP?
• Question 15 A patient has had a problem with substance use and has been
receiving treatment for addiction. Which additional step might the PMHMP
suggest to help the patient maintain abstinence from drugs during and after
treatment?
• Question 16
The leader begins a group
meeting by doing the “names activity.” At the completion of the activity, the
leader explains that the activity is useful for all of the following reasons, excel
• Question 17 A 36-year-old client attends group therapy regularly but is
consistently tardy. The client explains that job and family obligations interfere
with attendance to the group. What is the most appropriate intervention by the
PMHNP?
• Question 18 Group participation is an important aspect of how successful
group therapy will be. The PMHNP recognizes that the gender of group
participants can play a role in the likelihood of group participation. Which
statement about gender and group composition does the PMHNP take into account?
• Question 19 When the counselor discussed assertiveness with the group
members, she began the session by providing definitions and asking group
members to line up consistent with where they feel they are currently in terms
of assertiveness. Why did she do this?
• Question 20 A patient in group therapy named Ted shares personal
information for the first time. He seems nervous but continues to talk. How
might the PMHNP use nonverbal positive reinforcement to support Ted’s feeling
more comfortable?
• Question 21 Members of a therapy group have been meeting for several
months. During group therapy, a patient is bossy and controlling. During this
week’s session, she is confronted by another group member about her behavior
and replies, “This is not how I normally act. You are not my family and
friends. I don’t act the same way around them.” What can the PMHNP deduce from
her behavio
• Question 22 A PNHNP is holding a group therapy session for a father and
his 10-year-old son, whom the father explains has been acting out lately. The
son says, “He is always telling me what to do and never listens when I have an
idea.” Which solution would the PMHNP most likely suggest as an approach to the
problem?
• Question 23 A PMHNP is treating a patient in individual therapy and
thinks the patient may be a good candidate for group therapy. The patient is
motivated to start group therapy, which meets twice a month. Then the patient
adds, “I can come to the first two meetings, but then will be away on business
for at least a month, maybe longer. But then I can come to the at least one
meeting before my next trip.” Based on this information, what is the most
likely recommendation by the PMHN
• Question 24 Members of a therapy
group have been meeting for several weeks. While a member named Margaret is
talking about how her spouse ignores her when she tries to tell him what to do,
another member named Nicole interrupts and says, “Maybe he thinks you are being
bossy.” Margaret replies by saying, “At least I’m not an alcoholic like you
are!” What is an appropriate response by the PMHNP?
• Question 25 A 9-year-old child who witnessed a fatal car accident has
come to therapy with her parents to get treatment. The child has been irritable
since the event and has not wanted to talk about it. Utilizing a trauma-focused
cognitive behavior therapy (TF-CBT) approach, the PMHNP has reviewed skills
that the parents may use to help their child at home. Based on the PMHNP’s
suggestion, which is a statement the parents might make after the child has a
temper tantrum?
• Question 26 During the first group meeting, a client states, “I am here
because I am very shy. I don’t mesh well with others and I rarely get
invitations to go anywhere.” Which statement about the client’s reason for seeking
help and treatment best applies?
• Question 27 A client is observed discussing many problems and complaints
during group therapy. However, when other group members attempt to offer
advice, the client does not accept it. Based on this observation, what can the
PMHNP determine about the client?
• Question 28 During a group therapy session, a member comments that
another member named Ted had no compassion. Ted replies, “Why does it matter if
I care one way or another. I can’t solve their problems.” The other member
starts crying and blames Ted for this. He shrugs and answers, “I don’t
understand why you are crying.” Based on this information, what is the most
likely determination the PMHNP can make about Ted?
• Question 29 Jane has been attending group therapy for the past year; she
and the therapist have determined that she has met her goals. Jane has been
arriving to group late or not coming to group at all. How does the PMHNP
correctly interpret Jane’s behavior?
• Question 30
A PMHNP is treating an
8-year-old child who was at a cousin’s house during a domestic violence
situation. Using a common factors model, the PMHNP wants to pay attention to
cultivating the relationship with the parents and child. After the child talks
about how nervous he or she has been since witnessing the trauma, what is an
appropriate response by the PMHNP?
• Question 31 The PMHNP is meeting with a married couple. The husband is 81
years old, and the wife is 78 years old. They tell the PMHNP that many of their
friends have passed away over the last couple of years, and it’s making them
feel sentimental about their lives and the fact that they are getting older.
Hearing this, the PMHNP uses a life review approach with the couple. What action
will the PMHNP employ?
• Question 32 A patient in group therapy for people dealing with panic
disorder is describing a recent panic attack. He says, “During this attack, I
felt like I was dying.” What is an appropriate response by the PMHNP using
didactic instruction?
• Question 33 A patient in group therapy discloses her concern about
feeling suicidal again in the future. Using the principle of universality, what
is an appropriate step by the PMHNP?
• Question 34 The PMHNP recognizes that extragroup behavior involves
behavior that occurs outside of the group or during subgrouping. Which
statement best describes extragroup behavior as it pertains to group therapy?
• Question 35 In a group therapy session for patients with anxiety
problems, a patient named Eve was afraid to disclose to the other members that
she was a victim of sexual abuse. She kept the secret for months, although she
hinted at it to other members. During a meeting, another member tried to
pressure Eve to disclose her secret, but she was flustered and not ready to
share. What is an appropriate response by the PMHNP?
• Question 36 During his second group therapy session, a member, who was
quiet the previous week, becomes very judgmental. He criticizes another member
by saying, “Mary, you are always late because you don’t respect our group.”
Then he adds, “In fact, all of you are disrespectful and uncaring.” What is an
appropriate step by the PMHNP?
• Question 37 A patient who has been depressed is seeing a PMHNP for
individual therapy. The patient explains that he has been avoiding most social
activities for the past few months. He is divorced and has joint custody of his
10-year-old daughter. Based on this information, what recommendation by the
PMHNP would most benefit the patient?
• Question 38 Following the PMHNP’s cancellation of a group session, he or
she notices a decrease in compliance and attendance within the group. What does
the PMHNP identify as the group’s reason for noncompliance?
• Question 39 A PNHNP is holding a group therapy session. Today, several
members have expressed fears about being unlovable. Based on this information,
what is an appropriate step by the PMHNP to raise the members’ self-esteem?
• Question 40 A patient named Tyrone was nervous sharing personal
information with the group. To compensate, he makes comments on other members’
problems as if he were the therapist. Another member of the group asked him,
“Do you think you’re better than everyone here?” What might the PMHNP help
Tyrone gain from this exchange?
• Question 41 A PMHNP is creating a therapy group and is including a
patient with borderline personality disorder. Which action would most likely
reduce the patient’s chance of separation anxiety
• Question 42 The anticipation of the first meeting among
psychotherapy group attendees may cause feelings of dread and uneasiness among
clients. How does the PMHNP demonstrate awareness and promote the success of
this first psychotherapy meeting?
• Question 43 For several months, a patient in group therapy always
participated in conversation but only shared positive stories about her own
life. During the next session, she finally confessed that she has been
depressed and cutting herself. What is the best response by the PMHNP?
• Question 44 Two PMHNPs are in charge of a therapy group that has
experienced several maladaptive interpersonal dramas lately. One of the
patients has been described by other members as argumentative. After a
particularly awkward session, one of the therapists feels that his own
interpersonal distortion of the session may be clouding his observation. What
is an appropriate step by that PMHNP?
• Question 45 A PMHNP is treating a 7-year-old child exhibiting signs of
aggression and attention problems. Before suggesting an intervention using a
common elements approach, what may the PMHNP consider?
• Question 46 The homogenous mode of composition involves a theory that
relates to group composition. When applying this theory, the PMHNP is aware
that the group will most likely consist of which of the following?
• Question 47 A patient has attended three group therapy sessions and has
remained silent throughout each. The patient has, however, been listening to
the other members. When the therapist makes eye contact with the patient, he or
she forces a smile but has clenched fists. What is the most appropriate
response by the PMHNP to help the patient?
• Question 48 The PMHNP is meeting with an older married couple. The couple
reports having concerns about becoming dependent on their adult children someday,
since several of their other friends have had to move in with their kids. They
make it clear to the PMHNP that they aren’t keen on therapy or taking medicine
but would be willing to try some alternative therapies. What does the PMHNP
suggest for evidence-based CAM modalities?
• Question 49 The PMHNP explains during a discussion that subgrouping has
the potential to make group therapy more complicated and less rewarding. Tara,
a member of the group, angrily states, “Well, Jack and I have been meeting
outside of the group for weeks now.” What is the PMHNP’s most appropriate
response?
• Question 50 Gregory is a middle-aged veteran participant in a group led
by the PMHNP. Since Gregory has been attending group, he frequently interrupts
others and seems to take much of the group time for himself. The PMHNP
identifies Gregory as a monopolist and confronts him. She explains that she
does not want him to talk less; instead, she actually encourages him to talk
more. What is the likely cause of the PMHNP’s explanation?
• Question 51 The PMHNP understands that conflicts within the psychotherapy
group can be troublesome for clients and have the potential to reduce the
effectiveness of the group process. As it pertains to group meetings, the PMHNP
understands which statement to be true about conflict?
• Question 52 One member of a therapy group had been quiet for the first
several sessions. The member revealed to the other members feeling of
depression and emptiness. This week, the member was full of energy and talking
very quickly. The member became irritated with another member tried to interrupt,
started yelling, and then broke into a fit of laughter. Based on the situation,
what can the PMHNP determine about the member?
• Question 53 A group member who suffers from depression and anxiety says
during the session, “I don’t see how any of this is going to help. I am still
too anxious to leave the house and do the things I want to do.” What is an
appropriate response by the PMHNP?
• Question 54 A PMHNP is leading a group therapy session for patients with
substance abuse problems. After one member shares a problem, other members
offer support, concern, and observations. The PMHNP points out that the group
is offering many truthful reactions and helpful feedback. Which principle does
this illustrate?
• Question 55
The PMHNP provides cognitive
behavioral therapy (CBT) to an older adult patient with depression. The
patient’s 41-year-old daughter and 32-year-old son attend one of his sessions
with the PMHNP so that they can learn more about how to help their father. What
does the PMHNP say to the daughter and son about the goals of their father’s
CBT?
• Question 56 The PMHNP recognizes that hostility is unavoidable in a group
and acknowledges that a frequent source of hostility can be parataxic
distortions. Which situation is likely to present a parataxic distortion within
the group?
• Question 57 Members of group therapy have been meeting for several weeks.
The PMHNP often starts sentences with a thank you or compliment such as, “Good
observation.” The PMHNP notices that some of the group members having been
starting their statements with compliments. To which principle can the PMHNP attribute
this process?
• Question 58 A client diagnosed with
depression has begun to feel despair and expresses a desire to leave the group
because he or she does not believe it is helpful. Which action by the PMHNP
will most likely contribute to the client staying in the group?
• Question 59 A 14-year-old girl named Laura and her parents are meeting
with a PMHNP. The parents explain why they are there by saying, “Laura has been
unhappy since she moved to a new school. She has been moody and often talks
back to us.” Laura sits quietly and looks uncomfortable. Which is the best
response by the PMHNP?
• Question 60 Many key principles assist with composing intensive interactional
psychotherapy groups. When composing a psychotherapy group, utilizing the
intensive interactional approach, which key principle does the PMHNP identify
as being false?
• Question 61 A PMHNP notices that adolescents in a therapy group have not
been getting along. They are divided into two main groups and each
automatically dislikes members of the other group. What is an appropriate step
for the PMHNP to take?
• Question 62 During an initial
screening session, the PMHNP is considering a patient for group therapy. The
patient is recently divorced and says he is lonely and depressed. What is the
best referral by the PMHNP?
• Question 63
During an initial meeting, a
patient who has been discussing suicide says to the PMHNP, “I’m so depressed
that I don’t want to leave my house. All I want to do is stay in bed.” What
type of therapy would the PMHNP most likely recommend to this patient?
• Question 64 A member in group therapy named Tom asked others for
suggestions to a problem he was having. He did not think a suggestion by a
member named Steve would work, and for the rest of session, the group took
sides arguing why the idea would work or would not work. The session ended with
Tom agreeing to try the suggestion and report back to the group the following
week. Based on this session, what is an appropriate step by the PMHNP?
• Question 65 The PMHNP is working with an older adult woman and her adult
children. The children report that the mother was diagnosed with dementia, and
they are all concerned about her welfare. The plan is for the mother to move in
with one of the children, but they are still worried about how the mother will
manage during the day when she is left alone. What does the PMHNP identify
as the focus of the family therapy?
• Question 66 During a group session, a member turns to the
PMHNP and says, “I need some advice. My manager asked me to take on an extra
project, and now I’m overwhelmed. I don’t want to seem incompetent, so I agreed
to the extra work. What do you recommend I do?” What is the best response by
the PMHNP in order to shape group behavior?
• Question 67 During a group therapy session, a member shares that she
often feels lonely and depressed. She has been turning down invitations to
spend time with friends lately, because she does not want to leave the house.
What is an appropriate step for the PMHNP to take?
• Question 68 Self-disclosure is a very important part of group therapy.
Which of the following conditions does the PMHNP identify in his or her own
life as a possible hindrance to self-disclosure
• Question 69 A PMHNP is meeting with the mother of a 10-year-old boy named
Malik, who has been depressed since his parents’ divorce. The mother explains
that her goal for treatment is to help Malik feel better so he can become his
“usual outgoing self.” She insists that she does not want him on medication.
Which is the best response by the PMHNP?
• Question 70 A client has attended five group therapy sessions yet has not
engaged verbally with others in the group. The PMHNP has identified the client
as a “silent member.” Which statement is true about silent members as related
to group therapy?
• Question 71 A narcissistic patient was unhappy that other members did not
seem concerned about his or her dating problems, which the patient spent half
the session talking about. The patient confronted the group by saying, “All of
you are rude and uncaring!” When group members ignored this comment, the
patient said, “And no one said anything nice about my new haircut either!” What
is an appropriate response by the PMHNP?
• Question 72 According to Dr. Carlson, since Adler talked about how the
social setting in which we live influences our lives, the best way parents can
change their children’s behavior is to change:
• Question 73 In the parent consultation session, the parent discusses her
son “Blake” who has changed since his 13th birthday. Dr. Carlson discusses the
power conflict that the parent appears to be getting into with her son. When
they discuss approaches they can use to help Blake experience increased
responsibility, Dr. Carlson explains that the parent must make a commitment with
her son by agreeing to:
• Question 74 A PMHNP is evaluating a patient who has problems with
authority and has trouble accepting criticism. The patient is aware of these
problems and wants to change. Based on this, what is an appropriate action by
the PMHNP?
• Question 75 A PMHNP has a therapy group in which many members have been
dropping out over the past several weeks. Members have complained that they do
not feel part of the group. What is an appropriate step for the PMHNP to take?
• Question 76 When completing this exam, did you comply with Walden
University’s Code of Conduct including the expectations for academic integrity?

MIDTERM_EXAM_(3).docx (56.85 KB)

• Question 1
The PMHNP is
meeting with the parents of a school-aged girl. The mother reports feeling
frustrated, because they cannot get their daughter to do her homework. “All she
wants to do is play on her phone,” the father reports. The mother tells the
PMHNP that they have tried threatening her by telling her that she won’t be
able to have her friends over and that she won’t be allowed to watch TV. Which
of the following responses made by the PMHNP demonstrates use of the Premack
principle?
• Question 2
The PMHNP is
meeting with a family composed of two parents and their two children. The PMHNP
observes that the mother projects her concerns onto one of the children, and
that child seems to conform to the parents’ way of thinking. The other child
seems to be less involved in the family’s fusion. What action taken by the
PMHNP demonstrates the use of the Bowen Family Systems Therapy model?
• Question 3
The PMHNP is
working with a patient who is sleep deprived and depressed. Which of the
following is an appropriate scaling question for the PMHNP to ask?
• Question 4
The PMHNP is
working with the parents of an adolescent daughter. The parents complain that
the daughter is misbehaving and having emotional outbursts on a nightly basis.
However, the parents cannot agree on ways to discipline and deal with the
daughter. This leads to arguments between them. What does the PMHNP do to
support the strategic use of rituals?
• Question 5
A family is in
therapy because they have been unable to resolve conflicts and are arguing
frequently. When using a strategic family therapy approach, which of the
following directives might the PMHNP suggest to create a sense of togetherness?
• Question 6
The PMHNP is
working with a family composed of two parents and their 16-year-old son. The
parents report they have been experiencing conflict regarding the son’s defiant
behavior in the home. Which action will the PMHNP employ as part of the early
phase of the therapy?
• Question 7
The PMHNP is
working with 12-year-old twin sisters. Their parents report that the twins got
into a big fight recently, which they haven’t been able to overcome. Which
cognitive interaction can the PMHNP use to help the sisters gain a new
perspective of the argument to help soften their own opinion of it?
• Question 8
The PMHNP is
meeting with a married couple. The woman feels very insecure, particularly when
it comes to her husband working with women in his office. She reports, “My
girlfriends say that it’s not attractive to be insecure like I am, so I’m
really making the problem worse by being so insecure.” How can the PMHNP
externalize the woman’s problem?
• Question 9
The PMHNP is
providing family therapy to two parents and their twin 14-year-old children.
The children become defiant around bedtime and are still working on their
homework late into the night. How does the PMHNP employ an experiential
technique of family sculpting?
• Question 10
The PMHNP is
assessing a married couple who disclosed on the intake form that that they are
having intimacy issues. During the assessment, the PMHNP asks the couple what
brings them in today. The wife is quick to answer, “My husband doesn’t listen
to me anymore.” Using the Mental Research Institute (MRI) assessment technique,
how does the PMHNP respond to this?
• Question 11
During a family
therapy session, a 10-year-old girl says to her father, “You are at work all
the time and are never around.” What is the most appropriate response by the
PMHNP to improve communication?
• Question 12
The PMHNP is
assessing a 19-year-old patient who reports feeling burdened and constrained by
her family. “I feel like I can’t live my own life, and like I need their
approval for everything I do,” she says during the assessment. Which response
by the PMHNP supports the principles of family therapy?
• Question 13
The PMHNP has just
completed an intake assessment on a 15-year-old patient and believes the
patient would benefit from family therapy. How does the PMHNP describe the
goals of the therapy to the patient and the patient’s parents?
• Question 14
The PMHNP is
working with a married couple who have agreed to seek sex therapy due to the
wife’s gradual decrease in interest in sex. The wife explains that she feels as
though she cannot feel comfortable naked and enjoying being intimate. The PMHNP
recognizes that the couple could possibly benefit from sensate focus. To apply
the sensate focus exercise, the PMHNP suggests the couple first do what?
• Question 15
During a family
therapy session, the PMHNP identifies a significant amount of emotional fusion
between the parents and their young adult son. The son admits that he tries to
seek distance from his parents. This is why he moved out of state for college,
though he still comes back to visit out of obligation. What does the PMHNP
interpret about this scenario?
• Question 16
The PMHNP is
providing narrative therapy to a family. Although each family member assigns a
“problem” to another, the PMHNP attempts to separate each person in the family
from their problems. The goal is to find something they all have in common so
the family can unite. What will the PMHNP do next to help facilitate this goal?
• Question 17
The PMHNP is
providing family therapy to a married couple having an issue with
communication. Using the structural family model, what does the PMNHP have the
couple do as part of enactment?
• Question 18
The PMHNP is
meeting with a woman and her 11-year-old child, who was a victim of sexual
abuse. The offender is the child’s stepfather, who is currently in jail. What
action does the PMHNP employ with the child and mother during the first
session?
• Question 19
The PMHNP is
providing marital therapy to a husband and wife who have been married for 6
years. They are attending therapy sessions, because they both want to get their
marriage back on track. They report that lately they have not been
communicating well or meeting each other’s needs. What does the PMHNP suggest
to the couple when applying a behavior exchange technique?
• Question 20
The PMHNP is
working with a family that includes two parents and their two children. The
PMHNP defined the problem and goal in a previous session. Today, the PMHNP
wants to find out whether the family has experienced any attempted solutions.
What does the PMHNP identify as an attempted solution that actually perpetuates
the family problem?
• Question 21
Which of the
following is an exception question that the PMHNP can ask when working with a
patient who is having trouble managing stress at work?
• Question 22
During the initial
assessment of a newly married couple, the PMHNP learns that they decided to
come to family therapy in order to address their communication problems. Which
of the following actions taken by the PMHNP demonstrates the use of the
solutions-focused approach?
• Question 23
The PMHNP is
meeting with a family that consists of a mother and father and their two
daughters, ages 8 and 10. During the session, the PMHNP hears one child say, “My
sister never gets into trouble because she’s the smart one.” Which family
therapy theory is most applicable to this family?
• Question 24
The PMHNP is
assessing a family that consists of a mother and a father and their daughter
Rachel. The family is discussing the issue of time management in the home,
particularly involving the daughter’s extracurricular schedule. The mother
asks, “Rachel, how many times has your father been late to pick you up from
soccer?” What does the PMHNP take away from this interaction?
• Question 25
The PMHNP is
working with a father and his son, who is 7 years old. According to the father,
the son frequently experiences outbursts and poor impulse control. Using the
differentiation of self-concept, what advice does the PMHNP offer the child?
• Question 26
The PMHNP is
meeting with a set of parents and their 12-year-old son, who according to the
parents is fearful of “nearly everything.” The son admits that he does not like
to ride his bike, play with his friends, or participate in activities such as
sports, in which he could hurt himself or become dirty. What does the PMHNP say
to the son to personify the problem using externalizing conversation
techniques?
• Question 27
The PMHNP is
meeting with a married couple who have recently had a baby. The transition of
becoming new parents has caused a lot of friction and tension in the household.
The wife wishes the husband would help out at least once with the nighttime
feedings so she can get more than 3 hours of sleep at night. The husband feels
like this is an unfair request, because the wife no longer works, but she still
asks the husband to do a lot of errands during the day. What does the PMHNP do
to create a quid pro quo contract between the husband and wife?
• Question 28
The PMHNP is working
with a family consisting of a father, a mother, and a daughter who is a
sophomore in high school. The issue being discussed has to do with the
daughter’s emotional outbursts about wanting to spend more time with her
friends. Recently, the daughter blew up at the parents over the fact that they
wouldn’t let her go to a party, since older kids from the school were throwing
it. This outburst led to arguments in the household, which led to the daughter
getting grounded for 2 weeks. Which theory does the PMHNP recognize as the most
applicable?
• Question 29
The PMHNP is
working with a married couple who are having trouble communicating. The wife
wants to ask for things from the husband, but she doesn’t want to be perceived
as a nag. The husband wants to tell the wife that he needs alone time, but he
doesn’t want to hurt her feelings. Which pretend technique can the PMHNP use
with the couple?
• Question 30
The PMHNP is
discussing problem-solving techniques with a married couple. What
recommendation will the PMHNP provide to the couple?
• Question 31
The PMHNP is
performing an intake assessment on parents who had their son later in life.
Since their son left for college 6 months ago, the couple reports arguing a lot
and not getting along in general. When applying the theory of the family life
cycle, what does the PMHNP say in response to this concern?
• Question 32
The PMHNP is
meeting with a single father and his adolescent daughter. They have been
“butting heads” because of the daughter’s differing opinions about her curfew
and social life. They haven’t been able to communicate well. The PMHNP tries an
experiential technique of family drawing. What will the PMHNP have the father
and daughter do for this technique?
• Question 33
The PMHNP is
assessing a young husband and wife who just had their first baby. Ever since
having the baby, the couple has been arguing more frequently, which the husband
believes is the result of sleep deprivation. Also, the husband believes the
wife has post-partum depression. Using the Bowen Family Systems Therapy model,
what does the PMHNP do as part of the assessment? Select all that apply.
• Question 34
A PMHNP learns
that the family has been experiencing dysfunction because a mother and her
teenage son have been getting easily annoyed and yelling at each other. When
using a strategic family therapy approach, which directive should the PMHNP
suggest to solve the problem?
• Question 35
A PMHNP is using a
structural family therapy approach. During a family therapy session, a child
says, “Is that what you really mean?” Tracking the phrase, the PMHNP discovers
that the family often uses sarcasm when communicating. What is the appropriate
next step by the PMHNP?
• Question 36
The PMHNP wants to
identify the unique outcomes of a married couple who are having arguments about
finances. In particular, the wife is concerned about her husband splurging
without consulting her. What question will the PMHNP ask to arrive at the
unique outcomes?
• Question 37
The PMHNP is
working with parents who argue about ways to discipline their school-aged son. The
PMHNP initiates enactment, telling the parents to discuss the disciplinary
choices directly with each other. At what point does the PMHNP determine that
the parents are demonstrating enmeshment?
• Question 38
During a family
therapy session, the PMHNP hears the father say to the son, “You shouldn’t play
video games where you shoot people.” According to the Bion school of thought,
what is the content of the message that the father is trying to express?
• Question 39
During family
therapy, a husband says to his spouse, “When you ignore me, I can’t help but
shout.” Using an emotionally focused family therapy approach, the PMHNP
comments to the husband, “You feel like you are invisible and need to be
heard.” Why does the PMHNP make this comment?
• Question 40
The PMHNP is
working with a father and his teenage daughter. The father has full custody of
his daughter as of recently. He reports that the two of them get into arguments
all the time over curfew, chores, and the daughter’s lack of responsibility
that “she gets from her mother.” The daughter feels like the father never
listens to her. Which of the following actions taken by the PMHNP demonstrates
unbalancing the relationship?
• Question 41
The PMHNP is
meeting with a husband and wife and observes that the husband is able to
maintain his composure while the wife becomes more teary and emotional
throughout the session. Which principle is used to describe this observation?
• Question 42
The PMHNP is
meeting with a family that consists of a husband, wife, and the wife’s mother
and sister. The husband complains to the PMHNP that the way his mother-in-law
and sister-in-law barge into their home whenever they want, without any
warning, is becoming intrusive. He says, “Because, of course, everyone in the
family has keys to our home.” Which pattern does the PMHNP identify in this
family relationship?
• Question 43
The PMHNP meets
with the parents of a 3-year-old boy, who was adopted at 6 months of age. The
parents ask the PMHNP if he will see the child individually for therapy
sessions on a weekly basis, based on the fact that the parents are having
difficulty getting their son to listen to them. Which statement made by the
PMHNP supports the systems theory approach to treatment?
• Question 44
The PMHNP is
meeting with a mother and her teenage daughter; they are having trouble getting
along. The mother complains that the daughter is defiant and never listens or
goes out whenever she wants to. The daughter complains that the mother is too
strict and won’t let her see her friends. What does the PMHNP do to employ the
use of the paradoxical intervention technique?
• Question 45
The PMHNP is
meeting with parents who are having difficulty disciplining their child at home
during his emotional and behavioral outbursts. The mother feels that the father
is too strict but realizes that she is tired of getting “walked on” by their
child. Which statement made by the PMHNP demonstrates the use of internal
family systems therapy model?
• Question 46
The PMHNP is
meeting with two women, ages 35 and 42, who are concerned about their mother’s
use of alcohol. During the meeting, what question(s) should the PMHNP ask the
mother to help uncover the potential drinking problem?
• Question 47
Members of a
therapy group have become aligned and are starting to take ownership of their
group experience. They are sharing more and are being more open with each
other. During the next session, the PMHNP decides to address termination of the
group. Which of the following is the most appropriate response by the PMHNP
when a group member expresses anxiety about termination?
• Question 48
When using a
cognitive behavioral approach, a PMHNP says to a group member, “Carla, it
sounds like Greg thinks that you might want to try yoga for relaxation.” What
would be an appropriate next statement by the PMHNP to Carla?
• Question 49
The PMHNP is
meeting with a single mother and her 19-year-old son who lives with her. The
son complains that his mother is always nagging him. What is the PMHNP’s
interpretation of this scenario according to a complementarity approach?
• Question 50
The PMHNP is
meeting with a mother and father for the first time in a family session. As
soon as the session begins, the mother says, “I don’t know what to do anymore.
Our son is flunking math. I think we should pull him out of football, but I
don’t get any support in that decision. What would you do if you were us?” The
PMHNP recognizes this as what?
• Question 51
The PMHNP works
with a husband and a wife, but in separate sessions, to address marital issues.
One day, the wife asks the PMHNP how her husband is progressing with his
therapy. Which response made by the PMHNP is most appropriate?
• Question 52
The PMHNP meets
with the parents of a 6-year-old; they are having a difficult time with their
child’s behavior. The PMHNP aims to bring the family together and asks the
parents to think about one of the challenging issues they face with their
child. The PMHNP says, “Imagine this situation happening as a scene in a movie,
one that you can rewind and watch again. Watch this scene again, this time
paying attention to what you feel, what you see, and what you hear.” The
parents are then asked to re-experience the same scene from the child’s point
of view. Continuing to use Satir’s technique of the experiential model, what
does the PMNHP have the parents do next?
• Question 53
The PMHNP is
working with a single mother and her adolescent son. The mother reports to the
PMHNP that all she wants is for her son to call her when he is going to be late
to dinner, so that she doesn’t worry about where he is. The son explains that
his mom is “too paranoid” and calls or texts him constantly throughout the day,
even if it doesn’t have to do with his whereabouts. How can the PMHNP advise
the mother and son to accommodate one another?
• Question 54
The PMHNP is
working with a family in a group setting. When employing the experiential
technique, what action will the PMHNP take with the family during assessment?
• Question 55
The PMHNP is
meeting with a mother and her 9-year-old child. The child is upset that the
father left the house and hasn’t been back in a long time. Which action will
the PMHNP perform to employ the role-playing technique with the child?
• Question 56
The PMHNP is
meeting with a family consisting of two parents and their 10-year-old son. The
parents are concerned about the child’s behavior. “He keeps disobeying us. All
he does is misbehave,” the mother cries. The PMHNP meets individually with the
son for a few sessions to learn more about his behavior and identifies that he
is participating in attention-seeking behaviors. When the PMHNP invites the
parents and son back to a family group setting, what action made by the PMHNP
supports the use of constructivism?
• Question 57
While in a family
therapy session, a wife comments, “Instead of spending time with me, he is
usually watching sports on television.” Using an emotionally focused family
therapy approach, what is an appropriate response by a PMHNP using an evocative
question technique?
• Question 58
A client in group
therapy has been suffering from anxiety and is worried that she will have a
panic attack again. Which of the following interventions demonstrates use of
the principle of imparting knowledge?
• Question 59
Using a systemic
family therapy approach, a PMHNP is meeting with a couple for an initial
session and is asking each member to describe why he or she came to family
therapy. After creating a genogram, the PMHNP says, “I can see that the men in
your family are often the sole providers, and the women have been in charge of
running the household.” Which is the most appropriate next response by the
PMHNP?
• Question 60
During a family
therapy session, the mother says, “I don’t know why my son is always in trouble
at school. He does what he wants to do.” The father adds, “He’s almost 14 years
old. It’s up to him to get his life in order.” What is the most appropriate
intervention by the PMHNP?
• Question 61
A couple and their
13-year-old daughter have been in family therapy. The mother explains that her
daughter is unhappy at private school and would like to be in public school.
The father has been listening quietly and then says, “We are upset that our
daughter wants to leave private school.” When using a systemic family therapy
approach, what is the appropriate response by the PMHNP to the father?
• Question 62
The PMHNP is
meeting with an established patient who is trying to resolve issues between her
and her husband. The woman convinces her husband to join her for this session.
Using a solutions-focused approach, which of the following statements would be
most appropriate for the PMHNP to make?
• Question 63
The PMHNP meets
with a single mother and her son. The mother reports that the son is defiant
when it comes to doing chores at home. “If he does not do his chores, then I
don’t have a picture-perfect house, and I don’t feel like a good mother,” she
explains. The PMHNP identifies this as a problem-saturated story. How does the
PMHNP respond to the family?
• Question 64
The PMHNP is
meeting with a mother and her adult daughter, who report that they have had a
hard time getting long. The adult daughter complains that her mother tells her
what to do regarding her children, which puts strain on the adult daughter’s
marriage. The mother denies this and explains that she is “only trying to
help.” What does the PMHNP say to the mother or daughter to convey acceptance
into this family?
• Question 65
The PMHNP meets
with an older adult couple having marital problems. The husband and wife both
admit to the PMHNP that it is difficult for them to speak to each other because
of how much they disagree on things lately. The husband complains that the wife
is always talking about their issues to their adult daughter. The wife reports
that the husband does the same thing. Using the Bowen Family Systems Therapy
model, what does the PMHNP interpret about this family dynamic?
• Question 66
A man calls a
PMHNP to set up an initial appointment for family therapy. He explains, “My wife lost her job several
months ago. She has been angry and less patient with the kids. All of the
stress is taking a toll on me. I can’t focus at the office and I’m mentally
exhausted at home.” Based on this phone contact, who would the PMHNP most
likely choose to see for the first session?
• Question 67
The PMHNP is
leading a group session when a group member who is usually quiet angrily
interrupts another group member. He then apologizes for his outburst and
explains that he has been having a hard time since his only child left for
college. Using a person-centered approach to group psychotherapy, which of the
following is the most appropriate response by the PMHNP?
• Question 68
A group member
realizes he gets anxious when making small talk and tends to talk only about
himself. Using the principle of development of socializing techniques, what
might the PMHNP recommend that the group do next?
• Question 69
The PMHNP is
meeting with a husband and wife who have separated but are trying to rekindle
the marriage. The PMHNP asks the couple what they hope to gain from the
sessions, and they provide the PMHNP with vague answers. What can the PMHNP can
ask the couple to help them create better defined goals?
• Question 70
A PMHNP has
integrated group treatment into his practice. After the orientation phase,
group members have been exchanging ideas. One member says, “I think you should
confront your son and ask why he is so disrespectful.” Another member responds
by saying, “That is a terrible idea. If you confront him, he will just be angry
with you.” The first member then replies, “You are not the expert here!” The
rest of the group members then start taking sides as the debate continues. What
step should the PMHNP take to help group development?
• Question 71
A PMHNP is working
with a mother and daughter to help them improve their communication skills. The
mother explains that they have had numerous arguments caused by
miscommunication lately. Using a structural family therapy approach, what is
the appropriate response by the PMHNP?
• Question 72
The PMHNP is
meeting with a family that consists of a mother, father, and son. The son
reports, “Whenever Mom gets upset with Dad, she vents to me about it.” Which
concept describes the mother’s behavior in this scenario?
• Question 73
The PMHNP is
working with a married couple in a family session setting. The wife reports
feeling upset because her husband does not pay attention to her. Which
statement made by the PMHNP will challenge the wife to see things differently?
• Question 74
The PMHNP is
working with a family during their first therapy session. According to the
Gestalt school of perception, what must the PMHNP do to change the group
behavior?
• Question 75
The PMHNP is
working with the parents of an 8-year-old. They are facing challenges with
their daughter’s school because of her behavior toward other students. “Our
daughter has become a problem,” they explain. Which statement(s) made by the
PMHNP supports the use of the narrative therapy model?
• Question 76
When completing
this exam, did you comply with Walden University’s Code of Conduct including
the expectations for academic integrity?