Walden NURS6650

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?