• 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
• 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withdrawn and refuses to do anything about it.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
• 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,
• 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
• 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
• 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
• 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
• 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
• 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
• 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
• 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
• 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
• 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
• 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
• 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
• 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
• 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
• 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?