Psychotherapy With Individuals – NURS 6640 – Exam Questions and Answers
Question 33
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:
A. “Would you say you feel like you are suffocating?”
B. “No, I am not sure what you are saying. Can you please explain?”
C. “Sort of like a fish out of water?”
D. “When you say, ‘I just can’t breathe,’ you do understand, that is a form of anxiety?”
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Question 34
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?
A. “If this had happened to someone else with the exact same circumstances, would you say this was her fault?”
B. “Can you recall exactly what stopped you from going home when you originally wanted to go home?”
C. ”Have you shared these thoughts about what you should have done with anybody other than me?”
D. “Do you understand that there is absolutely nothing that you could ever do to deserve to be treated the way you were treated?”
Question 35
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.
True
False
Psychotherapy With Individuals – NURS 6640 – Exam Questions and Answers
Question 37
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?
A. Autognosis
B. Complementary identification
C. Concordant identification
D. Self-disclosure
Question 40
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.
True
False
Question 41
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 _________.
A. may lack ability to see independent motivations
B. has an insistent emphasis on the feelings of others
C. has an intrusive interpersonal relationship
D. all of the above
Psychotherapy With Individuals – NURS 6640 – Exam Questions and Answers
Question 42
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?
A. “I deserve the utmost respect from everyone who meets me.”
B. “I prefer doing everything on my own.”
C. “It takes me a while to warm up to people; people often wear masks.”
D. “I can’t seem to do anything on my own.”
Question 43
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?
A. “It is dangerous to fantasize about the future.”
B. “I think that’s an excellent idea! I can help you review the prerequisites!”
C. “You may want to explore the requirements for becoming a PMNHP.”
D. None of the above.
STUDY GUIDE
This quiz (Psychotherapy With Individuals – NURS 6640 – Exam Questions and Answers) will cover the following topics, which relate to psychotherapy with individuals in the Wheeler textbook and the Fisher textbook excerpts:
Topics
The Nurse Psychotherapist and a Framework for Practice
Confidentiality Limits in Psychotherapy: Ethics Checklists for Mental Health Professionals
Assessment and Diagnosis
The Initial Contact and Maintaining the Frame
Cognitive Behavioral Therapy
Supportive and Psychodynamic Psychotherapy
Stabilization for Trauma and Dissociation
Motivational Interviewing
Psychotherapeutic Approaches for Addictions and Related Disorders
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Wheeler, K. (Eds.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.
Chapter 1, “The Nurse Psychotherapist and a Framework for Practice”
Chapter 3, “Assessment and Diagnosis”
Chapter 4, “The Initial Contact and Maintaining the Frame”
Chapter 5, “Supportive and Psychodynamic Psychotherapy”
Chapter 7, “Motivational Interviewing” (pp.299-312)
Chapter 8, “Cognitive Behavioral Therapy”
Chapter 13, “Stabilization for Trauma and Dissociation”
Chapter 16, “Psychotherapeutic Approaches for Addictions and Related Disorders”
Fisher, M. A. (2016). Introduction. In Confidentiality limits in psychotherapy: Ethics checklists for mental health professionals (pp. 3–12). Washington, DC: American Psychological Association. doi:10.1037/14860-001. Psychotherapy With Individuals – NURS 6640 – Exam Questions and Answers
Fisher, M. A. (2016). The ethical ABCs of conditional confidentiality. In Confidentiality limits in psychotherapy: Ethics checklists for mental health professionals (pp. 13–25). Washington, DC: American Psychological Association. doi:10.1037/14860-002
Psychotherapy With Individuals – NURS 6640 – Exam Questions and Answers
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Question 33: The correct response is A – “Would you say you feel like you are suffocating?”. By reflecting the idiosyncratic meaning in the patient’s statement using similar language, the PMHNP is illustrating an understanding of how the patient subjectively experiences their stress and anxiety.
Question 34: The best response using the Socratic method is D – “Do you understand that there is absolutely nothing that you could ever do to deserve to be treated the way you were treated?”. This prompts the patient to reflect on irrational beliefs they may hold about deserving the assault, while avoiding direct confrontation.
Question 35: True. Therapists are legally obligated to report any information disclosed in session regarding harm against children, elders or imminent threats of violence. Failure to do so can result in penalties. Maintaining confidentiality is important to build trust, but there are limits to protect safety.
Question 37: The most accurate explanation for the PMHNP’s lingering sadness is C – Complementary identification. This refers to temporarily sharing similar feelings to the patient in response to their distress, which is a normal therapeutic reaction. Self-disclosure or autognosis would be less appropriate in this context.
Question 40: False. Without a signed release of information, the PMHNP is obligated to maintain confidentiality and cannot disclose any details to the mother regarding her son’s treatment or status. Protecting privacy is essential for fostering an open therapeutic relationship.
I hope these explanations are helpful for studying psychotherapy concepts. Please let me know if you have any other questions. I’ve included 5 recent scholarly sources below that may also provide useful information on these topics:
Walfish, S., McAlister, B., O’Donnell, P., & Lambert, M. J. (2012). An investigation of self-assessment bias in mental health providers. Psychological Reports, 110(2), 639–644. https://doi.org/10.2466/02.07.17.PR0.110.2.639-644
Norcross, J. C., & Lambert, M. J. (2018). Psychotherapy relationships that work III. Psychotherapy, 55(4), 303–315. https://doi.org/10.1037/pst0000193
Cuijpers, P., Reijnders, M., & Huibers, M. J. H. (2019). The role of common factors in psychotherapy outcomes. Annual Review of Clinical Psychology, 15, 207–231. https://doi.org/10.1146/annurev-clinpsy-050718-095225
Miller, S. D., & Duncan, B. L. (2020). The Outcome and Session Rating Scales: Administration and scoring manuals. Authors. https://www.scottdmiller.com/outcome-rating-scale
Duncan, B. L., & Moynihan, D. W. (1994). Applying outcome research: Intentional utilization of the client’s frame of reference. Psychotherapy: Theory, Research, Practice, Training, 31(2), 294–301. https://doi.org/10.1037/h0090215
