the patient threatens an act of violence to the therapist. What would be the most appropriate response by the PMHNP?
Quiz: Final Exam
This exam will cover the following topics from the Wheeler textbook, which relate to psychotherapy of individuals:
· Supportive and Psychodynamic Psychotherapy
· Interpersonal Psychotherapy
· Humanistic-Existential and Solution-Focused Approaches to Psychotherapy
· Psychotherapy With Children
· Psychotherapy With Older Adults
· Termination and Outcome Evaluation
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.
1. 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 ___________.
|A.||return to a normal system of functioning|
|B.||break the feeling/behavior connection|
|C.||use more appropriate ways to satisfy needs|
|D.||all of the above|
1. 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?
|A.||Suggesting that the patient goes to church to pray for God’s help|
|B.||Telling the patient to write letters to the biological fathers requesting money|
|C.||Suggesting that the patient seek professional legal help|
|D.||Asking the patient why she thinks it is so hard to get the money she deserves|
1. 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?
|A.||Immediately report the threat to the local police department|
|B.||Allow the patient to explore his feelings|
|C.||Review the therapeutic treatment frame|
|D.||Call the patient the next day to follow up|
1. 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?
|A.||“Express your emotion, and do not hold anything back.”|
|B.||“Let’s not think too much about emotion right now. Let’s focus on what got you upset in the first place.”|
|C.||A and B|
|D.||None of the above|
1. 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?
|A.||“How were you feeling at the time when that happened?”|
|B.||“What are you experiencing now as you share this story?”|
|C.||“Did you allow yourself to feel anger when your father left?”|
|D.||“Are able to let go of the painful emotions you felt as a child?”|
1. 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?
|A.||Give the patient as much time needed to respond to questions and comments.|
|B.||A statement that both challenges the patient’s resistance and offers an opportunity to discuss the issues allows the patient to argue with him/herself to help produce a desired change.|
|C.||You must give full attention to the patient because nonverbal and verbal reactions are equally important.|
|D.||The PMHNP should be ready with a response when communicating with the patient. She understands that silence is also a therapeutic response.|
1. The PMHNP who practices motivational interviewing understands its relationship to patient behaviors and/or outcomes to mean which of the following?
|A.||An increased use of motivational interviewing is linked to inconsistent behaviors in the patient. This is related to decreased client engagement and poor outcomes.|
|B.||A decreased use of motivational interviewing is linked to more consistent behaviors in the patient. This is related to decreased client engagement and poor outcomes.|
|C.||There is a higher incidence of inconsistent behaviors with motivational interviewing. This is related to client engagement and better outcomes.|
|D.||There is a lower incidence of inconsistent behaviors with motivational interviewing. This is related to client engagement and better outcomes.|
1. 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?
|A.||Mood Disorder Questionnaire|
|B.||Montgomery-Asberg Depression Rating Scale|
|C.||AB Clinician Depression Screen|
|D.||Brief Psychiatric Rating Scale|
1. 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 _________.
|A.||primary health care setting with some specialized care|
|B.||state psychiatric hospital and/or emergency room|
|C.||substance abuse treatment system|
|D.||mental health system of care|
1. 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 ______________.
|A.||focus on the substance abuse problem before addressing any trauma|
|B.||integrate services that encompass mind, body, spirit, and community|
|C.||help the patient use fear of relapse to provide motivation for recovery|
|D.||none of the above|
1. 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?
|A.||“I noticed that your fingers were tapping. Can you give a voice to your fingers?”|
|B.||“I’m going to ask you to exaggerate the movement of tapping your fingers.”|
|C.||“Explore what is emerging in your body now. What are you experiencing right now?”|
|D.||None of the above.|
1. 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:
|A.||“I sincerely commend you for being here and seeking treatment; this is a great first step.”|
|B.||“If no one knows about your substance usage, why are you here?”|
|C.||“Just because no one knows about your drug usage does not mean you do not have a problem.”|
|D.||“I am wondering if your use of pain medication has ever prompted you to seek medical attention.”|
1. 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?
|D.||All of the above|
1. 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?
|A.||Address the termination phase with the patient at the last session|
|B.||Manage termination issues as part of the treatment|
|C.||Determine the PMHNP’s readiness to terminate the therapeutic relationship|
|D.||None of the above|
1. 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?
|A.||Cognitive behavioral therapy (CBT)|
|B.||Interpersonal psychotherapy (IPT)|
|C.||Combination of CBT and IPT|
|D.||Combination of CBT and medication|
1. 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?
|A.||“You may want to look into therapeutic oils and aromatherapy as an alternative to medication.”|
|B.||“Some patients have good results with medicine. Are you sure you don’t want to try…|