NRNP6645 midterm exam 2021

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Question 1

According to Freud’s Psychosexual Stages framework a patient exhibiting excessive envy and jealousy failed to successfully manage anxiety during which stage?

 

A.            Oral

 

B.            Anal

 

C.            Latency

 

                Phallic/Oedipal

 

 

 

Question 2

The advanced practice psychiatric nurse psychotherapist is informed by the managed care company that authorization for additional treatment with a patient has been denied. The advanced practice psychiatric nurse is concerned stopping treatment will jeopardize the patient’s safety and realizes which of the following are ethical options?

 

A.            It is incumbent on the therapist to ensure that treatment continues.

 

B.            Stop treatment immediately.

 

C.            Attempt to work out a payment plan with the patient.

 

D.            A and C

 

 

uestion 3

Which of the following is consistent with the aims of supportive psychotherapy?

 

A.            Restructure defenses

 

B.            Strengthen defenses

 

C.            Promote problem-solving

 

D.            B and C

 

 

Question 4

Which of the following is consistent regarding termination in brief psychodynamic therapy?

 

A.            The termination date is set within 10 weeks of anticipated termination.

 

B.            The termination date is set in the beginning of treatment within 30 sessions

 

C.            The termination date is set in the beginning of treatment within 60 sessions.

 

D.            The termination date is flexible and is set mutually by the therapist and patient once major issues have been addressed.

 

 

Question 5

In therapy groups where group members gain through receiving help from group members and giving help to group members, which of Yalom’s therapeutic benefits is being realized?

 

A.            Altruism

 

B.            Catharsis

 

C.            Imparting Information

 

D.            Development of socializing techniques

 

 

Question 6

The skilled psychotherapist assists the patient to stay in the Resilience Zone. Which of the following symptoms are consistent with hypoarousal?

 

A.            Pain, anxiety, fatigue

 

B.            Emptiness, emotional paralysis, emotional numbness

 

C.            Euphoria, irritability, panic

 

D.            Angry outbursts, anxiety, exhaustion

 

 

Question 7

According to Peplau’s Interpersonal Relations Model for nursing, a cornerstone for the psychotherapeutic process is understanding, assessing, and managing which of the following?

 

A.            Anger

 

B.            Anxiety

 

C.            Resilience

 

D.            Holism

 

 

Question 8

According to Freud, failure to successfully accomplish the tasks of learning independence and control is associated with which of the following problematic traits?

 

A.            Excessive dependency

 

B.            Orderliness

 

C.            Sexual identity issues

 

D.            Excessive guilt

 

 

Question 9

The advanced practice psychiatric nurse may intervene as appropriate with agencies or persons in order to advocate for the patient; do for the patient what he or she cannot do for self, always with an aim toward maximum independence and growth which is consistent with which basic strategy of dynamic supportive therapy?

 

A.            Make connections

 

B.            Encourage patient activity

 

C.            Manipulate the environment

 

D.            Maximize adaptive coping mechanisms

 

 

Question 10

Optimal family development is thought to take place in which of the following circumstances?

 

A.            Family members are differentiated, anxiety is low, and partners maintain emotional contact with their own families.

 

B.            Family members lack differentiation, anxiety is low, and partners maintain emotional contact with their own families.

 

C.            Family members are differentiated, anxiety is moderate, and partners reduce emotional contact with their parents and siblings.

 

D.            Family members lack differentiation, avoid anxiety and partners avoid emotional contact with parents and siblings.

 

 

Question 11

The therapist using a CBT approach in which the therapist encourages the patient to investigate whether their thoughts are based on facts or assumptions is known as which of the following?

 

A.            Labeling of Distortions

 

B.            Questioning the Evidence

 

C.            Advantages and Disadvantages

 

D.            Examining Options and Alternatives

 

 

Question 12

Cultural relativity (Horowitz, 1982) refers to

 

A.            How we relate to those from other culture

 

B.            Similarities between various cultures

 

C.            Differences between Eastern and Western cultures

 

D.            Behavior considered normal or abnormal depends on social and cultural norms.

                               

 

 

uestion 13

Patients who would not be considered ideal candidates for psychoanalytic psychotherapy are which of the following?

 

A.            Patients with primarily primitive defenses

 

B.            Patients with primarily mature defense mechanisms

 

C.            Patients with neurotic to healthy personality organization.

 

D.            Patients with the capability to engage in a therapeutic alliance

 

 

Question 14

During the initial phase of family therapy one person is identified as “the problem”. The family therapist challenges linearity by which of the following?

 

A.            Asking the children how they would fix or deal with the problem person.

 

B.            Asking the person identified as the problem to meet privately prior to the next meeting.

 

C.            Asking the person identified as the problem how they think the problem could be fixed.

 

D.            Asking how others in the family are involved in or effected by “the problem”.

 

 

Question 15

Yalom states the group therapy analogue to relationship in individual therapy is which of the following?

 

A.            Universality

 

B.            Cohesiveness

 

C.            Social microcosm

 

D.            The corrective emotional experience

 

 

Question 16

The nurse psychotherapist realizes that “true presence” in a therapeutic relationship involves which of the following? Check all that apply.

 

A.            Listening to what is important to the patient.

 

B.            Listening to what the meaning of a situation is in the moment.

 

C.            “Being with” the patient rather than “doing to” the patient.

 

D.            Acceptance, nonjudgmental attitude and empathy.

 

 

Question 17

Which of the following is not consistent with clinical practice guidelines for use of psychodynamic therapy for various psychiatric disorders?

 

A.            Panic-focused psychodynamic psychotherapy is recommended as an initial treatment for Panic Disorder

 

B.            No RCTs support use of psychodynamic therapy for Obsessive-Compulsive Disorder.

 

C.            Psychodynamic therapy is considered a first-line treatment for Schizophrenia

 

D.            Psychodynamic therapy is a therapeutic treatment option for Major Depressive Disorder.

Question 18

The advanced practice psychiatric nurse who assists the patient to maintain eye contact appropriately, shaking hands appropriately, appropriate language in public is doing which of the following?

 

A.            Social Skills Training

 

B.            Shame-Attacking Exercises

 

C.            Guided Contingency Management

 

D.            Examining Options and Alternatives

 

 

Question 19

Evidenced based guidelines for patient treatment are based on which of the following?

 

A.            Consensus of expert panel

 

B.            Systematic reviews of case studies.

 

C.            Systematic reviews of randomized controlled studies (RTC).

 

D.            A and C

 

 

Question 28

 

Schizoid personality is a pathological outcome associated with which of Erickson’s psychosocial stages?

 

A.            Autonomy vs. self-doubt

 

B.            Industry vs. inferiority

 

C.            Identity vs. role confusion

 

D.            Intimacy vs. isolation

Question 29

Which of the following is not consistent cross-cultural research related to mental health and mental illness.

 

A.            Culture determines what is considered a psychiatric disorder.

 

B.            Neurobiological mechanisms linked to stress and trauma vary across cultures.

 

C.            Individuals from different cultural backgrounds vary in their interoceptive awareness.

 

D.            Individuals from different cultural backgrounds are similar in their interoceptive awareness.

Question 30

The CBT therapist asks the patient “On a scale of 1 to 10 how would you rate your level of depression today?” “And how does that compare to 2 months ago?” This is an example of what type of question type in Socratic Dialogue?

 

A.            Application question

 

B.            Analysis question

 

C.            Evaluation question

 

D.            This would not be a question consistent with Socratic Dialogue.

Question 31

In general, the lower the patient is on Maslow’s hierarchy of needs

 

A.            The less active the therapist must be.

 

B.            The more active the therapist must be.

 

C.            The more neutral the therapist must be.

 

D.            The more enmeshed the therapist must be.

Question 32

Strategies for working with anxiety are central to all therapy approaches. Which strategy would be consistent with a behavioral therapy approach?

 

A.            Restructuring

 

B.            Interpretations

 

C.            Desensitization

 

D.            Exploring wishes

Which technique would be helpful to use with individuals who blame themselves for most bad outcomes?

 

A.            Reattribution

 

B.            Decatastrophizing

 

C.            Advantages and Disadvantages

 

D.            Examining options and alternatives

Question 34

The quality of the therapeutic relationship is most closely linked to which school of therapy?

 

A.            Freudian

 

B.            Gestalt

 

C.            CBT

 

D.            None of the above

Question 35

Which of the following is a responsible way for the therapist to safely set appropriate limits on availability.

 

A.            The therapist just needs to notify either in person or by mail that they will not be available at certain times.

 

B.            The therapist has an answering machine that clearly states that if this is an emergency, the ???? patient should go to the ED or call a crises hotline.

 

C.            Ask another therapist to cover for vacations and time off, as this is for emergency only ???? specifics about patients should not be shared.

 

D.            Both A and B

Question 36

A patient being treated with supportive psychodynamic psychotherapy has been missing sessions and coming late when coming to sessions. The advanced practice psychiatric nurse recognizes this behavior as which of the following?

 

A.            Avoidance

 

B.            A sign the patient has met goals.

 

C.            The patient is ready to talk about termination of therapy.

 

D.            The patient is bored because the sessions have not been very interesting.

 

Question 41

 

According to Yalom, which of the following is consistent with the therapeutic benefit of imitative behavior?

 

A.            Imitative behavior generally plays a more important role in early stages of a group.

 

B.            Imitative behavior may allow an individual to experiment with a new behavior.

 

C.            Finding out what we are not is progress toward finding out what we are.

 

D.            All of the above

Question 42

A group member becomes angry with the group leader accusing the leader of being too controlling and showing favoritism. This behavior is consistent with which of Yalom’s therapeutic factors?

 

A.            Catharsis

 

B.            Interpersonal learning

 

C.            Development of socializing techniques

 

D.            Question 43

Family dialogue is encouraged.

 

A.            Genogram

 

B.            Family schema

 

C.            Family drawing

 

D.            Family sculpting

 

Question 44

An advanced practice psychiatric nurse is sued for continuing to work with a patient despite the treatment not working. The advanced practice psychiatric nurse realizes that which of the following will be considered in this case?

 

A.            Was the standard of care followed?

 

B.            Was there harm to the patient?

 

C.            This is a frivolous lawsuit. The advanced practice psychiatric nurse cannot be sued for this.

 

D.            A and B

 

Question 53

 

Groups with a greater sense of solidarity exhibit which of the following? Check all that apply.

 

A.            Higher rate of attendance

 

B.            Acceptance for a variable level of active participation

 

C.            A concrete system for measuring cohesiveness

 

D.            A and B

Question 54

A group of co-occurring, relatively invariant symptoms found in a specific cultural group, community or context, which may or may not be recognized as an illness within the culture but such cultural patterns of distress and features of illness may be recognizable by the outside observer is known as which of the following?

 

A.            Cultural syndrome

 

B.            Cultural formulation

 

C.            Cultural idiom of distress

 

D.            Cultural explanation or perceived cause

Question 55

The therapist using a CBT approach says to the patient: “You say you become depressed. Explain to me what depressed feels like to you.” This is an example of what question type in Socratic Dialogue?

 

A.            Memory question

 

B.            Translation question

 

C.            Application question

 

D.            Interpretation question

                               

Question 56

Which of the following is not consistent with the resilience model proposed by Miller-Kraus?

 

A.            This resilience model is based on neurophysiology.

 

B.            The resilience zone in an internal state of adaptability and flexibility.

 

C.            We feel our best when we have a strong sympathetic system to regulate emotions.

 

D.            We feel our best and deal effectively with life when we are in our resilience zone.

Question 57

Bowen emphasized the family therapist

 

A.            Remain neutral, focus on content

 

B.            Focus on metacommunication

 

C.            Create a psychodrama

 

D.            Become immersed in the family dynamics

Question 58

Which of the following is true about the CBT cognitive processes of primary and secondary thinking?

 

A.            Primary thinking recognizes the indeterminate, negative and irrational thinking as forever part of human action.

 

B.            Secondary thinking recognizes the indeterminate, negative and irrational thinking as foremost.

 

C.            Primary thinking views the social and cultural world in determinate, positive and rational terms.

 

D.            B and C

Question 59

Which of the following is consistent with literature regarding suicide. Check all that apply.

                A.            Assessing patient safety is of paramount importance for the advanced practice psychiatric nurse during the initial patient contact.

                B.            More that half of those who commit suicide do not have known mental health problem.

                C.            The highest risk factor for suicide is a relationship problem.

                D.            Suicidality can be assessed by using reliable and valid self-report questionnaires.

Question 60

In supportive psychodynamic psychotherapy the content of the sessions most often focuses on which of the following?

                A.            Feelings and defenses

                B.            Life stresses and feelings

                C.            Life stresses and problem-solving

                D.            B and C

Question 61

The focus of therapy in brief psychodynamic psychotherapy is on which of the following?

                A.            The focus is on structured homework assignments.

                B.            The focus in on the rupture of the therapeutic alliance

                C.            The focus in on transference that naturally occurs during the sessions.

                D.            The focus is on interpersonal relationships outside of the therapeutic relationship.

Question 62

Common patterns of behavior and experience derived from the settings in which people live is known as which of the following?

                A.            Race

                B.            Culture

                C.            Ethnicity

                D.            Family structure

uestion 63

During the initial contact with an individual seeking family therapy it is important for the family therapist to:

                A.            Identify the presenting problem and arrange a consultation with everyone living in the family household.

                B.            Identify the presenting problem and arrange a consultation with the caller to ensure family therapy is really necessary.

                C.            Identify the presenting problem and arrange to meet with the caller and the family member that is creating most of the problem.

                D.            Identify the presenting problem and arrange a consultation with the parents of the

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