NRNP 6645 Psychotherapy Midterm Exam (2026–2028)
Week 6 Walden University – 150 Practice Questions
with Answers & Rationales
1. A patient with major depressive disorder reports persistent low mood, fatigue, and
loss of interest. Which therapy is first-line?
A. Psychoanalysis
B. CBT
C. Aversion therapy
D. Hypnosis
Answer: B. CBT
CBT is first-line for depression due to strong evidence in restructuring negative thought
patterns.
2. Which neurotransmitter is most associated with depression?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. GABA
Answer: B. Serotonin
Low serotonin levels are strongly linked with depressive symptoms.
3. A patient in CBT is asked to identify “automatic thoughts.” What is the goal?
A. Suppress emotions
B. Challenge cognitive distortions
C. Increase medication adherence
D. Avoid discussing trauma
Answer: B. Challenge cognitive distortions
CBT targets distorted thinking patterns that influence behavior and mood.
,4. Which defense mechanism involves refusing to accept reality?
A. Projection
B. Denial
C. Sublimation
D. Displacement
Answer: B. Denial
Denial is an unconscious refusal to accept painful reality.
5. Which therapy is most appropriate for borderline personality disorder?
A. DBT
B. CBT only
C. Exposure therapy
D. Aversion therapy
Answer: A. DBT
Dialectical Behavior Therapy is the gold standard for BPD.
6. A patient describes hearing voices that others cannot hear. This is:
A. Delusion
B. Hallucination
C. Illusion
D. Confabulation
Answer: B. Hallucination
Hallucinations are sensory perceptions without external stimulus.
7. Which symptom is characteristic of schizophrenia?
A. Elevated mood
B. Disorganized speech
C. Panic attacks
D. Somatic complaints
,Answer: B. Disorganized speech
Disorganized speech is a positive symptom of schizophrenia.
8. What is the main goal of motivational interviewing?
A. Confront resistance aggressively
B. Enhance intrinsic motivation for change
C. Provide psychoanalysis
D. Diagnose personality disorders
Answer: B. Enhance intrinsic motivation for change
MI helps patients resolve ambivalence.
9. Which stage of grief involves denial and shock?
A. Acceptance
B. Bargaining
C. Denial
D. Depression
Answer: C. Denial
Denial is the first stage in Kübler-Ross model.
10. A patient with OCD repeatedly washes hands. What is first-line therapy?
A. Exposure and Response Prevention (ERP)
B. Psychoanalysis
C. Hypnosis
D. Aversion therapy
Answer: A. ERP
ERP is the most effective behavioral treatment for OCD.
11. Which disorder is characterized by episodic mania and depression?
A. MDD
B. Bipolar I disorder
, C. Schizophrenia
D. GAD
Answer: B. Bipolar I disorder
Bipolar I includes full manic episodes.
12. A manic patient shows pressured speech and decreased sleep. Priority
intervention?
A. Encourage stimulation
B. Set firm limits
C. Encourage isolation
D. Use insight therapy
Answer: B. Set firm limits
Mania requires structure and limit setting.
13. Which medication class is first-line for depression?
A. Benzodiazepines
B. SSRIs
C. Antipsychotics
D. Mood stabilizers
Answer: B. SSRIs
SSRIs are first-line antidepressants.
14. Which symptom is most consistent with generalized anxiety disorder?
A. Hallucinations
B. Excessive uncontrollable worry
C. Grandiosity
D. Flashbacks
Answer: B. Excessive uncontrollable worry
GAD involves chronic anxiety and worry.
Week 6 Walden University – 150 Practice Questions
with Answers & Rationales
1. A patient with major depressive disorder reports persistent low mood, fatigue, and
loss of interest. Which therapy is first-line?
A. Psychoanalysis
B. CBT
C. Aversion therapy
D. Hypnosis
Answer: B. CBT
CBT is first-line for depression due to strong evidence in restructuring negative thought
patterns.
2. Which neurotransmitter is most associated with depression?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. GABA
Answer: B. Serotonin
Low serotonin levels are strongly linked with depressive symptoms.
3. A patient in CBT is asked to identify “automatic thoughts.” What is the goal?
A. Suppress emotions
B. Challenge cognitive distortions
C. Increase medication adherence
D. Avoid discussing trauma
Answer: B. Challenge cognitive distortions
CBT targets distorted thinking patterns that influence behavior and mood.
,4. Which defense mechanism involves refusing to accept reality?
A. Projection
B. Denial
C. Sublimation
D. Displacement
Answer: B. Denial
Denial is an unconscious refusal to accept painful reality.
5. Which therapy is most appropriate for borderline personality disorder?
A. DBT
B. CBT only
C. Exposure therapy
D. Aversion therapy
Answer: A. DBT
Dialectical Behavior Therapy is the gold standard for BPD.
6. A patient describes hearing voices that others cannot hear. This is:
A. Delusion
B. Hallucination
C. Illusion
D. Confabulation
Answer: B. Hallucination
Hallucinations are sensory perceptions without external stimulus.
7. Which symptom is characteristic of schizophrenia?
A. Elevated mood
B. Disorganized speech
C. Panic attacks
D. Somatic complaints
,Answer: B. Disorganized speech
Disorganized speech is a positive symptom of schizophrenia.
8. What is the main goal of motivational interviewing?
A. Confront resistance aggressively
B. Enhance intrinsic motivation for change
C. Provide psychoanalysis
D. Diagnose personality disorders
Answer: B. Enhance intrinsic motivation for change
MI helps patients resolve ambivalence.
9. Which stage of grief involves denial and shock?
A. Acceptance
B. Bargaining
C. Denial
D. Depression
Answer: C. Denial
Denial is the first stage in Kübler-Ross model.
10. A patient with OCD repeatedly washes hands. What is first-line therapy?
A. Exposure and Response Prevention (ERP)
B. Psychoanalysis
C. Hypnosis
D. Aversion therapy
Answer: A. ERP
ERP is the most effective behavioral treatment for OCD.
11. Which disorder is characterized by episodic mania and depression?
A. MDD
B. Bipolar I disorder
, C. Schizophrenia
D. GAD
Answer: B. Bipolar I disorder
Bipolar I includes full manic episodes.
12. A manic patient shows pressured speech and decreased sleep. Priority
intervention?
A. Encourage stimulation
B. Set firm limits
C. Encourage isolation
D. Use insight therapy
Answer: B. Set firm limits
Mania requires structure and limit setting.
13. Which medication class is first-line for depression?
A. Benzodiazepines
B. SSRIs
C. Antipsychotics
D. Mood stabilizers
Answer: B. SSRIs
SSRIs are first-line antidepressants.
14. Which symptom is most consistent with generalized anxiety disorder?
A. Hallucinations
B. Excessive uncontrollable worry
C. Grandiosity
D. Flashbacks
Answer: B. Excessive uncontrollable worry
GAD involves chronic anxiety and worry.
