NRNP 6645 PSYCHOTHERAPY WITH
MULTIPLE MODALITIES MIDTERM
2023-2024 | Grade A Q&A | Verified
Answers | PMHNP | Pass Guaranteed
OMAINS | GRADED A+]
D
[DOMAIN 1: COGNITIVE BEHAVIORAL THERAPY (CBT) — 35 Questions]
Question 1.1
Which of the following best defines Cognitive Behavioral Therapy (CBT)?
A. A therapy focused solely on changing maladaptive behaviors through reinforcement
schedules
B. A system of psychotherapy based on a theoretical framework which maintains how an
individual structures his or her experiences largely determines how he or she feels and behaves
C. A therapy that exclusively addresses unconscious conflicts from childhood
D. A humanistic approach emphasizing unconditional positive regard
Answer: B [CORRECT]
Rationale: CBT is fundamentally a system of psychotherapy based on a theoretical framework
which maintains how an individual structures his or her experiences largely determines how he
or she feels and behaves. The cognitive model posits that thoughts influence feelings, which
influence behaviors—all three are interconnected. This definition captures the essence of CBT
as both a cognitive and behavioral intervention.
Question 1.2
According to Beck's Cognitive Triad, which three domains are involved in maladaptive thinking?
A. Self, therapist, and family
B. Self, world, and future
C. Past, present, and future
D. Id, ego, and superego
Answer: B [CORRECT]
Rationale: Beck's Cognitive Triad involves negative views of self, world, and future. Maladaptive
thoughts relating to this triad are rooted in irrational or illogical assumptions. For example, a
depressed patient might think "I am worthless" (self), "The world is a hostile place" (world), and
"Things will never get better" (future).
Question 1.3
A patient states, "I made one mistake at work, so I'm a complete failure." This is an example of
which cognitive distortion?
A. Overgeneralization
, . All-or-nothing thinking (black-and-white thinking)
B
C. Catastrophizing
D. Mind reading
Answer: B [CORRECT]
Rationale: All-or-nothing thinking (black-and-white thinking) involves viewing situations in
extreme categories without recognizing middle ground. The patient views one mistake as total
failure, ignoring any partial successes. This is one of the most common cognitive distortions
seen in depression.
Question 1.4
A patient says, "My boss criticized me once, so he must hate me." This represents which
cognitive distortion?
A. Labeling
B. Overgeneralization
C. Fortune telling
D. Personalization
Answer: B [CORRECT]
Rationale: Overgeneralization involves drawing broad negative conclusions based on a single
event. The patient takes one instance of criticism and generalizes it to the boss's entire attitude
toward them. This distortion maintains negative beliefs by selectively attending to confirming
evidence while ignoring disconfirming evidence.
Question 1.5
A patient with panic disorder reports, "I feel my heart racing, so I must be having a heart attack."
This represents which cognitive distortion?
A. Mind reading
B. Emotional reasoning
C. Catastrophizing
D. Both B and C
Answer: D [CORRECT]
Rationale: This scenario demonstrates both emotional reasoning (assuming feelings reflect
reality—"I feel afraid, so it must be dangerous") and catastrophizing (expecting the worst
possible outcome—heart attack). In panic disorder, interoceptive exposure is used to target
these specific distortions by intentionally inducing feared physical sensations.
Question 1.6
The CBT technique where a therapist guides the patient through a series of questions and
answers to elicit automatic assumptions and examine the logic and evidence that relates to
them is called:
A. Thought stopping
B. Socratic dialogue
C. Cognitive rehearsal
D. Behavioral activation
Answer: B [CORRECT]
Rationale: Socratic dialogue is a mutual discovery process in which the therapist guides the
patient through questions to examine the evidence for and against automatic thoughts. This
, iffers from simply telling the patient their thoughts are irrational; instead, it empowers the
d
patient to discover alternative perspectives through guided inquiry.
Question 1.7
The "downward arrow" technique in CBT is used to:
A. Increase behavioral activation
B. Uncover underlying core beliefs by repeatedly asking "If that were true, what would it mean
about you?"
C. Stop automatic thoughts through physical stimuli
D. Schedule worry time for generalized anxiety disorder
Answer: B [CORRECT]
Rationale: The downward arrow technique is used to uncover underlying core beliefs by
repeatedly asking "If that were true, what would it mean about you?" This technique moves from
surface-level automatic thoughts to deeper schemas that drive maladaptive patterns. For
example, "I'm late" → "I'm irresponsible" → "I'm a bad person" → "I'm unlovable."
Question 1.8
A patient interrupts their stream of anxious thoughts by snapping a rubber band on their wrist.
This CBT technique is called:
A. Systematic desensitization
B. Thought stopping
C. Interoceptive exposure
D. Cognitive rehearsal
Answer: B [CORRECT]
Rationale: Thought stopping involves interrupting the stream of thought with a sudden stimulus
(snapping a rubber band, saying "stop it"). While historically used in CBT, contemporary practice
often favors more cognitive approaches, as thought stopping alone may not address the
underlying belief system.
Question 1.9
First-line treatment for Obsessive-Compulsive Disorder (OCD) in CBT is:
A. Cognitive restructuring alone
B. Exposure with response prevention (ERP)
C. Systematic desensitization
D. Worry time scheduling
Answer: B [CORRECT]
Rationale: Exposure with response prevention (ERP) is the first-line CBT treatment for OCD.
The patient is exposed to the trigger (e.g., touching a "contaminated" object) while refraining
from the compulsive behavior (e.g., hand washing). This breaks the anxiety-compulsion cycle
and allows habituation to occur.
Question 1.10
A patient with panic disorder is asked to exercise to intentionally induce a racing heart. This
technique is called:
A. In vivo exposure
B. Interoceptive exposure
C. Behavioral activation
D. Systematic desensitization
, nswer: B [CORRECT]
A
Rationale: Interoceptive exposure involves intentionally inducing feared physical sensations
(e.g., racing heart via exercise, dizziness via spinning) to reduce fear of those sensations in
panic disorder. This is a core component of Panic Control Treatment (PCT), which also includes
cognitive restructuring and breathing retraining.
Question 1.11
In CBT for Generalized Anxiety Disorder (GAD), the technique where the patient postpones
worry to a designated time is called:
A. Cognitive rehearsal
B. Worry time scheduling
C. Decatastrophizing
D. Behavioral experiments
Answer: B [CORRECT]
Rationale: Worry time scheduling is a containment technique for GAD where the patient
postpones worry to a designated 20-30 minute period. This helps contain worry rather than
allowing it to permeate the entire day, while still acknowledging that worry has a place.
Question 1.12
A patient with depression is encouraged to increase engagement in positive activities to improve
mood. This CBT technique is called:
A. Cognitive restructuring
B. Behavioral activation
C. Systematic desensitization
D. Socratic questioning
Answer: B [CORRECT]
Rationale: Behavioral activation involves increasing engagement in positive activities to improve
mood, based on the principle that activity increases access to positive reinforcement. In
depression, withdrawal from reinforcing activities maintains the depressive cycle. Behavioral
activation directly targets this pattern.
Question 1.13
A patient with social anxiety is asked to speak up in a meeting to test the prediction "everyone
will think I'm stupid." This is an example of:
A. Thought stopping
B. Behavioral experiment
C. Cognitive rehearsal
D. Systematic desensitization
Answer: B [CORRECT]
Rationale: Behavioral experiments test the validity of automatic thoughts by collecting real-world
data. Rather than simply discussing the thought in session, the patient gathers evidence by
conducting an experiment. This is particularly powerful because it provides experiential
disconfirmation of maladaptive beliefs.
Question 1.14
A patient with hypochondriasis is asked to delay seeking reassurance from their doctor to see if
their feared health outcome actually occurs. This represents:
A. Interoceptive exposure
MULTIPLE MODALITIES MIDTERM
2023-2024 | Grade A Q&A | Verified
Answers | PMHNP | Pass Guaranteed
OMAINS | GRADED A+]
D
[DOMAIN 1: COGNITIVE BEHAVIORAL THERAPY (CBT) — 35 Questions]
Question 1.1
Which of the following best defines Cognitive Behavioral Therapy (CBT)?
A. A therapy focused solely on changing maladaptive behaviors through reinforcement
schedules
B. A system of psychotherapy based on a theoretical framework which maintains how an
individual structures his or her experiences largely determines how he or she feels and behaves
C. A therapy that exclusively addresses unconscious conflicts from childhood
D. A humanistic approach emphasizing unconditional positive regard
Answer: B [CORRECT]
Rationale: CBT is fundamentally a system of psychotherapy based on a theoretical framework
which maintains how an individual structures his or her experiences largely determines how he
or she feels and behaves. The cognitive model posits that thoughts influence feelings, which
influence behaviors—all three are interconnected. This definition captures the essence of CBT
as both a cognitive and behavioral intervention.
Question 1.2
According to Beck's Cognitive Triad, which three domains are involved in maladaptive thinking?
A. Self, therapist, and family
B. Self, world, and future
C. Past, present, and future
D. Id, ego, and superego
Answer: B [CORRECT]
Rationale: Beck's Cognitive Triad involves negative views of self, world, and future. Maladaptive
thoughts relating to this triad are rooted in irrational or illogical assumptions. For example, a
depressed patient might think "I am worthless" (self), "The world is a hostile place" (world), and
"Things will never get better" (future).
Question 1.3
A patient states, "I made one mistake at work, so I'm a complete failure." This is an example of
which cognitive distortion?
A. Overgeneralization
, . All-or-nothing thinking (black-and-white thinking)
B
C. Catastrophizing
D. Mind reading
Answer: B [CORRECT]
Rationale: All-or-nothing thinking (black-and-white thinking) involves viewing situations in
extreme categories without recognizing middle ground. The patient views one mistake as total
failure, ignoring any partial successes. This is one of the most common cognitive distortions
seen in depression.
Question 1.4
A patient says, "My boss criticized me once, so he must hate me." This represents which
cognitive distortion?
A. Labeling
B. Overgeneralization
C. Fortune telling
D. Personalization
Answer: B [CORRECT]
Rationale: Overgeneralization involves drawing broad negative conclusions based on a single
event. The patient takes one instance of criticism and generalizes it to the boss's entire attitude
toward them. This distortion maintains negative beliefs by selectively attending to confirming
evidence while ignoring disconfirming evidence.
Question 1.5
A patient with panic disorder reports, "I feel my heart racing, so I must be having a heart attack."
This represents which cognitive distortion?
A. Mind reading
B. Emotional reasoning
C. Catastrophizing
D. Both B and C
Answer: D [CORRECT]
Rationale: This scenario demonstrates both emotional reasoning (assuming feelings reflect
reality—"I feel afraid, so it must be dangerous") and catastrophizing (expecting the worst
possible outcome—heart attack). In panic disorder, interoceptive exposure is used to target
these specific distortions by intentionally inducing feared physical sensations.
Question 1.6
The CBT technique where a therapist guides the patient through a series of questions and
answers to elicit automatic assumptions and examine the logic and evidence that relates to
them is called:
A. Thought stopping
B. Socratic dialogue
C. Cognitive rehearsal
D. Behavioral activation
Answer: B [CORRECT]
Rationale: Socratic dialogue is a mutual discovery process in which the therapist guides the
patient through questions to examine the evidence for and against automatic thoughts. This
, iffers from simply telling the patient their thoughts are irrational; instead, it empowers the
d
patient to discover alternative perspectives through guided inquiry.
Question 1.7
The "downward arrow" technique in CBT is used to:
A. Increase behavioral activation
B. Uncover underlying core beliefs by repeatedly asking "If that were true, what would it mean
about you?"
C. Stop automatic thoughts through physical stimuli
D. Schedule worry time for generalized anxiety disorder
Answer: B [CORRECT]
Rationale: The downward arrow technique is used to uncover underlying core beliefs by
repeatedly asking "If that were true, what would it mean about you?" This technique moves from
surface-level automatic thoughts to deeper schemas that drive maladaptive patterns. For
example, "I'm late" → "I'm irresponsible" → "I'm a bad person" → "I'm unlovable."
Question 1.8
A patient interrupts their stream of anxious thoughts by snapping a rubber band on their wrist.
This CBT technique is called:
A. Systematic desensitization
B. Thought stopping
C. Interoceptive exposure
D. Cognitive rehearsal
Answer: B [CORRECT]
Rationale: Thought stopping involves interrupting the stream of thought with a sudden stimulus
(snapping a rubber band, saying "stop it"). While historically used in CBT, contemporary practice
often favors more cognitive approaches, as thought stopping alone may not address the
underlying belief system.
Question 1.9
First-line treatment for Obsessive-Compulsive Disorder (OCD) in CBT is:
A. Cognitive restructuring alone
B. Exposure with response prevention (ERP)
C. Systematic desensitization
D. Worry time scheduling
Answer: B [CORRECT]
Rationale: Exposure with response prevention (ERP) is the first-line CBT treatment for OCD.
The patient is exposed to the trigger (e.g., touching a "contaminated" object) while refraining
from the compulsive behavior (e.g., hand washing). This breaks the anxiety-compulsion cycle
and allows habituation to occur.
Question 1.10
A patient with panic disorder is asked to exercise to intentionally induce a racing heart. This
technique is called:
A. In vivo exposure
B. Interoceptive exposure
C. Behavioral activation
D. Systematic desensitization
, nswer: B [CORRECT]
A
Rationale: Interoceptive exposure involves intentionally inducing feared physical sensations
(e.g., racing heart via exercise, dizziness via spinning) to reduce fear of those sensations in
panic disorder. This is a core component of Panic Control Treatment (PCT), which also includes
cognitive restructuring and breathing retraining.
Question 1.11
In CBT for Generalized Anxiety Disorder (GAD), the technique where the patient postpones
worry to a designated time is called:
A. Cognitive rehearsal
B. Worry time scheduling
C. Decatastrophizing
D. Behavioral experiments
Answer: B [CORRECT]
Rationale: Worry time scheduling is a containment technique for GAD where the patient
postpones worry to a designated 20-30 minute period. This helps contain worry rather than
allowing it to permeate the entire day, while still acknowledging that worry has a place.
Question 1.12
A patient with depression is encouraged to increase engagement in positive activities to improve
mood. This CBT technique is called:
A. Cognitive restructuring
B. Behavioral activation
C. Systematic desensitization
D. Socratic questioning
Answer: B [CORRECT]
Rationale: Behavioral activation involves increasing engagement in positive activities to improve
mood, based on the principle that activity increases access to positive reinforcement. In
depression, withdrawal from reinforcing activities maintains the depressive cycle. Behavioral
activation directly targets this pattern.
Question 1.13
A patient with social anxiety is asked to speak up in a meeting to test the prediction "everyone
will think I'm stupid." This is an example of:
A. Thought stopping
B. Behavioral experiment
C. Cognitive rehearsal
D. Systematic desensitization
Answer: B [CORRECT]
Rationale: Behavioral experiments test the validity of automatic thoughts by collecting real-world
data. Rather than simply discussing the thought in session, the patient gathers evidence by
conducting an experiment. This is particularly powerful because it provides experiential
disconfirmation of maladaptive beliefs.
Question 1.14
A patient with hypochondriasis is asked to delay seeking reassurance from their doctor to see if
their feared health outcome actually occurs. This represents:
A. Interoceptive exposure
