1
NRNP 6645 Psychotherapy Midterm Exam Walden
University Actual Exam 2026/2027 – Complete Exam-
Style Questions with Detailed Rationales | Pass
Guaranteed – A+ Graded
[SECTION 1: Psychotherapy Theories & Modalities — Questions 1-20]
Q1: A PMHNP utilizing a psychodynamic approach interprets a patient's recurring lateness to
sessions as a manifestation of resistance. According to this theoretical framework, resistance is
best understood as:
A. A deliberate attempt by the patient to sabotage the therapy to anger the therapist.
B. An unconscious defense mechanism used by the ego to avoid anxiety-provoking material.
C. A conscious refusal to cooperate due to the high cost of therapy.
D. A behavioral issue that requires strict boundary setting and limit enforcement.
Correct Answer: B
Rationale: In psychodynamic theory, resistance is the patient's unconscious opposition to the
process of therapy, often surfacing when the patient gets close to repressed or anxiety-provoking
material. It serves as a defense mechanism to protect the ego from distress. Option A attributes
malice rather than unconscious process; Option C misses the unconscious component; Option D
relies on a behavioral/managerial framework rather than a psychodynamic one.
Q2: During a session, a patient begins to treat the PMHNP with the same hostility and suspicion
they exhibit toward their abusive father. This phenomenon is known as:
A. Countertransference
B. Transference
C. Projection
D. Displacement
Correct Answer: B
,2
Rationale: Transference occurs when a patient unconsciously redirects feelings, desires, and
expectations from significant figures in their past onto the therapist. This provides a window into
the patient's internal object relations. Countertransference is the therapist's emotional reaction to
the patient; projection is attributing one's own feelings to others; displacement is redirecting
impulses elsewhere, but transference is the specific term for the therapeutic relationship context.
Q3: A PMHNP is explaining the cognitive model of depression to a client. Which of the
following cognitive distortions is described by the thought, "If I fail this exam, my entire life is
ruined and I am a total failure"?
A. Overgeneralization
B. Catastrophizing
C. Mind Reading
D. Labeling
Correct Answer: B
Rationale: Catastrophizing involves predicting a negative future outcome without evidence and
viewing that outcome as unbearable or unmanageable. The client jumps from a specific event
(failing an exam) to a global catastrophe ("entire life ruined"). Overgeneralization is applying
one specific event to all areas; mind reading is assuming others' thoughts; labeling is applying a
harsh negative label to oneself.
Q4: According to Aaron Beck’s Cognitive Therapy, the "Cognitive Triad" consists of three
negative views that characterize depression. These are:
A. Negative views of the self, the world, and the future.
B. Negative views of the therapist, the therapy, and the cost.
C. Negative views of the past, the present, and the unconscious.
D. Negative views of society, culture, and the government.
Correct Answer: A
Rationale: Beck identified that depressed individuals hold a negative view of themselves
(worthlessness), the world (interpreted as hostile or demanding), and the future (hopelessness).
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These three components interact to maintain the depressive state. Options B, C, and D do not
represent the cognitive triad.
Q5: In Dialectical Behavior Therapy (DBT), the concept of "Dialectics" implies that:
A. The therapist must always agree with the client to avoid conflict.
B. Truth is absolute and unchangeable.
C. Two opposing truths can coexist, and therapy involves finding a synthesis between acceptance
and change.
D. The client must choose between being emotional or being logical.
Correct Answer: C
Rationale: DBT is based on a dialectical worldview, emphasizing the tension between two
opposites: acceptance (validation of the client as they are) and change (moving toward healthy
behaviors). The goal is to find the synthesis (the middle path). Options A and D suggest a false
dichotomy, while B ignores the fluidity of truth in this modality.
Q6: A therapist using Motivational Interviewing (MI) asks a client, "On a scale of 1 to 10, how
confident are you that you could cut down on your drinking?" This technique is known as:
A. Affirmation
B. Open-ended questioning
C. Scaling
D. Reflection
Correct Answer: C
Rationale: Scaling is a specific technique in MI used to help clients quantify their readiness,
confidence, or importance regarding change. It invites the client to evaluate their status and
discuss why the number isn't lower. Affirmations build confidence; open-ended questions invite
narrative; reflections mirror client talk.
, 4
Q7: Which of the following best describes the primary goal of Interpersonal Psychotherapy
(IPT)?
A. To uncover unconscious conflicts from early childhood.
B. To improve interpersonal functioning and reduce symptoms by addressing current social
problems.
C. To reinforce positive behaviors through a system of rewards.
D. To challenge irrational beliefs through logical analysis.
Correct Answer: B
Rationale: IPT focuses on the link between current interpersonal problems (such as grief, role
disputes, or role transitions) and psychiatric symptoms. By improving social functioning and
interpersonal relationships, symptoms improve. Option A is psychodynamic; Option C is
behavioral; Option D is CBT.
Q8: Carl Rogers' Person-Centered Therapy posits three "Core Conditions" necessary for
therapeutic growth. Which of the following is NOT one of them?
A. Unconditional Positive Regard
B. Empathy
C. Transference Analysis
D. Congruence/Genuineness
Correct Answer: C
Rationale: Rogers emphasized that the therapist must provide unconditional positive regard,
empathy, and congruence (genuineness). Transference is a concept central to
psychodynamic/psychoanalytic therapy, not the person-centered approach, which focuses on the
"here and now" relationship rather than projecting past figures.
Q9: In classical conditioning (Pavlov), the process of presenting a conditioned stimulus (CS)
repeatedly without the unconditioned stimulus (UCS) is called:
A. Acquisition
NRNP 6645 Psychotherapy Midterm Exam Walden
University Actual Exam 2026/2027 – Complete Exam-
Style Questions with Detailed Rationales | Pass
Guaranteed – A+ Graded
[SECTION 1: Psychotherapy Theories & Modalities — Questions 1-20]
Q1: A PMHNP utilizing a psychodynamic approach interprets a patient's recurring lateness to
sessions as a manifestation of resistance. According to this theoretical framework, resistance is
best understood as:
A. A deliberate attempt by the patient to sabotage the therapy to anger the therapist.
B. An unconscious defense mechanism used by the ego to avoid anxiety-provoking material.
C. A conscious refusal to cooperate due to the high cost of therapy.
D. A behavioral issue that requires strict boundary setting and limit enforcement.
Correct Answer: B
Rationale: In psychodynamic theory, resistance is the patient's unconscious opposition to the
process of therapy, often surfacing when the patient gets close to repressed or anxiety-provoking
material. It serves as a defense mechanism to protect the ego from distress. Option A attributes
malice rather than unconscious process; Option C misses the unconscious component; Option D
relies on a behavioral/managerial framework rather than a psychodynamic one.
Q2: During a session, a patient begins to treat the PMHNP with the same hostility and suspicion
they exhibit toward their abusive father. This phenomenon is known as:
A. Countertransference
B. Transference
C. Projection
D. Displacement
Correct Answer: B
,2
Rationale: Transference occurs when a patient unconsciously redirects feelings, desires, and
expectations from significant figures in their past onto the therapist. This provides a window into
the patient's internal object relations. Countertransference is the therapist's emotional reaction to
the patient; projection is attributing one's own feelings to others; displacement is redirecting
impulses elsewhere, but transference is the specific term for the therapeutic relationship context.
Q3: A PMHNP is explaining the cognitive model of depression to a client. Which of the
following cognitive distortions is described by the thought, "If I fail this exam, my entire life is
ruined and I am a total failure"?
A. Overgeneralization
B. Catastrophizing
C. Mind Reading
D. Labeling
Correct Answer: B
Rationale: Catastrophizing involves predicting a negative future outcome without evidence and
viewing that outcome as unbearable or unmanageable. The client jumps from a specific event
(failing an exam) to a global catastrophe ("entire life ruined"). Overgeneralization is applying
one specific event to all areas; mind reading is assuming others' thoughts; labeling is applying a
harsh negative label to oneself.
Q4: According to Aaron Beck’s Cognitive Therapy, the "Cognitive Triad" consists of three
negative views that characterize depression. These are:
A. Negative views of the self, the world, and the future.
B. Negative views of the therapist, the therapy, and the cost.
C. Negative views of the past, the present, and the unconscious.
D. Negative views of society, culture, and the government.
Correct Answer: A
Rationale: Beck identified that depressed individuals hold a negative view of themselves
(worthlessness), the world (interpreted as hostile or demanding), and the future (hopelessness).
,3
These three components interact to maintain the depressive state. Options B, C, and D do not
represent the cognitive triad.
Q5: In Dialectical Behavior Therapy (DBT), the concept of "Dialectics" implies that:
A. The therapist must always agree with the client to avoid conflict.
B. Truth is absolute and unchangeable.
C. Two opposing truths can coexist, and therapy involves finding a synthesis between acceptance
and change.
D. The client must choose between being emotional or being logical.
Correct Answer: C
Rationale: DBT is based on a dialectical worldview, emphasizing the tension between two
opposites: acceptance (validation of the client as they are) and change (moving toward healthy
behaviors). The goal is to find the synthesis (the middle path). Options A and D suggest a false
dichotomy, while B ignores the fluidity of truth in this modality.
Q6: A therapist using Motivational Interviewing (MI) asks a client, "On a scale of 1 to 10, how
confident are you that you could cut down on your drinking?" This technique is known as:
A. Affirmation
B. Open-ended questioning
C. Scaling
D. Reflection
Correct Answer: C
Rationale: Scaling is a specific technique in MI used to help clients quantify their readiness,
confidence, or importance regarding change. It invites the client to evaluate their status and
discuss why the number isn't lower. Affirmations build confidence; open-ended questions invite
narrative; reflections mirror client talk.
, 4
Q7: Which of the following best describes the primary goal of Interpersonal Psychotherapy
(IPT)?
A. To uncover unconscious conflicts from early childhood.
B. To improve interpersonal functioning and reduce symptoms by addressing current social
problems.
C. To reinforce positive behaviors through a system of rewards.
D. To challenge irrational beliefs through logical analysis.
Correct Answer: B
Rationale: IPT focuses on the link between current interpersonal problems (such as grief, role
disputes, or role transitions) and psychiatric symptoms. By improving social functioning and
interpersonal relationships, symptoms improve. Option A is psychodynamic; Option C is
behavioral; Option D is CBT.
Q8: Carl Rogers' Person-Centered Therapy posits three "Core Conditions" necessary for
therapeutic growth. Which of the following is NOT one of them?
A. Unconditional Positive Regard
B. Empathy
C. Transference Analysis
D. Congruence/Genuineness
Correct Answer: C
Rationale: Rogers emphasized that the therapist must provide unconditional positive regard,
empathy, and congruence (genuineness). Transference is a concept central to
psychodynamic/psychoanalytic therapy, not the person-centered approach, which focuses on the
"here and now" relationship rather than projecting past figures.
Q9: In classical conditioning (Pavlov), the process of presenting a conditioned stimulus (CS)
repeatedly without the unconditioned stimulus (UCS) is called:
A. Acquisition
