NRNP 6645 Midterm Examination
2026/2027 | Newly Released| Latest Update
Walden University
100 Questions with Verified Answers & Rationales
Graded A+| 100% Correct | Guaranteed Pass
Q1. A PMHNP is conducting an initial interview with a new patient who presents with symptoms of
anxiety. The nurse practitioner establishes a safe environment, listens attentively, and validates the
patient's feelings of distress. According to Bordin’s model of the therapeutic alliance, which
component is the PMHNP primarily demonstrating in this interaction?
A. The agreement on goals
B. The agreement on tasks
C. The bond
D. The transference
Correct Answer: C
Rationale: Correct because Bordin’s model identifies the bond as the emotional attachment and
sense of trust established between therapist and patient, characterized by trust, acceptance, and
confidence. While goals and tasks are other components of the alliance, the description of
establishing safety, listening, and validating specifically refers to the relational bond.
Q2. A patient with obsessive-compulsive disorder reports engaging in compulsive checking
behaviors for 3 hours a day. The PMHNP using a Cognitive Behavioral Therapy (CBT) framework
explains that the checking behavior provides temporary relief but reinforces the anxiety cycle.
Which technique is the PMHNP using to prepare the patient for intervention?
A. Free association
B. Psychoeducation
C. Interpretation of the transference
D. Reflection of feeling
Correct Answer: B
Rationale: Correct because psychoeducation is a fundamental CBT technique used to explain the
cognitive and behavioral maintenance of the disorder, helping the patient understand the function of
their symptoms. This rationale aligns with the CBT structure of socializing the patient to the model
before initiating cognitive or behavioral techniques.
,Q3. During a session, a patient states, "You are just like my father; you always criticize me and
never listen." A PMHNP utilizing a psychodynamic perspective recognizes this phenomenon as:
A. Countertransference
B. Resistance
C. Transference
D. Projection
Correct Answer: C
Rationale: Correct because transference in psychoanalytic therapy refers to the patient’s
unconscious displacement of feelings, desires, and expectations from significant figures in their past
onto the therapist. This is a core concept in psychodynamic therapy used to understand interpersonal
patterns.
Q4. A PMHNP is treating a patient with major depressive disorder using Interpersonal Therapy
(IPT). The patient reports that her depression began shortly after her youngest child left for college,
and she feels a loss of purpose. Which of the four IPT problem areas is the primary focus?
A. Grief
B. Role dispute
C. Role transition
D. Interpersonal deficits
Correct Answer: C
Rationale: Correct because IPT focuses on role transitions when a patient is struggling to cope with
a change in life status, such as a child leaving home (empty nest), leading to a loss of identity or role.
This aligns with the IPT manual's focus on helping the patient master the new role and grieve the old
one.
Q5. When conducting a suicide risk assessment, the PMHNP asks about the presence of a suicide
plan, access to lethal means, and previous attempts. Which principle of bioethics is the nurse
practitioner prioritizing by determining the patient's safety and need for hospitalization?
A. Beneficence
B. Nonmaleficence
C. Justice
D. Autonomy
Correct Answer: A
Rationale: Correct because beneficence refers to the ethical obligation to act in the patient's best
interest and prevent harm, such as suicide. While nonmaleficence involves "doing no harm," the
active intervention to ensure safety through risk assessment is a direct application of beneficence.
, Q6. A patient with a history of childhood trauma presents with emotional lability, self -harm
behaviors, and chronic feelings of emptiness. The PMHNP selects Dialectical Behavior Therapy
(DBT) as the treatment modality. Which core concept of DBT explains the acceptance of the
patient's current reality while simultaneously pushing for change?
A. Validation
B. Dialectics
C. Mindfulness
D. Chain analysis
Correct Answer: B
Rationale: Correct because dialectics is the central philosophy of DBT that focuses on the tension
and synthesis between two opposites, primarily acceptance and change. This framework helps the
therapist balance validating the patient's pain while encouraging them to adopt healthier coping
mechanisms.
Q7. A PMHNP is utilizing Motivational Interviewing (MI) with a patient who is ambivalent about
stopping alcohol use. The nurse practitioner asks, "If you decided to stop drinking, what do you
think might be different about your life in a month?" Which MI strategy is being employed?
A. Rolling with resistance
B. Developing discrepancy
C. Eliciting change talk
D. Supporting self-efficacy
Correct Answer: C
Rationale: Correct because the question is designed to evoke "change talk" by asking the patient to
imagine the benefits of sobriety, which strengthens their intrinsic motivation for change. MI
specifically focuses on eliciting the patient's own arguments for change rather than imposing them
externally.
Q8. In the context of family systems therapy, a genogram is constructed to visualize family
relationships across generations. When the PMHNP notes a pattern of substance abuse in the
grandfather, father, and now the patient, this is referred to as:
A. Triangulation
B. Multigenerational transmission process
C. Differentiation of self
D. Enmeshment
Correct Answer: B
Rationale: Correct because the multigenerational transmission process describes how patterns of
functioning, such as substance abuse or anxiety, are passed down from one generation to the next
within family systems theory. This concept helps the PMHNP understand the patient's symptoms in
the context of family history.
2026/2027 | Newly Released| Latest Update
Walden University
100 Questions with Verified Answers & Rationales
Graded A+| 100% Correct | Guaranteed Pass
Q1. A PMHNP is conducting an initial interview with a new patient who presents with symptoms of
anxiety. The nurse practitioner establishes a safe environment, listens attentively, and validates the
patient's feelings of distress. According to Bordin’s model of the therapeutic alliance, which
component is the PMHNP primarily demonstrating in this interaction?
A. The agreement on goals
B. The agreement on tasks
C. The bond
D. The transference
Correct Answer: C
Rationale: Correct because Bordin’s model identifies the bond as the emotional attachment and
sense of trust established between therapist and patient, characterized by trust, acceptance, and
confidence. While goals and tasks are other components of the alliance, the description of
establishing safety, listening, and validating specifically refers to the relational bond.
Q2. A patient with obsessive-compulsive disorder reports engaging in compulsive checking
behaviors for 3 hours a day. The PMHNP using a Cognitive Behavioral Therapy (CBT) framework
explains that the checking behavior provides temporary relief but reinforces the anxiety cycle.
Which technique is the PMHNP using to prepare the patient for intervention?
A. Free association
B. Psychoeducation
C. Interpretation of the transference
D. Reflection of feeling
Correct Answer: B
Rationale: Correct because psychoeducation is a fundamental CBT technique used to explain the
cognitive and behavioral maintenance of the disorder, helping the patient understand the function of
their symptoms. This rationale aligns with the CBT structure of socializing the patient to the model
before initiating cognitive or behavioral techniques.
,Q3. During a session, a patient states, "You are just like my father; you always criticize me and
never listen." A PMHNP utilizing a psychodynamic perspective recognizes this phenomenon as:
A. Countertransference
B. Resistance
C. Transference
D. Projection
Correct Answer: C
Rationale: Correct because transference in psychoanalytic therapy refers to the patient’s
unconscious displacement of feelings, desires, and expectations from significant figures in their past
onto the therapist. This is a core concept in psychodynamic therapy used to understand interpersonal
patterns.
Q4. A PMHNP is treating a patient with major depressive disorder using Interpersonal Therapy
(IPT). The patient reports that her depression began shortly after her youngest child left for college,
and she feels a loss of purpose. Which of the four IPT problem areas is the primary focus?
A. Grief
B. Role dispute
C. Role transition
D. Interpersonal deficits
Correct Answer: C
Rationale: Correct because IPT focuses on role transitions when a patient is struggling to cope with
a change in life status, such as a child leaving home (empty nest), leading to a loss of identity or role.
This aligns with the IPT manual's focus on helping the patient master the new role and grieve the old
one.
Q5. When conducting a suicide risk assessment, the PMHNP asks about the presence of a suicide
plan, access to lethal means, and previous attempts. Which principle of bioethics is the nurse
practitioner prioritizing by determining the patient's safety and need for hospitalization?
A. Beneficence
B. Nonmaleficence
C. Justice
D. Autonomy
Correct Answer: A
Rationale: Correct because beneficence refers to the ethical obligation to act in the patient's best
interest and prevent harm, such as suicide. While nonmaleficence involves "doing no harm," the
active intervention to ensure safety through risk assessment is a direct application of beneficence.
, Q6. A patient with a history of childhood trauma presents with emotional lability, self -harm
behaviors, and chronic feelings of emptiness. The PMHNP selects Dialectical Behavior Therapy
(DBT) as the treatment modality. Which core concept of DBT explains the acceptance of the
patient's current reality while simultaneously pushing for change?
A. Validation
B. Dialectics
C. Mindfulness
D. Chain analysis
Correct Answer: B
Rationale: Correct because dialectics is the central philosophy of DBT that focuses on the tension
and synthesis between two opposites, primarily acceptance and change. This framework helps the
therapist balance validating the patient's pain while encouraging them to adopt healthier coping
mechanisms.
Q7. A PMHNP is utilizing Motivational Interviewing (MI) with a patient who is ambivalent about
stopping alcohol use. The nurse practitioner asks, "If you decided to stop drinking, what do you
think might be different about your life in a month?" Which MI strategy is being employed?
A. Rolling with resistance
B. Developing discrepancy
C. Eliciting change talk
D. Supporting self-efficacy
Correct Answer: C
Rationale: Correct because the question is designed to evoke "change talk" by asking the patient to
imagine the benefits of sobriety, which strengthens their intrinsic motivation for change. MI
specifically focuses on eliciting the patient's own arguments for change rather than imposing them
externally.
Q8. In the context of family systems therapy, a genogram is constructed to visualize family
relationships across generations. When the PMHNP notes a pattern of substance abuse in the
grandfather, father, and now the patient, this is referred to as:
A. Triangulation
B. Multigenerational transmission process
C. Differentiation of self
D. Enmeshment
Correct Answer: B
Rationale: Correct because the multigenerational transmission process describes how patterns of
functioning, such as substance abuse or anxiety, are passed down from one generation to the next
within family systems theory. This concept helps the PMHNP understand the patient's symptoms in
the context of family history.
