1
NRNP 6645 Psychotherapy with Multiple
Modalities Midterm Exam Actual Exam
2026/2027 Complete Exam-Style Questions with
Detailed Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
Section 1: Foundations of Psychotherapy & Therapeutic Frameworks
Q1: A new patient begins therapy and consistently arrives 10 minutes late, then apologizes
profusely and asks if the therapist is angry. The therapist recognizes this as an early
manifestation of which therapeutic concept?
A. Therapeutic alliance rupture
B. Countertransference
C. Transference [CORRECT]
D. Working through
Correct Answer: C
Rationale: The best answer is C. This choice is correct because the patient is unconsciously
projecting feelings and expectations from past relationships onto the therapist, which is the
classic definition of transference. In psychodynamic thinking, this pattern of lateness paired with
fear of the therapist's anger often reflects early relational templates. The literature supports that
recognizing transference early helps build the framework for deeper therapeutic work.
Q2: During the third session with a 28-year-old patient with depression, the therapist notices
they feel unusually protective and want to reassure the patient that everything will be fine. The
,2
therapist's supervisor suggests exploring this reaction. This supervisory guidance most directly
addresses:
A. Countertransference [CORRECT]
B. Transference
C. Therapeutic alliance
D. Resistance
Correct Answer: A
Rationale: The best answer is A. This choice is correct because the therapist's own emotional
reaction and protective impulse toward the patient is a manifestation of countertransference,
which requires self-awareness and supervision to prevent it from interfering with treatment.
Remember that in this clinical situation, the priority is understanding the therapist's internal
response rather than labeling the patient's behavior.
Q3: In Rogers' person-centered therapy, which condition is considered essential for therapeutic
change?
A. Interpretation of unconscious conflicts
B. Systematic desensitization
C. Paradoxical intention
D. Unconditional positive regard [CORRECT]
Correct Answer: D
Rationale: The best answer is D. This choice is correct because Carl Rogers identified
unconditional positive regard—accepting the patient without judgment—as one of the three core
conditions necessary for personality change, alongside empathy and congruence. This aligns
with the humanistic therapeutic framework that emphasizes the therapeutic relationship as the
primary vehicle for change.
, 3
Q4: A patient with borderline personality disorder becomes intensely angry when the therapist
maintains the session time boundary, accusing the therapist of being cruel and abandoning. From
a psychodynamic perspective, this reaction best illustrates:
A. A therapeutic alliance rupture requiring immediate repair
B. Cognitive distortion of catastrophizing
C. Resistance to behavioral activation
D. Projection of internal object relations onto the therapist [CORRECT]
Correct Answer: D
Rationale: The best answer is D. This choice is correct because the patient's intense anger at a
neutral boundary reflects the projection of internalized relational patterns, often rooted in early
experiences of abandonment, onto the therapeutic relationship. This matches the psychodynamic
understanding of how patients with borderline features reenact past relationships in the here-and-
now of therapy.
Q5: Which theoretical approach emphasizes the patient's subjective experience, freedom,
responsibility, and the search for meaning?
A. Cognitive-behavioral therapy
B. Psychodynamic therapy
C. Existential therapy [CORRECT]
D. Dialectical behavior therapy
Correct Answer: C
Rationale: The best answer is C. This choice is correct because existential therapy centers on
universal human concerns including freedom, responsibility, isolation, and meaninglessness,
helping patients confront these givens of existence. This aligns with the existential therapeutic
framework pioneered by thinkers like Yalom and Frankl.
NRNP 6645 Psychotherapy with Multiple
Modalities Midterm Exam Actual Exam
2026/2027 Complete Exam-Style Questions with
Detailed Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
Section 1: Foundations of Psychotherapy & Therapeutic Frameworks
Q1: A new patient begins therapy and consistently arrives 10 minutes late, then apologizes
profusely and asks if the therapist is angry. The therapist recognizes this as an early
manifestation of which therapeutic concept?
A. Therapeutic alliance rupture
B. Countertransference
C. Transference [CORRECT]
D. Working through
Correct Answer: C
Rationale: The best answer is C. This choice is correct because the patient is unconsciously
projecting feelings and expectations from past relationships onto the therapist, which is the
classic definition of transference. In psychodynamic thinking, this pattern of lateness paired with
fear of the therapist's anger often reflects early relational templates. The literature supports that
recognizing transference early helps build the framework for deeper therapeutic work.
Q2: During the third session with a 28-year-old patient with depression, the therapist notices
they feel unusually protective and want to reassure the patient that everything will be fine. The
,2
therapist's supervisor suggests exploring this reaction. This supervisory guidance most directly
addresses:
A. Countertransference [CORRECT]
B. Transference
C. Therapeutic alliance
D. Resistance
Correct Answer: A
Rationale: The best answer is A. This choice is correct because the therapist's own emotional
reaction and protective impulse toward the patient is a manifestation of countertransference,
which requires self-awareness and supervision to prevent it from interfering with treatment.
Remember that in this clinical situation, the priority is understanding the therapist's internal
response rather than labeling the patient's behavior.
Q3: In Rogers' person-centered therapy, which condition is considered essential for therapeutic
change?
A. Interpretation of unconscious conflicts
B. Systematic desensitization
C. Paradoxical intention
D. Unconditional positive regard [CORRECT]
Correct Answer: D
Rationale: The best answer is D. This choice is correct because Carl Rogers identified
unconditional positive regard—accepting the patient without judgment—as one of the three core
conditions necessary for personality change, alongside empathy and congruence. This aligns
with the humanistic therapeutic framework that emphasizes the therapeutic relationship as the
primary vehicle for change.
, 3
Q4: A patient with borderline personality disorder becomes intensely angry when the therapist
maintains the session time boundary, accusing the therapist of being cruel and abandoning. From
a psychodynamic perspective, this reaction best illustrates:
A. A therapeutic alliance rupture requiring immediate repair
B. Cognitive distortion of catastrophizing
C. Resistance to behavioral activation
D. Projection of internal object relations onto the therapist [CORRECT]
Correct Answer: D
Rationale: The best answer is D. This choice is correct because the patient's intense anger at a
neutral boundary reflects the projection of internalized relational patterns, often rooted in early
experiences of abandonment, onto the therapeutic relationship. This matches the psychodynamic
understanding of how patients with borderline features reenact past relationships in the here-and-
now of therapy.
Q5: Which theoretical approach emphasizes the patient's subjective experience, freedom,
responsibility, and the search for meaning?
A. Cognitive-behavioral therapy
B. Psychodynamic therapy
C. Existential therapy [CORRECT]
D. Dialectical behavior therapy
Correct Answer: C
Rationale: The best answer is C. This choice is correct because existential therapy centers on
universal human concerns including freedom, responsibility, isolation, and meaninglessness,
helping patients confront these givens of existence. This aligns with the existential therapeutic
framework pioneered by thinkers like Yalom and Frankl.
