NR 605 Final Exam Diagnosis & Management in Psychiatric-Mental Health
Practicum Chamberlain College of Nursing Question Bank (Latest 2026/2027
Edition) – 100% Correct Questions, Answers & Detailed Rationales
Total Questions: 60
Time Allowed: 120 Minutes
Passing Score: 80%
Instructions: Select the BEST answer for each question based on psychotherapy
principles, clinical management standards, and evidence-based practice. For SATA
questions, select all that apply.
SECTION 1: COGNITIVE-BEHAVIORAL THERAPY & THIRD-WAVE
THERAPIES
Questions 1–12
Question 1
A 34-year-old client with major depressive disorder states, "I failed my nursing exam, so
I'm obviously not smart enough to ever be a good nurse. I might as well quit school
now." The PMHNP recognizes this as which cognitive distortion?
A. Catastrophizing
,B. All-or-nothing thinking
C. Mind reading
D. Emotional reasoning
Correct Answer: B
Rationale: The client's statement demonstrates all-or-nothing thinking (also called
dichotomous or black-and-white thinking), a cognitive distortion characterized by
viewing situations in extremes with no middle ground. Failing one exam is interpreted as
complete incompetence, ignoring any past successes or the possibility of improvement.
Catastrophizing involves expecting the worst possible outcome; mind reading assumes
knowing others' thoughts without evidence; emotional reasoning uses feelings as
evidence of truth.
Question 2
A 28-year-old client with generalized anxiety disorder reports excessive worry about
work performance. During CBT sessions, the PMHNP guides the client through
examining evidence for and against catastrophic beliefs about being fired. This
technique is best described as:
A. Systematic desensitization
B. Socratic dialogue (guided discovery)
C. Thought stopping
D. Exposure and response prevention
Correct Answer: B
,Rationale: Socratic dialogue (guided discovery) is a core CBT technique where the
therapist asks open-ended questions to help the client examine the evidence for their
beliefs, identify logical inconsistencies, and arrive at more balanced conclusions. The
PMHNP is not telling the client what to think but guiding them to discover alternative
perspectives through collaborative inquiry. This differs from thought stopping (abrupt
interruption of negative thoughts) and exposure techniques.
Question 3
A 42-year-old client with chronic low back pain and comorbid depression is referred for
psychotherapy. The PMHNP recommends Acceptance and Commitment Therapy (ACT).
Which statement best describes the core mechanism of ACT?
A. Teaching the client to challenge and eliminate all negative thoughts about pain
B. Helping the client accept difficult internal experiences while committing to valued life
directions
C. Using systematic exposure to gradually reduce pain sensitivity
D. Focusing exclusively on behavioral activation to increase activity levels
Correct Answer: B
Rationale: ACT is a third-wave CBT that emphasizes psychological flexibility through
acceptance of difficult thoughts and feelings (rather than elimination), clarification of
personal values, and committed action toward valued goals. The acronym ACT
represents Accepting reactions, Choosing valued direction, and Taking action. It is
distinct from traditional CBT's emphasis on cognitive restructuring and has strong
evidence for chronic pain, depression, anxiety, and substance use disorders.
, Question 4
A PMHNP is integrating nursing theory with CBT principles in a treatment plan for a
client with depression. Which nursing theorist's work is most aligned with CBT's
emphasis on self-efficacy and the client's active role in managing their own health?
A. Dorothea Orem
B. Hildegard Peplau
C. Martha Rogers
D. Jean Watson
Correct Answer: A
Rationale: Dorothea Orem's Self-Care Deficit Theory aligns with CBT principles by
emphasizing the client's capacity for self-care and the nurse's role in supporting
self-efficacy. Orem's theory focuses on the client's ability to perform self-care activities,
which parallels CBT's emphasis on teaching clients skills to manage their own thoughts,
feelings, and behaviors. Roy's Adaptation Model also relates to CBT through the concept
of adaptive coping responses to environmental stimuli.
Question 5
A 19-year-old college student with social anxiety disorder states, "I know everyone in
class is judging me when I speak. I can feel them thinking I'm stupid." The PMHNP
identifies this as which cognitive distortion?
A. Should statements
B. Overgeneralization
Practicum Chamberlain College of Nursing Question Bank (Latest 2026/2027
Edition) – 100% Correct Questions, Answers & Detailed Rationales
Total Questions: 60
Time Allowed: 120 Minutes
Passing Score: 80%
Instructions: Select the BEST answer for each question based on psychotherapy
principles, clinical management standards, and evidence-based practice. For SATA
questions, select all that apply.
SECTION 1: COGNITIVE-BEHAVIORAL THERAPY & THIRD-WAVE
THERAPIES
Questions 1–12
Question 1
A 34-year-old client with major depressive disorder states, "I failed my nursing exam, so
I'm obviously not smart enough to ever be a good nurse. I might as well quit school
now." The PMHNP recognizes this as which cognitive distortion?
A. Catastrophizing
,B. All-or-nothing thinking
C. Mind reading
D. Emotional reasoning
Correct Answer: B
Rationale: The client's statement demonstrates all-or-nothing thinking (also called
dichotomous or black-and-white thinking), a cognitive distortion characterized by
viewing situations in extremes with no middle ground. Failing one exam is interpreted as
complete incompetence, ignoring any past successes or the possibility of improvement.
Catastrophizing involves expecting the worst possible outcome; mind reading assumes
knowing others' thoughts without evidence; emotional reasoning uses feelings as
evidence of truth.
Question 2
A 28-year-old client with generalized anxiety disorder reports excessive worry about
work performance. During CBT sessions, the PMHNP guides the client through
examining evidence for and against catastrophic beliefs about being fired. This
technique is best described as:
A. Systematic desensitization
B. Socratic dialogue (guided discovery)
C. Thought stopping
D. Exposure and response prevention
Correct Answer: B
,Rationale: Socratic dialogue (guided discovery) is a core CBT technique where the
therapist asks open-ended questions to help the client examine the evidence for their
beliefs, identify logical inconsistencies, and arrive at more balanced conclusions. The
PMHNP is not telling the client what to think but guiding them to discover alternative
perspectives through collaborative inquiry. This differs from thought stopping (abrupt
interruption of negative thoughts) and exposure techniques.
Question 3
A 42-year-old client with chronic low back pain and comorbid depression is referred for
psychotherapy. The PMHNP recommends Acceptance and Commitment Therapy (ACT).
Which statement best describes the core mechanism of ACT?
A. Teaching the client to challenge and eliminate all negative thoughts about pain
B. Helping the client accept difficult internal experiences while committing to valued life
directions
C. Using systematic exposure to gradually reduce pain sensitivity
D. Focusing exclusively on behavioral activation to increase activity levels
Correct Answer: B
Rationale: ACT is a third-wave CBT that emphasizes psychological flexibility through
acceptance of difficult thoughts and feelings (rather than elimination), clarification of
personal values, and committed action toward valued goals. The acronym ACT
represents Accepting reactions, Choosing valued direction, and Taking action. It is
distinct from traditional CBT's emphasis on cognitive restructuring and has strong
evidence for chronic pain, depression, anxiety, and substance use disorders.
, Question 4
A PMHNP is integrating nursing theory with CBT principles in a treatment plan for a
client with depression. Which nursing theorist's work is most aligned with CBT's
emphasis on self-efficacy and the client's active role in managing their own health?
A. Dorothea Orem
B. Hildegard Peplau
C. Martha Rogers
D. Jean Watson
Correct Answer: A
Rationale: Dorothea Orem's Self-Care Deficit Theory aligns with CBT principles by
emphasizing the client's capacity for self-care and the nurse's role in supporting
self-efficacy. Orem's theory focuses on the client's ability to perform self-care activities,
which parallels CBT's emphasis on teaching clients skills to manage their own thoughts,
feelings, and behaviors. Roy's Adaptation Model also relates to CBT through the concept
of adaptive coping responses to environmental stimuli.
Question 5
A 19-year-old college student with social anxiety disorder states, "I know everyone in
class is judging me when I speak. I can feel them thinking I'm stupid." The PMHNP
identifies this as which cognitive distortion?
A. Should statements
B. Overgeneralization
