EXAMINATION PAPER
EXAM TITLE: NRNP 6645 Psychotherapy Multiple Modalities Final Exam
Questions | 100% Correct Answers with Detailed Rationales (2026/2027)
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SECTION 1: Cognitive-Behavioral Therapy and Its Variants
Question 1
A 28-year-old patient with major depressive disorder reports believing they are a failure,
that the world is unfair, and that their future is hopeless. According to Aaron Beck's
cognitive model of depression, this pattern reflects which core construct?
A. Learned helplessness
B. The cognitive triad
C. Dysfunctional attitudes
D. Schema activation
Correct Answer: B
Rationale: Beck's cognitive triad consists of negative views of the self, the world, and
the future. Option A refers to Seligman's behavioral model. Option C refers to underlying
assumptions that predispose depression but are not the triad itself. Option D is too
vague and not the specific construct.
,Question 2
During a CBT session, a PMHNP asks a patient, "What evidence supports your belief
that your colleagues think you are incompetent? What evidence contradicts it? If a
friend had this thought, what would you tell them?" These questions exemplify which
CBT technique?
A. Cognitive restructuring
B. Behavioral activation
C. Socratic questioning
D. Thought stopping
Correct Answer: C
Rationale: Socratic questioning involves guided discovery through systematic
questioning to help patients evaluate their beliefs. Option A is broader and refers to the
overall process of changing maladaptive cognitions. Option B is a behavioral
intervention for depression. Option D involves interrupting unwanted thoughts rather
than examining them.
Question 3
,A 34-year-old patient presents with panic disorder and agoraphobia. They avoid grocery
stores due to fear of panic attacks. After psychoeducation, which intervention should
the PMHNP prioritize to facilitate interoceptive exposure?
A. Teaching diaphragmatic breathing to eliminate anxiety before exposure
B. Creating a fear hierarchy and conducting in-vivo exposure to grocery stores
C. Prescribing an SSRI before initiating any psychotherapeutic intervention
D. Using cognitive restructuring to eliminate all catastrophic thoughts prior to exposure
Correct Answer: B
Rationale: In-vivo exposure with a fear hierarchy is the evidence-based behavioral
intervention for panic disorder with agoraphobia. Option A promotes safety behaviors
that can maintain anxiety. Option C is pharmacological, not psychotherapeutic. Option D
is unnecessary because cognitive restructuring does not need to precede exposure.
Question 4
A patient states, "I failed my exam, so I will definitely fail out of graduate school, never
get a job, and end up homeless." This statement exemplifies which cognitive distortion?
A. Mind reading
B. Catastrophizing
C. All-or-nothing thinking
D. Emotional reasoning
Correct Answer: B
, Rationale: Catastrophizing involves predicting an escalating chain of worst-case
outcomes from a single event. Option A involves assuming others' thoughts. Option C
involves dichotomous thinking without the future-oriented escalation. Option D involves
using feelings as evidence of facts.
Question 5
A 45-year-old patient with moderate depression prefers a time-limited, structured
approach focused on symptom reduction and skill acquisition. They want homework
and measurable goals. Which statement best supports selecting CBT over brief
psychodynamic therapy?
A. CBT exclusively addresses unconscious conflicts that maintain depressive
symptoms
B. Psychodynamic therapy is contraindicated for all patients with moderate depression
C. CBT offers an evidence-based, structured protocol with explicit skill-building aligned
with the patient's preferences and goals
D. Brief psychodynamic therapy requires longer treatment than standard CBT for
equivalent outcomes
Correct Answer: C
Rationale: CBT is structured, time-limited, and emphasizes skill-building and homework,
which aligns with this patient's preferences. Option A incorrectly attributes unconscious
conflict work to CBT. Option B is false because psychodynamic therapy is not
contraindicated. Option D is not consistently supported by evidence.