NR565 VERIFIED EXAM QUESTIONS AND ANSWERS
What CRM skill?
• Tracking
• Gesturing
• Titration
• Resourcing & Resource Intensification
• Help Now!
• Pendulation
• Grounding
• Shift and Stay
Pendulation
Rationale: Pendulation is used along with titration and is often referred to as looping,
switching between resourcing and titration, to help the client move between a state of
arousal triggered by a traumatic event and a state of calm.
Eye Movement Desensitization and Reprocessing therapy (EMDR)
-used for neural network integration for processing traumatic and adverse life events
-Most efficient trauma tx
-Used for:
• PTSD, depression, SUDs, anxiety, panic disorder & phobias
-developed by Dr. Francine Shapiro in the late 1980s
-eight-phase psychotherapy
• focuses on earlier life experiences
• present stressors or triggers
• desired thoughts & actions for the future
phases of Eye Movement Desensitization and Reprocessing therapy (EMDR)
1. Client Hx & Tx Planning
-Assess readiness for EMDR using Dissociative Experiences Scale
2. Preparation
-Establish therapeutic alliance, provide psychoeducation about EMDR & relaxation
,strategies
3. Assessment
-ID aspects of the target or an image to process that best represents the traumatic
injury.
4. Desensitization
-Create bilateral stimulation with eye movements, sound, and/or tapping.
5. Installing & Strengthening (+) Cognition
-Use (+) cognition with repeated eye movements when the distress has been reduced.
6. Body Scan
-ensure all aspects of the traumatic injury have been processed.
7. Closure
-self-calming strategies to end session with the pt feeling safe, psychoeducation about
journaling feelings that come up after session is over.
8. Re-evaluation
-Determine if (+) results maintained
& ID new targets that need processing.
"window of tolerance"
resilient zone (RZ) or therapeutic window
-When you are in your Window of Tolerance, you feel like you can deal with whatever's
happening in your life
-You might feel stress or pressure, but it doesn't bother you too much
-ideal place to be
-Working with a practitioner can help expand window of tolerance
• more able to cope with challenges
How Trauma can Affect Your Window of Tolerance
, When stress & trauma shrink your window of tolerance, it doesn't take much to throw
you off balance.
Hyperarousal
-Anxious, Angry, Out of Control, Overwhelmed
• body wants to fight or run away
Hypoarousal
-Spacy, Zoned Out, Numb, Frozen
• body wants to shut down
Areas of brain r/t traumatic experiences
Amygdala
-alarm system for stressful events
Hippocampus
-assists with learning
• including memories about safety & danger
Prefrontal Cortex
-controls behavior & emotion
Elisabeth is a 30-year-old who presents for psychotherapy. Elisabeth's eight-
month-old daughter died suddenly in the night two years ago. The coroner
determined the death was sudden infant death syndrome (SIDS). Elisabeth is a
critical care nurse and is having difficulty understanding how her baby died so
suddenly and without warning. She feels like she should have detected some
symptoms of distress and feels guilty that her attempts at cardiopulmonary
resuscitation (CPR) did not revive her baby. She also has disturbing memories of
finding her baby dead in the crib. The psychiatric mental health nurse practitioner
(PMHNP) selects EMDR as a psychotherapeutic approach.
Which of the following responses are congruent with EMDR? Select all that apply.
What CRM skill?
• Tracking
• Gesturing
• Titration
• Resourcing & Resource Intensification
• Help Now!
• Pendulation
• Grounding
• Shift and Stay
Pendulation
Rationale: Pendulation is used along with titration and is often referred to as looping,
switching between resourcing and titration, to help the client move between a state of
arousal triggered by a traumatic event and a state of calm.
Eye Movement Desensitization and Reprocessing therapy (EMDR)
-used for neural network integration for processing traumatic and adverse life events
-Most efficient trauma tx
-Used for:
• PTSD, depression, SUDs, anxiety, panic disorder & phobias
-developed by Dr. Francine Shapiro in the late 1980s
-eight-phase psychotherapy
• focuses on earlier life experiences
• present stressors or triggers
• desired thoughts & actions for the future
phases of Eye Movement Desensitization and Reprocessing therapy (EMDR)
1. Client Hx & Tx Planning
-Assess readiness for EMDR using Dissociative Experiences Scale
2. Preparation
-Establish therapeutic alliance, provide psychoeducation about EMDR & relaxation
,strategies
3. Assessment
-ID aspects of the target or an image to process that best represents the traumatic
injury.
4. Desensitization
-Create bilateral stimulation with eye movements, sound, and/or tapping.
5. Installing & Strengthening (+) Cognition
-Use (+) cognition with repeated eye movements when the distress has been reduced.
6. Body Scan
-ensure all aspects of the traumatic injury have been processed.
7. Closure
-self-calming strategies to end session with the pt feeling safe, psychoeducation about
journaling feelings that come up after session is over.
8. Re-evaluation
-Determine if (+) results maintained
& ID new targets that need processing.
"window of tolerance"
resilient zone (RZ) or therapeutic window
-When you are in your Window of Tolerance, you feel like you can deal with whatever's
happening in your life
-You might feel stress or pressure, but it doesn't bother you too much
-ideal place to be
-Working with a practitioner can help expand window of tolerance
• more able to cope with challenges
How Trauma can Affect Your Window of Tolerance
, When stress & trauma shrink your window of tolerance, it doesn't take much to throw
you off balance.
Hyperarousal
-Anxious, Angry, Out of Control, Overwhelmed
• body wants to fight or run away
Hypoarousal
-Spacy, Zoned Out, Numb, Frozen
• body wants to shut down
Areas of brain r/t traumatic experiences
Amygdala
-alarm system for stressful events
Hippocampus
-assists with learning
• including memories about safety & danger
Prefrontal Cortex
-controls behavior & emotion
Elisabeth is a 30-year-old who presents for psychotherapy. Elisabeth's eight-
month-old daughter died suddenly in the night two years ago. The coroner
determined the death was sudden infant death syndrome (SIDS). Elisabeth is a
critical care nurse and is having difficulty understanding how her baby died so
suddenly and without warning. She feels like she should have detected some
symptoms of distress and feels guilty that her attempts at cardiopulmonary
resuscitation (CPR) did not revive her baby. She also has disturbing memories of
finding her baby dead in the crib. The psychiatric mental health nurse practitioner
(PMHNP) selects EMDR as a psychotherapeutic approach.
Which of the following responses are congruent with EMDR? Select all that apply.
