NURS 6640 Midterm Exam Test Bank Questions with Answers Graded A+ 2025

Question 1 1 out of 1 points A 35-year-old patient seeks treatment for depression and anxiety after an abusive relationship. To help empower the patient, the PMHNP wants to teach the safe-place exercise to create a feeling of calm. In order to walk the patient through the exercise, the PMHNP first says: Answer: A. “Identify an image of a safe place that makes you feel calm.” Question 2 1 out of 1 points The PMHNP is working with a patient who has dissociative disorder and requests pharmacological interventions for dealing with her trauma. What education does the PMHNP provide to the patient regarding medication therapy? Answer: C. “The medication may provide symptom relief, but you still need psychotherapy.” Question 3 1 out of 1 points The patient attempts the PMHNP’s sleep hygiene recommendations for 2 weeks, but does not make any progress mitigating nightmares and hyperarousal. Which behavioral strategy does the PMHNP suggest next? Answer: D. All of the above Question 4 1 out of 1 points After informing a prospective patient about limits of confidentiality, the patient consents to the “conditions” of confidentiality and signs an informed consent form. Several weeks later, a lawyer representing the patient’s spouse for a court case, asks the PMHNP for the disclosure of information about the patient. The PMHNP should: Answer: C. Limit disclosure to the extent legally possible lOMoAR cPSD| Question 5 1 out of 1 points The PMHNP meets with an adolescent patient who has depression and often presents with resistance when discussing his parent’s divorce. For the past couple of sessions, the patient has been quiet, sometimes refusing to speak. To further support the therapeutic relationship, the PMNHP: Answer: A. Observes and points out the behavior Question 6 1 out of 1 points The PMHNP employs psychodynamic psychotherapy with a patient who experiences anxiety and depression. As the process enters the psychoanalytic end of the psychodynamic continuum, the PMNHP will focus on: Answer: A. Interpreting unconscious conflict in the patient Question 7 1 out of 1 points The PMHNP is working with a patient who witnessed her father pass away after suffering for several months from terminal cancer. The PMHNP sees this as a traumatic event. The patient reports sometimes feeling out of touch with surroundings; almost as if things feel like a dream. “Sometimes that sensation lingers for a while,” the patient says, “and other times I snap out of it quickly.” What does the PMHNP infer about the condition based on psychotherapy concepts for trauma? Answer: B. The patient is reporting signs of dissociation. Question 23 1 out of 1 points The PMHNP is treating a patient with a substantial fear of feeling closed in (claustrophobia). Thus, the patient will not get into an elevator. The office where he works is on the 10th floor and this requires that he walk up and down the stairs in the morning and evening to get to his office. lOMoAR cPSD| With permission from the patient, the PMHNP is beginning systematic desensitization to address the patient’s need to use the elevator. What is the PMHNP’s best plan of action? Answer: A. Begin by having the patient stand in front of the elevator and write down his feelings Question 24 1 out of 1 points The PMHNP has a session with a patient who was injured and traumatized from an explosion at the industrial plant where he used to work. During the session, an outside noise startles the patient and he experiences a flashback of the loud boom from the explosion. The PMHNP witnesses the patient present with anxiety and belabored breathing. What is the appropriate action of the PMHNP? Answer: D. Have the patient use the relaxation response (take a deep breath, exhale long, and slow down) Question 25 1 out of 1 points When the patient comes into the office, she says, “I just saw a friend of mine out in the waiting room. What’s wrong with him?” The PMHNP says, “He’ll be fine. He has mild depression.” Which of the following statement is correct related to confidentiality rights? Answer: A. The PMHNP was not protecting patient confidentially rights. Question 26 1 out of 1 points You are seeing a 29-year-old widow whose husband recently died overseas while serving his country in the military. She has been mourning the loss of her husband for several months, and continues to grieve. She refuses to go to group grieving sessions, but reports that she is still able to go to work and her fitness classes sometimes, and even makes attempts to stay social. She says, “Sometimes it’s like he’s not even gone. Other times it feels like it’s been an eternity since I’ve seen him. It’s hard to talk about this type of stuff with my girlfriends, especially since all of their husbands are still alive.” The PMHNP understands that it is appropriate to employ which therapeutic principle? lOMoAR cPSD| Answer: A. Encouraging catharsis Question 27 1 out of 1 points A PMHNP is caring for a 21-year-old woman who is suffering from anxiety and is having difficulty managing stress. Which of the following would be an appropriate step by the PMHNP? Answer: D. All of the above Question 28 1 out of 1 points The PMHNP is working with an adult patient who has somatic complaints caused by a history of childhood abuse. As part of the therapeutic process, what does the PMHNP do to assess and organize a trauma history? Answer: B. Construct a timeline of the patient’s life Question 29 1 out of 1 points The PMHNP meets with a 47-year-old male patient who is fearful of leaving the house after having witnessed his neighbor getting run over by a car. When the PMHNP asks why he is afraid to leave his house, the patient replies, “Because another accident might occur.” Which cognitive behavioral therapy (CBT) strategy does the PMHNP employ? Answer: B. Stress inoculation therapy Question 30 1 out of 1 points The PMHNP is working with a patient who seems dissatisfied with the therapeutic relationship. The PMHNP invites the patient to discuss her feelings regarding the PMHNP openly and lOMoAR cPSD| honestly. It becomes clear to the PMHNP that they are experiencing an alliance rupture. How does the PMHNP repair the therapeutic alliance? Answer: D. All of the above Question 31 1 out of 1 points Your patient is a 65-year-old male who has a strained relationship with his son and daughter. His children refuse to participate in a family session. The PMHNP asks the patient to draw his family genogram as a next step to . Answer: C. provide background information for the patient’s family structure Question 32 0 out of 1 points The PMHNP is meeting with a 38-year-old divorced, single mother who has been seeing the PMHNP for anxiety and anger management. During one of the sessions, the patient tells the PMHNP that she is having a problem getting her child support payments from her ex-husband, which is triggering increased anxiety and anger, which she admittedly takes out on her children. How does the PMHNP respond in a way that upholds the supportive psychodynamic psychotherapy approach? Answer: D. Suggesting that the patient start going to church to help find more solace. Question 33 1 out of 1 points The PMHNP is caring for a patient with dissociated self-state that the PMHNP identifies as being associated with traumatic experiences in the patient’s past. What approach does the PMHNP use with the patient that is crucial to the psychodynamic therapy process? Answer: A. Assisting the patient to experience and accept the various dimensions of the self through enhanced awareness of the traumatic states Question 34 lOMoAR cPSD| 1 out of 1 points When a PMHNP is seeing a patient for the first time, what is an important step to assure that the patient and provider understand the limits of their discussion? Answer: C. Have a discussion about the confidentiality and its limits Question 8 1 out of 1 points The PMHNP is working with a school-aged child who has been diagnosed with depression. The child has attended several sessions with the PMNHP, but recently presents with avoidant behavior by showing increased distress and being late to sessions. What approach does the PMHNP need to employ with the child to continue making therapeutic progress? Answer: B. Using communication techniques that are expressive Question 9 1 out of 1 points An 11-year-old patient has been exhibiting low self-esteem at school and acting out. According to Maslow’s hierarchy of needs, which of the following questions would best be addressed first by the PMHNP? Answer: C. “Is Joel getting enough sleep at home?” Question 10 1 out of 1 points The PMHNP is working with a patient who experiences anxiety around her parents that later leads to poor impulse control. What will the PMHNP do to employ psychodynamic psychotherapy properly for this patient? Answer: D. All of the above Question 11 lOMoAR cPSD| 1 out of 1 points The patient is a 56-year-old female patient diagnosed with panic disorder and reports symptoms that include heart palpitations, frequent trembling, and feelings of choking in stressful situations. What special consideration does the PMHNP make? Answer: D. A and B Question 12 1 out of 1 points The PMHNP is working with a veteran who has posttraumatic stress disorder (PTSD). The PMHNP believes that dual awareness will be beneficial in allowing the patient to focus on the here and now. What strategies can the PMHNP use to develop dual awareness in the patient? Answer: D. All of the above Question 13 1 out of 1 points The PMHNP has been treating a 15-year-old patient with a history of abuse and neglect. Thirty minutes into their therapy session the patient jumps up and begins to pace around the room. Utilizing Socratic dialogue (SD) the PMHNP’s best action would be to: Answer: C. Say, “I noticed a change. Can you tell me what happened?” Question 14 1 out of 1 points The PMHNP is caring for a patient with borderline personality disorder. Using a psychoanalytic psychotherapy approach, the PMHNP attempts to intensify the patient’s transference to enhance emotional processing by: Answer: D. increasing the number of sessions per week Question 15 0 out of 0 points lOMoAR cPSD| When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Answer: Yes Question 16 1 out of 1 points An initial evaluation reveals that an 11-year-old patient has moved to a new school after her parents’ recent divorce, and is having trouble making friends. The patient has normal mental status and exhibits appropriate behavior. What is the most appropriate scale for the PMHNP to use to get more information? Answer: D. Impact of Event Scale Question 17 1 out of 1 points A PMHNP is treating a 50-year-old patient who suffers from depression. When he was growing up, he was often responsible for taking care of his three younger siblings. Since then, the patient puts other people’s needs before his own. Based on this information, the PMHNP would conclude that his interpersonal style is . Answer: A. overly nurturing Question 18 1 out of 1 points The PMHNP is assessing a patient who grew up in a foster home because she was neglected and abused by her birth parents at a young age. The patient admits to having difficulty forming and maintaining relationships throughout her life. Understanding maladaptive schemas, which statement does the PMHNP predict that the patient is likely to make? Answer: C. “It takes me a while to warm up to people; people often wear masks.” lOMoAR cPSD| Question 19 1 out of 1 points A 28-year-old male patient is experiencing distress related to the workplace. What might the PMHNP ask to assess affective development? Answer: D. All of the above. Question 20 1 out of 1 points The PMHNP is meeting with a new patient who is a young veteran back from serving two tours overseas. When reviewing the patient’s health history file that was sent from the VA, the PMHNP learns that several months ago, the patient was diagnosed with PTSD, but never followed up with treatment for it. After a comprehensive mental health assessment, the PMHNP confirms the PTSD diagnosis and understands that which therapeutic approach will be the most effective as a first-line treatment modality? Answer: B. Employing cognitive behavioral therapy with the patient Question 21 1 out of 1 points An elderly patient in a nursing home has been losing interest in activities and now refuses to leave his room. After a physical exam, he is referred to a PMHNP for an initial assessment. True or false: After speaking with the patient, an appropriate screening tool for the PMHNP to use would be the Geriatric Depression Scale. Answer: True Question 22 1 out of 1 points A 65-year-old patient has suffered the loss of his wife. He is in a state of hyperarousal with increased sympathetic nervous system arousal. One or more interventions may help the patient to deal with this arousal. To decrease sympathetic nervous system arousal, the PMHNP’s treatment strategy is . lOMoAR cPSD| Answer: D. all of the above Question 35 1 out of 1 points The PMHNP understands that anxiety and depression are two disorders in which their symptoms may overlap. When discussing this, you explain that the autonomic nervous system is activated and further helps distinguish anxiety symptoms by making the following points: Answer: B. “You may experience fear, sweating, and muscle tension.” Question 36 1 out of 1 points A PMHNP is preparing confidentiality forms for his patients. What is the most appropriate first step he should take? Answer: B. Research his profession’s ethics code and state/federal laws Question 37 1 out of 1 points A PMHNP has been working with a young female patient who suffers from depression to change self-defeating behaviors. By creating a presence of acceptance and using good listening skills, the PMHNP’s overall goal is to . Answer: A. deepen the patient’s understanding of herself in order to cultivate empowerment Question 38 lOMoAR cPSD| 1 out of 1 points The PMHNP is meeting with a 42-year-old man with depression brought on by the recent passing of his wife. As he describes the circumstances surrounding his late wife’s death, the PMHNP begins to feel sad. The sadness lingers for several hours, and the PMHNP finds it difficult to focus on other patients for the rest of the day. What is the most appropriate explanation for the reaction that the PMHNP is experiencing? Answer: C. Concordant identification Question 39 1 out of 1 points A 24-year-old female patient presents for her initial appointment with the PMHNP. Which action will the PMHNP take to establish therapeutic alliance? Answer: D. All of the above Question 40 1 out of 1 points A PMHNP is treating a 45-year-old female patient who is upset that her brother has not been calling since his divorce. When asked to describe her brother and what prompts him not to call as frequently, she says, “Everything is about him, not me. I think he’s jealous that I have a good marriage and he wants me to be unhappy, too. So he doesn’t call to upset me and ruin my relationships.” Based on this information, the PMHNP can conclude that the patient . Answer: A. may lack ability to see independent motivations Question 41 1 out of 1 points The PMHNP is working with a 56-year-old man who is being seen because of his anxiety and depression. During the therapy sessions, the PMHNP assists the patient in discussing his experiences and expanding on his thoughts and feelings. He tells the PMHNP stories about how he used to be teased by his coworkers at the office for becoming too anxious in large conference rooms. The PMHNP listens to the patient and helps focus on his strengths to promote self- understanding. Which principle best accounts for the PMHNP’s interactions with the patient? lOMoAR cPSD| Answer: A. Therapeutic communication Question 42 0 out of 1 points During cognitive behavioral therapy (CBT), a 64-year-old male patient, states, “My wife hates me! She’s just waiting for me to die.” Using Socratic dialogue (SD) the PMHNP demonstrates understanding of analysis when she responds: Answer: B. “Where is the evidence that your wife hates you?” Question 43 1 out of 1 points A PMHNP is taking a history and wants to assess how the patient copes with adversity. To do so, the therapist asks questions about the patient’s belief system. What would be an appropriate question to ask? Answer: D. All of the above. Question 44 1 out of 1 points A patient named Steve is seeking therapy to get help with his home situation, stating that he has been stressed since his mother-in-law moved into the house. What can the PMHNP do to assist the patient in constructing a narrative? Answer: B. Elicit details so Steve becomes more self-disclosing and self-examining Question 45 1 out of 1 points The PMHNP is having a therapy session with Charlotte, a 20-year-old victim of date rape. The patient states, “I shouldn’t have been there; I should have just gone home. This was all my fault; how could I have been so stupid?” Using the Socratic Method, what is the PMHNP’s best response? lOMoAR cPSD| Answer: A. “If this had happened to someone else with the exact same circumstances, would you say this was her fault?” Question 19 0 out of 1 points During a session, the PMHNP asks a patient with a history of sexual abuse to recall the relationship she had as a child with her parents. The patient responds by saying she has a headache and her stomach hurts, and starts talking about her physical ailments. What is the appropriate response by the PMHNP? Answer: C. Tell the patient that she may not get better if she does not face her fears Question 20 1 out of 1 points The PMHNP is mentoring a student. After working with a patient during a session, the student laments about all the things she should have, or could have, said to the patient. “I feel guilty that I didn’t speak up more about the patient’s concern toward her son,” says the student. The PMHNP understands that the student is exhibiting signs of which therapeutic concept? Answer: A. Countertransference Question 21 1 out of 1 points The PMHNP is working with a patient who witnessed her father pass away after suffering for several months from terminal cancer. The PMHNP sees this as a traumatic event. The patient reports sometimes feeling out of touch with surroundings; almost as if things feel like a dream. “Sometimes that sensation lingers for a while,” the patient says, “and other times I snap out of it quickly.” What does the PMHNP infer about the condition based on psychotherapy concepts for trauma? Answer: B. The patient is reporting signs of dissociation. lOMoAR cPSD| Question 22 1 out of 1 points A 65-year-old patient has suffered the loss of his wife. He is in a state of hyperarousal with increased sympathetic nervous system arousal. One or more interventions may help the patient to deal with this arousal. To decrease sympathetic nervous system arousal, the PMHNP’s treatment strategy is . Answer: D. all of the above Question 23 1 out of 1 points The PMHNP has been assisting a shy and timid 23-year-old male patient struggling with esteem and self-concept issues. Over the weekend, this patient was given the task of completing an exercise that would usually cause him distress and shame, also called a shame-attacking exercise. The PMHNP determines that this task has successfully been achieved when the patient states: Answer: A. “I was able to eat in public yesterday despite how loudly I chew.” Question 24 1 out of 1 points A 16-year-old female patient has had a stable therapeutic relationship with the PMHNP for several months. The PMHNP notices what appears to be fresh cigarette burns on the patient’s arm. When asked, the patient admits to this self-injurious behavior. Although the patient is still depressed, her mood seems to be somewhat better this week. True or false: The PMHNP would most likely consider this patient stabilized and ready to move to Stage II. Answer: False Question 25 1 out of 1 points The PMHNP is meeting with a 42-year-old man with depression brought on by the recent passing of his wife. As he describes the circumstances surrounding his late wife’s death, the lOMoAR cPSD| PMHNP begins to feel sad. The sadness lingers for several hours, and the PMHNP finds it difficult to focus on other patients for the rest of the day. What is the most appropriate explanation for the reaction that the PMHNP is experiencing? Answer: C. Concordant identification