1
NRNP 6665 FINAL EXAM (VERSION-2, 100 Q & A WITH RATIONALES,
LATEST-2025-2026) / NRNP 6665N FINAL EXAM / WALDEN
UNIVERSITY | 100% VERIFIED Q&A
1. CBT — Cognitive distortion intervention
A 32-year-old client reports, “I’m a complete failure because I didn’t get
promoted.” The PMHNP recognizes this as a cognitive distortion. Which
CBT intervention is most appropriate?
A. Free association
B. Thought challenging
C. Role playing
D. Exposure therapy
Correct Answer: B. Thought challenging
Rationale: CBT addresses distorted cognitions. Thought challenging helps the
client evaluate evidence and reframe all-or-nothing thinking.
2. IPT — Role disputes
A client undergoing Interpersonal Psychotherapy (IPT) reports increasing
conflict with their spouse since the birth of their first child. According to the
IPT model, which focus area should be prioritized?
A. Past childhood trauma
B. Maladaptive cognitions
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C. Interpersonal role disputes
D. Spiritual conflicts
Correct Answer: C. Interpersonal role disputes
Rationale: IPT targets four areas: grief, role disputes, role transitions, and
interpersonal deficits. This case fits a role dispute.
3. Psychodynamic — Unconscious conflict
A 41-year-old client avoids discussing painful childhood experiences but
expresses strong emotions toward the therapist. What is the primary goal of
this therapeutic approach?
A. Correcting faulty thought patterns
B. Building insight into unconscious conflicts
C. Rehearsing new social skills
D. Changing reinforcement schedules
Correct Answer: B. Building insight into unconscious conflicts
Rationale: Psychodynamic therapy focuses on increasing awareness of
unconscious drives and conflicts to promote insight.
4. MI — Ambivalence about change
A client with alcohol misuse states, “I want to stop drinking, but I don’t
think I can.” Which motivational interviewing response is most appropriate?
A. “You need to quit drinking immediately.”
B. “Why can’t you control yourself?”
C. “You’re feeling unsure, but coming here shows you’ve already started
,3
change.”
D. “We’ll force a treatment plan if you won’t cooperate.”
Correct Answer: C. “You’re feeling unsure, but coming here shows you’ve
already started change.”
Rationale: MI uses empathy, reflective listening, and supports change talk.
Confrontation is discouraged.
5. DBT — Self-harm urges
A client with borderline personality disorder reports urges to self-harm
during arguments. Which DBT module would best help in these situations?
A. Cognitive restructuring
B. Distress tolerance
C. Exposure hierarchy
D. Free association
Correct Answer: B. Distress tolerance
Rationale: DBT teaches mindfulness, emotion regulation, distress tolerance, and
interpersonal effectiveness. Distress tolerance helps manage crises safely.
6. Ethics — Confidentiality and suicide risk
A 15-year-old client reveals a plan to overdose on pills tonight. The parents
are unaware. What is the provider’s ethical duty?
A. Keep confidentiality to build trust
B. Share the information only with peers
C. Break confidentiality and initiate safety planning
D. Ignore and allow the client to process feelings
, 4
Correct Answer: C. Break confidentiality and initiate safety planning
Rationale: Protecting life outweighs confidentiality. Safety planning and guardian
notification are mandatory when suicide risk is imminent.
7. PTSD — Evidence-based therapy
A 28-year-old veteran presents with nightmares, hypervigilance, and
avoidance behaviors following combat. Which psychotherapy has the
strongest evidence for PTSD?
A. Gestalt therapy
B. Eye Movement Desensitization and Reprocessing (EMDR)
C. Client-centered therapy
D. Psychoanalysis
Correct Answer: B. Eye Movement Desensitization and Reprocessing (EMDR)
Rationale: EMDR and trauma-focused CBT are first-line treatments for PTSD.
Other therapies are less effective.
8. Depression — Cognitive distortion
A client with major depressive disorder says, “I’ll never be good enough at
work, no matter what I do.” This is an example of which cognitive
distortion?
A. Personalization
B. Overgeneralization
C. Catastrophizing
D. All-or-nothing thinking
NRNP 6665 FINAL EXAM (VERSION-2, 100 Q & A WITH RATIONALES,
LATEST-2025-2026) / NRNP 6665N FINAL EXAM / WALDEN
UNIVERSITY | 100% VERIFIED Q&A
1. CBT — Cognitive distortion intervention
A 32-year-old client reports, “I’m a complete failure because I didn’t get
promoted.” The PMHNP recognizes this as a cognitive distortion. Which
CBT intervention is most appropriate?
A. Free association
B. Thought challenging
C. Role playing
D. Exposure therapy
Correct Answer: B. Thought challenging
Rationale: CBT addresses distorted cognitions. Thought challenging helps the
client evaluate evidence and reframe all-or-nothing thinking.
2. IPT — Role disputes
A client undergoing Interpersonal Psychotherapy (IPT) reports increasing
conflict with their spouse since the birth of their first child. According to the
IPT model, which focus area should be prioritized?
A. Past childhood trauma
B. Maladaptive cognitions
,2
C. Interpersonal role disputes
D. Spiritual conflicts
Correct Answer: C. Interpersonal role disputes
Rationale: IPT targets four areas: grief, role disputes, role transitions, and
interpersonal deficits. This case fits a role dispute.
3. Psychodynamic — Unconscious conflict
A 41-year-old client avoids discussing painful childhood experiences but
expresses strong emotions toward the therapist. What is the primary goal of
this therapeutic approach?
A. Correcting faulty thought patterns
B. Building insight into unconscious conflicts
C. Rehearsing new social skills
D. Changing reinforcement schedules
Correct Answer: B. Building insight into unconscious conflicts
Rationale: Psychodynamic therapy focuses on increasing awareness of
unconscious drives and conflicts to promote insight.
4. MI — Ambivalence about change
A client with alcohol misuse states, “I want to stop drinking, but I don’t
think I can.” Which motivational interviewing response is most appropriate?
A. “You need to quit drinking immediately.”
B. “Why can’t you control yourself?”
C. “You’re feeling unsure, but coming here shows you’ve already started
,3
change.”
D. “We’ll force a treatment plan if you won’t cooperate.”
Correct Answer: C. “You’re feeling unsure, but coming here shows you’ve
already started change.”
Rationale: MI uses empathy, reflective listening, and supports change talk.
Confrontation is discouraged.
5. DBT — Self-harm urges
A client with borderline personality disorder reports urges to self-harm
during arguments. Which DBT module would best help in these situations?
A. Cognitive restructuring
B. Distress tolerance
C. Exposure hierarchy
D. Free association
Correct Answer: B. Distress tolerance
Rationale: DBT teaches mindfulness, emotion regulation, distress tolerance, and
interpersonal effectiveness. Distress tolerance helps manage crises safely.
6. Ethics — Confidentiality and suicide risk
A 15-year-old client reveals a plan to overdose on pills tonight. The parents
are unaware. What is the provider’s ethical duty?
A. Keep confidentiality to build trust
B. Share the information only with peers
C. Break confidentiality and initiate safety planning
D. Ignore and allow the client to process feelings
, 4
Correct Answer: C. Break confidentiality and initiate safety planning
Rationale: Protecting life outweighs confidentiality. Safety planning and guardian
notification are mandatory when suicide risk is imminent.
7. PTSD — Evidence-based therapy
A 28-year-old veteran presents with nightmares, hypervigilance, and
avoidance behaviors following combat. Which psychotherapy has the
strongest evidence for PTSD?
A. Gestalt therapy
B. Eye Movement Desensitization and Reprocessing (EMDR)
C. Client-centered therapy
D. Psychoanalysis
Correct Answer: B. Eye Movement Desensitization and Reprocessing (EMDR)
Rationale: EMDR and trauma-focused CBT are first-line treatments for PTSD.
Other therapies are less effective.
8. Depression — Cognitive distortion
A client with major depressive disorder says, “I’ll never be good enough at
work, no matter what I do.” This is an example of which cognitive
distortion?
A. Personalization
B. Overgeneralization
C. Catastrophizing
D. All-or-nothing thinking
