NRNP 6635 Week 6 Midterm Exam Actual Exam 2026/2027 –
Psychotherapy & Psychiatric Assessment Review with
Detailed Rationales | 100% Verified | Pass Guaranteed – A+
Graded
Section 1: Foundational Psychotherapy Theories & Approaches (15
Questions)
Q1: A 28-year-old patient reports, "I always sabotage relationships when they get
serious. My therapist says I expect abandonment because my father left when I was
five." This therapist's interpretation aligns most closely with which theoretical
framework?
A. Cognitive-behavioral therapy focusing on automatic thoughts
B. Psychodynamic therapy emphasizing early attachment and unconscious patterns
[CORRECT]
C. Humanistic therapy emphasizing present-moment self-actualization
D. Behavioral therapy emphasizing operant conditioning
Correct Answer: B
Rationale: The therapist links current relational patterns to early childhood experiences
and unconscious expectations, which is core to psychodynamic/attachment-based
theory. Option A focuses on present cognitions, not developmental origins. Option C
emphasizes present awareness over historical causality. Option D focuses on
observable behavior modification, not intrapsychic conflict.
Q2: A PMHNP is working with a patient who has borderline personality disorder. The
patient alternates between idealizing the therapist ("You're the only one who
,understands me") and devaluing them ("You don't care about me at all"). According to
psychodynamic theory, this phenomenon is best described as:
A. Resistance
B. Splitting [CORRECT]
C. Sublimation
D. Intellectualization
Correct Answer: B
Rationale: Splitting is a primitive defense mechanism characteristic of borderline
personality organization, involving the inability to integrate positive and negative
aspects of self or others, resulting in alternating idealization and devaluation. Option A
(resistance) opposes therapeutic progress. Option C (sublimation) channels impulses
constructively. Option D (intellectualization) uses reasoning to avoid affect.
Q3: A patient with major depressive disorder completes a thought record with their
therapist. They identify the automatic thought: "I'm a failure because I didn't get the
promotion." The therapist guides them to examine evidence for and against this belief,
consider alternative explanations, and develop a balanced thought. This technique is
central to:
A. Psychodynamic interpretation
B. Cognitive restructuring in CBT [CORRECT]
C. Free association
D. Empty chair technique
Correct Answer: B
Rationale: Cognitive restructuring involves identifying, examining, and modifying
distorted automatic thoughts and core beliefs, which is the described intervention.
Option A focuses on unconscious meaning. Option C is a psychodynamic technique for
,accessing unconscious material. Option D is a Gestalt technique for unfinished
business.
Q4: A therapist practicing client-centered therapy consistently demonstrates empathy,
unconditional positive regard, and congruence. According to Carl Rogers, these three
conditions are:
A. Techniques to challenge distorted thinking
B. The necessary and sufficient conditions for therapeutic personality change
[CORRECT]
C. Strategies for managing transference
D. Methods for behavioral activation
Correct Answer: B
Rationale: Rogers proposed that empathy, unconditional positive regard, and
congruence (genuineness) are the necessary and sufficient conditions for therapeutic
change. Option A describes CBT techniques. Option C describes psychodynamic
concepts. Option D describes behavioral interventions for depression.
Q5: A PMHNP is conducting family therapy with a family where the identified patient is a
16-year-old with anorexia nervosa. The therapist observes that the parents are
overinvolved in the adolescent's eating behaviors, while the adolescent withdraws and
refuses to eat. Using structural family therapy concepts, the therapist would describe
this pattern as:
A. A healthy boundary structure
B. An enmeshed subsystem with diffuse boundaries [CORRECT]
C. A disengaged family system
D. A rigid hierarchy with clear boundaries
Correct Answer: B
, Rationale: Structural family therapy (Minuchin) describes enmeshment as
overinvolvement and blurred boundaries between subsystems, which matches the
described pattern. Option A incorrectly labels the pattern as healthy. Option C
(disengagement) involves emotional distance and rigid boundaries. Option D describes
a healthy structural alternative.
Q6: A patient with panic disorder is taught to intentionally induce physical sensations
(racing heart, shortness of breath) in a safe environment while reframing catastrophic
interpretations. This intervention is an example of:
A. Systematic desensitization
B. Interoceptive exposure [CORRECT]
C. Flooding
D. Thought stopping
Correct Answer: B
Rationale: Interoceptive exposure specifically targets feared internal bodily sensations
in panic disorder to extinguish conditioned anxiety responses. Option A involves
graduated exposure to external phobic stimuli. Option C involves prolonged exposure to
the most feared stimulus. Option D involves interrupting negative thoughts, not
exposure to sensations.
Q7: A PMHNP is using motivational interviewing with a patient who is ambivalent about
reducing alcohol use. The patient says, "I know drinking is bad for my health, but it's how
I relax after work." The therapist responds, "On one hand, you value your health, and on
the other, drinking helps you cope with stress." This technique is called:
A. Confrontation
B. Developing discrepancy
C. Double-sided reflection [CORRECT]
Psychotherapy & Psychiatric Assessment Review with
Detailed Rationales | 100% Verified | Pass Guaranteed – A+
Graded
Section 1: Foundational Psychotherapy Theories & Approaches (15
Questions)
Q1: A 28-year-old patient reports, "I always sabotage relationships when they get
serious. My therapist says I expect abandonment because my father left when I was
five." This therapist's interpretation aligns most closely with which theoretical
framework?
A. Cognitive-behavioral therapy focusing on automatic thoughts
B. Psychodynamic therapy emphasizing early attachment and unconscious patterns
[CORRECT]
C. Humanistic therapy emphasizing present-moment self-actualization
D. Behavioral therapy emphasizing operant conditioning
Correct Answer: B
Rationale: The therapist links current relational patterns to early childhood experiences
and unconscious expectations, which is core to psychodynamic/attachment-based
theory. Option A focuses on present cognitions, not developmental origins. Option C
emphasizes present awareness over historical causality. Option D focuses on
observable behavior modification, not intrapsychic conflict.
Q2: A PMHNP is working with a patient who has borderline personality disorder. The
patient alternates between idealizing the therapist ("You're the only one who
,understands me") and devaluing them ("You don't care about me at all"). According to
psychodynamic theory, this phenomenon is best described as:
A. Resistance
B. Splitting [CORRECT]
C. Sublimation
D. Intellectualization
Correct Answer: B
Rationale: Splitting is a primitive defense mechanism characteristic of borderline
personality organization, involving the inability to integrate positive and negative
aspects of self or others, resulting in alternating idealization and devaluation. Option A
(resistance) opposes therapeutic progress. Option C (sublimation) channels impulses
constructively. Option D (intellectualization) uses reasoning to avoid affect.
Q3: A patient with major depressive disorder completes a thought record with their
therapist. They identify the automatic thought: "I'm a failure because I didn't get the
promotion." The therapist guides them to examine evidence for and against this belief,
consider alternative explanations, and develop a balanced thought. This technique is
central to:
A. Psychodynamic interpretation
B. Cognitive restructuring in CBT [CORRECT]
C. Free association
D. Empty chair technique
Correct Answer: B
Rationale: Cognitive restructuring involves identifying, examining, and modifying
distorted automatic thoughts and core beliefs, which is the described intervention.
Option A focuses on unconscious meaning. Option C is a psychodynamic technique for
,accessing unconscious material. Option D is a Gestalt technique for unfinished
business.
Q4: A therapist practicing client-centered therapy consistently demonstrates empathy,
unconditional positive regard, and congruence. According to Carl Rogers, these three
conditions are:
A. Techniques to challenge distorted thinking
B. The necessary and sufficient conditions for therapeutic personality change
[CORRECT]
C. Strategies for managing transference
D. Methods for behavioral activation
Correct Answer: B
Rationale: Rogers proposed that empathy, unconditional positive regard, and
congruence (genuineness) are the necessary and sufficient conditions for therapeutic
change. Option A describes CBT techniques. Option C describes psychodynamic
concepts. Option D describes behavioral interventions for depression.
Q5: A PMHNP is conducting family therapy with a family where the identified patient is a
16-year-old with anorexia nervosa. The therapist observes that the parents are
overinvolved in the adolescent's eating behaviors, while the adolescent withdraws and
refuses to eat. Using structural family therapy concepts, the therapist would describe
this pattern as:
A. A healthy boundary structure
B. An enmeshed subsystem with diffuse boundaries [CORRECT]
C. A disengaged family system
D. A rigid hierarchy with clear boundaries
Correct Answer: B
, Rationale: Structural family therapy (Minuchin) describes enmeshment as
overinvolvement and blurred boundaries between subsystems, which matches the
described pattern. Option A incorrectly labels the pattern as healthy. Option C
(disengagement) involves emotional distance and rigid boundaries. Option D describes
a healthy structural alternative.
Q6: A patient with panic disorder is taught to intentionally induce physical sensations
(racing heart, shortness of breath) in a safe environment while reframing catastrophic
interpretations. This intervention is an example of:
A. Systematic desensitization
B. Interoceptive exposure [CORRECT]
C. Flooding
D. Thought stopping
Correct Answer: B
Rationale: Interoceptive exposure specifically targets feared internal bodily sensations
in panic disorder to extinguish conditioned anxiety responses. Option A involves
graduated exposure to external phobic stimuli. Option C involves prolonged exposure to
the most feared stimulus. Option D involves interrupting negative thoughts, not
exposure to sensations.
Q7: A PMHNP is using motivational interviewing with a patient who is ambivalent about
reducing alcohol use. The patient says, "I know drinking is bad for my health, but it's how
I relax after work." The therapist responds, "On one hand, you value your health, and on
the other, drinking helps you cope with stress." This technique is called:
A. Confrontation
B. Developing discrepancy
C. Double-sided reflection [CORRECT]
